Blood Glucose Levels Research Articles

PITUITARY STALK INTERRUPTION SYNDROME REVEALED BY SEVERE AND PERSISTENT NEONATAL HYPOGLYCEMIA

We present the case of a newborn who exhibited severe and persistent neonatal hypoglycemia without any apparent risk factors. The persistence of profound hypoglycemia, measured at 0.22 mmol/L, prompted an extensive biological workup that revealed a significant decrease of several pituitary hormones. The diagnosis of pituitary stalk interruption syndrome (PSIS) was confirmed by magnetic resonance imaging (MRI), which showed a complete interruption of the pituitary stalk. Prompt initiation of replacement therapy led to a notable clinical improvement and stabilization of blood glucose levels, thereby minimizing the risk of further hypoglycemic episodes.This case underscores the importance of broadening the etiological investigation in cases of persistent hypoglycemia without an obvious context, as hypoglycemia can be the sole clinical manifestation of PSIS. This congenital developmental anomaly of the pituitary gland represents a diagnostic emergency, and the prognosis is highly dependent on the prompt implementation of hormonal replacement therapy.

Modified streptozotocin-induced diabetic model in rodents.

Streptozotocin (STZ)-induced type I diabetes mellitus (DM) models have been pivotal in diabetes research due to their ability to mimic the insulin-dependent hyperglycemia akin to human type I diabetes. However, these models often suffer from poor induction rates and low survival post-STZ induction, especially in long-term experiments, necessitating insulin supplementation, which introduces additional variables to experiments. To address this, we present a novel modification to the STZ-induced DM model in C57BL/6J mice to improve survival rates without insulin supplementation. Our method involves non-fasting, low-dose STZ injections dissolved in pH-neutral phosphate buffer saline instead of acidic sodium citrate buffer, administered over 5 days. We observed hyperglycemia induction in 94.28% of mice within a week post-injection, with stable high blood glucose levels, stable body weight, and minimal mortality up to 21 weeks. Notably, omitting 10% sucrose in water and fasting did not affect hyperglycemia induction. Our findings suggest that the modified protocol not only decreases the experimental effort of the researchers, but reduces animal stress and mortality, thus enhancing experimental outcomes and animal welfare. By optimizing the STZ-induced DM model in C57BL/6J mice, our study provides a valuable resource for researchers aiming to study diabetes and its complications while minimizing experimental variability and animal usage.

The Effect of Sociodemographic Characteristics on The Lifestyle Among Type 2 Diabetic Patients in Mosul City

Introduction: Diabetes Mellitus is a condition that causes persistently increased blood glucose levels in the body. It is the second leading cause of years spent disabled globally and is a major cause of death with high mortality rates. Objective: To identify the effect of sociodemographic characteristics on the lifestyle among type 2 diabetes mellitus in Mosul City. Methods and materials: A non-experimental cross-sectional study design was implemented on a total of 400 Type II Diabetic Patients who make periodic visits to Al-Wafaa Specialized Centre for Diabetes and Endocrinology by A non-probability sample. A developed interviewing questionnaire was used to collect information related to sociodemographic, and lifestyle was assessed by using HPLP-II, from October 15th, 2023, to June 1st, 2024. The collected data were compiled and analysed using percentages, mean, standard deviation, minimum, maximum, Spearman’s Correlation and Chi Square using SPSS version 26. P values of 0.05 were used as a cut-off point for the significance of the statistical test. Results: Majority of participants were female, reside in urban areas, married, unable to read and write, unemployed and never smoked (52.3%, 78.7%, 79.0%, 29.7%, 57.4%, and 44.2%) respectively. In addition to that, there was a significant correlation between the sociodemographic characteristics and lifestyle among the participants. The patients scored highest in the interpersonal relations and scored lowest in the physical activity factors. Finally, most of the patients practiced health-promoting lifestyle pattern moderately (63.5%). Conclusions: The study showed that, there is a significant correlation between lifestyle and sociodemographic characteristics of the study participants.

The Glycemic Index of Gayam (Inocarpus fagifer Forst) Cookies as a High Dietary Fiber Food

The type 2 diabetes (T2D) is still one of the world's public health problems. It needs serious handling and prevention efforts in the nutritional aspect. The high prevalence of T2D is related to the low intake of dietary fiber. This type of food has a low glycemic index (GI). Gayam is a high-dietary fiber material that can be used for the manufacture of flour and as processed food material for the high-dietary fiber cookies. The objectives of this research were to study the GI evaluation of cookies from gayam flour. Cookies were tested for chemical composition, and glycemic index. The glycemic index evaluation test used 12 volunteers taken from the healthy group/nondiabetic, normal nutritional status (BMI: 18.5-22.9), and age 19-55 years. The results of this study indicate the dietary fiber content of gayam cookies was 4.57 g/100 g and included in the category of high dietary fiber food. The glycemic index of gayam cookies was 43 and the low glycemic index category. The obtained results show for the first time the potential of gayam cookies in hyperglycaemia management. The conclusion of this study was that gayam cookies has high dietary fiber content and low GI level. Gayam cookies can be used as an alternative snack to control blood glucose levels in the prevention of diabetes mellitus.

Body weight training versus series 7 diabetes dance: their influence on glucose levels in patients with type 2 diabetes mellitus

Managing blood glucose levels is critical for preventing complications associated with type 2 diabetes mellitus (T2DM). Physical activity has been shown to be an effective strategy for glucose control, with various forms of exercise yielding different results. This research aims to explore the effects of body weight training and series 7 diabetes dance on reducing blood glucose levels in patients with T2DM, and to compare the efficacy of these two interventions in achieving glucose control. The type of research was a quasi-experiment with a two groups pre-test post-test design. The series 7 diabetes dance group performed the exercise 4 times a week (duration: 170 minutes 8 seconds/week), while the body weight training group performed exercise 3 times a week (8 movements, number of repetitions close to failure, circuit system, 3 sets per training session). Both groups were doing an exercise program for three months. The research sample was for about 16 patients of type 2 diabetes mellitus (8 people per group, devided randomly), taken by using non probability sampling technique, purposive sampling type (effect size 1.6, significant level (α) 0.05 and Power 0.8). The data analysis used the paired sample t test and the independent t test with a significance level of α = 0.05.The results showed that 1) there is no significant effect of series 7 diabetes dance towards the decreasing the level of blood sugar of the patients with type 2 diabetes mellitus), 2) there is a significant effect of body weight training towards the decreasing level of blood glucose of the patients with type 2 diabetes mellitus, 3) dody weight training is more effective in decreasing the level of blood glucose of patients with type 2 diabetes mellitus compared to series 7 diabetes dance. Future research must be carried out as a true experiment with a larger number of samples and with the HbA1c research instrument.

Effect of Single Low-Dose Dexamethasone on Peri-operative Blood Glucose Levels

Background: Post-operative nausea and vomiting (PONV) is the second most common complaint reported after surgery with an incidence of 30%-80%. PONV is associated with numerous morbidities, hence prevention is beneficial. Dexamethasone is used as a prophylactic anti-emetic agent, however, being a corticosteroid, it could cause hyperglycaemia which is associated with a number of other adverse effects. Objectives: To study the effect of a single low-dose intravenous dexamethasone given as a prophylactic anti-emetic agent on perioperative blood glucose levels. Methods: Eighty-eight women who had elective myomectomy or hysterectomy under combined spinal-epidural (CSE) anaesthesia were randomised into two groups of 44 each. Following baseline blood glucose estimation, one group had 4 mg (1 ml) of intravenous dexamethasone 1-2 seconds after blood glucose check while the control group had 1 ml of normal saline. Blood glucose was measured every hour intra-operatively and two-hourly post-operatively till 12 hours after drug administration. Nausea, vomiting, dyspepsia, pain, motor block duration and urinary output were assessed hourly. Results: The mean maximum change in blood glucose from baseline in the dexamethasone group was statistically significantly higher than in the control group, 51.00±26.57 mg/dl vs. 35.80±25.71 mg/dl (p = 0.007) so also was the mean maximum blood glucose, 153.93±31.63 mg/dl vs. 139.52±28.95 mg/dl (p = 0.028) respectively. Conclusion: Intravenous dexamethasone at a single, low-dose (4 mg) used as a prophylaxis for nausea and vomiting is associated with significant increase in blood glucose concentration.

Development of a T2D App for Elderly Users: Participatory Design Study via Heuristic Evaluation and Usability Testing

Diabetes management applications effectively help patients monitor blood glucose levels and adjust diet and exercise plans. However, most diabetes management apps, including the SugarShift application developed in 2023, use generalized designs that often fail to consider the unique cognitive and physiological characteristics of elderly users, thereby impacting their acceptance and usage. This paper proposes an enhancement for the SugarShift application by introducing a mode specifically designed for elderly users. This proposed enhancement aims to directly involve elderly patients so as to meet their needs better through a participatory design approach. A heuristic evaluation conducted with six experts identified 126 usability issues and 179 heuristic violations in the current version, which has led to the recommendation to develop optimization strategies tailored for elderly users. Subsequent usability testing with 28 elderly patients and six experts emphasized the importance of interface simplicity, logical operation, and interaction quality in enhancing user experience. These factors improve usability, facilitate information processing, and reduce cognitive load. Despite the overall usability of SUS scores, significant challenges still need to be addressed in information display, system feedback, and user interaction. Recommendations for future enhancements include simplifying data entry and presentation, improving readability, and providing timely feedback to enhance usability and user satisfaction, ultimately increasing user retention.

Retinal microcirculation changes in prediabetic patients with short-term increased blood glucose using optical coherence tomography angiography.

Retinal microcirculation alterations are early indicators of diabetic microvascular complications. Optical coherence tomography angiography (OCTA) is a noninvasive method to assess these changes. This study analyzes changes in retinal microcirculation in prediabetic patients during short-term increases in blood glucose using OCTA. To investigate the changes in retinal microcirculation in prediabetic patients experiencing short-term increases in blood glucose levels using OCTA. Fifty volunteers were divided into three groups: Group 1 [impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)], Group 2 (both IFG and IGT), and a control group. Retinal microcirculation parameters, including vessel density (VD), perfusion density (PD), and foveal avascular zone (FAZ) metrics, were measured using OCTA. Correlations between these parameters and blood glucose levels were analyzed in both the fasting and postprandial states. One hour after glucose intake, the central VD (P = 0.023), central PD (P = 0.026), and parafoveal PD (P < 0.001) were significantly greater in the control group than in the fasting group. In Group 1, parafoveal PD (P < 0.001) and FAZ circularity (P = 0.023) also increased one hour after glucose intake. However, no significant changes were observed in the retinal microcirculation parameters of Group 2 before or after glucose intake (P > 0.05). Compared with the control group, Group 1 had a larger FAZ area (P = 0.032) and perimeter (P = 0.018), whereas Group 2 had no significant differences in retinal microcirculation parameters compared with the control group (P > 0.05). Compared with Group 1, Group 2 had greater central VD (P = 0.013) and PD (P = 0.008) and a smaller FAZ area (P = 0.012) and perimeter (P = 0.010). One hour after glucose intake, Group 1 had a larger FAZ area (P = 0.044) and perimeter (P = 0.038) than did the control group, whereas Group 2 showed no significant differences in retinal microcirculation parameters compared with the control group (P > 0.05). Group 2 had greater central VD (P = 0.042) and PD (P = 0.022) and a smaller FAZ area (P = 0.015) and perimeter (P = 0.016) than Group 1. At fasting, central PD was significantly positively correlated with blood glucose levels (P = 0.044), whereas no significant correlations were found between blood glucose levels and OCTA parameters one hour after glucose intake. A short-term increase in blood glucose has a more pronounced effect on retinal microcirculation in prediabetic patients with either IFG or IGT.

Diminished light sensitivities of ON alpha retinal ganglion cells observed in a mouse model of hyperglycemia

This study aimed to investigate potential functional changes in retinal ganglion cells (RGCs) in a mouse model of hyperglycemia and explore possible therapeutic approaches. Hyperglycemia resembling type 1 diabetes mellitus (DM) was induced in C57BL/6 mice through intraperitoneal injection of streptozotocin (STZ). Blood glucose levels were confirmed to be elevated after 1 week and 4 weeks of injection. Mice with blood glucose levels above 350 mg/mL after 4 weeks of one-dose STZ injection were considered hyperglycemic. The light sensitivity of ON alpha (α) retinal ganglion cells (RGCs), not OFF αRGCs, was reduced in the hyperglycemic mouse model. The number of apoptotic cells, RGCs, and amacrine cells (ACs) remained unaffected at this stage. Similarly, the eletroretinogram (ERG) and optokinetic test results showed no significant differences. The application of picrotoxin (PTX) to block GABA receptors could increase the light sensitivity of ON αRGCs by 1 log unit in hyperglycemic mice. The results show that ON αRGCs may be more susceptible to microenvironmental changes caused by hyperglycemia than OFF αRGCs. This decline in light sensitivity may occur before cell apoptosis during the early stages of the hyperglycemic mouse model but has the potential to be reversed.

Common Hyperglycemia Susceptibility Loci in Metabolic Syndrome Patients from Karachi, Pakistan: A Cross Sectional Study

Background: More than 75 genetic susceptibility loci have been implicated with hyperglycemia. SNPs in genes linked with satiety, insulin sensitivity, BMR (Adiponectin, FTO, and MC4R), and inflammation and autoimmunity (TNF-a) have been shown to have a relationship with metabolic syndrome. Objectives: To measure the frequency of ADIPOQ, FTO, MCR4, and TNF SNPs in metabolic syndrome patients and controls, and to assess the association of these with hyperglycemia and adiposity status. Methods: A cross-sectional study was conducted. Baseline investigations including lipid profiles, blood glucose levels, and BMI calculation were conducted for n=113 Metabolic Syndrome and n=47 healthy controls. Tetra ARMS PCR and gel electrophoresis were conducted for Adiponectin rs266729, Adiponectin rs1501299, FTO rs9939609, MCR4 rs1297013, and TNF rs1800629. Statistical analysis was performed using SPSS version 26. Results: Difference was observed in lipid profiles (including LDL, triglycerides, and cholesterol but not HDL), body fat percentage (p= 0.034), and both fasting (p=0.000) and random (p=0.000) blood glucose levels among metabolic syndrome patients versus controls. Adiponectin rs1501299, FTO rs9939609, and MCR4 rs1297013 showed genotype frequency differences between groups. Spearman’s correlation was applied to test any association of risk allele with study variables and MCR4 rs1297013 showed an independent association with Fasting Blood Glucose Level (r=0.238; p=0.024) irrespective of age, weight, or gender. Conclusion: MCR4 rs1297013 polymorphism is an independent risk factor leading to hyperglycemia in the study population, however, no other SNPs were identified to carry a significant risk. Large-scale genome-wide studies are required to identify the unique set of risk genes for the Pakistani population

Implementasi Senam Kaki Untuk Menurunkan Kadar Gula Darah pada Penderita Diabetes Melitus Tipe 2 di Rumah Sakit Tentaratk Iv 01.07.01 Pematangsiantar

Diabetes is a chronic metabolic disease characterized by increased blood glucose levels, which over time causes serious damage to the heart, blood vessels, eyes, kidneys and nerves. The aim of this study is to describe nursing care in the application of foot exercises to reduce blood sugar levels in patients with type 2 diabetes mellitus. Diabetes is a chronic metabolic disease characterized by elevated blood glucose levels, which over time causes serious damage to the heart, blood vessels, eyes, kidneys and nerves. The aim of this study is to describe nursing care in the application of foot exercises to reduce blood sugar levels in patients with type 2 diabetes mellitus. leg exercises can reduce blood sugar levels. The application of foot exercises can reduce blood sugar levels in type 2 diabetes mellitus patients.

Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Obesity and Blood Glucose Level Regarding Their Association with Metabolic Health in Adults

Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Obesity and Blood Glucose Level Regarding Their Association with Metabolic Health in Adults

A Performance Analysis of RNN Algorithms for Accurate Hypoglycemia Prediction in Type-1 Diabetes

Diabetes is a chronic disease originating from preeminent blood glucose levels where there is an impairment in the ability of the human body to produce or effectively use insulin, therefore resulting in possible complications to various organ systems. Hypoglycemia can be defined as a critical condition in diabetes that is characterized by very low levels of blood sugar and can emanate from any imbalance between insulin, glucose, and external factors such as medication or physical activity. The prediction of hypoglycemia is a very important task in diabetes management, which encompasses sophisticated technologies and deep-learning systems, such as RNNs, in performing analyses on patient-specific data. These must provide timely warnings to avoid hazardous blood sugar dips. This paper takes a close look at the performance of RNN in the case of accurate hypoglycemia prediction among patients with Type-1 Diabetes, considering a dataset from Shanghai T1DM. In this work, three different RNN architectures are considered for performance evaluation: Long-Short-Term Memory (LSTM), Gated Recurrent Unit (GRU), and Simple RNN. The main goal was to compare their predictive performances in forecasting hypoglycemic events, which is an issue of utmost relevance when it comes to proactive diabetes management. The results show generally variable performances by the RNN models. Overall, GRU performed with striking accuracy in hypoglycemia predictions, while LSTM had high specificity. These findings underline that various metrics should be considered for the comprehensive evaluation of predictive models in the management of diabetes. It will give an idea about various RNN algorithms, strengths, and weaknesses to develop more effective and personalized strategies related to hypoglycemia prediction in Type-1 Diabetes.

Is It Time for a New Algorithm for the Pharmacotherapy of Steroid-Induced Diabetes?

Glucocorticoids (GS) are widely used in multiple medical indications due to their anti-inflammatory, immunosuppressive, and antiproliferative effects. Despite their effectiveness in treating respiratory, skin, joint, renal, and neoplastic diseases, they dysregulate glucose metabolism, leading to steroid-induced diabetes (SID) or a significant increase of glycemia in people with previously diagnosed diabetes. The risk of adverse event development depends on the prior therapy, the duration of the treatment, the form of the drug, and individual factors, i.e., BMI, genetics, and age. Unfortunately, SID and steroid-induced hyperglycemia (SIH) are often overlooked, because the fasting blood glucose level, which is the most commonly used diagnostic test, is insufficient for excluding both conditions. The appropriate control of post-steroid hyperglycemia remains a major challenge in everyday clinical practice. Recently, the most frequently used antidiabetic strategies have been insulin therapy with isophane insulin or multiple injections in the basal-bolus regimen. Alternatively, in patients with lower glycemia, sulphonylureas or glinides were used. Taking into account the pathogenesis of post-steroid-induced hyperglycemia, the initiation of therapy with glucagon-like peptide 1 (GLP-1) analogs and dipeptidyl peptidase 4 (DPP-4) inhibitors should be considered. In this article, we present a universal practical diagnostic algorithm of SID/SIH in patients requiring steroids, in both acute and chronic conditions, and we present a new pharmacotherapy algorithm taking into account the use of all currently available antidiabetic drugs.

Intestinal Motility Dysfunction in Goto-Kakizaki Rats: Role of the Myenteric Plexus.

The morpho-quantitative analysis of myenteric plexus neurons in the small and large intestines of 120-day-old male GK rats was investigated. The diabetes was confirmed by high fasting blood glucose levels. The myenteric plexus was evaluated through wholemount immunofluorescence. The morpho-quantitative analyses included evaluating neuronal density (neurons per ganglion) of the total neuronal population, the cholinergic and nitrergic subpopulations, and enteric glial cells per ganglion. The cell body area of 100 neurons per segment per animal was measured. The total neurons and nitrergic subpopulation were unaltered in the GK rats' small and large intestines. The cholinergic subpopulation exhibited decreased density in the three segments of the small intestine and an increased number in the proximal colon of the GK rats. The number of enteric glial cells increased in the ileum of the GK rats, which could indicate enteric gliosis caused by the intestinal inflammatory state. The area of the cell body was increased in the total neuronal population of the jejunum and ileum of the GK rats. Frequency histograms of the cell body area distribution revealed the contribution of cholinergic neurons to larger areas in the jejunum and nitrergic neurons in the ileum. The constipation previously reported in GK rats might be explained by the decrease in the density of cholinergic neurons in the small intestine of this animal model.

High levels of blood lipid and glucose predict adverse prognosis in patients with aneurysmal subarachnoid hemorrhage

ObjectiveWe conducted a retrospective study on the prognostic factors of aneurysmal subarachnoid hemorrhage (aSAH) patients in the author's Hospital from January 2019 to May 2023. To discuss the association of the blood lipid and glucose levels of patients with the prognosis of aSAH, and verify that high blood lipid and glucose levels are important factors affecting adverse prognosis. MethodsAll patients with aSAH were collected as the case group, which was divided into two groups according to the modified Rankin Scores (mRS), the good prognosis group (Group A, mRS ＜ 3) and the adverse prognosis group (Group B,mRS ≥3). The clinical data of age, gender, accompanied chronic diseases (hypertension, diabetes), smoking, drinking, Glasgow Coma Scale (GCS), Hunt-Hess (H-H) grade, Modified Fisher grade, total cholesterol (TC) , triglyceride (TG) , high-density cholesterol lipoprotein (HDL-C) , low-density cholesterol lipoprotein (LDL-C) , blood glucose (BG) , responsible aneurysm diameter and location were recorded too. Correlations between blood lipid and glucose levels and Modified Fisher grade were assessed by the Spearman correlation analysis. The receiver operating characteristic (ROC) curve was utilized to evaluate the diagnostic efficacy. The effect of blood lipid and glucose levels on adverse prognosis was analyzed by Logistic regression models. ResultA total of 259 patients with aSAH were enrolled. The average age of all patients is (56.54 ± 10.52) years, including 96 males and 163 females. They were divided into Group A (n = 146) and Group B (n = 113). Univariate analysis results show that age, the levels of TC, TG, LDL-C, and BG were higher in Group B (P < 0.05). Besides, Group B had more severe GCS, H-H grade, and Modified Fisher grade than Group A, and a higher proportion of intracranial aneurysms with larger diameter (P < 0.05). Correlation analysis showed that TC, TG, LDL-C, and BG levels were positively correlated with Modified Fisher grade (P < 0.05) and H-H grade (P < 0.05). Multivariate logistic regression model analysis showed that high level of Modified Fisher grade (OR = 0.079, 95%CI: 0.027–0.230) , high level of H-H grade (OR = 0.204, 95%CI: 0.067–0.622) , TC (OR = 10.711, 95%CI: 2.457–46.700) , LDL-C (OR = 0.178, 95%CI: 0.039–0.823) and BG (OR = 1.273, 95%CI: 1.012–1.602) increased the risk of adverse prognosis. The AUC of “H-H grade”, “Modified Fisher grade”, “TC level”, “LDL-C level” and “BG level” was 0.822, 0.885, 0.860, 0.772, and 0.721, respectively, in the ROC curve. ConclusionModified Fisher grade, H-H grade, TC, LDL-C, and BG levels at admission were independent predictors of adverse prognosis of aSAH. Besides, TC, LDL-C, and BG levels were positively correlated with Modified Fisher grade and Hunt-Hess grade. What's more, high levels of TC, LDL-C, and BG combined with Modified Fisher grade and H-H grade can identify high-risk groups with adverse prognoses in aSAH patients.

Secondary diabetes mellitus in acromegaly: Case report and literature review.

Acromegaly, predominantly resulting from a pituitary adenoma, is marked by excessive secretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). However, normalization of blood glucose levels posttreatment is rarely achieved. This case study aims to highlight the diagnostic challenges posed by overlapping symptoms of acromegaly and diabetes, emphasizing the importance of precise diagnosis and effective treatment strategies for optimal patient outcomes. A 22-year-old male was hospitalized for diabetic ketoacidosis and exhibited classic signs of acromegaly, such as enlarged hands and feet, and distinct facial changes. The patient's diagnosis of acromegaly, attributed to a pituitary adenoma, was confirmed through clinical observations, laboratory findings (notably raised serum GH and IGF-1 levels, and absence of GH suppression after glucose load during an OGTT), and pituitary MRI scans. The patient underwent 2 surgical tumor resections followed by gamma knife radiosurgery (GKRS). After treatment, GH, IGF-1, and blood glucose levels normalized without further need for hypoglycemic intervention. Posttreatment, the patient achieved stable GH, IGF-1, and blood glucose levels. The hyperglycemia was attributed to the GH-secreting tumor, and its resolution followed the tumor's removal. This case emphasizes the need for comprehensive assessment in patients with acromegaly to address coexisting diabetic complications. Surgical and radiotherapeutic management of acromegaly can lead to significant metabolic improvements, highlighting the importance of interdisciplinary care in managing these complex cases.

GLP-1 receptor agonist-induced diabetic ketoacidosis: A case report.

Glucagon-like peptide-1 is an endogenous incretin that plays an active role in weight loss and hypoglycemia. Dulaglutide is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), which has been approved for the treatment of patients with type 2 diabetes (T2D). GLP-1RAs can increase insulin secretion and inhibit glucagon release, thereby leading to a decrease in blood glucose levels within the body. Specifically, GLP-1RAs control postprandial blood glucose levels by inhibiting hepatic glucose production and delaying gastric emptying. However, attention should be given to gastrointestinal adverse reactions. There are currently a few cases of GLP-1RA causing diabetic ketoacidosis (DKA). The following report details the case of a 50-year-old Chinese female who has been living with diabetes for 12 years. Initially diagnosed with T2D, she was subsequently identified as a patient with latent autoimmune diabetes in adults (LADA) following treatment. The patient presented severe nausea, vomiting, and fatigue 1 day after injecting dulaglutide 1 time and discontinuing insulin therapy. She was diagnosed with severe DKA in the emergency department. LADA and DKA. Changed from dulaglutide to insulin therapy. After discontinuing dulaglutide and switching to insulin for blood glucose reduction, the patient's DKA was corrected, and blood glucose levels returned to normal. This case suggests that clinicians should be alert to patients with severe DKA in cases of severe gastrointestinal adverse reactions after the use of GLP-1RAs. In addition, in most countries, GLP-1RAs are administered to patients with T2D, but we should consider the use of GLP-1RAs in patients with type 1 diabetes and LADA.

Exhaustive computational studies on pyrimidine derivatives as GPR119 agonist for the development of compounds against NIDDM

BackgroundType-2 Diabetes (T2DM) is a long-term medical disorder characterized by Insulin deficiency and high blood glucose levels. Among other medications to cure T2DM, the review of the literature found that various Pyrimidine derivatives act as an agonist for G-protein-coupled receptor 119 (GPR119) was proposed to control blood glucose levels by enhancing the function of pancreatic Beta-cells and its mechanism of action with fewer adverse effects. In the present research work, In-silico investigations were carried out to investigate the potential of the Pyrimidine analog as an agonist to the protein target GPR119 receptor. We performed exhaustive molecular modeling and protein modeling methodologies such as homology modeling, and molecular docking along with various drug designing tools such as 3D-QSAR and Pharmacophore Mapping to ascertain the design of better GPR119 agonists.ResultsBased on in-depth computational studies, we designed new pyrimidine moiety and analyzed them for GPR119 receptor agonist and further explored the ADMET properties. Designed compounds were found to exhibit better-predicted activities as compared to reference compound.ConclusionsThe current research on pyrimidine derivatives, using molecular docking, 3D-QSAR and Pharmacophore mapping demonstrated that the obtained computational model has significant properties and the designed molecules and Dataset from this model, produced antidiabetic compound against the target GPR119 i.e., compound 1S, 1Z and 1D with the docking score of − 11.696, − 9.314 and − 8.721, respectively. The pharmacokinetics and drug-likeness studies revealed that these compounds may be the future candidates for the treatment of diabetes acting via the GPR119 agonist mechanism.

Chondroitin Sulfate from Halaelurus burgeri Skin Inhibits Hepatic Endoplasmic Reticulum Stress and Inflammation, and Regulates Gut Microbiota.

Previous study has demonstrated the chemical structure of chondroitin sulfate (CHS) from Halaelurus burgeri skin and its effects on insulin resistance. However, the precise impact of this phenomenon on endoplasmic reticulum (ER) stress and inflammation, which contribute to insulin resistance, remains unclear. This study is to investigate the impact of CHS on ER stress, inflammatory response and signaling, and gut microbiota in high-fat diet (HFD)-fed mice. HFD-fed C57BL/6J mice receive dietary gavage intervention of CHS for 18 weeks. Blood, liver tissue, and feces are harvested for further investigation. Results show that CHS inhibits ER stress, accompanied by lowered blood glucose, nitric oxide (NO), reactive oxygen (ROS), and free fatty acids (FFA) levels, and increases hepatic glycogen accumulation. Moreover, hepatic inflammation is improved by CHS treatment via inactivation of Toll-like receptor 4 (TLR4) signaling and its downstream c-jun N-terminal kinase (JNK) and nuclear factor kappa B (NFκB) pathways. Additionally, CHS regulates gut microbiota, particularly the decline in the Firmicutes to Bacteroidetes ratio. CHS also lowers fecal lipopolysaccharide and elevates several fecal short chain fatty acids. These findings suggest that CHS from H. burgeri skin may be an alternative functional food supplement for anti-ER stress, anti-inflammtion, and regulation of gut microbiota.