Glucose Levels In Individuals Research Articles

Pendampingan Aktifitas Senam Kaki bagi Peserta Prolanis Diabetes Melitus di Wilayah Kerja Puskesmas Kujangsari Kota Bandung

Prediabetic individuals participating in the Prediabetes Lifestyle Program (prolanis DM) have exhibited irregular adherence to lower limb exercises, resulting in persistent fluctuations in blood glucose levels. Engaging in lower limb exercises holds substantial benefits for stabilizing blood glucose levels in individuals with diabetes mellitus (DM). This community nursing intervention aims to enhance the ability of prediabetic prolanis participants to perform lower limb exercises. The intervention involves direct assistance and guidance to prediabetic prolanis participants during their lower limb exercise routines. A total of 31 participants were provided with instructional videos on DM-specific lower limb exercises and were evaluated twice over two months during their visits to the Kujangsari Primary Health Center. After the sessions, the lower limb exercises were assessed using a scoring format ranging from 1 to 3, with final results categorized accordingly. Results indicated that 54.8% of participants achieved a 'Good' rating for their lower limb exercise performance. This personalized support and guidance are anticipated to augment the participants' lower limb exercise proficiency and motivation to exercise regularly. The DM-specific lower limb exercise videos are envisioned to serve as a reference for participants, enabling them to pursue self-care by performing these exercises at home and maintaining stable blood glucose levels.

Low-calorie diet-induced weight loss is associated with altered brain connectivity and food desire in obesity.

The main objective of this study is to better understand the effects of diet-induced weight loss on brain connectivity in response to changes in glucose levels in individuals with obesity. A total of 25 individuals with obesity, among whom 9 had a diagnosis of type 2 diabetes, underwent functional magnetic resonance imaging (fMRI) scans before and after an 8-week low-calorie diet. We used a two-step hypereuglycemia clamp approach to mimic the changes in glucose levels observed in the postprandial period in combination with task-mediated fMRI intrinsic connectivity distribution (ICD) analysis. After the diet, participants lost an average of 3.3% body weight. Diet-induced weight loss led to a decrease in leptin levels, an increase in hunger and food intake, and greater brain connectivity in the parahippocampus, right hippocampus, and temporal cortex (limbic-temporal network). Group differences (with vs. without type 2 diabetes) were noted in several brain networks. Connectivity in the limbic-temporal and frontal-parietal brain clusters inversely correlated with hunger. A short-term low-calorie diet led to a multifaceted body response in patients with obesity, with an increase in connectivity in the limbic-temporal network (emotion and memory) and hormone and eating behavior changes that may be important for recovering the weight lost.

The Potential of Red Betel Leaf and Mangosteen Peel in Lowering Blood Sugar Levels in Patients with Diabetes Mellitus

A study comparing the effects of red betel leaf decoction, mangosteen peel juice, and conventional medication on blood glucose levels in individuals with type II diabetes mellitus was conducted in Indonesia. The research involved three groups of eight participants each, selected through purposive sampling. Following administration, the average blood glucose level was 190.75 mg/dL for red betel leaf decoction, 194.38 mg/dL for mangosteen peel juice, and 186.50 mg/dL for conventional medication. Surprisingly, there was no significant difference in the effectiveness of red betel leaf decoction and mangosteen peel juice in managing blood sugar levels, with a p-value of 0.582 (p<0.05). These findings suggest that both herbal interventions are comparable to conventional medication in regulating blood glucose levels among type II diabetes patients. In conclusion, the study highlights the potential of red betel leaf and mangosteen peel as alternative non-pharmacological interventions for managing diabetes. Further research is warranted to explore their mechanisms of action and long-term effects on diabetes management

The consumption of walnuts has an impact on decreasing fasting blood glucose levels in individuals with concurrent hyperglycemia and hyperlipidemia: a randomized control trial

Nationally, the prevalence of Diabetes Mellitus (DM) has increased by 0.5%. In 2013, it was approximately 1.5%, rising to 2.0% in 2018. On the other hand, it is known that administering walnut extract can reduce blood sugar levels in diabetic patients. The aim of this study is to determine the effect of walnut consumption on blood sugar levels. The research was conducted experimentally, using a pre-post test control group design. The research sample consisted of mothers with fasting blood sugar levels ≥200 mg/dL and total cholesterol levels ≥200 mg/dL (hyperglycemic and hyperlipidemic). The total sample size was 50 mothers, divided into 2 groups. Samples were selected using simple random sampling. The intervention involved giving 50 grams of walnut (Canarium Indicum L.) daily for 8 weeks to the treatment group. The research was conducted in the working area of the Paccerakang Community Health Center in Makassar City, Indonesia. Statistical analysis was performed using paired T-tests. There was a decrease in fasting blood glucose levels in the treatment group from 244.12 mg/dL to 195.52 mg/dL. In the control group, there was a slight decrease in blood sugar levels from 236.92 mg/dL to 229.96 mg/dL. Paired T-test analysis in the treatment group showed a value of p=0.00, indicating a significant difference in cholesterol levels before and after the intervention in the treatment group. In the control group, the value was p=0.07, indicating no significant difference in cholesterol levels in the control group. Administering 50 grams of walnuts per day for 8 weeks significantly lowered fasting blood sugar levels in hyperlipidemic and hyperglycemic mothers.

Optimizing Blood Glucose Regulation in Type 1 Diabetes Patients via Genetic Algorithm-Based Fuzzy Logic Controller Considering Substantial Meal Protocol

Effective management of blood glucose levels in individuals with type 1 diabetes, especially after meals, is crucial for diabetes care. Artificial pancreas systems (APS) perform automated insulin delivery in subjects with type 1 diabetes mellitus (T1DM). In this study, an optimized fuzzy logic controller was designed to achieve a euglycemic range after a substantial meal intake. All in silico simulations were performed using the MATLAB/Simulink environment, leveraging control variability grid analysis (CVGA), and the performance of the controller was evaluated. The proposed controller is based on a fuzzy-logic control law designed in three stages. First, a nonlinear framework of the glucose-insulin regulatory system was identified based on the heavy meal protocol of three patients given as follows: for subject ID 117-1, a total of 295 gCHO; for subject ID 126-1, 236 gCHO; and subject ID 128-1, 394 gCHO over a day. Then, an iterative tree structure was employed to establish a stabilizing control rule for insulin delivery, integrating inputs from two Mamdani Fuzzy Inference System (FIS) objects. Finally, a genetic algorithm refines the control system by fine-tuning the uncertainty of the fuzzy membership functions. Two scenarios were considered for three patients to assess the performance of the proposed controller. The results indicated its effectiveness under various conditions, achieving a time in the range of 61.25%, 71% and 61.10% respectively for the three subjects. The obtained results are analyzed and compared with IMC and multi-objective output feedback controllers. The findings of the study reveal that the proposed controller shows promising advancements in tailored strategies for type 1 diabetes patients, outperforming the other controllers in terms of blood glucose regulation.

Optimizing blood glucose regulation in type 1 diabetes: A fractional order controller approach

This study presents the design and implementation of a Fractional Order Proportional, Integral, and Derivative (FOPID) controller intended for the regulation of blood glucose levels in individuals with type 1 diabetes mellitus (T1DM). The efficacy of this controller is evaluated through its application to a nonlinear Stolwijk–Hardy model simulating T1DM patients, accounting for a range of physiological conditions. Utilizing a genetic algorithm, the parameters of the FOPID controller are fine-tuned. By conducting a comparative analysis with previously established control algorithms, the performance of the proposed controller is validated, demonstrating its superior performance. The results underscore the significant improvements achieved by the proposed controller in maintaining blood glucose concentrations within safe thresholds, particularly in scenarios involving disruptions due to meals.

Hubungan faktor metabolik dan konsumsi makanan minuman manis dengan kadar gula darah pada usia 30-60 tahun di Puskesmas Simalingkar

High blood glucose levels (hyperglycemia) can be caused by several conditions, including diabetes mellitus (DM). Among the top 5 nations in the world with the most DM cases in 2021 is Indonesia. There are 161,267 DM patients in North Sumatra, with 31,482 cases in Medan. Simalingkar Community Health Center is one of the health centers in Medan with the highest number of DM cases in 2022. This study intends to examine the association between blood glucose levels in individuals aged 30 to 60 at Simalingkar Community Health Center and metabolic variables, particularly obesity as assessed by body mass index (BMI) and belly circumference, as well as the consumption of sugary foods and beverages. This research is a cross-sectional study. 120 participants were included in this research sample and use accidental sampling method. Data analysis was done univariately, bivariately using the chi-square test and multivariately using logistic regression. The results showed that BMI (RP=1.701; 95% CI=1.095–2.645; p=0.022), abdominal circumference (RP=2.124; 95% CI=1.253–3.600; p=0.003) and sweet foods and beverages consumption (RP=2.042; 95% CI=1.358–3.069; p=0.001) were significantly associated with blood glucose levels. The habit of consuming sweet foods and drinks is the most dominant factor influencing a person to experience hyperglycemia (OR=3,345; 95% CI=1,512-7,387). The community is advised to control blood glucose levels by maintaining ideal body weight and reducing consumption of sweet foods and beverages to prevent type 2 DM.

Preliminary characterization of gut mycobiome enterotypes reveals the correlation trends between host metabolic parameter and diet: a case study in the Thai Cohort

The association between the gut mycobiome and its potential influence on host metabolism in the Thai Cohort was assessed. Two distinct predominant enterotypes, Saccharomyces (Sa) and Aspergillus/Penicillium (Ap/Pe) showed differences in gut mycobiota diversity and composition. Notably, the Sa enterotype exhibited lower evenness and richness, likely due to the prevalence of Saccharomyces, while both enterotypes displayed unique metabolic behaviors related to nutrient metabolism and body composition. Fiber consumption was positively correlated with adverse body composition and fasting glucose levels in individuals with the Sa enterotype, whereas in the Ap/Pe enterotype it was positively correlated with fat and protein intake. The metabolic functional analysis revealed the Sa enterotype associated with carbohydrate metabolism, while the Ap/Pe enterotype involved in lipid metabolism. Very interestingly, the genes involved in the pentose and glucuronate interconversion pathway, such as polygalacturonase and l-arabinose-isomerase, were enriched in the Sa enterotype signifying a metabolic capacity for complex carbohydrate degradation and utilization of less common sugars as energy sources. These findings highlight the interplay between gut mycobiome composition, dietary habits, and metabolic outcomes within the Thai cohort studies.

The effect of mindful eating on dietary behaviour and fasting blood glucose in type 2 diabetes mellitus patients

Diet plays a pivotal role in the comprehensive therapy for individuals with type 2 diabetes mellitus, contributing significantly to maintaining stable glycemic control. Mindful Eating, as an intervention, focuses on enhancing dietary behavior by directing attention, thoughts, and feelings towards eating activities. This study aimed to investigate the impact of mindful eating on dietary behavior and fasting blood glucose levels in individuals with type 2 diabetes mellitus. Employing a quasi-experimental method with a pretest-posttest control group design, the study included a sample of 63 participants (selected through convenience sampling). Data collection utilized the Personal Diabetes Questionnaire (PDQ) and a glucometer. Statistical analysis involved Wilcoxon, Mann-Whitney, and Independent T-tests. The findings revealed that mindful eating exercises had a significant influence on dietary behavior (p = 0.025) and fasting blood glucose levels (p = 0.033). The practice of mindful eating led to notable improvements in dietary behavior and ensured controlled fasting blood glucose levels by the study's conclusion. Incorporating mindful eating exercises into eating patterns is recommended as a crucial aspect of diabetes management, aiming to enhance dietary behavior and sustain stable glycemic control.

Identification of individuals with diabetes who are eligible for continuous glucose monitoring forecasting

Background and objectivesPredicting glucose levels in individuals with diabetes offers potential improvements in glucose control. However, not all patients exhibit predictable glucose dynamics, which may lead to ineffective treatment strategies. We sought to investigate the efficacy of a 7-day blinded screening test in identifying diabetes patients suitable for glucose forecasting. MethodsParticipants with type 1 diabetes (T1D) were stratified into high and low initial error groups based on screening results (eligible and non-eligible). Long-term glucose predictions (30/60 min lead time) were evaluated among 334 individuals who underwent continuous glucose monitoring (CGM) over a total of 64,460,560 min. ResultsA strong correlation was observed between screening accuracy and long-term mean absolute relative difference (MARD) (0.661–0.736; p < 0.001), suggesting significant predictability between screening and long-term errors. Group analysis revealed a notable reduction in predictions falling within zone D of the Clark Error Grid by a factor of three and in zone C by a factor of two. ConclusionsThe identification of eligible patients for glucose prediction through screening represents a practical and effective strategy. Implementation of this approach could lead to a decrease in adverse glucose predictions.

Preventing severe hypoglycemia in adults with type 2 diabetes (PHT2): Design, delivery and evaluation framework for a randomized controlled trial

BackgroundSevere hypoglycemia is a common and feared complication of medications used to lower blood glucose levels in individuals with diabetes. Psychoeducational interventions can prevent severe hypoglycemia in individuals with type 1 diabetes (T1D). We aim to determine the effectiveness of this approach among adults with type 2 diabetes (T2D) at elevated risk for severe hypoglycemia. MethodsPreventing Hypoglycemia in Type 2 diabetes (PHT2) is a two-arm, parallel, randomized controlled trial. Participants are eligible if they are adults with T2D receiving care at an integrated group practice in Washington state and have experienced one or more episodes of severe hypoglycemia in the prior 12 months or have impaired awareness of hypoglycemia (Gold score ≥ 4). Participants are randomized to proactive nurse care management with or without my hypo compass, an evidence-based, psychoeducational intervention combining group and individual self-management training. For this study, my hypo compass was adapted to be suitable for adults with T2D and from an in-person to a virtual intervention over videoconference and telephone. The primary outcome is any self-reported severe hypoglycemia in the 12 months following the start of the intervention. Secondary outcomes include biochemical measures of hypoglycemia, self-reported hypoglycemia awareness, fear of hypoglycemia, and emergency department visits and hospitalizations for severe hypoglycemia. The study includes a process evaluation to assess implementation fidelity and clarify the causal pathway. ConclusionThe PHT2 trial will compare the effectiveness of two approaches for reducing severe hypoglycemia in adults with T2D.Trial registration: clinicaltrials.gov, # NCT04863872

Antidiabetic Activity, Phytochemical Analysis, and Acute Oral Toxicity Test of Combined Ethanolic Extract of Syzygium polyanthum and Muntingia calabura Leaves.

Syzygium polyanthum is known for its capacity to regulate blood glucose levels in individuals with diabetes, while Muntingia calabura leaves have a traditional history as an alternative therapy due to their antidiabetic compounds. The combination of these two plants is expected to yield more optimized antidiabetic agents. This study aims to assess the antidiabetic activity of the combined ethanolic extract of S. polyanthum and M. calabura leaves by measuring the in vitro inhibition of the α-glucosidase enzyme and the blood glucose level in streptozotocin-induced rats and to determine the phytochemical contents of total phenolics, total flavonoids, and quercetine as marker compounds. Acute oral toxicity test was also evaluated. Both plants were extracted by maceration using 96% ethanol. Various combinations of S. polyanthum and M. calabura leaves extracts (1 : 1, 2 : 1, 3 : 1, 1 : 3, and 1 : 2) were prepared. The in vitro test, along with the total phenolic and total flavonoid content, were measured by using UV-Vis spectrophotometry, while quercetine levels were quantified through high-performance liquid chromatography (HPLC). The in vivo and acute toxicity tests were performed on rats as an animal model. The findings demonstrated that the 1 : 1 combination of S. polyanthum and M. calabura leaves ethanolic extract displayed the highest enzyme inhibitory activity with IC50 value of 36.43 µg/mL. Moreover, the combination index (CI) was found <1 that indicates the synergism effect. This combination also decreases the blood glucose level in rats after 28 days of treatments without significant difference with positive control glibenclamide (p > 0.005), and it had medium lethal doses (LD50) higher than 2000 mg/kg BW. Phytochemical analysis showed that the levels of total phenolics, total flavonoids, and quercetine were 30.81% w/w, 1.37% w/w, and 3.25 mg/g, respectively. These findings suggest the potential of combined ethanolic extracts of S. polyanthum and M. calabura leaves (1 : 1) as raw materials for herbal antidiabetic medication.

Impact of Anaemia on HbA1c Interpretation Among Normogylcaemic Individuals With Diabetes Mellitus: A Clinical Laboratory Observational Study.

Over the past decades, glycosylated haemoglobin (HbA1c) has been a gold standard for monitoring diabetes control over a long period, relative to blood glucose level (BGL) which measures short-term results. It is speculated that anaemia and factors that induce haemolysis may cause falsely elevated HbA1c leading to 'false positive' interpretations. This study aimed to investigate how anaemia impacts HbA1c. This was a pathology-based observational pilot study using archived data of diabetic subjects monitored with both BGL and HbA1c in regional New South Wales (NSW), Australia. A total of 28,487 cases of blood glucose results were pooled and those with HbA1c and anaemia results were evaluated for correlation with the BGL results. Data collection was limited to de-identified information from the laboratory information system, hence details on the ethnicity and medical history were unavailable. Descriptive frequencies and Pearson correlations were performed. In the pooled data, 53.36% of individuals were females, and 50.54% had BGL ≥5.6 mmol/L. In the pilot dataset, the majority (64.86%) were males, 18.92% with BGL ≤5.6 mmol/L and 67.57% had HbA1c (≥6.5%). In the entire dataset, BGL was moderately and positively correlated with HbA1c (r = 0.6), whereas in the subset of individuals with normo-BGL and anaemia, the correlation was negative (r = -0.2). This pilot investigation observed a pertinent issue, which is a negative correlation between glycaemia and HbA1c in patients with anaemia. HbA1c was falsely increased despite normal blood glucose levels in individuals with anaemia. This advances the speculation that anaemia falsely increases HbA1c. Therefore, caution is necessary while interpreting HbA1c results for patients with anaemia, and new methods for interpretation are required.

Tingkat Kecemasan dengan Kadar Gula Darah Penderita Diabetes Mellitus Tipe II di Puskesmas Kerabitan I

The primary issue in type II diabetes mellitus is the body's inadequate reaction to insulin (insulin resistance), resulting in the inability of glucose to enter the cells. Preserving mental well-being, particularly by preventing anxiety, is a method that can be employed to address insulin resistance in individuals with diabetes. The objective of this study was to establish the correlation between anxiety levels and blood glucose levels in individuals diagnosed with Type II diabetes mellitus. The research employed a quantitative correlation methodology with a cross-sectional approach. The study consisted of a sample size of 40 respondents, and the sampling method employed was non-probability sampling using purposive sampling. The findings indicated that a significant proportion of participants, specifically 33 individuals (82.5%), reported experiencing mild anxiety and had elevated blood glucose levels. The Spearman's Rho correlation test yielded a statistically significant result (p-value = 0.017, &lt;0.05). A correlation was observed between the anxiety levels and blood sugar levels of patients diagnosed with type II diabetes mellitus at UPTD Puskesmas Kerambitan I in 2021. It is important for individuals with diabetes to prioritize their psychological well-being, particularly by avoiding anxiety as it can negatively impact blood glucose levels.

Effect of Neck-Deep Immersion in Cool or Thermoneutral Water on Blood Glucose Levels in Individuals With Type 1 Diabetes.

It is unclear whether immersion in cool water, typical of many beaches, increases the concentration of blood glucose in individuals with type 1 diabetes mellitus (T1DM). To test the hypothesis in individuals with T1DM that immersion neck-deep in cool water (COOL) causes an increase in blood glucose concentration, but not exposure to thermoneutral water (THERMO) or thermoneutral air. Eight overnight-fasted participants with T1DM were exposed for 60 minutes on separate days to 3 experimental conditions: cool water (COOL, 23 °C); thermoneutral water (THERMO, 33.5 °C); or thermoneutral air (24 °C). They then recovered for 60 minutes on land at 24 °C. At time intervals, we measured: blood glucose and plasma insulin concentration, rate of carbohydrate and fat oxidation, skin and core temperature, subcutaneous blood flow, and shivering via electromyography. There was no change in blood glucose concentration during the 3 experimental conditions (P > .05). During recovery after COOL, blood glucose increased (P < .05) but did not change in the other 2 conditions. The rate of carbohydrate oxidation during and early after COOL was higher than in the other 2 conditions (P < .05), and COOL led to a decrease in subcutaneous blood flow and the concentration of plasma insulin (P < .05). Cool or thermoneutral neck-deep immersion in water does not cause a change in the concentration of blood glucose in people with T1DM, but on-land recovery from COOL causes an increase in blood glucose that may be due, at least in part, to the accompanying decrease in plasma insulin.

Correlational analysis between salivary and blood glucose levels in individuals with and without diabetes mellitus: a cross-sectional study

Objective To estimate the association of patient-related demographic, socioeconomic status, physical activity, stress, and dietary factors influencing the relationship between salivary and blood glucose levels in individuals with and without diabetes mellitus (DM). Method This cross-sectional study was conducted on 166 participants with and without DM. Saliva and blood were collected to estimate the glucose levels. Age, gender, occupation, socioeconomic and education level, BMI, hip to waist circumference, stress, dietary pattern, lifestyle, physical activity, family history of diabetes, and type of diabetes were recorded. The association of saliva to predict blood glucose levels was analysed using Spearman Rank Correlation and how these patient-related factors influence the correlation was estimated for future machine learning models. The difference in medians for various groups was calculated using the Mann-Whitney U Test or Kruskal Wallis Test. Results Blood glucose level is not significantly correlated to salivary glucose level. However, a statistically significant difference in the median blood glucose levels for diabetic participants (median = 137) compared to healthy controls (p-value < .05) was noted. The correlation between blood and salivary glucose was more positive for higher levels of glucose (Spearman 0.4). Age, alcohol consumption, monthly wages, intake of vegetables, and socioeconomic status affect blood glucose levels. Conclusion A correlation between saliva and blood glucose levels in healthy individuals was weak. Saliva should only be used as a monitoring tool rather than a diagnostic tool and is more reliable for patients with poorly controlled diabetes mellitus.

Analysis of Urinary Fibronectin Levels in Patients with Type 2 Diabetes Mellitus and Non-Diabetes Mellitus

Diabetic nephropathy is a microvascular complication associated with high glucose levels in individuals with diabetes mellitus (DM). Fibronectin, an early marker of diabetic nephropathy, can indicate the occurrence and progression of renal damage. This cross-sectional study aimed to compare urinary fibronectin levels in patients with type 2 diabetes mellitus and non-diabetes mellitus. A sample of 50 DM patients was divided into two groups: the DM group and the non-DM group. Urinary fibronectin levels were measured using the ELISA method, while albuminuria levels were determined by the albumin-to-creatinine ratio (ACR). Statistical analysis was performed to assess the relationship between urinary fibronectin levels and urine albumin. Results: The average urinary fibronectin level in DM patients was 2.07 ± 3.04 ng/mL, which was slightly higher than the level observed in non-DM patients (1.09 ± 0.56 ng/mL). However, this difference was not statistically significant (p 0.05). Additionally, there was no significant relationship found between urinary fibronectin levels and urine albumin (p = 0.001). Conclusion: The findings of this study indicate that urinary fibronectin levels in individuals with DM were slightly higher than those without DM. However, this difference did not reach statistical significance. The lack of a significant relationship between urinary fibronectin levels and urine albumin suggests that fibronectin may provide additional information about renal damage in DM patients, independent of albuminuria. Further research is necessary to explore the clinical significance of urinary fibronectin as a potential biomarker for diabetic nephropathy.

Gut microbiota-mediated associations of green tea and catechin intakes with glucose metabolism in individuals without type 2 diabetes mellitus: a four-season observational study with mediation analysis

This four-season observational study aimed to examine the mediating role of the gut microbiota in the associations between green tea and catechin intakes and glucose metabolism in individuals without type 2 diabetes mellitus (T2DM). In each of the 4 seasons, 85 individuals without T2DM (56 male [65.9%]; mean [standard deviation] age: 43.3 [9.4] years) provided blood samples, stool samples, 3-day weighed dietary records, and green tea samples. Catechin intake was estimated by analyzing the tea samples. Linear mixed-effects model analysis showed that green tea intake was negatively associated with fasting blood glucose and insulin levels, even after considering the seasonal variations. Of the gut microbial species associated with green tea intake, the mediation analysis revealed that Phocaeicola vulgatus mediated the association between green tea intake and fasting blood glucose levels. These findings indicate that green tea can improve glucose metabolism by decreasing the abundance of P. vulgatus that is associated with elevated blood glucose levels in individuals without T2DM.

HPLC-DAD technique for the quantification of a recently approved anti-diabetic triple combination along with two toxic official impurities: Toxicity confirmation aided by molecular docking application

BackgroundGliflozins and gliptins are two distinct groups of pharmacological drugs that reduce blood glucose levels in individuals with type II diabetes in various ways that may perform their functions harmoniously. Trijardy® tablet, which contains empagliflozin, linagliptin, and metformin, was recently approved. The scientific database does not yet have a method that is sensitive enough to quantify the aforementioned medications in the presence of metformin official toxic impurities melamine and cyanoguanidine. Molecular docking modeling was utilized in this work to further prove the toxicity of melamine.MethodsThe five analytes listed before were quantified using RP-HPLC-diode array detector and a Zorbax® C8 column (4.6 × 250 mm, 5 μm) with isocratic mobile phase composed of acetonitrile and 0.05 M potassium dihydrogen phosphate buffer, which had been treated by ?-phosphoric acid to restore a pH of 4.0 (90:10, v/v) at a flow rate of 1.2 mL/min and the eluted peaks were scanned at 250 nm.ConclusionThe utilization of the simplest isocratic elution mode give the current technique a significant time-and cost-saving benefit. The current method can quantify the triple therapy agents in the presence of each other as well as with two official toxic impurities of metformin in one short analytical run.

Abstract P249: Moderate-to-Severe Depression Symptoms Are Associated With Poorly Controlled Glucose Levels in Persons With Type 2 Diabetes Mellitus

Objective: To investigate whether the severity of depression symptoms is associated with poor long-term control of plasma glucose levels in individuals with type 2 diabetes. Methods: Electronic health record [EHR] data of 2842 individuals with mental illness enrolled in the Penn State Clinical Assessment and Rating Evaluation System [PCARES] registry were used. Demographics, body mass index [BMI], baseline type 2 diabetes mellitus [T2DM] status and all available glucose labs were extracted from the EHR. The nine-item patient health questionnaire [PHQ-9] was used to determine baseline depression symptoms. PHQ-9 scores greater than/equal to 10 indicated moderate-to-severe depression symptoms, whereas scores less than 10 indicated none-to-mild depression symptoms. While the baseline glucose measurement had to be within ± 90 days of the baseline PHQ-9 date, longitudinal glucose measurements had to be on or after this date and within one year of the second follow-up glucose lab test date. Each glucose lab test had to be within one year of the preceding lab test. There were 917 individuals that met the criteria for baseline and follow-up glucose measurements and contributed to the effective study sample. Linear mixed-effects models were used to assess the association between baseline depression and changes in glucose levels, with a focus on persons with baseline diabetes. Results are reported as beta-coefficients (standard errors [SE]) and P -values. Results: The study sample included 917 individuals, with 65% females (596 of 917) and 85% (780 of 917) Non-Hispanic Caucasians. The mean (SD) age, PHQ-9 score, BMI, and glucose were 47.7 (16.9) years, 12.0 (7.1), 31.6 (8.6) Kg/m 2, and 115.9 (48.8) mg/dl, respectively. At baseline, 62.0% had moderate-to-severe depression (569 of 917), and 37.1% of persons had T2DM (341 of 917). Among individuals without T2DM, there was no association between the severity of depression symptoms and follow-up glucose levels with a beta (SE) of 1.1 (1.1) and P =0.32. Among persons with T2DM (N=341), there was an average increase in glucose levels by 2.8 (2.1) mg/dl, P =0.17, per year of follow-up. When stratified by the severity of depression symptoms, individuals with moderate-to-severe depression symptoms had a significant increase in glucose levels at 6.2 (2.7) mg/dl, P =0.02, per year of follow-up, indicative of poor control of blood glucose levels. Whereas, among persons with none-to-mild depression symptoms, blood glucose levels showed a non-significant decline at 2.6 (3.4) mg/dl, P =0.45, per year of follow-up. Conclusions: In this clinic-based sample of persons with mental illness, moderate-to-severe depression symptoms were associated with significantly increasing blood glucose levels among persons with co-morbid T2DM. Our findings underscore integrated physical and mental healthcare services and routine depression screening among persons with diabetes.