Fasting Glucose Levels Research Articles

Fasting glucose levels at diagnosis and delivery are associated with postpartum glucose abnormalities in GDM women.

Women with a history of gestational diabetes mellitus (GDM) significantly increase the risk of developing type 2 diabetes later in life. Although the increased glucose levels typically return to normal range after delivery for most GDM women, a significant proportion of GDM women develop impaired glucose tolerance or overt diabetes after delivery. Several factors associated with postpartum glucose abnormalities have been identified, yet the link between fasting glucose levels at diagnosis of GDM and postpartum glucose abnormalities remains unclear. In this retrospective study with 866 GDM women, we found that 12.5% presented with abnormal postpartum fasting glucose levels (prediabetes). Among those with postpartum fasting glucose abnormalities (n = 109), 63 (57%) women had abnormal fasting glucose levels at diagnosis, indicating an odds ratio of 1.662 (95% CI: 1.12, 2.479, p < 0.001) for these GDM women developing postpartum fasting glucose abnormalities, compared to those GDM women with normal postpartum fasting glucose levels. Additionally, of GDM women with abnormal postpartum glucose levels (n = 109),70 (64%) presented with abnormal fasting glucose levels one day before delivery. The odds ratio for these GDM women presenting with abnormal postpartum fasting glucose levels was 3.751 (95% CI: 2.462, 5.664, p < 0.001) compared to those GDM women with normal postpartum fasting glucose levels. Furthermore, GDM women with additional insulin treatment or delivered an LGA infant significantly increased the risk of developing postpartum fasting glucose abnormalities. Our findings suggest that abnormal fasting glucose levels at diagnosis or shortly before delivery could be a predictive indicator for postpartum glucose abnormalities in GDM women.

Access to high-fat diet results in increased sensitivity to the psychostimulant effects of MDPV in mice.

The current study investigated the effects of high-fat diet on acute response to 3,4-methylenedioxypyrovalerone (MDPV) in mice. MDPV is a beta-cathinone derivative endowed with psychostimulant activity. Similarly to recreational substances, consumption of palatable food stimulates the mesolimbic dopaminergic system, resulting in neuroadaptive changes. Adolescent C57BL/6N mice were fed either control diet (CD), 10% of kcal from fat, or high-fat diet (HFD), 60% of kcal from fat. After eight weeks, one group of HFD-fed mice had their diet changed to CD for an additional two weeks. Fasting glucose levels and glucose tolerance were measured to detect impairment in glucose metabolism. Subsequently, the mice were treated with either MDPV (1mg/kg) or saline, and their locomotor activity was measured. Using reverse transcriptase quantitative polymerase chain reaction (RT-qPCR), the expression of dopamine receptor D1 (Drd1), dopamine receptor D2 (Drd2), and FBJ osteosarcoma oncogene B (FosB) genes was measured in the striatum of mice. Feeding with HFD caused obesity and glucose intolerance in mice. Restriction of fat reduced body mass and reversed impairment of glucose metabolism. HFD-fed mice responded to MDPV with higher potency than CD-fed counterparts, with an increased incidence of stereotypies. A change of diet partially reversed this effect. Downregulation of Drd2 was observed in the mice that switched from HFD to CD, whereas treatment with MDPV caused upregulation of FosB only in the CD-fed mice. Current results suggest that obesity may increase sensitivity to psychostimulant effects of MDPV and elevate the risk of addiction as mice fed with HFD responded to acute treatment with MDPV with higher potency and showed tolerance of FosB induction in response to the drug.

P-28 A CASE OF MODY TYPE 9 WITH C.89T&amp;gt;C MUTATION IN PAX4 GENE

Abstract Introduction Maturity-onset diabetes (MODY) is a rare type of diabetes mellitus (DM) with autosomal dominant inheritance that occurs at a young age, constituting 1-2% of all DM cases. Most MODY cases are misdiagnosed as type 1 or type 2 DM. MODY9 is a rare type caused by a mutation in the Paired box gene 4 (PAX4). We aimed to present a case that had been followed for eight years, initially diagnosed as type 1 DM, but later diagnosed with MODY type 9 after a PAX4 gene mutation was detected as a result of genetic analysis. Clinical Case A 23-year-old male patient had been followed up for eight years with a diagnosis of type 1 DM. In the evaluation, his body mass index was normal, fasting glucose level was 143 mg/dl, HbA1c was 9.5%, C peptide level was 607 pmol/L (370-1470 pmol/L), low-density lipoprotein was 112 mg/dl, and triglyceride was 60 mg/dl. He did not show signs of diabetic neuropathy or retinopathy and had no history of hospitalization due to diabetic ketoacidosis. His father also had DM. Because the patient was diagnosed at a young age, type 1 DM was accepted without checking insulin autoantibodies at the time of diagnosis, and intensive insulin therapy was started. Due to the patient's age, normal body mass index, normal C peptide level, family history and genetic evaluation was requested for monogenic diabetes diseases. As a result of the analysis performed in the patient's genetic laboratory, the C.89T&amp;gt;C missense variant in the PAX4 gene was detected. As a result of clinical findings and gene analysis, the patient was diagnosed with MODY type 9. Conclusion PAX4-MODY typically presents between ages 6 to 44 and is more common in men. The severity of diabetes may vary, with some patients experiencing diabetic ketoacidosis (DKA), impaired glucose tolerance, and potential complications such as renal or retinal issues, or end-stage renal failure. Treatment for MODY9 primarily involves a diabetic diet, physical activity, insulin therapy, and possibly oral hypoglycemic agents, tailored to the individual's disease progression.

Baseline Fasting Glucose Level, Age, Sex, and Body Mass Index and the Development of Diabetes in US Adults

Understanding the interplay between diabetes risk factors and diabetes development is important to develop individual, practice, and population-level prevention strategies. To evaluate the progression from normal and impaired fasting glucose levels to diabetes among adults. This retrospective community-based cohort study used data from the Rochester Epidemiology Project, in Olmsted County, Minnesota, on 44 992 individuals with at least 2 fasting plasma glucose (FPG) measurements from January 1, 2005, to December 31, 2017. People who met criteria for diabetes on or before their first FPG measurement were excluded. Data were electronically retrieved in December 2019 with analyses finalized in November 2024. The exposure was baseline FPG level, with covariates including the following measures that are consistently recorded in the electronic health record: body mass index (BMI), age, and sex. The cumulative probability of freedom from diabetes was estimated and presented graphically using a Kaplan-Meier curve. Multivariable Cox proportional hazards regression modeling was used to estimate the partial hazard ratios (HRs) for variables of interest. Diabetes was defined as an FPG level greater than 125 mg/dL. A total of 44 992 individuals (mean [SD] age at baseline, 43.7 [11.8] years; 26 025 women [57.8%]) were included. The baseline mean (SD) BMI was 28.9 (6.6). Over a median follow-up of 6.8 years (IQR, 3.6-9.7 years), 3879 individuals (8.6%) developed diabetes. The Kaplan-Meier 10-year cumulative risk of incident diabetes was 12.8% (95% CI, 12.4%-13.2%). All initial FPG levels outside a range of 80 to 94 mg/dL were associated with increased risk for diabetes (ie, FPG <70 mg/dL: HR, 3.49 [95% CI, 2.19-5.57]; FPG 120-125 mg/dL: HR, 12.47 [10.84-14.34]). Other independent risk factors were male sex (HR, 1.31 [95% CI, 1.22-1.40]), older age (≥60 years: HR, 1.97 [95% CI, 1.71-2.28]), and any abnormal category of BMI, including underweight (BMI <18.5: HR, 2.42 [95% CI, 1.77-3.29]; BMI ≥40: HR, 4.03 [95% CI, 3.56-4.56]). There was a significant additive association of variables, particularly FPG level and BMI. For instance, a woman aged 55 to 59 years with a BMI of 18.5 to 24.9 and an FPG level of 95 to 99 mg/dL had an estimated 10-year diabetes risk of 7.0%. However, an almost doubling of risk to 13.0% was observed if the BMI was 30.0 to 34.9, and risk more than doubled again to 28.0% if FPG level also increased to 105 to 109 mg/dL. A nomogram was generated to facilitate individual classification into one of four 10-year risk categories. This retrospective cohort study of 44 992 individuals suggests that FPG level, age, BMI, and male sex were all associated with development of diabetes, with significant interaction between these variables. These data contribute to understanding the clinical course of diabetes and highlight the substantial individual variation in diabetes risk according to commonly measured clinical variables. The findings facilitate lifestyle and pharmacologic interventions to treat those at highest risk of diabetes to reduce future morbidity and mortality. Further work is needed to validate this risk categorization tool for different populations.

Study on the effects of Mogroside V in inhibiting NLRP3-mediated granulosa cell pyroptosis and insulin resistance to improve PCOS

ObjectivePolycystic Ovary Syndrome (PCOS) is a prevalent endocrinopathy in reproductive-aged women, contributing to 75% of infertility cases due to ovulatory dysfunction. The condition poses significant health and psychological challenges, making the study of its pathogenesis and treatment a research priority. This study investigates the effects of Mogroside V (MV) on PCOS, focusing on its anti-inflammatory and anti-insulin resistance properties.MethodsForty-five female Sprague–Dawley rats were divided into three groups: control, PCOS model, and MV treatment. The PCOS model was induced using a high-fat diet and letrozole. The MV treatment group was subsequently administered MV after the establishment of the PCOS model. The study monitored body mass, assessed estrous cycle changes, and measured serum hormone levels. Transcriptome sequencing and bioinformatics were used to identify differentially expressed genes related to inflammation and insulin resistance. Expression of pyroptosis and insulin resistance markers was analyzed using qRT-PCR, Western blot, and IHC. Additionally, an in vitro model assessed MV's impact on inflammation and insulin resistance.ResultsThe PCOS group exhibited elevated serum testosterone (T), luteinizing hormone (LH), insulin, and fasting glucose levels, along with increased insulin resistance (HOMA-IR) and decreased estradiol (E2), which were reversed by MV treatment. Transcriptome analysis identified significant gene expression changes between groups, particularly in pathways related to NLRP3 inflammation and insulin metabolism. MV treatment normalized the expression of ovarian pyroptosis factors (NLRP3, Caspase-1, GSDMD) and inflammatory cytokines (IL-1β, IL-18). In cellular models, MV increased E2 levels, reduced LDH release, and decreased the expression of insulin resistance and pyroptosis markers. Correlation analysis showed pyroptosis factors were positively correlated with HOMA-IR and IGF1, and negatively with IGF1R and E2 levels.ConclusionMV improves PCOS by reducing pyroptosis and insulin resistance, enhancing insulin sensitivity, and promoting estrogen synthesis, thereby restoring granulosa cell function and follicular development.

Clinical Predictors of Aspirin Resistance in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Aspirin treatment is recommended as a secondary prevention strategy and could be a potential primary prevention strategy for cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM). However, aspirin resistance is notably common among diabetic patients, compromising the efficacy of aspirin treatment. Hence, our study sought to assess the clinical predictors of aspirin resistance (AR) in T2DM patients. We conducted a systematic search of three major medical databases (PubMed, Embase, and Cochrane Library) to identify relevant articles up to September 17, 2024. Details of publications and investigated parameters were extracted from the selected studies. The meta package in the R language software was utilized to synthesize the evidence concerning clinical predictors of AR. We applied either a fixed- or random effects model based on the heterogeneity observed among the included studies. The pooled results were visually displayed using forest plots. In total, 10 publications were finally included in our study (n = 2113 patients). AR was predominantly linked to specific laboratory parameters, particularly those indicative of heightened insulin resistance and inadequate lipid management. Specifically, the laboratory parameters associated with AR included fasting glucose level (mean difference (MD) = 8.21; 95% confidence interval (CI) = 2.55 to 13.88), glycated hemoglobin (MD = 0.22; 95% CI = 0.06 to 0.38), high-density lipoprotein (HDL) level (MD = -2.02; 95% CI = -3.62 to -0.42), low-density lipoprotein (LDL) level (MD = 7.00; 95% CI = 2.87 to 11.13), total cholesterol level (MD = 9.52; 95% CI = 4.37 to 14.67), and triglyceride levels (MD = 12.51; 95% CI = 3.47 to 21.55). Markers associated with dyslipidemia and blood glucose levels are robust indicators of AR in individuals with T2DM. These findings imply that assessing lipid and glucose regulation could enhance the development of personalized preventive approaches for vascular complications linked to diabetes. CRD42023388170, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=388170.

A short-course of low-dose insulin detemir effectively decreases blood glucose levels in gestational diabetic women undergoing dexamethasone treatment to promote newborn lung maturity.

Pregnant women with gestational diabetes mellitus undergoing glucocorticoid treatment to prevent neonatal respiratory distress syndrome could have increased glucose level. We performed a retrospective study and reviewed gestational diabetic women who received an intramuscular dexamethasone injection (6 mg, every 12 hours, 4 times) in our hospital between December 2018 and June 2020. Eligible pregnant women were assigned to the study group (with simultaneous subcutaneous insulin detemir injection, 2-4 units per day) or the control group (without insulin detemir injection). The fasting and 2-hour postprandial blood glucose levels were measured before and on days 1, 2, and 3 after the insulin detemir injection. The changes in their blood glucose levels were compared before and after the drug administrations as well as between the 2 groups. A total of 104 pregnant women were analyzed, including 48 women in the study group and 56 women in the control group. The blood glucose levels increased, with the peak levels occurring on the next day, after the dexamethasone administration in both groups. Compared with the control group, the study group had lower 2-hour postprandial blood glucose levels on days 2 and 3 after the insulin detemir injection (P < .05). There were no statistically significant differences in the fasting blood glucose levels between the 2 groups. Dexamethasone administration increased the blood glucose levels in the pregnant women with gestational diabetes mellitus. A short-course of low-dose insulin detemir administration effectively lowered the blood glucose levels in these women.

Hypomagnesemia in adults with type 2 diabetes mellitus in Riyadh, Saudi Arabia: A cross-sectional study.

This study investigates the prevalence of hypomagnesemia in adults with type 2 diabetes mellitus (T2DM) in Riyadh, Saudi Arabia, and examines its association with various metabolic parameters. Conducted as a cross-sectional study at King Saud University, Riyadh, it included 294 Saudi adults aged 25 to 65 years, comprising 119 T2DM patients, 80 prediabetics, and 95 nondiabetic controls. Participants underwent physical examinations, and fasting blood samples were analyzed for glucose, glycated hemoglobin (HbA1c), lipid profile, and serum magnesium levels. Statistical analysis revealed that lower magnesium levels were significantly more prevalent in T2DM patients (1.65 ± 4.9 mg/L) compared to prediabetes (2.48 ± 5.2 mg/L) and controls (2.9 ± 5.4 mg/L; P < .001). T2DM patients with magnesium deficiency exhibited higher levels of fasting glucose (11.2 ± 3.9 mmol/L), HbA1c (8.6 ± 2.1 mmol/L), and triglycerides (2.1 ± 0.9 mmol/L), along with increased insulin resistance (Homeostatic Model Assessment of Insulin Resistance = 6.6) and decreased insulin sensitivity (Quantitative Insulin Sensitivity Check Index = 0.29). Magnesium levels correlated negatively with glucose (R = -0.58) and HbA1c (R = -0.61). The area under the curve for serum magnesium in predicting HbA1c > 5.7 was 0.88, and for HbA1c ≥ 6.5, it was 0.91, indicating high diagnostic accuracy. These findings suggest that magnesium deficiency significantly impacts the metabolic profile of T2DM patients in Riyadh. Therefore, routine monitoring of magnesium levels is crucial in diabetes management, and further research is needed to explore the benefits of magnesium supplementation in T2DM care.

State of type 2 diabetic Iraqi patients after hospitalization for COVID-19

Background The coronavirus-19 (COVID-19) pandemic, triggered by the severe acute respiratory syndrome coronavirus 2, has affected over 100 million people and killed around 2 million individuals. One of the most common chronic illnesses in the world is diabetes, which greatly raises the risk of hospitalization and death for COVID-19 patients. Objective This study aims to analyze the novel coronavirus's general characteristics and shed light on COVID-19 and its management in diabetic individuals by measuring some metabolic and inflammatory factors in type 2 diabetic patients with and without COVID-19. Methods One hundred Iraqi patients with type 2 diabetes mellitus (T2DM) were enrolled in the current study; 50 had COVID-19 with the Omicron variant, and 50 weren't. The diagnosis was designed by the consultant medical staff at the clinic. Eligible individuals had a positive nasal swab for reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 infection. They were compared with 50 healthy individuals as a control group. Every participant's anthropometric and clinical features were measured. The study includes the study groups’ glycemic, lipid profile, serum urea, and C-reactive protein (CRP) measurements. Results There were remarkable rises ( p &lt; 0.05) in fasting and random blood glucose, serum lipid, and urea levels in diabetic patients with COVID-19 compared to those without COVID-19 and the control group. Also, a significant elevation ( p = 0.01) was found in fasting serum insulin among diabetic patients with COVID-19 as compared to those without COVID-19 and the control group (32.75 ± 8.63 vs. 25.82 ± 3.50 and 10.65 ± 1.12) µU/L, respectively. Serum CRP levels significantly increased ( p = 0.0001) in diabetic patients with COVID-19 compared to other groups. Conclusion Hyperglycemia, hyperinsulinemia, and dyslipidemia resulting from cytokine storm significantly increased the risk of hospitalization and death among coronavirus disease-19 patients. It has been concluded that T2DM reliably predicts morbidity among COVID-19 patients presenting with symptoms suggestive of severe hyperglycemia. The results also show the temporary and reversible deficiency in insulin secretion associated with severe acute respiratory syndrome coronavirus-2 infection. Consequently, it is recommended to examine variables of insulin sensitivity and pancreatic islet activity among patients with COVID-19 who have a history of diabetes.

Current Perspectives of Diabetic Dyslipidemia and Treatment Modalities.

Diabetes mellitus is associated with an increased risk of atherosclerosis related to dyslipidemia. Although the terms hyperlipidemia and Diabetes Mellitus [DM] or diabetic dyslipidemia are interrelated to each other, these two conditions have some differences. This study aimed to highlight possible mechanisms of hyperlipidemia and/or dyslipidemia in diabetic patients, which can be treated with available and newer hypolipidemic drugs. We also re-checked current specific guidelines and their recommendations on the management of patients with diabetic dyslipidemia. Comprehensive search of peer-reviewed journals was performed based on a wide range of keywords, including diabetes mellitus, dyslipidemia, hyperlipidemia, insulin resistance, free-fatty acids, cardiovascular disease, SCORE-2 calculation, statins, PCSK-9 inhibitors, and fibrates. Diabetic patients with dyslipidemia, including decreased HDL cholesterol, a predominance of small dense LDL particles, and increased triglyceride levels, are more prone to suffering from micro and macrovascular complications regardless of plasma fasting glucose levels. Recent guidelines suggested using the validated scoring system called SCORE2-Diabetes. Moderate to high dosages of statins, aiming for LDL cholesterol reduction, is still the cornerstone in the management of diabetic patients with dyslipidemia. Nowadays, other recommended non-statin drugs, including proprotein convertase subtilisin/kexin type 9 [PCSK9] inhibitors or other novel therapeutic agents [bempedoic acid, inclisiran], are particularly important and given place in recently published guidelines. The risk of developing atherosclerotic cardiovascular diseases in people with DM is relatively higher than in patients' without DM. Optimal management of lipid parameters and achieving desired target values in lipid parameters are still a challenging issue for clinicians.

Adjunctive Mantram Repetition Program to Promote Lifestyle Modifications for Managing Impaired Glucose Tolerance: A Case Report from the USA.

We report the case of a 63-year-old man with impaired fasting glucose who was unable to lose weight, engage in exercise or omit refined carbohydrates from his diet until he initiated the Mantram Repetition Program (MRP). Four months following implementation, the patient had lost weight and fasting glucose levels decreased to near normal. These parameters continued to improve at ninemonths. The patient attributed his success to the adjunctive mantram repetition program which also improved his mood and wellbeing. Implementation of the MRP may be a useful adjunct to promote lifestyle changes in patients with mental health diagnoses.

Prevalence of Hypocalcemia in Infants of Mothers with Gestational Diabetes

Objective: To evaluate the prevalence of newborn hypocalcemia among infants of mothers with gestational diabetes. Study Design &amp; Setting: This cross-sectional study was conducted at PNS Shifa Hospital, Karachi, from November 2023 to March 2024 Methodology: Each mother's fasting blood sugar level was evaluated by drawing 5 ml of blood. At 24 hours after delivery, sterile blood samples (2 cc) were taken to determine the neonate's calcium level; a serum calcium level below 7 mg/dl was regarded as hypocalcemia. All information was gathered using a research template that was created in-house. Serum calcium was measured using the Arsenazo III method, and serum albumin was assessed using the bromocresol green (BCG) method. Results: The mean ± S.D. of the maternal age of the study participants was 26.83 ± 3.87 years. The mean ± S.D. of the gestational age of the study participants was 37.35 ± 0.86 weeks. The mean ± S.D. of fasting glucose levels of the study participants was 104.5 ± 15.1 mg/dl. A total of 27.5% of infants born to mothers with gestational diabetes had hypocalcemia. Infants' median Apgar scores at 1 and 5 minutes were 6 and 9, respectively. The prevalence of hypocalcemia in newborns was highest among mothers aged 21–30, though this difference was not statistically significant (p = 0.139). Conclusion: The results showed that 27.5% of infants born to mothers with gestational diabetes had hypocalcemia. Maternal age did not have a statistically significant association with hypocalcemia in newborns.

L-type calcium channel blockade worsens glucose tolerance and β-cell function in C57BL6/J mice exposed to intermittent hypoxia.

Intermittent hypoxemia (IH), a pathophysiologic consequence of obstructive sleep apnea (OSA), adversely affects insulin sensitivity, insulin secretion, and glucose tolerance. Nifedipine, an L-type calcium channel blocker frequently used for the treatment of hypertension, can also impair insulin sensitivity and secretion. However, the cumulative and interactive repercussions of IH and nifedipine on glucose homeostasis have not been previously investigated. Adult male C57BL6/J mice were exposed to either nifedipine or vehicle concurrently with IH or intermittent air (IA) over 5 days. IH exposure entailed cycling fractional-inspired oxygen levels between 0.21 and 0.055 at a rate of 60 events/h. Nifedipine (20 mg/kg/day) or vehicle was administered via subcutaneous osmotic pumps resulting in four groups of mice: IA-vehicle (control), IA-nifedipine, IH-vehicle, and IH-nifedipine. Compared with IA (control), IH increased fasting glucose (mean Δ: 33.0 mg/dL; P < 0.001) and insulin (mean Δ: 0.53 ng/mL; P < 0.001) with nifedipine having no independent effect. Furthermore, glucose tolerance was worse with nifedipine alone, and IH further exacerbated the impairment in glucose disposal (P = 0.013 for interaction). Nifedipine also decreased glucose-stimulated insulin secretion and the insulinogenic index, with addition of IH attenuating those measures further. There were no discernible alterations in insulin biosynthesis/processing, insulin content, or islet morphology. These findings underscore the detrimental impact of IH on insulin sensitivity and glucose tolerance while highlighting that nifedipine exacerbates these disturbances through impaired β-cell function. Consequently, cautious use of L-type calcium channel blockers is warranted in patients with OSA, particularly in those at risk for type 2 diabetes.NEW & NOTEWORTHY The results of this study demonstrate the interaction between intermittent hypoxemia (IH) and nifedipine in a murine model. IH raises fasting glucose and insulin levels, with nifedipine exacerbating these disturbances. Glucose tolerance worsens when nifedipine is administered alone, and IH magnifies the impairment in glucose disposal. These findings raise the possibility of potential deleterious effects of L-type calcium channel blockers in patients with obstructive sleep apnea (OSA).

MODERATE EXERCISE AND ANTIOXIDANT DYNAMICS: UNRAVELLING THE INFLUENCE OF FAMILY HISTORY IN PREDIABETES

Objectives: This study investigates the effects of moderate-intensity physical activity on glycemic control and antioxidant capacity in prediabetics, regardless of whether they have a family history of diabetes. Methods: It was conducted at the Physiology Department of the Institute of Basic Medical Sciences in Peshawar, Pakistan. The study included a cohort of 50 adult participants who were diagnosed with prediabetes. Out of the total, 25 individuals had a positive family history of diabetes (PFHG), and the other 25 had a negative family history (NFHG). The group consisted of 22 females and 28 males, whose ages ranged from 18 to 35 years. The diagnosis of prediabetes was made based on glycated hemoglobin values falling between 5.7-6.4% and impaired fasting glucose levels ranging from 100-125 mg/dL. Anthropometric measurements and biochemical testing were conducted before and after the exercise session. The Participants engaged in moderate exercise for 30 minutes, with a maximum heart rate of 70% ± 5%, five days a week for eight weeks. Their exercise was tracked using a pedometer. An enzyme-linked immunosorbent test (ELISA) was conducted to measure both individual and total antioxidants. Results: Anthropometric measurements, fasting blood glucose (P&lt;0.001), and glycated hemoglobin (P&lt;0.001) showed significant changes at post-intervention. A slight rise in uric acid levels (P&lt;0.005) and a substantial increase in total antioxidant concentration (P&lt;0.001) was observed. Peroxidase, vitamin C, and nitric oxide significantly dropped (P&lt;0.001). Conclusion: Engaging in moderate physical activity for 8 weeks, there was a notable decrease in the levels of individual antioxidants. Additionally, there was a slight increase in overall antioxidant capacity and uric acid. Both groups experienced an apparent fall in their anthropometric measurements and diabetes profile.

Effect of ozone oil and non-surgical periodontal treatment in patients with type 2 diabetes. In-vivo and in-vitro studies with fibroblasts and Candida albicans.

To evaluate the clinical effectiveness of ozonated sunflower oil (Oz) as an adjunctive of non-surgical periodontal therapy in patients with type 2 diabetes mellitus (DM2), on fibroblast cell viability and migration and the effectiveness of Oz on a Candida albicans (C. albicans) culture. In total, 32 sites in 16 DM2 with moderate to advanced periodontal disease with periodontal pocket depths ≥5mm were selected. The treatments were divided into two groups: control, saline solution (SS) as an adjunctive of scaling and root planing (SRP+SS), and test, Oz as an adjunctive of SRP (SRP+Oz). Hematological [fasting glucose level (FGL) and hemoglobin A1c (HbA1c)] and microbiological samples were collected from the participants at baseline and three months after periodontal treatment and the microbiological samples were analyzed by PCR. C. albicans was previously tested by the agar diffusion test. The effect of Oz was tested on cell viability and fibroblast migration. The groups showed no statistically significant differences (paired t-test-p>0.05) regarding hematological parameters, FGL (median - baseline 171.41, 3 months 164mg/dL), and HbA1c (baseline 8%, 3 months 7.5%) (Kruskal-Wallis One-Way Nonparametric-p>0.05) after periodontal therapy. The groups showed statistical differences for periodontal parameters between baseline and three months (paired t-test-p<0.05). PCR analysis showed a reduction in the percentage of C. albicans in the SRP+Oz group after three months (McNemar's test-p=0.002). Cell viability was lower in the high glucose Dulbecco's modified Eagle's medium (4500 mg/L) than in low glucose (1000 mg/L) (RM-ANOVA-p<0.0001). The wound healing test showed reduced fibroblast migration (one-way ANOVA with Dunnett's post-test-p<0.01). Oz showed high C. albicans antifungal inhibition (Kruskal-Wallis test-p=0.0001). SRP+Oz effectively reduced C. albicans in-vitro and in-vivo but showed no clinical improvements compared to the control. Cell viability and wound healing of fibroblasts showed no improvements.

Association of Insulin Resistance With Radiographic Lung Abnormalities and Incident Lung Disease: The Framingham Offspring Study.

Insulin resistance (IR) may be a risk factor for lung disease, but objective evidence is limited. We sought to define the relationship of longitudinal IR with radiographic imaging outcomes and examiner-identified incident lung disease in the Framingham Offspring Study. Participants without baseline lung disease underwent repeated measurements of fasting insulin and glucose levels over an average period of 13.6 years, from which time-weighted average HOMA-IR was calculated. Each participant then underwent a cardiac gated whole-lung computed tomography scan, which was analyzed for the presence of emphysema, interstitial lung abnormalities (ILAs), and quantitative airway features. Incident lung disease was determined by a study examiner. The relationship of HOMA-IR to these outcomes was estimated in models adjusted for demographics, BMI, and lifetime smoking. A total of 875 participants with longitudinal IR data and outcomes were identified. Their mean age was 51.5 years, and BMI was 26.7 kg/m2. HOMA-IR was temporally unstable, with a within-person SD approximately two-thirds of the between-person SD. In adjusted models, a 1 SD increase in log(HOMA-IR) z score was associated with higher odds of qualitative emphysema (odds ratio [OR] 1.33; 95% CI 1.04-1.70), ILAs (OR 1.35; 95% CI 1.05-1.74), and modest increases in airway wall thickness and wall area percentage. These radiographic findings were corroborated by a positive association of HOMA-IR with incident lung disease. IR is associated with radiographic lung abnormalities and incident lung disease. Deeper phenotyping is necessary to define mechanisms of IR-associated lung injury.

HOMA-IR value in predicting retinal microvascular dysfunction.

Obesity and retinal microvasculature dysfunction are linked and impact visual acuity. The aim of this study was to determine the relationship between the HOMA-IR score and the presence of vascular dysfunction (capillary perfusion and flux index) of the optic nerve head (ONH) of the retina in obese patients and to determine its diagnostic performance to predict vascular dysfunction. A case-control study was conducted in 2022 involving individuals from obese and non-obese groups. Insulin resistance was measured using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score using the levels of insulin and fasting glucose. Optical coherence tomography angiography (OCT-A) was performed to evaluate the flux index and capillary perfusion of ONH. The correlation between HOMA-IR, flux index, and capillary perfusion was assessed using Pearson's correlation, and the diagnostic performance of HOMA-IR, including sensitivity, specificity, and the area under the curve (AUC), was measured. Logistic regression was used to identify the association between the HOMA-IR cutoff score with the presence of retinal microvascular dysfunction. A total of 80 individuals were included from each obese and non-obese group. The HOMA-IR score showed significant negative correlations with the perfusion of the superior (p < 0.001), inferior (p < 0.001), and outer (p = 0.008) regions of the retinal of ONH. For the flux index, the HOMA-IR score had significant negative correlations with the superior (p = 0.001), inferior (p < 0.001), nasal (p = 0.003), and outer (p = 0.035) regions of ONH of the retina. The receiver operating characteristic (ROC) curve analysis for the HOMA-IR score at a cutoff value of 5.51 demonstrated an area under the curve (AUC) of 0.819, with a 95% confidence interval (CI) ranging from 0.727 to 0.912, suggesting its effectiveness in detecting vascular dysfunction. Multivariate logistic regression revealed a significant association between the HOMA-IR cutoff score of 5.51 with capillary perfusion of the superior (p = 0.005) and nasal region (p = 0.043), as well as the flux index of the inferior (p = 0.013) and outer (p = 0.022) regions of the ONH. These findings suggest that HOMA-IR is a promising biomarker for predicting retinal microvascular dysfunction in obese patients.

Relation of Polycystic Ovary Syndrome (PCOS) with Gestational Diabetes Mellitus

Introduction: PCOS is a common condition that increases the risk of gestational diabetes mellitus (GDM) due to insulin resistance. The purpose of this study is to evaluate the relationship between PCOS and Gestational Diabetes Mellitus. Aim of the study: The aim of the study was to evaluate the relationship between Polycystic Ovary Syndrome (PCOS) and the development of Gestational Diabetes Mellitus (GDM) in pregnancy. Methods: This comparative cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from June 2015 to May 2016. It involved 100 pregnant women, 50 with PCOS and 50 without, who underwent fasting glucose, 2-hour OGTT, and HOMA-IR tests. Data on gestational diabetes and pregnancy complications were collected and analyzed using SPSS version 22.0. Result: The study revealed that the PCOS group was older (29.4 ± 4.1 years) compared to the Non-PCOS group (27.2 ± 5.0 years), with a higher incidence of GDM (26.00% vs. 10.00%). Pregnancy complications like preterm birth were more common in the Non-PCOS group (24.00%), while GDM occurred more often in the PCOS group (26.00%). Additionally, the PCOS group had higher fasting and 2-hour OGTT glucose levels and showed greater insulin resistance (3.5 ± 1.2 vs. 2.3 ± 0.9). Conclusion: This study confirms that women with Polycystic Ovary Syndrome (PCOS) have an increased risk of Gestational Diabetes Mellitus (GDM) and exhibit impaired glucose metabolism, underscoring the importance of close monitoring during pregnancy.

Association of the triglyceride-glucose index with cardiovascular mortality risk and competing risks in arthritis patients

This study aims to investigate the relationship between the triglyceride-glucose index (TyG) and all-cause mortality as well as cardiovascular mortality in arthritis patients. Additionally, it seeks to analyze the nonlinear characteristics and threshold effects of TyG index. We included 5,559 adult participants with arthritis from the 1999–2018 National Health and Nutrition Examination Survey (NHANES). The TyG index was calculated using fasting triglycerides and glucose levels. We employed Cox proportional hazards models and restricted cubic spline analyses to examine the relationship between TyG index and all-cause mortality in arthritis patients. Competing risks models were used to analyze the association between TyG index and cardiovascular mortality as well as mortality from other causes. Over a median follow-up period of 7.8 years, 1,388 cases of all-cause mortality were recorded among arthritis patients, including 369 cases of cardiovascular mortality. After adjusting for confounding factors, TyG index was found to be nonlinearly positively associated with all-cause mortality (P = 0.0019), with a significant increase in mortality risk when TyG index ≥ 8.43. Compared to the quartile 2 of TyG index, the highest quartile was associated with a 36% increased risk of all-cause mortality (HR 1.36, 95% CI 1.12–1.65). Additionally, competing risks models indicated that high TyG index levels were significantly associated with increased risks of cardiovascular mortality and mortality from other causes. Subgroup analyses confirmed the robustness of the association between TyG index and cardiovascular mortality in arthritis patients. The TyG index is nonlinearly associated with all-cause mortality and represents a potential prognostic indicator for mortality risk in arthritis patients.

Therapeutic Potential of Ginger Ethanolic Extract, Ginger-Loaded Chitosan ‎Nanoparticles, and Chitosan Nanoparticles in Induced Type 2 Diabetes Mellitus in Dogss in Induced Type 2 Diabetes Mellitus in Dogs

Type 2 diabetes mellitus (T2DM) in dogs is a complex, multifactorial disease that is characterized by chronic hyperglycemia and insulin resistance. Current therapeutic options are often limited by side effects and variable efficacy, highlighting the need for more effective and safer treatments. This study assessed the therapeutic potential of ginger ethanolic extract (GEE), GEE-loaded chitosan nanoparticles (GEE-CNPs), and chitosan nanoparticles (CNPs) against T2DM in dogs. Twenty adult local breed mongrel dogs of both sexes, aged 7 to 13 months, with an average body weight of 10.4±0.76 kg, were included. The dogs were allocated into five groups (n=4 each): a non-diabetic, untreated Negative Control group, and four diabetic treatment groups, following T2DM induction via a single intravenous alloxan-nicotinamide injection. Each treatment group received daily oral administrations of either saline (Positive Control), GEE, GEE-CNPs, or CNPs at a dosage of 81.7 mg/kg BW over 45 days. Serum glycemic status (fasting serum glucose, insulin, and insulin resistance) was ‎recorded at baseline and on days 7, 14, 21, 28, 35, 42, and 45 post-treatments. ‎Additionally, on day 45, serum lipid profiles, liver function indicators (alanine aminotransferase [ALT], gamma-glutamyl transferase [GGT], and bilirubin), and ‎markers of antioxidant status (glutathione [GSH] and malondialdehyde [MDA]) were assessed.‎ The results showed that dogs in the diabetic Positive Control group ‎exhibited ‎hyperglycemia, dyslipidemia‎, liver ‎dysfunction, and elevated ‎oxidative stress markers, ‎‎underscoring the severe impact of T2DM. Compared to the diabetic Positive Control, oral GEE, GEE-CNPs, and CNPs ‎treatments significantly (P&lt;0.05) improved ‎fasting glucose levels, insulin sensitivity, lipid profiles (reduced total cholesterol, ‎triglycerides, and LDL-C), liver function markers, and antioxidant status, indicating ‎enhanced metabolic health and reduced oxidative stress. The findings suggest that GEE, GEE-CNPs, and CNPs offer potential as therapeutic agents for T2DM in dogs, demonstrating ‎significant benefits in glycemic control, lipid normalization, liver function, and oxidative ‎stress reduction. Further investigations with larger cohorts and longer durations are ‎recommended to confirm these results and ascertain the clinical applicability and safety of ‎these natural remedies in managing canine diabetes‎‎‎.