Fasting Venous Blood Glucose Research Articles

Insulin Resistance in Systemic Lupus Erythematosus

The objective: to analyze the frequency of insulin resistance (IR) in patients with systemic lupus erythematosus (SLE), study of traditional and rheumatic disease-related risk factors for the development of IR, assessment of the possibility of using of Finnish Type 2 Diabetes Risk Assessment Form (FINDRISC) to detect IR. Materials and methods. 58 patients with SLE (53 women and 5 men) without diabetes mellitus (DM) and hyperglycemia were included in the one-time study. The patients have received the inpatient treatment at the regional medical and diagnostic center of the communal enterprise “Poltava Regional Clinical Hospital named after M. V. Sklifosofsky PRC” in 2020-2023. The average age of patients was 38 [28; 43] years, the average duration of the disease is 4.0 [0.6; 6.0] years. 49 (85%) patients received glucocorticoids (GC), 20 (34%) – hydroxychloroquine, 26 (45%) – immunosuppressants, 2 (3%) persons received biological drugs. In all patients fasting glucose and insulin levels were determined, and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was calculated. The value of the HOMA-IR index ≥2.77 corresponded to the presence of IR. Traditional risk factors for type 2 DM and the risk of its development in the next 10 years in patients with SLE were assessed using the FINDRISC questionnaire. Results. IR was determined in 14 (24%) of 58 patients with SLE. The average value of the HOMA-IR index was 1.8 [1.3; 2,6]. The data of patients with and without IR were similar in terms of sex, age, duration and activity of SLE, therapy performed at the time of examination, frequency of traditional risk factors for type 2 DM. Body mass index (BMI), waist circumference (WC), and insulin concentration were higher in patients with IR. The HOMA-IR index was correlated with BMI (r=0.7; p<0.001), WC (r=0.6; p<0.001), risk categories for the development of type 2 diabetes according to FINDRISС (r=0.4; p=0.04), the SLEDAI-2K index (r=–0.3; p<0.02), the serum concentration of C3 complement (r=0.4; p=0.035) and the duration of GC therapy (r=0.4; p=0.02). Conclusions. IR was diagnosed in 24% of patients with SLE without a history of DM and with a normal fasting venous blood glucose level. The HOMA-IR index increased as SLE activity decreased and the duration of GC treatment increased. However, the development of IR was statistically significantly associated only with an increase in BMI and WC. The use of the FINDRISC questionnaire, which allows to assess the risk of developing type 2 DM in the general population, did not help to detect IR in patients with SLE.

Нарушения углеводного обмена у пациентов с боевыми травмами

Aim. To investigate the prevalence and some aspects of the carbohydrate metabolism pathology in patients with combat limb injuries. Materials and methods. 210 patients who suffered from combat injuries of the lower and/or upper extremities from 4 to 58 days (mean 15.9±8.7 days) before admission to the hospital were enrolled in the study. All study participants were men. The mean age of the patients was 36.0±8.4 years (19–59 years). Fasting venous blood glucose concentrations were determined in all patients. Patients with hyperglycemia underwent a study of the glycemic profile and HbA1c. Stress-induced hyperglycemia, estimated mean glucose level over the past 3 months (ADAG), and glycemic gap were calculated. Insulin in fasting blood plasma was determined and the HOMA-IR insulin resistance index was calculated. Results. The incidence of hyperglycemia was 23.3%. In the general group of patients, the mean glucose concentration was 5.5±1.0 mmol/l (3.1–9.73 mmol/l). In the group of patients with hyperglycemia, the mean blood glucose level reached 6.7±0.9 mmol/l, in patients with normal glucose concentration – 5.1±0.5 mmol/l (p<0.000001). The mean fasting blood glucose concentration in patients aged 40 years and older reached 5.7±1.1 mmol/l, those under 40 years old – 5.2±0.8 mmol/l (p=0.005). A significant direct correlation was registered between the fasting glucose level upon admission to the hospital and the age of the patients (r=0.26; p=0.00003). The relative risk of hyperglycemia in patients aged 40 years and older was 1.84 (confidence interval 1.005–3.37; p=0.01). The mean time elapsed since injury in patients with hyperglycemia reached 13.2±5.7 days, with normal glucose concentration – 16.7±9.2 days (p=0.02). Patients with hyperglycemia had lower levels of total protein (58.3±10.2 and 62.1±6.9 g/l, respectively; p=0.004), albumin (31.2±4.6 and 33.2±4.9 g/l; p=0.04), hemoglobin (97.7±18.9 and 105.9±16.9 g/l; p=0.004), but higher levels of C-reactive protein (61.0±55.4 and 32.9±38.1 mg/l; p=0.0001), leukocytes (10.6±4.4 and 9.3±3.4×109/l; p=0.02), count of neutrophils (7.8±4.3 and 6.4±2.9×109/l; p=0.01), proportion of neutrophils (71.6±9.6% and 67.7±7.7%; p=0.004), as well as fibrinogen concentration (5.7±1.4 and 4.8±1.2 g/l; p=0.0002) than patients with normal blood glucose levels. In patients with hyperglycemia, the mean HbA1c level was 5.3±0.6%, stress-induced hyperglycemia – 1.4±0.2 mmol/l. The median glycemic gap reached 1.51 mmol/l (Q1–Q3: 0.88–2.1 mmol/l). The median insulin concentration was 12.9 µIU/ml (Q1–Q3: 9.2–27.0 µIU/ml), the insulin resistance index was 3.3 (Q1–Q3: 2.1–8.8). The mean fasting blood glucose concentration at the last determination in patients with initial hyperglycemia reached 5.8±1.3 mmol/l. During observation, in 64.6% of the patients with hyperglycemia upon admission, glucose levels returned to normal, while in 35.4% mild hyperglycemia remained. The median time to normalization of fasting blood glucose concentration or to the last determination of this indicator was 17.5 days (Q1–Q3: 8–30 days). Conclusions. The study results indicate a frequent detection of hyperglycemia in patients with combat limb injuries. In most cases the increase in fasting glucose levels is small and in most patients this indicator returns to normal within a relatively short time. It is necessary to continue research of stress-induced hyperglycemia in the patients with combat injuries and to elucidate the pathogenetic basis of this pathology.

Neutrophil: Lymphocyte and Platelet: Lymphocyte ratios measured before transplantation and their correlation with new-onset diabetes post-transplantation in renal transplant recipients

PurposeOur goal was to evaluate the neutrophil:lymphocyte (NLR) and platelet:lymphocyte (PLR) ratios measured before transplantation and their correlation with new-onset diabetes after transplantation (NODAT) in renal transplant recipients. Patients and methodsWe conducted our study in 324 adult patients consecutively admitted to Military Hospital 103, Ha Noi, Viet Nam, who received kidney allografts from living donors. These patients were followed-up during the first 2 years post-transplantation for NODAT. We examined the association between NLR and PLR measured prior to transplantation in patients with NODAT: NLR and PLR were calculated based on the results of the complete blood count. The criteria for diagnosis of a fully symptomatic NODAT case were based on the guidelines established by the American Diabetes Association and included fasting venous blood glucose and glycosylated hemoglobin A1c (HbA1c) levels, with or without an oral glucose tolerance test. ResultsThe overall rate of NODAT during the two years after kidney transplantation was 13.6%. We found mean values of age and body mass index (BMI), and median values of NLR, PLR, high sensitivity C-reactive protein (hs-CRP) levels, and the arteriosclerosis ratio in the NODAT group to be significantly higher than those of the non-NODAT group (all p < 0.05). Furthermore, an adjusted multivariate regression analysis showed that age (area under the curve [AUC] = 0.727, p < 0.001), BMI (AUC = 0.846, p < 0.001), serum hs-CRP levels (AUC = 0.884, p < 0.001), NLR (AUC = 0.888; p < 0.001), and PLR (AUC = 0.818; p < 0.001) had predictive value for NODAT. ConclusionNLR and PLR measured before transplantation were good predictors for NODAT in the first 2 years post-renal transplantation.

Insulin resistance and its role in the pathogenesis of pre-diabetes development in obese adolescents

Background. The prevalence of childhood obesity has increased significantly over the past three decades worldwide, and in this regard, the frequency of diseases associated with obesity, including disorders of carbohydrate metabolism, has increased. The involvement of insulin resistance and insulin deficiency in the development of prediabetes in obesity has been established. However, the significance of each pathological mechanism in the development of prediabetes in childhood and adolescence has not been established. In this regard, in children's practice, there is no reliable data on methods of prevention and treatment of prediabetes in obesity.&#x0D; Aim. To study the role of insulin resistance in the development of prediabetes in obese adolescents.&#x0D; Materials and methods. The study involved 95 adolescents with obesity. Inclusion criteria: SDS BMI≥2.0, Tanner stage ≥II, age 18.0 years, exclusion criteria: diabetes mellitus. The sample was divided into prediabetics (n=40, mean age 14.0±1.53 years; SDS BMI 3.09±0.54, boys n=23) and non-prediabetics (n=55, mean age 14.6±1.67 years; SDS BMI 3.11±0.54; boys n=32). Both groups were matched on age, SDS BMI, sex (p=0.082, p=0.975, p=0.947, respectively). The research consisted of estimates of BMI, insulin, C-peptide, fasting venous blood glucose, HbA1c, cholesterol, low-density lipoprotein, high Density Lipoprotein, triglycerides, alanine aminotransferase, aspartat aminotransferase, HOMA-IR and TyG indices, results of oral glucose tolerance test at 0 and 2 hours after glucose load, ultrasound of the hepatobiliary system. Prediabetes in adolescents was diagnosed using American Diabetes Association criteria. Data was analyzed by using SPSS Statistics for Windows, Version 26.0.&#x0D; Results. Prediabetes was diagnosed in 42.1% (40/95) of cases. There were statistically significant differences between the indices of groups with prediabetes and normal glucose metabolism: fasting plasma glucose – FPG (mean 5.63±0.49; 95% confidence interval – CI 5.48–5.79 vs 5.03±0.42; 4.92–5.15 mmol/L; p0.001); 2hPG (mean 7.04±0.93; 95% CI 6.74–7.34 vs 6.23±0.82; 6.01–6.46 mmol/l; p0.001); HbA1c (mean 5.5±0.31; 95% CI 5.39–5.59% vs 5.2±0.25; 5.15–5.29%; p0.001); cholesterol (4.47±0.73; 95% CI 4.23–4.72 vs 3.96±0.92; 3.73–4.24 mmol/l; p=0.004), low-density lipoprotein (2.89±0.96, 95% CI 2.55–3.20 vs 2.46±0.89, 2.21–2.71 mmol/l; p=0.036). There were no significant differences in fasting insulin, C-peptide, triglycerides, high density lipoprotein, aspartat aminotransferase, alanine aminotransferase, HOMA-IR index and TyG, were also no significant differences in the frequency of hepatic steatosis (47.5% vs 52.7%; p=0.532).&#x0D; Conclusion. Teenagers with obesity, with prediabetes, and without disorders of carbohydrate metabolism had a similar level of peripheral tissue sensitivity to the action of insulin. There are additional factors leading to the formation of prediabetes with obesity in the child population that have to be learned in future researches.

Twice-daily injections and multiple daily injections of insulin in toddlers with type 1 diabetes: a retrospective cohort study.

Twice-daily injections and multiple daily injections of insulin in toddlers with type 1 diabetes: a retrospective cohort study.

Effects of gestational diabetes mellitus on gut microbiota of 3-month-old infants: a prospective control study

To explore the effect of gestational diabetes mellitus on the gut microbiota of their offsprings, the gut microbiota of 3-month-old infants whose mothers diagnosed with and without gestational diabetes mellitus(GDM) was compared. Pregnant women and their 3-month-old infants who were examined, delivered and follow-up visited in a county in Hebei Province from June 2016 to December 2019 were included in our study. The pregnants and their infants with result of fasting venous blood glucose≥5.1 mmol/L in the second or third trimester were included in GDM group. Fecal samples of 3-month-old infants were collected and 16 S rDNA high-throughput sequencing technology was used to explore the change of gut microbiota. A total of 48 pairs of subjects were included, 16 in GDM group and 32 in control group. Comparison of gut microbiota diversity: analysis of the Alpha diversity index showed that the Observed Species index, margalef index and menhinick index of GDM group were(141.4±17.2), (13.66±1.66) and(0.83±0.10), respectively, which were significantly lower than that of control group(154.9±21.7), (15.00±2.11) and(0.91±0.13), respectively. Sequence analysis: at phylum level, the abundance of the Firmicutes, Bacteroidetes, Actinobacteria and Proteobacteria were 54.28(47.84), 23.58(23.48), 11.20(30.99) and 0.12(0.07), respectively, while the control group were 42.05(36.23), 29.64(21.30), 9.31(15.82) and 0.15(10.14), respectively. The two groups were mainly composed of these 4 phyla and Actinobacteria was the most abundant. At genus level, there were mainly Bifidobacteria, lactobacillus, Enterobacteria, Bacteroidales and Clostridiales in both groups. The abundance of Erysipelotrichales in GDM group(0.01(0.01)) was significantly lower than that in control group(0.04(0.06))(P&lt;0.05). The abundance of Micrococcales in GDM group(0.13(0.24) was significantly lower than that in control group(0.29(0.78))(P&lt;0.05). PCoA analysis showed that the gut microbiota structure of GDM group and control group was similar. LEfSe analysis showed Erysipelatoclostridium was significantly increased in control group(P&lt;0.05). GDM can reduce the diversity and richness of gut microbiota of 3-month-old infants and has no significant effect on the phylum level but has effect on some genus level. It suggests that GDM may still have some potential effect on slightly elder infants.

Association between combat-related traumatic injury and cardiovascular risk

ObjectiveThe association between combat-related traumatic injury (CRTI) and cardiovascular risk is uncertain. This study aimed to investigate the association between CRTI and both metabolic syndrome (MetS) and arterial stiffness.MethodsThis was...

Abstract 9349: The Relationship Between Combat-related Traumatic Injury and Cardiometabolic Risk

Introduction: The relationship between combat-related traumatic injury (CRTI) and cardiovascular risk is uncertain. Available data are largely derived from small retrospective or cross sectional studies. Hypothesis: This study was designed to investigate, prospectively, the link between CRTI and both metabolic syndrome (MetS) and arterial stiffness Methods: From March 2016 to August 2020, 1144 male combat veterans (UK-Afghanistan War 2003-14) were recruited into the ADVANCE cohort; they comprised 579 men with CRTI and 565 uninjured participants frequency-matched for age, service, rank, regiment, deployment period and role-in-theatre. Investigations included quantification of injury severity (New Injury Severity Scale [NISS]), whole body composition (dual-energy X-ray absorptiometry), arterial stiffness (heart rate-adjusted central augmentation index [cAIx] and pulse wave velocity [PWV]), fasting venous blood glucose, lipids and high sensitivity C-reactive protein (hs-CRP). Insulin resistance was quantified using the estimated glucose disposal rate. The relationships of CRTI to MetS and cAIx were examined using modified Poisson and multiple linear regression analyses respectively. Results: The participants were aged 34·1±5·4 years, which was similar in the CRTI and uninjured groups; the mean time from injury or relevant deployment was 8·3±2·1 years. MetS prevalence (18·0% vs 11·8%; adjusted IRR 1·46; 1·10, 1·94) and cAIx (17·61±8·79 vs 15·23±8·19: p&lt;0·0001) were higher among the CRTI than uninjured group. Abdominal waist circumference, visceral fat area, triglycerides, insulin resistance and hs-CRP were higher and HDL-cholesterol lower with CRTI. There were no significant between-group differences in blood glucose, blood pressure or PWV. CRTI, its severity (↑NISS), lower age and socioeconomic status (SEC) were independently associated with both MetS and cAIx. Conclusions: CTRI is associated with an increased prevalence of MetS and arterial stiffness which are also influenced by age, injury severity and SEC. The longitudinal impact of CRTI on clinical cardiovascular events needs further examination

A Case of Autoimmune Hypoglycemia (Insulin Autoimmune Syndrome)

Introduction: Insulin Autoimmune Syndrome (IAS) is a condition caused by Insulin Autoantibody (IAA). IAS was initially reported in 1970 by Yukimasa Hirata from Japan. From 1970 to 2009, 380 cases were reported worldwide. We report a case of IAS in an African-American man who had recurrent episodes of syncope secondary to hypoglycemia. Case Report: A 50-year-old African American man with hypertension presented to emergency room after syncope. His initial blood glucose (BG) was 27 mg/dl. After Dextrose and glucagon injection, BG became 270 and he regained consciousness without any deficit. Vital signs and physical examination were unremarkable. He was not on any medication, and had no access to insulin or oral hypoglycemic agents. No family history of endocrine disorders, malignancy or autoimmune diseases were reported. He had been hospitalized two times for syncope secondary to hypoglycemia. During hospitalization, fasting insulin level was >1000 IU/ml with high C-peptide (3.5ng/ml). Hypoglycemic agents assay was negative. During outpatient follow-ups, fasting labs showed C-peptide 1.59 ng/ml, Insulin antibody 37.6 U/ml while venous BG was 65 mg/dl. Random BG at different occasions were 65, 68 and 55 mg/dl. HbA1C was normal. BMI was gradually increased from 32.4 to 34.8 in 6 months. During the third hospitalization, fasting venous BG were 45 and 57 on two different days, Insulin was 2111 IU/ml and C-Peptide was 1.78 ng/ml. Other labs including cortisol and TSH were normal. CT abdomen was unremarkable. Discussion: In IAS, Insulin secreted after meal is bound by IAA. It causes hyperglycemia unchecked which triggers further insulin secretion. When the bound insulin dissociates from antibodies, it causes significant hyperinsulinemia and subsequent hypoglycemia. IAS can occur regardless of previous insulin exposure, as a solitary autoimmune manifestation or in association with other autoimmune disorders. It can be induced by drugs that contain sulfhydryl group. Etiology of IAS is still not fully understood but there are theories that genetic predisposition such as class II Human Leukocyte Antigen (HLA) and environmental triggers such as medications, viruses, hematological diseases etc. might play a role. In our patient, failure to test IAA in past admissions and lack of continuity of care delayed the diagnosis. Conclusion: IAS should be considered especially in those who have no clear etiology of hypoglycemia in order to avoid unnecessary diagnostic and therapeutic procedures. Gold standard test for definitive diagnosis is IAA. As IAS is frequently self-remitting, supportive management is usually recommended. In severe cases, pharmacotherapies that reduce insulin secretion and immunosuppressants are occasionally necessary. But there is still no study that compares different treatment measures.

STUDY TO DETERMINE THE RELATION BETWEEN HBA1C, LIPID PROFILE AND CRP IN INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS IN A TERTIARY CARE HOSPITAL

Aim: The aim of this study to determine the relation between HbA1C, Lipid profile and CRP in individuals with type 2 diabetes mellitus.&#x0D; Material and methods: This prospective observational study was carried out in the Department of Medicine in Nalanda Medical College and Hospital at Patna, Bihar India for 1 year. The patients above 30 years with fasting venous blood glucose value equal or more than 100 mg/dl and postprandial glucose &gt;140 mg/dl were include in this study. FBS and PPBS, CRP (immunoturbidimetric method), and HbA1C (ion exchange chromatography using HPLC) lipid profile samples were drawn at entry and at subsequent follow-up with a minimum gap of 3-6 months.&#x0D; Results: There was no significant difference between gender, age and BMI (p&gt;0.05). FBS and HbA1C were directly correlated. PPBS showed a direct correlation with both HbA1C and CRP in this study. There was a significant positive correlation between CRP and total cholesterol (p&lt;0.05). There was no significant correlation between CRP and LDL cholesterol (p&gt;0.05). There was a negative correlation between HDL cholesterol and CRP. There was significant positive correlation between CRP and triglyceride levels (p&lt;0.05). There was significant correlation between CRP and HbA1C (p&lt;0.05).&#x0D; Conclusion: We concluded that the CRP is an additional marker of better glycaemic control and also correlates with the dyslipidaemia profile seen in type 2 diabetes mellitus.&#x0D; Keywords: C-reactive protein, Glycemic control, Hemoglobin A1C, Type 2 diabetes mellitus.

Adverse pregnancy outcomes associated with moderate elevations in blood pressure or blood glucose in Ugandan women; a prospective cohort study

BACKGROUNDThe association between overt hypertension and diabetes and adverse pregnancy outcomes is well documented. Recent evidence suggests that even moderate elevations in blood pressure or blood glucose may confer a significant risk in a dose-dependent manner. However, these studies have primarily been undertaken in white populations in high-income settings. Hypertension and diabetes are emerging as major public health issues in sub-Saharan Africa as the region undergoes rapid urbanization. It is therefore important to understand how such noncommunicable conditions contribute to pregnancy outcomes in these populations.OBJECTIVEThis study aimed to determine the association between stage 1 hypertension or fasting blood glucose in the gestational diabetes mellitus-range and adverse pregnancy outcomes in Uganda, and to describe the effects of other contributing factors such as maternal obesity.STUDY DESIGNThis was a prospective cohort study of 2857 women at 5 major hospitals in urban and semiurban central Uganda. Women were enrolled at 24 to 28 weeks’ gestation. Data about the maternal demographics, anthropometrics, fasting venous blood glucose, blood pressure, and pregnancy outcomes were collected. Moderate elevations in blood pressure and blood glucose were defined using the latest American College of Cardiology and American Heart Association definition of stage 1 hypertension and the World Health Organization's criteria for fasting blood glucose in the gestational diabetes mellitus-range. The primary outcomes of interest were perinatal death and large birthweight for gestational age, and the secondary outcomes were preterm birth, cesarean delivery, and neonatal admission. A multivariable logistic regression analysis was used.RESULTSStage 1 hypertension increased the odds of perinatal death by more than 2-fold (adjusted odds ratio, 2.68; 95% confidence interval, 1.36–5.29), with a positive but insignificant association with preterm birth. Hyperglycemia in the gestational diabetes mellitus-range was associated with cesarean delivery only (adjusted odds ratio, 1.65; 95% confidence interval, 1.20–2.27). Maternal obesity increased the risk of having large birthweight babies (adjusted odds ratio, 2.30; 95% confidence interval, 1.74–3.02), a cesarean delivery (adjusted odds ratio, 2.75; 95% confidence interval, 2.17–3.48), and neonatal admission (adjusted odds ratio, 1.63; 95% confidence interval, 1.16–2.30).CONCLUSIONModerate elevations in blood pressure and maternal obesity are stronger predictors of adverse maternal and neonatal outcomes than moderate elevations in blood glucose levels and should be the focus of intervention in these resource-poor settings. Further research is needed to determine the cost-effectiveness of identifying and managing moderate elevations in blood pressure and maternal obesity.

Stress hyperglycaemia is associated with poor functional outcomes in patients with acute ischaemic stroke after intravenous thrombolysis.

Transient hyperglycaemia in the context of illness with or without known diabetes has been termed as 'stress hyperglycaemia'. Stress hyperglycaemia can result in poor functional outcomes in patients with acute ischaemic stroke (AIS) who underwent mechanical thrombectomy. We investigated the association between stress hyperglycaemia and clinical outcomes in AIS patients undergoing intravenous thrombolysis (IVT). We examined 666 consecutive patients with AIS who underwent IVT from 2006 to 2018. All patients had a glycated haemoglobin level (HbA1c) and fasting venous blood glucose measured within 24 h of admission. Stress hyperglycaemia ratio (SHR) was defined as the ratio of the fasting glucose to the HbA1c. Univariate and multivariate analyses were employed to identify predictors of poor functional outcomes (modified Rankin Scale 3-6 at 3 months) after IVT. Three-hundred and sixty-one patients (54.2%) had good functional outcomes. These patients tended to be younger (60.7 ± 12.7 vs. 70 ± 14.4 years, P < 0.001), male (70.7% vs. 51.5%, P < 0.001), had lower prevalence of atrial fibrillation (13.0% vs. 20.7%, P = 0.008) and lower SHR (0.88 ± 0.20 vs. 0.99 ± 26, P < 0.001). Patients with high SHR (≥0.97) were slightly older than those with low SHR (<0.97) and were more likely to have diabetes mellitus. On multivariate analysis, higher SHR was independently associated with poor functional outcomes (adjusted odds ratio 3.85, 95% confidence interval 1.59-9.09, P = 0.003). SHR appears to be an important predictor of functional outcomes in patients with AIS undergoing IVT. This may have important implications on the role of glycaemic control in the acute management of ischaemic stroke.

Study to evaluate the correlation between various biochemical parameters (HbA1C, lipid profile and CRP) among type 2 diabetes mellitus patients

Aim: The aim of this study to determine the relation between HbA1C, Lipid profile and CRP in individuals with type 2 diabetes mellitus. Material and Methods: This prospective observational study was carried out in the Department of Medicine Metro Hospital and Cancer Research Centre, Jabalpur, MP India from July 2018 to February 2020. The patients above 30 years with fasting venous blood glucose value equal or more than 100 mg/dl and postprandial glucose >140 mg/dl were include in this study. FBS and PPBS, CRP (Immuno turbid metric method), and HbA1C (ion exchange chromatography using HPLC) lipid profile samples were drawn at entry and at subsequent follow-up with a minimum gap of 3-6 months. Results: There was no significant difference between gender, age and BMI (p>0.05). FBS and HbA1C were directly correlated. PPBS showed a direct correlation with both HbA1C and CRP in this study. There was a significant positive correlation between CRP and total cholesterol (p0.05). There was a negative correlation between HDL cholesterol and CRP. There was significant positive correlation between CRP and triglyceride levels (p

Can urine albumin/creatinine ratio replace 24 hours urinary albumin?

Objective: To analyze the correlation between urinary albumin/creatinine ratio (ACR) and 24-hour urinary microalbumin (UMA) and evaluate the predictive value of ARC for early diabetic nephropathy. Methods: A total of 368 patients with type 2 diabetes mellitus were retrospectively collected. Early diabetic nephropathy was defined as 24h UMA 30~<300 mg/24h. The correlation between ACR and 24hUMA, and the area under the receiver operating characteristic (ROC) curve of ACR in diagnosis of early diabetic nephropathy were calculated. Gender, age, course of disease, fasting venous blood glucose, glycosylated hemoglobin, blood pressure, triglyceride and total cholesterol were used as adjusting variables to establish univariate and multivariate logistic models of ACR for early diabetic nephropathy, respectively. A regression model was used to evaluate the diagnostic value of ACR for early diabetic nephropathy. Results: The correlation between ACR and 24h UMA was 0.658. The area under ROC curve of ACR for early diabetic nephropathy was 0.907 before and 0.933 after adjustments of gender, age, course of disease, fasting venous blood glucose, glycosylated hemoglobin, blood pressure, triglyceride and total cholesterol, respectively. The OR value of ACR of diabetic nephropathy was 2.016 before and 2.762 after same adjustments. The calibration of Hosmer-Lemeshow chi-square test evaluation model was 19.362 before (P=0.13) and 14.928 after adjustments (P=0.061). Conclusion: ACR is a better predictor for early diabetic nephropathy although its value is influenced by gender, age, course of disease, blood sugar, lipid, and blood pressure.

Study on the relationship between screen time and prediabetes in adolescents

Objective To explore the relationship between screen time and prediabetes in adolescents. Methods A cross-section study. A total of 532 adolescents aged 12~18 years in Shandong Zibo Vocational Institute were selected by stratified sampling method. The screen time was investigated by questionnaire survey. Measuring fasting fingertip blood glucose, screening for who with potentially abnormal blood glucose, and measuring their fasting venous blood glucose, which is to determine whether it is prediabetes. Results With the increase of screen time, the risk of prediabetes increased continuously. Compared with adolescents with those who spend 0~119 minute per day screen time, the risk of prediabetes of adolescents with an average daily screen time of 120~239, 240~317, ≥318 minute increased by 0.37%, 2.63%, and 3.57%, respectively. After multi-factor adjustment, the risk of prediabetes with who take 240~317, ≥318 minute per day screen time is still higher than who with the average daily screen time of 0~119 minute, the adjusted OR was 2.502 (95% CI 1.279-4.897), 2.337(95% CI=1.189-4.594). Conclusion The results of this study show that the longer the screen time, the higher the risk of prediabetes in adolescents, and adolescents should be encouraged to reduce screen time. Key words: Adolescent; Prediabetic state; Screen time

Identification of risk factors affecting impaired glucose metabolism among the adult population of district Srinagar

BackgroundThe World has seen an emerging trend of diabetes among adolescents and moderately aged people over the last decade. The aim of the study was to identify the risk factors associated with impaired glucose metabolism and the prevalence of impaired glucose metabolism among the adult population of district Srinagar. MethodsMulti-stage cluster random sampling design was used and from each household, participants were selected using a Kish grid method. Socio-demographic and clinical data were collected. The participants were then subjected to fasting venous blood glucose estimation. ResultsAge, waist circumference, hip circumference, weight, and body mass index were all statistically significant between normoglycemic participants and those with impaired glucose metabolism (p < 0.018). On logistic regression, subjects who had a higher BMI were more likely to develop Impaired glucose metabolism (OR = 3.52, OR 95% CI = 1.25–9.87); Moreover, consumption of carbonated drinks, (3–6 times/week OR = 4.40, OR 95% CI = 2.06–9.40; >6 times/week OR = 11.04, OR 95% CI = 0.86–140.66) was found to be a potential risk factor. Participants with a family history of diabetes were more susceptible to develop impaired glucose metabolism (OR = 6.41, OR 95% CI = 3.22–12.78). The risk effect of these factors was even stronger before adjusting for age, sex, family history of diabetes, and BMI in participants. ConclusionRisk factors for impaired glucose metabolism include increasing age, obesity, and higher consumption of carbonated drinks, hypertension, smoking behavior, high-calorie diet intake and positive family history of diabetes.

Prevalence of type 2 diabetes mellitus among adult population of District Srinagar

Over the previous 30 years, the status of diabetes has changed from being considered as a mellow issue of the elderly to one of the significant reasons for morbidity and mortality influencing the young and moderately aged individuals. The aim of the study was to estimate the prevalence of type 2 diabetes mellitus (T2DM) and impaired fasting glycemia (IFG) in the adult population, age ≥ 20 years of District Srinagar and determine its sociodemographic and lifestyle correlates. The study was conducted among the adult population of District Srinagar with a sample size of 580. A three-stage cluster random sampling design was used, and study participants were selected using a Kish grid method. Sociodemographic data, anthropometric data, and other data were collected as per the pretested semi-structured proforma. The participants were then subjected to fasting venous blood glucose estimation. The American Diabetes Association (ADA) criteria 2015 were used for classifying the subjects as normal, pre-diabetic, and diabetics. The prevalence of T2DM was 9.8% and that of IFG was 22.2%,the majority of them (9.1%) had known T2DM. The prevalence of IFG and T2DM was statistically associated with increasing age (p < 0.001), marital status (p < 0.001), educational status (p < 0.001), high chocolates and carbonated drinks consumption (p < 0.001), level of physical inactivity (p < 0.05), body mass index (p < 0.001), family history of T2DM (p < 0.001), and smoking behavior and hypertension (p < 0.001). Our analysis suggests an increase in the prevalence of T2DM in District Srinagar.

Intervention to Reduce Unnecessary Glucose Tolerance Testing in Pregnant Women.

Gestational diabetes mellitus (GDM) can be diagnosed in pregnant women by increased fasting plasma glucose alone, which eliminates the need for performing a 75 g oral glucose tolerance test (OGTT). If whole blood glucose meters are used to triage fasting samples in order to decide whether to give the glucose drink, a cutpoint with appropriate sensitivity and specificity for elevated fasting plasma glucose is needed. The number of GDM diagnoses by increased fasting plasma glucose alone was determined from specimens collected and tested at core laboratories in urban hospitals, rural health centers, and from specimens collected at patient phlebotomy service centers (PSCs) for plasma testing at a central laboratory. The number of glucose drinks avoided was counted after implementing the diagnostic cutoff of ≥95 mg/dL (5.3 mmol/L) at urban hospitals and rural health centers, which have on-site plasma testing, and after selecting a PSC meter fasting venous whole blood glucose cutpoint after calculating sensitivity and specificity for plasma glucose ≥95 mg/dL (5.3 mmol/L) using logistic regression. Among 4850 OGTTs, there were 1315 GDM diagnoses annually, of which 409 were from increased fasting plasma glucose. Ninety-one percent of OGTTs were performed at PSCs. If a fasting plasma glucose cutpoint of ≥95 mg/dL (5.3 mmol/L) was implemented at urban hospitals and rural health centers and a meter fasting venous whole blood glucose cutpoint of ≥108 mg/dL (6.0 mmol/L) (25% sensitivity, 99.9% specificity) was implemented at PSCs, the drink would be appropriately avoided by 145 patients/year, and inappropriately avoided by 3 patients/year. After implementing these cutpoints, the drink was appropriately avoided in 91 patients during a 36-week period, with none inappropriately avoiding it. Modifying fasting glucose cutpoints reduced unnecessary diagnostic OGTTs in pregnant women.

Correlation Between Apolipoprotein M and Inflammatory Factors in Obese Patients.

BackgroundThe aim of this study was to observe apolipoprotein M (ApoM) level in obese patients and to explore its correlation with inflammatory factors.Material/MethodsA total number of 96 participants were recruited and divided into 2 groups: the control group (or healthy group) whose participants had normal body weight (n=58), and the obese group with all its participants diagnosed with obesity (n=38). Data on blood pressure, body weight, height, body mass index, diastolic function of brachial artery endothelium, fasting venous blood glucose, blood lipids, plasmatic ApoM, interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), fasting insulin, and adiponectin levels were collected for both groups.ResultsIn the obese group, the levels of plasmatic ApoM, high-density lipoprotein cholesterol (HDL-C), and plasmatic adiponectin were significantly (p<0.05) decreased compared to the control group, and the levels of IL-6, TNF-α, CRP, and fasting insulin were significantly increased (p<0.05) compared to the control group. For the obese group, plasmatic ApoM level was positively correlated with HDL-C level and negatively correlated with levels of IL-6, TNF-α, CRP, insulin, and insulin resistance index. However, no significant correlations were revealed between plasmatic ApoM and the diastolic function of brachial artery endothelium, adiponectin level, blood pressure, and blood glucose level.ConclusionsObese patients showed significantly lower plasmatic ApoM levels than people with normal body weight, and ApoM level showed a strong correlation with CRP, TNF-α, and IL-6 levels, which indicated that ApoM might be regulated by these inflammatory factors.

Absolute cardiovascular risk of women using hormonal contraception in Porto-Novo.

SummaryIntroduction:Le but du present travail etait de determiner le risque cardiovasculaire absolu (RCVA) des femmes utilisant une contraception hormonale a Porto–Novo.MéthodeNous avons mene une etude transversale descriptive incluant des femmes au moment du renouvellement d’une methode contraceptive hormonale. La pression arterielle, la glycemie veineuse a jeun, l’indice de masse corporelle et l’hypertrophie ventriculaire gauche electrocardiographique ont ete etudiees. La determination du RCVA a ete double basee sur les modeles de l’Organisation Mondiale de la Sante (OMS/ISH) et de la Societe Europeenne de Cardiologie (ESC/ ESH).RésultatsL’age moyen des femmes etait de 35.3 ± 8.2 ans. La pression arterielle et la glycemie etaient elevees dans respectivement 24 et 1.5% des cas; 23.2% etaient obeses. L’hypertrophie du ventricule gauche etait presente dans 7.1% des cas. Un RCVA eleve etait retrouve chez 5.2% de ces femmes selon le modele de l’ESC/ESH.ConclusionL’existence de femmes a RCVA eleve dans ce groupe souleve le probleme de l’eligibilite cardiovasculaire a la methode contraceptive utilisee.