Glucose Levels Research Articles

Hypoglycaemia in screening oral glucose tolerance test in pregnancy with low birth weight fetus

Maternal hypoglycemia, a condition characterized by lower than normal blood glucose levels in pregnant women, has been increasingly associated with adverse pregnancy outcomes, including low birth weight (LBW) in neonates. LBW, defined as a birth weight of less than 2500 g, can result from various factors, including maternal nutrition, health status, and metabolic conditions like hypoglycemia. Maternal hypoglycemia may affect fetal growth by altering the supply of essential nutrients and oxygen to the fetus, leading to restricted fetal development and growth. This condition poses significant risks not only during pregnancy but also for the long-term health of the child, increasing the likelihood of developmental delays, health issues, and chronic conditions later in life. Research in this area has focused on understanding the mechanisms through which maternal hypoglycemia influences fetal development, with studies suggesting that alterations in placental blood flow and nutrient transport, as well as direct effects on fetal insulin levels and metabolism, may play a role. Given the potential impact of maternal hypoglycemia on neonatal health outcomes, early detection and management are crucial to minimize risks for LBW and its associated complications. Further investigations are needed to fully elucidate the complex interactions between maternal glucose levels and fetal growth, as well as to develop targeted interventions to support the health of both mother and child. Understanding these relationships is vital for improving prenatal care and outcomes for pregnancies complicated by hypoglycemia.

The use of Oral Anti-Diabetic Medications in Diabetes Mellitus type 1: An Educational Article and Expert Opinion

Diabetes mellitus type 1 is lifelong condition resulting from failure of production of insulin because of the loss of pancreatic islet beta-cells because of autoimmune damage. Patients with this type of diabetes need lifelong treatment with insulin to remain alive. Poor diabetic control which predisposes to a variety of complications is not uncommon in patients treated with insulin alone. Therefore, the use of medications that can possibly enhance the therapeutic effect of insulin and reduce the risk of diabetic complications has been considered. Oral anti-diabetics including acarbose, an inhibitor of intestinal α-glucosidase, metformin, a biguanide, sulfonylureas including glipizide, and sitagliptin, an inhibitor of dipeptidyl peptidase 4 (DPP-4) are primarily used for the treatment of non-insulin dependent diabetes (Type 2). The aim of this paper is to provide an overview of the use of oral anti-diabetics in the treatment of insulin dependent diabetes (Type 1). Expert opinion: The current evidence-based expert opinion recommends the judicious use of oral anti-diabetics especially acarbose and metformin in the treatment of unsatisfactorily controlled insulin dependent diabetes type 1. These medications can help in improving diabetic control through reducing glucose levels after meals, and can contribute to lowering the levels of glycosylated hemoglobin (HbA1c). The use of these oral anti-diabetics can also help in reducing insulin requirement.

Relationship of paraoxonase-1 and paraoxonase-3 with routine laboratory tests and oxidative stress in type 2 diabetes mellitus

Abstract Objectives We aimed to investigate the relationship between serum paraoxonase-1 (PON1) and paraoxonase-3 (PON3) levels and activities with hemoglobin A1c (HbA1c), serum fasting blood glucose, lipid profile, and oxidative stress in patients with type 2 diabetes mellitus (T2DM). Also, we aimed to examine PON1 and PON3 levels and activities in these patients according to the HbA1c goal in diabetes treatment and PON1192 phenotypes. Methods One hundred forty-one volunteers diagnosed with T2DM participated in this study. Serum PON1 and PON3 levels and activities, total oxidant status (TOS), and total antioxidant status (TAS) were measured. PON1192 phenotypes were determined by using PON1 activities. Also, HbA1c, serum fasting blood glucose, and lipid profile results, which were measured for routine examination on the same day as sample collection, were used for this study. Results There was a positive relationship between arylesterase and lactonase activities and high-density lipoprotein cholesterol (HDL-C), between lactonase activity and TAS, and a negative relationship between PON1 level and TAS in patients with T2DM. Our study also showed that PON3/HDL-C was higher in patients with HbA1c levels ≥7 %. Lactonase activities were higher in patients with PON1Q192Q and PON1Q192R phenotypes than in patients with PON1R192R phenotypes. Conclusions PON1 and PON3 levels and activities alone could not be associated with immediate or long-term blood glucose levels in patients with T2DM. Higher PON3/HDL-C in patients with HbA1c levels ≥7 % may show a protective role of PON3 in defense against higher glucose levels. Also, we found that the PON1192 phenotype can affect serum lactonase activity.

Diabetes screening among women with polycystic ovary syndrome: a descriptive study of commercial claims, 2011–2019

BackgroundPolycystic ovary syndrome (PCOS) is a hormonal disorder that affects 6–12% of United States women of reproductive age. Because women with PCOS are at an increased risk of developing type 2 diabetes, clinical practice guidelines from a number of organizations (e.g. American Diabetes Association, American College of Obstetricians and Gynecologists, US Preventive Services Task Force) recommend that individuals with PCOS are routinely screened for diabetes. Guidelines further indicate that an oral glucose tolerance test (OGTT) should be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is two-fold: 1) to estimate rates of diabetes screening among a nationwide sample of commercially insured women with PCOS and 2) to report the percentage of women screened using each test (OGTT, A1C, fasting plasma glucose) among those who were screened.MethodsWe used the MarketScan Commercial Claims database (2011–2019) to identify a sample of women aged 18–64 years with PCOS who were free from diabetes at baseline and had ≥ 5 years of continuous enrollment in their insurance plan. PCOS was ascertained using International Classification of Disease diagnosis codes (ICD-9: 256.4; ICD-10: E28.2). Diabetes screening was ascertained using Current Procedural Terminology (CPT) codes (A1C: 8303683037; Fasting blood sugar: 82947; OGTT: 82950). Diabetes screening rates were calculated for the overall study sample as well as across subgroups defined by age, overweight/obesity, hypertension, hypercholesterolemia, and vascular disease.ResultsIn our sample of 191,110 commercially insured women with PCOS, 73.40% were screened at least once for diabetes during a five-year period. Among the women screened, 19.24% were screened using the Androgen Excess Society (AES)-recommended OGTT, 61.58% were screened using A1C, and 23.37% were screened using fasting blood sugar.ConclusionsIn a sample of commercially insured individuals spanning the timeframe 2011–2019, nearly 75% of women with PCOS complied with the ACOG screening guidelines for diabetes. Although OGTT is recommended as the preferred screening tool for women with PCOS it was less commonly used than A1C and fasting blood sugar tests.

Personalized sleep and nutritional strategies to combat adverse effects of night shift work: a controlled intervention protocol

Abstract Background Working during the night interferes with the timing of normal daily activities and is associated with an increased risk of chronic diseases. Under controlled experimental conditions, interventions focusing on sleep and nutrition can mitigate the short-term adverse effects of shift work. However, it is unclear how these results translate to real-life, how they can be targeted to individual conditions, and how they relate to long-term health. Therefore, the current study aims to implement a personalized sleep and nutritional intervention among night shift workers in the field. Methods A non-blinded controlled intervention study is used, consisting of a run-in period, an intervention of 3 months, post-intervention measurements, and a follow-up after 12 months. Three study arms are included: sleep intervention, nutritional intervention, and control group (n = 25 each). Participants are healthy 18–60-year male night shift workers, with at least one year of experience in night shift work. Information from the run-in period will be used to personalize the interventions. The main outcomes are sleep measurements and continuous interstitial glucose levels. Furthermore, general health biomarkers and parameters will be determined to further evaluate effects on long-term health. Discussion This study aims to mitigate negative health consequences associated with night shift work by introducing two personalized preventive interventions. If proven effective, the personalized interventions may serve as practical solutions that can have a meaningful impact on the sustainable health and employability of night shift workers. This study will thereby contribute to the current need for high–quality data on preventative strategies for night shift work in a real-life context. Trial registration This trial has been registered under ClinicalTrials.gov Identifier NCT06147089. Registered 27 November 2023.

An antireductant approach ameliorates misfolded proinsulin-induced hyperglycemia and glucose intolerance in male Akita mice.

Protein folding in the endoplasmic reticulum (ER) requires a high ratio of oxidized to reduced glutathione (GSSG/rGSH). Since the GSSG/rGSH depends on total glutathione (tGSH = GSSG + rGSH) levels, we hypothesized that limiting GSH biosynthesis will ameliorate protein misfolding by enhancing the ER oxidative milieu. As a proof-of-concept, we used DL-buthionine-(S,R)-sulfoximine (BSO) to inhibit GSH biosynthesis in Akita mice, which are prone to proinsulin misfolding. We conducted a 2-week intervention to investigate if BSO was safe and a 6-week intervention to find its effect on glucose intolerance. In both cohorts, male heterozygous Akita (AK) and wild-type (WT) mice were continuously administered 15mM BSO. No adverse effects were observed on body weight, food intake, and water intake in either cohort. Unaltered levels of plasma aspartate and alanine aminotransferases, and cystatin-C, indicate that BSO was safe. BSO-induced decreases in tGSH were tissue-dependent with maximal effects in the kidneys, where it altered the expression of genes associated with GSH biosynthesis, redox status, and proteostasis. BSO treatment decreased random blood glucose levels to 80% and 67%of levels in untreated mice in short-term and long-term cohorts, respectively, and 6-h fasting blood glucose to 82% and 74%of levels in untreated mice, respectively. BSO also improved glucose tolerance by 37% in AK mice in the long-term cohort, without affecting insulin tolerance. Neither glucose tolerance nor insulin tolerance were affected in WT. Data indicate that BSO might treat misfolded proinsulin-induced glucose intolerance. Future studies should investigate the effect of BSO on proinsulin misfolding and if it improves glucose intolerance in individuals with Mutant Insulin Diabetes of Youth.

Effects of antiretroviral therapy on glycemic and inflammatory indices in people living with HIV (PLWH).

This study explores the relationship between different ART therapy based on NRTIs, and inflammatory markers, along with fasting blood glucose levels in treatment-naïve people living with HIV (PLWH). We retrospectively analyzed the variations in fasting blood glucose and inflammatory markers and their relationship with different ART regimens in 497 treatment-naïve PLWH at the ART clinic of Zhongnan Hospital of Wuhan University from June 2018 to March 2022. From baseline to 24 months, fasting blood glucose, systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV) and lymphocyte-to-monocyte ratio (LMR) in PLWH receiving ART increased, while neutrophillymphocyte ratio (NLR) decreased (p < .05). In the NNRTIs group, fasting blood glucose, SII, PIV and LMR were higher than before (p < .05). In the INSTIs group, fasting blood glucose and LMR increased (p < .05), while NLR was lower (p < .05). Compared to the INSTIs, fasting blood glucose in the NNRTIs group was higher at 12 and 24 months (p < .05). At 24 months, both NLR and SII were higher in the NNRTIs group than in the INSTIs group (p < .05). Despite the virus suppression, fasting blood glucose and certain inflammatory markers in PLWH can gradually increase. Compared to NNRTIs, the INSTIs regimen was associated with favorable alterations in the levels of glucose and inflammatory markers.

Unraveling Morphological, Physiological, and Transcriptomic Alterations Underlying the Formation of Little Leaves in Phytoplasma-Infected Sweet Cherry Trees.

Phytoplasmas are minute phytopathogenic bacteria that induce excessive vegetative growth, known as witches'-broom (WB), in many infected plant species during the later stages of infection. The WB structure is characterized by densely clustered little (small) leaves, which are frequently accompanied by chlorosis (yellowing). The mechanisms behind the formation of little leaves within WB structures (LL-WB) are poorly understood. To address this gap, the LL-WB formation was extensively studied using sweet cherry virescence (SCV) phytoplasma-infected sweet cherry plants. Based on morphological examinations, signs of premature leaf senescence were observed in LL-WB samples, including reduced leaf size, chlorosis, and alterations in shape. Subsequent physiological analyses indicated decreased sucrose and glucose levels and changes in hormone concentrations in LL-WB samples. Additionally, the transcriptomic analysis revealed impaired ribosome biogenesis and DNA replication. As an essential process in protein production, the compromised ribosome biogenesis and the inhibited DNA replication led to cell cycle arrest, thus affecting leaf morphogenesis and further plant development. Moreover, the expression of marker genes involved in premature leaf senescence was significantly altered. These results indicate a complicated interplay between the development of leaves, premature leaf senescence, and the pathogen-induced stress responses in SCV phytoplasma-infected sweet cherry trees. The results of this study provide insight into understanding the underlying molecular mechanisms driving the formation of little leaves and interactions between plants and pathogens. The findings might help control phytoplasma diseases in sweet cherry cultivation.

Evaluation of a Standardized Obstetrics Insulin Drip Protocol and Order Set

Objective The prevalence of pregnancies affected by diabetes is increasing, with the Centers for Disease Control and Prevention reporting that 1–2% of pregnant women have type 1 or type 2 diabetes and up to 10% of pregnancies are affected by gestational diabetes as of 2018. Maternal glycemic management is directly related to fetal and neonatal outcomes, and aberrant maternal hyperglycemia has known negative outcomes. Although most of glycemic management centers on outpatient treatment, evidence exists to support the use of intravenous insulin drips during inpatient admissions. This study aimed to evaluate an intravenous insulin protocol specific to the obstetric (OB) population. Research Design and Methods This was a single-center retrospective pre-/post- cohort study of OB patients with diabetes admitted to an academic medical center. Groups were differentiated based on admission date and protocol implementation with a 6-month washout period. Included patients received an intravenous insulin drip around either antenatal corticosteroid administration or during labor and delivery. Those who were within 7 days of receiving a diabetic ketoacidosis diagnosis or who were admitted to an intensive care unit were excluded. Results Fifty-nine patients received 69 distinct insulin drip orders. Twelve drips were included in the group admitted before initiation of the insulin drop protocol (pre-group) and 57 in the group admitted after the protocol went into effect (post-group). Time spent within the goal glucose range while on an insulin drip in the pre-group was 1.63% compared with 39.30% in the post-group (P &amp;lt;0.001). Glucose levels &amp;lt;70 mg/dL was 0.00% in the pre-group compared with 3.23% in the post-group (P = 0.045). There were no differences in severe hypoglycemia (glucose &amp;lt;50 mg/dL), hyperglycemia (glucose &amp;gt;110 mg/dL), or neonatal outcomes. Conclusion Implementation of a nursing-driven, obstetrics-specific intravenous insulin drip protocol significantly improved maternal glycemic management within a goal glucose range of 70–110 mg/dL during antenatal corticosteroid administration and labor and delivery.

Idiopathic intracranial hypertension following childbirth: a case report and management strategies

Introduction: A postpartum headache, also known as pseudotumor cerebri, is defined as a headache and shoulder or neck pain that occur in the first six weeks following childbirth. Common causes of headaches during puerperium include pre-eclampsia, subarachnoid hemorrhage, cerebral venous thrombosis, meningitis, brain tumors, cerebrovascular diseases, and posterior reversible encephalopathy syndrome. Pseudotumor cerebri is an extremely rare cause of postpartum severe headache with visual disturbance with or without papilledema. Case Presentation: Here we present a 32-year-old postpartum female patient who presented with a severe headache and visual disturbance for 10 days. Neurological examination did not show any focal or lateralizing deficit. However, a fundus examination showed severe bilateral papilledema. A contrast-enhanced brain MRI did not reveal a space-occupying mass lesion. MRV excluded venous occlusion. A lumbar puncture demonstrated high opening pressure of 75 cmH2O with a normal cell count and protein and glucose levels. The patient was diagnosed with idiopathic intracranial hypertension. After 8 weeks of treatment with diazomid and topiramate, the patient improved clinically and her papilledema regressed. Clinical Discussion: The occurrence of IIH is very rare among postpartum females. To our knowledge, very few cases of postpartum IIH have been reported in the medical literature. Although rare, patients with postpartum headache with visual disturbances should have a fundoscopic examination. The patient was diagnosed and managed in time, which led to significant clinical improvement and salvage of her vision. Conclusion: As described in this case, idiopathic intracranial hypertension can cause severe headaches with and without visual disturbance during the postpartum period (despite being rare in this period), it should be considered in the differential diagnosis.

Problems in screening for gestational diabetes mellitus by measurement of casual blood glucose levels at 24-28 gestational weeks.

This study aimed to evaluate the problems in screening for gestational diabetes mellitus (GDM) by casual blood glucose (CBG) measurements at 24-28 gestational weeks. Overall, 763 pregnant women who underwent the 50-g glucose challenge test (GCT) at 24-28 gestational weeks were enrolled. The preload blood glucose (0-h BG) level of 50-g GCT was considered as CBG. A total of 240 women with BG levels at 1-h after loading (1-h BG) on 50-g GCT ≥140 mg/dL underwent the 75-g oral glucose tolerance test, and 98 (40.8%) were diagnosed with GDM. Of the 99 women with GDM, 71 (71.7%) had 0-h BG on 50-g GCT <100 mg/dL. This study, where pregnant women underwent both CBG and 50-g GCT simultaneously, showed that when CBG at 24-28 gestational weeks ≥100 mg/dL alone was used for screening GDM, many pregnant women with GDM were overlooked.

Profiling Metabolites Distribution among Various Leaf Layers of Chinese Cabbage

Chinese cabbage is an important vegetable from both a nutritional and an economic standpoint, with the leafy head serving as the primary harvested organ. However, the nutrient accumulation as well as influencing factors within the leafy head have not yet been elucidated. Thus, the distribution of metabolites (soluble sugars, minerals, carotenoids, vitamin C, flavonoid compounds, glucosinolates, and total phenolic compounds) were investigated in different leaf layers of Chinese cabbage with varying head types. The results showed that the inner leaves consistently displayed markedly higher levels of fructose and glucose when contrasted with the outer leaves. Similarly, there was an accumulation of glucosinolates in the inner leaves. By contrast, however, the antioxidants content exhibited a consistent decline from the outer leaves towards the central core, in line with the diminishing antioxidant capacity. This descending trend was also apparent in the mineral content, encompassing calcium, sodium, magnesium and sulfur. These results will provide dietary instruction, especially for consumers who have particular dietary needs.

Development and validation of a machine learning-based framework for assessing metabolic-associated fatty liver disease risk

BackgroundThe existing predictive models for metabolic-associated fatty liver disease (MAFLD) possess certain limitations that render them unsuitable for extensive population-wide screening. This study is founded upon population health examination data and employs a comparison of eight distinct machine learning (ML) algorithms to construct the optimal screening model for identifying high-risk individuals with MAFLD in China.MethodsWe collected physical examination data from 5,171,392 adults residing in the northwestern region of China, during the year 2021. Feature selection was conducted through the utilization of the Least Absolute Shrinkage and Selection Operator (LASSO) regression. Additionally, class balancing parameters were incorporated into the models, accompanied by hyperparameter tuning, to effectively address the challenges posed by imbalanced datasets. This study encompassed the development of both tree-based ML models (including Classification and Regression Trees, Random Forest, Adaptive Boosting, Light Gradient Boosting Machine, Extreme Gradient Boosting, and Categorical Boosting) and alternative ML models (specifically, k-Nearest Neighbors and Artificial Neural Network) for the purpose of identifying individuals with MAFLD. Furthermore, we visualized the importance scores of each feature on the selected model.ResultsThe average age (standard deviation) of the 5,171,392 participants was 51.12 (15.00) years, with 52.47% of the participants being females. MAFLD was diagnosed by specialized physicians. 20 variables were finally included for analyses after LASSO regression model. Following ten rounds of cross-validation and parameter optimization for each algorithm, the CatBoost algorithm exhibited the best performance, achieving an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.862. The ranking of feature importance indicates that age, BMI, triglyceride, fasting plasma glucose, waist circumference, occupation, high density lipoprotein cholesterol, low density lipoprotein cholesterol, total cholesterol, systolic blood pressure, diastolic blood pressure, ethnicity and cardiovascular diseases are the top 13 crucial factors for MAFLD screening.ConclusionThis study utilized a large-scale, multi-ethnic physical examination data from the northwestern region of China to establish a more accurate and effective MAFLD risk screening model, offering a new perspective for the prediction and prevention of MAFLD.

Progression in central blood pressure and hemodynamic parameters and relationship with cardiovascular risk factors in a Spanish population. EVA follow-up study.

The progression of Central Blood Pressure (CBP) values and central hemodynamic parameters and its relationship with cardiovascular risk factors is quite unknown. We sought to investigate this association in a Spanish adult population without cardiovascular diseases. Prospective observational research with a five-year follow-up. Randomly sampled 501 individuals (mean age 56±14 years, 50.3% women). After five years, 480 individuals had a follow-up. Measurements taken using the SphygmoCor® (AtCor Medical Pty Ltd., Head Office,West Ryde, Australia), following all the recommendations established in the "International task force"1, giving an estimate of central blood pressure relative to measured brachial blood pressure (type 1 device). Progressions during follow-up: central systolic blood pressure (cSBP): 4.16±13.71 mmHg; central diastolic blood pressure (cDBP): 2.45±11.37 mmHg; central pulse pressure (cPP): 1.72±12.43 mmHg; pulse pressure amplification (PPA): 2.85±12.20 mmHg; ejection duration (ED): 7.00±47.87ms; subendocardial viability ratio (SEVR): -8.04±36.24%. In multiple regression analysis: cSBP positively associated with: BMI (β=0.476); waist size (β=0.159); number of cigarettes per day (β=0.192). Inversely associated with peripheral systolic blood pressure (β=-0.282). cDBP increase positively associated with number of cigarettes per day (β=0.174). Inversely associated with peripheral diastolic blood pressure (β=-0.292). cPP increase positively associated with BMI (β=0.330). Inversely associated with peripheral pulse pressure (β=-0.262). PPA increase positively associated with: BMI (β=0.276); number of cigarettes per day (β=0.281). ED progress inversely associated with basal plasma glucose (β=-0.286). All measures increased except for SEVR. Progressions in CBP and PPA were positively associated with anthropometric parameters and number of cigarettes and CBP inversely associated with peripheral blood pressure, although this association was different according to sex.

Global burden of chronic kidney disease in adolescents and young adults, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

BackgroundThe global status of chronic kidney disease (CKD) is underestimated, particularly the burden on adolescents and young adults (early-onset, aged 15–39).ObjectiveWe aim to investigate the pattern and trend of early-onset CKD from 1990 to 2019.MethodsWe analyzed age-specific rates of early-onset CKD incidence, death, and disability-adjusted life years (DALY) using Global Burden of Disease Study 2019 data. We examined the global, regional, national, gender-based, age group-based, and temporal changes of early-onset CKD burden from 1990 to 2019, as well as proportional DALY attributions of various risk factors.ResultsFrom 1990 to 2019, the global age-specific incidence rate (per 100,000 population) significantly increased from 25.04 (95% confidence interval 18.51, 31.65) to 32.21 (23.73, 40.81) for early-onset CKD. However, the global age-specific death rate significantly decreased from 2.96 (2.76, 3.15) to 2.86 (2.61, 3.11), and the age-specific DALY rate remained stable. Regarding sociodemographic indexes (SDI), countries with middle SDI had the highest incidence rates and the fastest increasing trends, while those with low and low-middle SDI experienced the highest death and DALY rates. Women had a generally higher age-specific incidence rate than men, whereas men showed higher age-specific death and DALY rates. In addition, the burdens of CKD increased with age among adolescents and young adults. Moreover, the main attributable risk factors for DALY of early-onset CKD were high systolic blood pressure (SBP), fasting plasma glucose (FPG), and body mass index (BMI).ConclusionThe age-specific incidence rate of early-onset CKD increased significantly from 1990 to 2019, and the age-specific DALY rate remained stable. High SBP, high FPG, and high BMI were the primary risk factors. Targeted prevention and healthcare measures should be developed considering age, gender, and region.

Combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin in the treatment of type 2 diabetes mellitus combined with heart failure: a systematic evaluation and meta-analysis based on a randomized controlled trial.

This systematic review examines the efficacy of a combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin in treating type 2 diabetes mellitus (T2DM) combined with heart failure (HF). Randomized controlled trials (RCTs) assessing the combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin for T2DM and CHF was conducted. The search, spanning from the database's establishment to June 2023, included seven databases: China Knowledge Network (CNKI), Wanfang Database, VIP Database, PubMed, Embase, Cochrane Library, and the Chinese Biomedical Literature Database. Two researchers screened and extracted data based on inclusion and exclusion criteria. The Cochrane Handbook version 5.1 guided the quality assessment of studies, and the meta-analysis was performed using RevMan 5.4 software. Eleven articles, encompassing a sample size of 1192 cases, were included. Meta-analysis results indicated that combining Qi benefiting and blood circulation promoting herbs with Dapagliflozin improved the clinical efficacy rate [OR=4.35, 95% CI (2.98, 6.35), P&lt;0.00001]. It reduced blood glucose levels, evidenced by decreased fasting blood glucose (FBG) [MD=-1.19, 95% CI (-1.30, -1.09), P&lt;0.00001], 2-hour postprandial blood glucose (2hPG) [MD=-1.95, 95% CI (-2.09, -1.80), P&lt;0.00001], and glycosylated haemoglobin (HbA1c) [MD=-1.40, 95% CI (-1.49, -1.31), P&lt;0.00001]. Inflammatory factors also reduced, including C-reactive protein (CRP) [MD=-4.93, 95% CI (-5.38, -4.48), P&lt;0.00001], tumor necrosis factor (TNF-α) [MD=-2.91, 95% CI (-3.32, -2.49), P&lt;0.00001], and interleukin-6 (IL-6) [MD=-11.10, 95% CI (-12.43, -9.43), P&lt;0.00001]. Additionally, left ventricular end-diastolic diameter (LVEDD) [SMD=-1.25, 95% CI (-1.45, -1.05), P&lt;0.00001], left ventricular end-systolic diameter (LVESD) [SMD=-1.34, 95% CI (-1.51, -1.13), P&lt;0.00001], and improved left ventricular ejection fraction (LVEF)[SMD=2.92, 95% CI (2.65, 3.19), P&lt;0.00001], 6-minute walk test (6MWT) [MD=35.59, 95% CI (29.72, 41.47), P&lt;0.00001], and Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores [MD=35.59, 95% CI (29.72, 41.47), P&lt;0.00001] were observed. The incidence of adverse events also decreased [RR=0.25, 95% CI (0.11, 0.56), P=0.0007]. The combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin shows potential in treating patients with T2DM and HF, suggesting its use as adjunctive therapy in clinical practice. However, the limited number and quality of the included studies necessitate further high-quality research to confirm these findings.

Effects of fortified electrolyte drink on cognitive, mood, and nutritional parameters: a randomised, single‐blind, placebo‐controlled study

SummaryElectrolyte drinks contain charged minerals and are easily accessible in the market. It has become popular for the food and beverage industry to add nutrients and/or active ingredients to electrolyte drinks and market them as functional beverages. This study aims to determine the interactive effects of electrolyte drinks added caffeine, glucose, and B‐group vitamins (FED) on cognitive, mood index, and nutritional parameters. A total of 34 university students participated in this randomised, single‐blind, and placebo‐controlled study. Participants in the intervention group consumed 500 mL of FED, while participants in the control group consumed 500 mL of an electrolyte drink (ED). Baseline and post‐intervention data on cognitive performance, mood index, blood glucose, blood pressure, heart rate, and urine specific gravity were measured. Results indicated no significant differences (P &gt; 0.05) in post‐intervention cognitive performance scores for simple reaction time, choice reaction time, verbal paired associates, visual paired associates, and digit symbol matching between the FED and ED groups. Levels of fatigue, confusion, and total mood disturbance (TMD) were significantly reduced (P &lt; 0.05) by 46.50%, 62.75%, and 9.54%, respectively, following FED consumption. Post‐intervention data indicated no differences between the FED and ED groups in blood pressure, heart rate, and urine specific gravity, except for the blood glucose parameter, in which the blood glucose level of the FED group was significantly greater (P &lt; 0.05) than that of the ED group. This study indicates that FED consumed in a realistic dose can reduce fatigue, confusion, and TMD. Further studies with a higher caffeine dosage, but within the safe range, could be conducted to investigate the cognitive enhancement potential of FED.

Effects of GABA on Oxidative Stress and Metabolism in High-Glucose Cultured Mongolian Sheep Kidney Cells

The Mongolian sheep, emblematic of the Inner Mongolian grasslands, is renowned for its exceptional stress resistance and adaptability to harsh environments, drawing considerable attention. Recent research has unveiled the novel role of γ-aminobutyric acid (GABA) in combating oxidative stress. This investigation examined how GABA impacts renal-cortex and medulla cells from Mongolian sheep exposed to high-glucose stress conditions, utilizing gene expression analysis and non-targeted metabolomics. Elevated glucose levels significantly reduced the viability of Mongolian sheep renal cells and increased reactive oxygen species (ROS) levels. Conversely, the introduction of GABA notably enhanced cell viability, reduced ROS production, and stimulated the expression of antioxidant genes (e.g., Gpx, SOD, CAT) in the renal cortex. In the renal medulla, CAT expression increased, while Gpx gene expression showed mixed responses. Metabolomics analysis indicated that high-glucose exposure altered various metabolites, whereas GABA alleviated the metabolic stress induced by high glucose through modulating glycolysis and the tricarboxylic acid cycle. In Mongolian sheep renal cells, GABA effectively mitigated oxidative damage triggered by high-glucose stress by upregulating antioxidant genes and regulating metabolic pathways, revealing insights into its potential mechanism for adapting to extreme environments. This finding offers a fresh perspective on understanding the stress resilience of Mongolian sheep and may provide valuable insights for research across diverse disciplines.

Impact of Microplastic Exposure on Blood Glucose Levels and Gut Microbiota: Differential Effects under Normal or High-Fat Diet Conditions

Microplastics are emerging pollutants that have garnered significant attention, with evidence suggesting their association with the pathogenesis of type 2 diabetes mellitus. In order to assess the impact of polystyrene microplastic exposure on alterations in the gut microbiota and the subsequent implications for glucose dysregulation under different dietary conditions in mice, we investigated the effects and disparities in the blood glucose levels induced by polystyrene microplastic exposure in mice fed a high-fat diet versus those fed a normal diet. Using 16S rRNA sequencing and bioinformatics analyses, we explored the dynamic changes and discrepancies in the gut microbiota stability induced by polystyrene microplastic exposure under varied dietary conditions, and we screened for gut genera associated with the potential of polystyrene microplastics to disrupt glucose homeostasis. Our findings indicate that a high-fat diet resulted in abnormal mouse body weight, energy intake, blood glucose levels and related metabolic parameters. Additionally, polystyrene microplastic exposure exacerbated the glucose metabolism disorders induced by a high-fat diet. Furthermore, the composition and diversity of the mouse gut microbiota were significantly altered following microplastic exposure, with 11 gut genera exhibiting a differential presence between mice fed a high-fat diet combined with microplastic exposure compared to those fed a normal diet with microplastic exposure. Moreover, Ucg-009 played an intermediary role in the association between a high-fat diet and the fasting blood glucose. Hence, our study demonstrates that polystyrene microplastic exposure exacerbates high-fat diet-induced glucose metabolism disorders, whereas its impact on the blood glucose under normal dietary conditions is not significant, highlighting the differential influence attributable to distinct alterations in characteristic gut genera.

Development and Validation of a Two-step Model to Predict Outcomes After Endovascular Treatment for Patients With Acute Ischemic Stroke.

Physicians and patients are eager to know likely functional outcomes at different stages of treatment after acute ischemic stroke (AIS). The aim of this study was to develop and validate a 2-step model to assess prognosis at different time points (pre- and posttreatment) in patients with AIS having endovascular thrombectomy (EVT). The prediction model was developed using a prospective nationwide Chinese registry (ANGEL-ACT). A total of 1676 patients with AIS who underwent EVT were enrolled into the study and randomly divided into development (n=1351, 80%) and validation (n=325, 20%) cohorts. Multivariate logistic regression, least absolute shrinkage and selection operator regression, and the random forest recursive feature elimination algorithm were used to select predictors of 90-day functional independence. We constructed the model via discrimination, calibration, decision curve analysis, and feature importance. The incidence of 90-day functional independence was 46.3% and 40.6% in the development and validation cohorts, respectively. The area under the curve (AUC) for model 1 which included 5 pretreatment predictors (age, admission National Institutes for Health Stroke Scale score, admission glucose level, admission systolic blood pressure, and Alberta Stroke Program Early Computed Tomography score) was 0.699 (95% confidence interval [CI], 0.668-0.730) in the development cohort and 0.658 (95% CI, 0.592-0.723) in the validation cohort. Two treatment-related predictors (time from stroke onset to puncture and successful reperfusion) were added to model 2 which had an AUC of 0.719 (95% CI, 0.688-0.749) and 0.650 (95% CI, 0.585-0.716) in the development cohort and validation cohorts, respectively. The 2-step prediction model could be useful for predicting the functional independence in patients with AIS 90-days after EVT.