Fructosamine Levels Research Articles

A proof-of-concept study to evaluate the efficacy and safety of BTI320 on post-prandial hyperglycaemia in Chinese subjects with pre-diabetes

BackgroundGalactomannan(s) are plant-derived fiber shown to reduce post-prandial blood glucose by delaying intestinal absorption of carbohydrates and slowing down gastric emptying. We examined glucose-lowering effects of BTI320, a propriety fractionated mannan(s) administered as a chewable tablet before meal in a proof-of-concept study in Chinese subjects with prediabetes.MethodsSixty Chinese adults aged 18–70 years with either impaired fasting glucose, impaired glucose tolerance, or glycated haemoglobin 5.7–6.4% (39-46 mmol/mol), were randomly assigned in 2:2:1 ratio to either BTI320 8 g (high dose), BTI320 4 g (low dose) or matching-placebo three times daily before meal for 16 weeks. The primary endpoint was change in fructosamine in subjects treated with BTI320 compared with placebo from baseline to week 4. Indices of glycaemic variability based on continuous glucose monitoring (CGM) and standard meal tolerance test were explored in secondary analyses.ResultsOf 60 subjects randomized, 3 subjects discontinued study treatment prematurely. In intention-to-treat analysis, no significant differences in change in serum fructosamine between low or high dose BTI320 and placebo were observed. Using random effect models, adjusted for variability by meals, treatment with low dose BTI320 was associated with reduction in 1-h (p < 0.01), 2-h (p = 0.01) and 3-h (p = 0.02) post-prandial incremental glucose area-under-curve and post-meal maximum glucose (p = 0.03) compared with placebo. Subjects receiving low dose BTI320 had greater body weight reduction than placebo group.ConclusionsBTI320 did not change fructosamine levels compared with placebo. BTI320 reduced glycaemic variability based on CGM indices.Trial registrationThe study was registered at www.clinicaltrials.gov, reference number NCT02358668 (9 February 2015).

A comparative analysis of fructosamine with other risk factors for kidney dysfunction in diabetic patients with or without chronic kidney disease

BackgroundHyperglycemia is the driving force for the development of diabetic nephropathy leading to the end stage renal disease. It is well known that in hyperglycaemic condition, serum proteins become glycated through non-enzymatic glycation. With the other risk factors, serum fructosamine may be an important risk factor for kidney impairment. To assess coexistence of frequently documented risk factors of kidney dysfunction with serum fructosamine in diabetic patients with chronic kidney disease (CKD). MethodsIn this study, total 150 individuals, as control, type2 diabetic patients without complication and with CKD were included. Blood samples were collected from all the samples to estimate blood glucose, HbA1c, serum creatinine, fructosamine levels and lipid profile. Statistical analysis i.e. regression and correlation between serum fructosamine and other documented risk factors for diabetic CKD has been done. P < 0.001 was considered significant. ResultsSerum fructosamine, HbA1c, creatinine levels, cholesterol and LDL were increased significantly (P < 0.001) in diabetic patients with CKD compared to without complications. Systolic and diastolic blood pressure and BMI were also significantly higher in diabetic patients compared to control. Serum creatinine, total cholesterol and LDL showed a significant positive correlation but HDL showed a negative correlation with fructosamine in CKD diabetic patients. No significant correlation was found with any risk factors in diabetic patients without complications expect HbA1c. ConclusionIt is concluded that elevated serum fructosamine level is strongly associated with kidney dysfunction in diabetic patients. As there is a significant link between serum fructosamine and other risk factors for CKD diabetic patients.

Glycemic variability in the development of cardiovascular complications in diabetes.

Diabetes mellitus represents a major risk factor for the development of coronary artery disease and other vascular complications. Glycated haemoglobin, fructosamine, and fasting blood glucose levels are partial parameters to exhaustively describe patient dysglycemic status. Thus, recently the new concept of glycemic variability has emerged, including information about two major aspects: the magnitude of blood glucose excursions (from nadir to peak, thus lower and higher spikes) and the time intervals in which these fluctuations occur. Despite the lack of consensus regarding the most appropriate definition and tools for its assessment, glycemic variability seems to have more deleterious effects than sustained hyperglycemia in the pathogenesis of diabetic cardiovascular complications. This manuscript aimed to review the most recent evidence on glycemic variability and its potential use in everyday clinical practice to identify diabetic patients at higher risk of cardiovascular complications and thus needing stricter monitoring and treatment.

Treatment with combination of pioglitazone and glimepiride decreases levels of chemerin and asymmetric dimethylarginine (ADMA) in obese type 2 diabetic patients

Chemerin is an adipokine that plays a crucial role in adipocyte differentiation and development, as well as in glucose and lipid metabolism. High levels of asymmetric dimethylarginine (ADMA), a naturally occurring product of metabolism, inhibit nitric oxide (NO) synthesis and are related to endothelial dysfunction. The aim of this study was to investigate the effect of vildagliptin therapy and the combination of pioglitazone and glimepiride on the levels of NO, ADMA, and chemerin in diabetic patients. The study was conducted on 140 subjects, including 40 apparently healthy subjects, and 100 type 2 diabetic obese patients; 50 of them were treated with vildagliptin, and the other 50 patients revived combination of pioglitazone and glimepiride, both groups were treated for 12 months. For all participants, the levels of fasting blood glucose (FBG), fructosamine, HbA1c, lipid profile, ADMA, NO, and chemerin were determined. The levels of those parameters were compared before and after treatment. In both treated groups, levels of FBG, fructosamine, HbA1c, TC, and LDL-C decreased after treatment. Levels of chemerin and ADMA decreased significantly after treatment, whereas the levels of NO increased compared to the baseline values. Additionally, levels of chemerin and ADMA in the group treated with combination of pioglitazone and glimepiride were significantly lower compared to the group treated with vildagliptin. In conclusion, treatment with combination of pioglitazone and glimepiride had a favorable effect on chemerin and ADMA levels in obese type 2 diabetic patients.

Efficacy, safety and acceptability of the new pen needle 34G × 3.5 mm: a crossover randomized non-inferiority trial; AGO 02 study

Objective: Insulin injection aspects, such as fear of injection and pain, directly affect glycemic control, patient adherence and quality of life. Use of thinner and shorter needles could increase acceptance of injections. The aim of the study is to evaluate the non-inferiority of the new 34G × 3.5 mm needle compared to a 32G × 4 mm in patients with diabetes treated with insulin.Methods: This is an open, randomized, two-period crossover, non-inferiority trial. Every treatment period lasted 3 weeks. Patients with type 1 or type 2 diabetes, treated with multiple daily insulin injections, were randomly assigned to receive a 34G × 3.5 mm or a 32G × 4 mm pen needle. The primary endpoint was the non-inferiority of the 34G × 3.5 mm in comparison with the 32G × 4 mm pen needle in terms of percentage absolute change of blood fructosamine (% |ΔFru|), using a non-inferiority margin of 20%.Results: Overall 77 patients were randomized and 73 completed the study. Patients characteristics were: 52% male, 80.5% affected by type 1 diabetes, mean age 52 years (±14.6), mean BMI 24.5 kg/m2 (±5.6), HbA1c 8% (±1.1) and baseline fructosamine level 350 µmol/l (±84). Mean fructosamine levels increased by 0.56 µmol/l with the 34G needle, while a reduction of 7.29 μmol/l was documented with the 32G needle. The difference between the two groups (7.84 μmol/l) was not statistically significant (p = .27). The % |ΔFru| between the two groups was 7.55% (95% CI 5.67–9.44), meeting the non-inferiority criterion. Glycemic variability, expressed as standard deviation of fasting blood glucose and post-prandial glucose, was not different between the two treatment groups (p = .63 and p = .77, respectively).Conclusions: The 34G × 3.5 mm needle was non-inferior to the 32G × 4 mm needle regarding fructosamine levels and glycemic variability supporting the suitability of the 34G × 3.5 mm needle for insulin injection in patients with diabetes.Clinical trial registration: NCT02690467

Biochemical and anthropometric changes during Ramadan among type 2 diabetes mellitus patients

In this study, our aim was to assess the impact of fasting during Ramadan on biochemical and anthropological factors in patients with type 2 diabetes and compare them with those who did not fast. This was a prospective study. It was carried out in the city of Yazd, Iran, during Ramadan of 2016. Body weight, height, waist circumference, blood pressure, body mass index (BMI), lipids, fasting plasma glucose (FPG), and fructosamine levels before and after Ramadan were assessed on 120 diabetic patients; 60 of whom had fasting, and 60 had no intention. Fifty-four patients from the fasting group (including 34 fasters with 10- to 25-day fasting (group 1) and 20 fasters with > 25-day fasting (group 2)) and 58 patients from the non-fasting group (group 3) completed the study. This study showed that the mean BMI in three groups significantly decreased, and the highest decrement was seen in group 1 at the end of Ramadan (p value 0.01). Fructosamine was increased in all groups, and the highest increment was seen in group 2 after Ramadan (p value < 0.001). We observed that glycemic status and LDL-C levels worsened after Ramadan in T2DM patients, and beneficial effects of Ramadan on anthropometric factors are not limited to fasters, and other non-faster Muslims also showed weight reduction after Ramadan.

The New Smartphone Application for Blood Glucose Monitoring (BGM) with Information-Motivation-Behavioral Skills (IMB) Model Study

Previous studies demonstrated the accuracy of the CONTOUR®NEXT ONE BGM system (BGMS), which includes a wireless-enabled BG meter that links to the CONTOUR®Diabetes app installed on a mobile device. The CONTOUR®Diabetes app Version 2 Prototype detects repeated behavioral patterns in testing results and reports them back to the user. By decision of the user, recommendations are triggered to help with elimination of conditions related to the diagnosed pattern. The goal of the interactive app interface implementation is to achieve behavioral change in people with diabetes for better adherence to treatment and sustained glycemic control. The app employs messaging via the IMB model. A 6-week study with 46 insulin-using people with diabetes was performed to assess operational parameters and user reactions to the system. Analyses were performed on glycemic variables, such as fructosamine levels and HbA1c, and on subject questionnaires. Fructosamine levels decreased significantly from the beginning to the end of the study (P = 0.0076). All but 1 subject had IMB patterns detected, ranging from messages relating to “running low” to “pre-dinner high.” “Critical High” was the most frequently detected pattern. A multivariate cluster analysis, based on questionnaire responses only, revealed that subjects could be classified into one of two clusters based on their responses to the app. The only demographic or diabetes history variable significantly related to cluster membership was diabetes type. One cluster included only subjects with type 1 diabetes; the other cluster was a mix of both diabetes types. To further evaluate the benefits and efficacy of IMB as it relates to glycemic control, a larger study following subjects over a longer time period is required. Disclosure S. Pardo: Employee; Self; Ascensia Diabetes Care. S. Zhuplatov: Employee; Self; Ascensia Diabetes Care. J. Wallace: Employee; Self; Ascensia Diabetes Care. T.S. Bailey: Research Support; Self; Abbott. Consultant; Self; Abbott. Speaker's Bureau; Self; Abbott. Research Support; Self; Ambra BioScience, Ascensia Diabetes Care, Becton, Dickinson and Company. Consultant; Self; Becton, Dickinson and Company. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Calibra Medical. Consultant; Self; Calibra Medical. Research Support; Self; Companion Medical, Dexcom, Inc., Glooko, Inc., GlySens Incorporated, Lexicon Pharmaceuticals, Inc., Eli Lilly and Company. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Research Support; Self; Medtronic MiniMed, Inc.. Consultant; Self; Medtronic MiniMed, Inc.. Speaker's Bureau; Self; Medtronic MiniMed, Inc.. Research Support; Self; Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Research Support; Self; Sanofi. Consultant; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Senseonics. Consultant; Self; Intarcia Therapeutics, Inc.. Research Support; Self; Versartis, Inc., Xeris Pharmaceuticals, Inc., MannKind Corporation.

Use of the New Smartphone Application for Blood Glucose Monitoring (BGM) with Information-Motivation-Behavioral Skills (IMB) Model Has an Impact on Diabetes Control Parameters

The accuracy of the CONTOUR®NEXT ONE BGM system (BGMS), which includes a wireless-enabled BG meter that links to the CONTOUR®Diabetes app installed on a mobile device, has been shown in previous studies. The CONTOUR®Diabetes app Version 2 Prototype detects repeated behavioral patterns in testing results and reports them back to the user. The user can choose to receive recommendations to help eliminate conditions related to the diagnosed pattern. The goal of the interactive app interface implementation is to achieve behavioral change in people with diabetes for better adherence to treatment and sustained glycemic control. The app employs messaging via the IMB model. A 6-week study with 46 insulin-using people with diabetes was performed to assess operational parameters and user reactions to the system. Further to per-protocol analyses, some post-hoc analyses were performed. In addition to a significant decrease in fructosamine level from the beginning to the end of the study (per-protocol analysis), there was a significant decrease in the number of above-target (“high”) blood glucose measurements per week per subject (P &amp;lt;0.0001). This result may be related to a decrease in extreme glycemic fluctuations. The average number of blood glucose tests performed per week increased significantly over the course of the study (P &amp;lt;0.0001), indicating the potential effects of using the system on encouraging patient adherence to treatment and better control of blood glucose levels. While not statistically significant, the average blood glucose values for fasting, before meal, and after meal consistently decreased. A larger study following subjects over a longer time period is required to evaluate the benefits and efficacy of IMB as it relates to glycemic control. Disclosure S. Pardo: Employee; Self; Ascensia Diabetes Care. S. Zhuplatov: Employee; Self; Ascensia Diabetes Care. J. Wallace: Employee; Self; Ascensia Diabetes Care. T.S. Bailey: Research Support; Self; Abbott. Consultant; Self; Abbott. Speaker's Bureau; Self; Abbott. Research Support; Self; Ambra BioScience, Ascensia Diabetes Care, Becton, Dickinson and Company. Consultant; Self; Becton, Dickinson and Company. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Calibra Medical. Consultant; Self; Calibra Medical. Research Support; Self; Companion Medical, Dexcom, Inc., Glooko, Inc., GlySens Incorporated, Lexicon Pharmaceuticals, Inc., Eli Lilly and Company. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Research Support; Self; Medtronic MiniMed, Inc.. Consultant; Self; Medtronic MiniMed, Inc.. Speaker's Bureau; Self; Medtronic MiniMed, Inc.. Research Support; Self; Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Research Support; Self; Sanofi. Consultant; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Senseonics. Consultant; Self; Intarcia Therapeutics, Inc.. Research Support; Self; Versartis, Inc., Xeris Pharmaceuticals, Inc., MannKind Corporation.

Oral supplementation with melatonin reduces oxidative damage and concentrations of inducible nitric oxide synthase, VEGF and matrix metalloproteinase 9 in the retina of rats with streptozotocin/nicotinamide induced pre-diabetes

Hyperglycemia mediated oxidative stress and pro-angiogenic molecules such as vascular endothelial growth factor (VEGF) and matrix metalloproteinase 9 (MMP9) are considered important for diabetic retinopathy onset and progression. Melatonin is a pineal hormone that regulates circadian and seasonal rhythms and most likely is involved in regulating glucose metabolism. We aimed to evaluate the potential benefit of melatonin supplementation to the pre-diabetic retina by assessing melatonin effects on lipid peroxidation (thiobarbituric acid reactive substances, TBARS), protein oxidation (advanced oxidation protein products, AOPP) and concentrations of inducible nitric oxide synthase (iNOS), VEGF and MMP9 in the retina of rats with pre-diabetes. Pre-diabetes was induced by streptozotocin (45 mg/kg, i.p.) following nicotinamide injection (110 mg/kg, i.p.). Beside mild hyperglycemia, lower serum insulin, increased fructosamine and lower HDL cholesterol, the present study demonstrated decreased serum melatonin in pre-diabetic rats, as well as, increased concentration of retinal TBARS, AOPP, iNOS, VEGF, and MMP9. Oral supplementation with melatonin (85 μg/animal/day) caused melatonin and HDL cholesterol levels to rise in treated rats and reduced levels of fasting serum glucose and fructosamine. It also affected serum insulin and quantitative insulin sensitivity check index (QUICKI) in treated groups but had no significant effect on non-fasting glucose. Finally, supplementation with melatonin reduced concentrations of TBARS, AOPP, iNOS, VEGF, and MMP9 in significant level, thereby exerting an overall positive effect on oxidative stress and pro-angiogenic signaling in the pre-diabetic retina. Thus, oral melatonin might be considered in an early treatment or in the prevention of retinal changes associated with pre-diabetes.

Inhibition of advanced glycation end products by Punica granatum Linn. leaves and its antioxidant activity

Advanced glycation end products (AGEs) are the consequent products by virtue of non-enzymatic reaction of reducing sugars with amino groups present either in lipids, nucleic acids or proteins. Lately AGEs have been embroiled in the inception of diabetes induced complications. In Ayurveda, Punica granatum is contemplated as “a pharmacy unto itself”. Punica granatum leaves have been stated to have anti-diabetic activity. The purpose of the existing study was to determine the anti-glycation potential of methanolic extract of Punica granatum leaves (MPGL) and investigate the fundamental mechanisms in discouraging the glycation process. Antioxidant activity of MPGL was estimated by DPPH (2,2-diphenyl-1-picrylhydrazyl) and ABTS (3-ethyl-benzothiazoline-6-sulfonic acid) radical scavenging assays. Both MPGL and aminoguanidine were evaluated against the formation of AGEs. Antiglycation activity was evaluated by determining the fluorescence intensity of AGEs and formation of fructosamine. Protein oxidation in the glycation process was determined by evaluating the protein carbonyl content and thiol group. MPGL demonstrated IC50 value of 15.602 ± 0.296 and 724.323 ± 16.451 µg/ml for the DPPH and ABTS radical scavenging assays respectively. Current study revealed that MPGL had cogent effects on the in vitro formation of AGEs. MPGL decreased fructosamine level and significantly counteracted the oxidative damage of protein by curbing protein carbonyl content and impeding the loss of thiol group. The anti-glycation activity was farther cogent than the glycation inhibitory activity attained using the standard drug, aminoguanidine. Thereupon, MPGL presents to be more encouraging to be emerged as an competent AGE inhibitor.

A comparison of serum fructosamine, 25-hydroxyvitamin D, calcium, and phosphorus levels in the first, second, and third trimester in obese and non-obese pregnant women with and without gestational diabetes mellitus

Previous study demonstrated that obesity and associated gestational diabetes mellitus (GDM) are increasing. However, the combination of obesity and GDM contribute to the pregnancy complication have yet to be elucidated. The aim of this study was to compare serum fructosamine, 25-hydroxyvitamin D, calcium, and phosphorus levels in the first, second, and third trimester in obese and non-obese pregnant women with and without gestational diabetes mellitus. We performed a prospective, case-control study in 30 obese women diagnosed with GDM, 30 non-obese pregnant women with GDM, and 30 non-obese and without GDM, age-matched pregnant women who were enrolled in the first, second, and third trimester and followed-up until delivery. Blood samples were collected once from each participant in the first trimester of pregnancy, during the fetal viability scan, once in the second trimester of gestation during screening for gestational diabetes mellitus, and once in the third trimester of gestation. Serum fructosamine, 25-hydroxyvitamin D, calcium, and phosphorus levels were measured. In the third trimester, fructosamine level (1.8 ± 0.08) was slightly higher in obese women who were diagnosed with GDM than in the second and first trimester (1.70 ± 0.12, 1.70 ± 0.09), respectively. But, in the third trimester, phosphorus levels were slightly lower in GDM women who were GDM women than in the first trimester. In the first, second, and third trimester, in these subjects, the mean levels of vitamin D and calcium were slightly different. Our data tend to support the concept that fructosamine, 25-hydroxyvitamin D, calcium, and phosphorus level assays can provide a good index of health control especially in obese. This study has increased our knowledge of biochemical changes in GDM among obese pregnant women with GDM.

Effect of photodynamic therapy as an adjuvant to non-surgical periodontal therapy: Periodontal and metabolic evaluation in patients with type 2 diabetes mellitus.

This pilot study aimed to evaluate the effect of antimicrobial photodynamic therapy (aPDT) as an adjuvant to non-surgical periodontal therapy (NSPT) on periodontal status and glycemic control in patients with type 2 diabetes mellitus and generalized chronic periodontitis. Twelve patients were evaluated at five time points: during the preparation of the patient (T0), during the treatment phase (T1) and after 30 (T2), 90 (T3) and 180 (T4) days. The patients had a mean age of 52.2 years and a 9.58-year history of diabetes, on average, and were divided into two randomized treatment groups: 6 patients received NSPT combined with aPDT (G1) and 6 patients received only NSPT (G2). The aPDT was applied associating the photosensitizing agent methylene blue (10 mg/ ml) with a red laser (660 nm-40 mW). The total time of exposure was 2 min per tooth. Whitin the limitation of this study, the results showed that the plaque index reduced significantly only in the control group (p = 0.02) at T2 (30 days). For bleeding on probing, both groups showed a significant reduction between T1 and T2, with no difference between groups G1 and G2. Regarding the probing depth, there were no differences between groups, but the parameters decreased over time when compared to T1. The glycated haemoglobin and fructosamine levels did not significantly differ between or within the groups at any time point. When NSPT was combined with aPDT, no additional benefits were observed for the periodontal and metabolic clinical parameters.

SEX DIFFERENCES OF CARBOHYDRATE AND LIPID METABOLISM IMPAIRMENT IN RATS WITH TYPE 2 DIABETES MELLITUS

A sex difference of carbohydrate and lipid metabolism disorders in rats with type 2 diabetes has been studied. It was established that type 2 diabetes leads to a more pronounced deterioration in carbohydrate toleranceand insulin sensitivity in males compared to female rats, but the sex doesn’t affect basal glycemia and fructosamine levels. It was found that the increase of body weight and visceral fat in rats with type 2 diabetes is moremanifested in females than in males. It has been determined that hypertriglyceridemia is higher in diabeticmales compared to diabetic females, and the level of common lipids in the liver, both intact females and femaleswith type 2 diabetes, is lower than that of the males. The obtained results indicate a more expressive impairment of glucose and lipid metabolism in males compared to females with type 2 diabetes

Functionality of cow milk naturally enriched with polyunsaturated fatty acids and polyphenols in diets for diabetic rats.

The increasing incidence of diabetes mellitus is becoming a serious threat to human health in various parts of the world. Studies with dairy products have shown a potential beneficial effect against diabetes. This experiment evaluated the supplementation of milk naturally enriched with polyunsaturated fatty acids (PUFA) and polyphenols in rats with streptozotocin-induced diabetes. Forty male 28-day-old Wistar rats were distributed in four experimental treatments of diabetic animals (streptozotocin induction) and a normal group (non-induced). Experimental treatments were: control (water), whole common milk (COM-M), milk enriched with PUFA (PUFA-M), milk enriched with PUFA and polyphenols (PUFA/P-M) through a special diet offered to dairy cows. Milk supplementation at a dose 5 mL/kg body weight was performed for 77 days, 42 days before and 35 days after diabetes induction. The COM-M supplementation increased brown fat deposits, reduced post-induction glucose levels, reduced blood fructosamine levels, and improved glucose tolerance. Milk enriched with PUFA reduced final fasting glucose, LDL levels, and improved blood antioxidant capacity. Milk enriched with PUFA and polyphenols promoted an increase in gastrocnemius muscle mass, and a reduction in mesenteric fat and LDL levels. Milk intake, with an emphasis on milk enriched with PUFA and polyphenols, attenuated the metabolic disorders of streptozotocin-induced diabetes in rats.

Índices de sensibilidade à insulina em fêmeas caninas: efeito do ciclo estral e da piometra

Ocurrence of estrous cycle and pyometra in female dogs are associated to insulin resistance status. Moreover, septic/ inflammatory environments such as pyometra may also course with reduced insulin sensitivity. The aim of this study was to check the effect of estrus cycle and pyometra on insulin sensitivity indexes. Based in blood basal glucose levels and serum insulin basal levels from bitches in different estrus cycle phases as well as in bitches with pyometra, different insulin sentivity indexes were calculated (HOMA B, HOMA R, insulinogenic index, amended insulin:glucose ratio, fructosamine and fructosamine:albumin ratio). The insulinogenic index and amended insulin:glucose ratio were more sensible in detecting relative hyperinsulinemic status, specially in pyometra patients. The lack of a cut-off point for HOMA indexes impairs its interpretation, notwithstanding their have been able to shown insulin resistance in female dogs with pyometra. Moreover, this different sensitivity indexes have prove to be really easy, cheap and useful and have some advantages comparing with basal insulin and glucose levels. Fructosamine was not a useful screening test in detecting differences in insulin sensitivity status despite there were a strong influence of hypoalbuminemia on fructosamine levels in bitches with pyometra. Fructosamine:albumina ratio is more reliable than fructosaminemia alone, and future studies are need to determine reference values for this ratio, as well to HOMA B and HOMA R indexes in female dogs.

Antiglycation and antioxidant activities of mogroside extract from Siraitia grosvenorii (Swingle) fruits.

Siraitia grosvenorii (Swingle) is one kind of medical and edible plants with various health-promoting properties. Recently, its hypoglycemic and antidiabetic activities have been reported, but the underlying mechanism remains to be explored. The current study was aimed to investigate the antioxidant and antiglycation activities of mogroside extract (MGE) from Siraitia grosvenorii (Swingle). The results showed that compared to glycated BSA, MGE at middle (125μg/mL) and high dose (500μg/mL) significantly inhibited BSA glycation evidenced by decreased fluorescent AGEs formation, protein carbonyls and Nε-(carboxymethyl) lysine (CML) level at 500μg/mL by 58.5, 26.7 and 71.2%, respectively. Additionally, the antiglycative activity of MGE (500μg/mL) was comparable to aminoguanidine (AG) at the equal concentration. However, the inhibitory effect of MGE on glycation-induced increase of fructosamine level and decrease of thiol level was not remarkable. MGE was a potent peroxide radicals scavenger (851.8μmol TE/g), moderate DPPH and ABTS radicals scavenger with IC50 1118.1 and 1473.2μg/mL, respectively, corresponding to positive controls ascorbic acid of IC50 9.6μg/mL, and trolox of IC50 47.9μg/mL, respectively, and mild reducing power. These findings suggest that MGE may serve as a new promising antiglycative agent against diabetic complications by inhibiting protein glycation and glycoxidation.

Evaluation of antidiabetic potential of steroidal alkaloid of Sarcococca saligna

The demand for natural medicines has increased because of their limited adverse effects. The aim of study is to explore the antidiabetic potential of isolated steroidal alkaloid from Sarcococca saligna in streptozotocin induced diabetic rats. To determine the antidiabetic activity of steroidal alkaloids, diabetes was induced in rats by injecting streptozotocin intraperitoneally at a dose of 40 mg/Kg. After a week of STZ injection the treatment were started and the 8th day was considered as the 1st day of treatment and up to four weeks the rats were treated with steroidal alkaloids. Animals were divided into five groups, group 1 considered as a control group by receiving normal saline (1 ml/Kg) twice daily and group 2, 3, 4 were treated with active compound sarcovagine-D, saracodine and holaphylline at the dose of 5 mg/Kg subcutaneously twice a day while group 5 was treated with a standard drug glibenclamide at a dose of 1 mg/Kg/day. The result showed that treated group 2 and 4 reduced the glucose level in blood significantly while group 3 showed moderate glucose reduction. The fructosamine level reduced significantly in treating group 4 from the 2nd week of treatment while group 2 and 3 decreased the level significantly in week 4 in diabetic rats. The treated groups showed gradual decreases the glucose level in 1st and 2nd week of oral glucose tolerance test compared to control group. The group receiving holaphylline (4) and sarcovagine-D (2) showed good improvements in blood lipids while the effect of compound on body weight showed less significant improvement. The present study concluded that steroid alkaloids from isolated Sarcococca saligna possess hypoglycemic effect and improve others diabetes associated complications. Together these finding further research is needed using a range of doses to explore the other possible beneficial effects in diabetes mellitus and its molecular mechanism.

Attenuation of Glucose-Induced Myoglobin Glycation and the Formation of Advanced Glycation End Products (AGEs) by (R)-α-Lipoic Acid In Vitro.

High-carbohydrate containing diets have become a precursor to glucose-mediated protein glycation which has been linked to an increase in diabetic and cardiovascular complications. The aim of the present study was to evaluate the protective effect of (R)-α-lipoic acid (ALA) against glucose-induced myoglobin glycation and the formation of advanced glycation end products (AGEs) in vitro. Methods: The effect of ALA on myoglobin glycation was determined via the formation of AGEs fluorescence intensity, iron released from the heme moiety of myoglobin and the level of fructosamine. The extent of glycation-induced myoglobin oxidation was measured via the levels of protein carbonyl and thiol. Results: The results showed that the co-incubation of ALA (1, 2 and 4 mM) with myoglobin (1 mg/mL) and glucose (1 M) significantly decreased the levels of fructosamine, which is directly associated with the decrease in the formation of AGEs. Furthermore, ALA significantly reduced the release of free iron from myoglobin which is attributed to the protection of myoglobin from glucose-induced glycation. The results also demonstrated a significant protective effect of ALA on myoglobin from oxidative damage, as seen from the decreased protein carbonyls and increased protein thiols. Conclusion: The anti-glycation properties of ALA suggest that ALA supplementation may be beneficial in the prevention of AGEs-mediated diabetic and cardiovascular complications.

Gestational impaired glucose tolerance (GIGT)-induced suppression of fetal thyroid secretion: effect on fetal outcome

Introduction: Gestational impaired glucose tolerance (GIGT) is a milder form of gestational diabetes mellitus (GDM), which is often poorly managed. Although, GDM is known to be associated with increased incidence of thyroid dysfunction, no study has been done to study the effect of GIGT on thyroid status and its effect on fetal outcome. Here, we carried out a study to assess thyroid function and glycemic status in both maternal and cord blood of the subjects with GIGT, and to find their association with the fetal outcome.Materials and methods: Women who came to the hospital for safe confinement during 37–40th weeks of gestation were recruited in the study. Based on the 2 hours post prandial blood glucose levels with 75 grams OGTT, done at 24–28 weeks of gestation, all the subjects were stratified into two groups: (1) Cases or GIGT group – women with blood glucose levels between 120 and 140 mg/dl and (2) Controls – women with blood glucose levels of less than 120 mg/dl. Three milliliters of venous blood was collected from mothers and 3 ml of cord blood was collected during delivery. New-borns were assessed for birth weight, head circumference, abdominal circumference, thigh circumference, and crown-heel length. Glycated hemoglobin was carried out using immunoturbidimetry (DiaSys Diagnostic Systems GmbH, Holzheim, Germany) and fructosamine was estimated using dye binding method (Biosystems, Spain). Estimation of total T3 (TT3), free T3 (FT3), total T4 (TT4), free T4 (FT4), and TSH was done by chemiluminescence in Siemens Advia Centaur CP using competitive immunoassay.Results: Although within the normal reference range, GIGT mothers had higher concentration of free and total T4 than controls. Cord fructosamine levels were significantly higher in babies of GIGT mothers than controls, indicating the reflection of maternal hyperglycemia. There was a positive correlation between the maternal glycated hemoglobin and cord blood fructosamine in the GIGT group. Statistically significant lower levels of total T3 and T4 with high TSH levels were found in babies with GIGT mothers, indicating the suppressive effect of maternal hyperglycemia on fetal thyroid function. Birth weight, head circumference, and thigh circumference were significantly higher in babies born to mothers with GIGT, which may be a combined effect of maternal hyperglycemia and fetal thyroid suppression.Conclusions: Maternal hyperglycemia, even in milder form of GIGT may cause suppression of fetal thyroid function. Both these factors may predispose to change in fetal anthropometry, leading to a large baby. Therefore, it is recommended to evaluate maternal and cord thyroid function for timely management strategies.

(R)-\u03b1-Lipoic acid inhibits fructose-induced myoglobin fructation and the formation of advanced glycation end products (AGEs) in vitro

BackgroundFructose-mediated protein glycation (fructation) has been linked to an increase in diabetic and cardiovascular complications due to over consumption of high-fructose containing diets in recent times. The objective of the present study is to evaluate the protective effect of (R)-α-lipoic acid (ALA) against fructose-induced myoglobin fructation and the formation of advanced glycation end products (AGEs) in vitro.MethodsThe anti-glycation activity of ALA was determined using the formation of AGEs fluorescence intensity, iron released from the heme moiety of myoglobin and the level of fructosamine. The fructation-induced myoglobin oxidation was examined using the level of protein carbonyl content and thiol group estimation.ResultsThe results showed that co-incubation of myoglobin (1 mg/mL), fructose (1 M) and ALA (1, 2 and 4 mM) significantly inhibited the formation of AGEs during the 30 day study period. ALA markedly decreased the levels of fructosamine, which is directly associated with the reduction of AGEs formation. Furthermore, ALA significantly reduced free iron release from myoglobin which is attributed to the protection of myoglobin from fructose-induced glycation. The results also demonstrated a significant protective effect of ALA on myoglobin oxidative damages, as seen from decreased protein carbonyl content and increased protein thiols.ConclusionThese findings provide new insights into the anti-glycation properties of ALA and emphasize that ALA supplementation is beneficial in the prevention of AGEs-mediated diabetic and cardiovascular complications.