Glucose Oxidase Method Research Articles

Prothrombin time and activated partial thromboplastin time in women with gestational diabetes mellitus

Impact of gestational diabetes mellitus (GDM) on the coagulation system still remains unclear and there is limited data available regarding haemostatic changes in GDM in Bangladesh. This study was aimed at determining plasmaprothrombin time (PT), activated partial thromboplastin time (APTT) in women with GDM. This cross sectional study encompassed 44 GDM (age: 28.5±3.8 years, BMI: 27.2±4.0kg/m2; mean±SD) and equal number of pregnant women with normal glucose tolerance (NGT) diagnosed on the basis of WHO criterion 2013 at or after 24 weeks of gestation to see PT and APTT. Plasma glucose was measured by glucose oxidase method, PT and APTT by automated coagulation analyzer. There was no statistically significant difference between the GDM and NGT groups for PT (12.3±0.5 vs. 12.2±0.4 sec, mean±SD; P=0.40) or APTT (30.53±1.01 vs. 30.9±4.5 sec, mean±SD; P=0.56). In conclusion, PT and APTT do not differ between women with or without GDM. BSMMU J 2022; 15(3): 146-150

Smartphone-based colorimetric determination of glucose in food samples based on the intrinsic peroxidase-like activity of nitrogen-doped carbon dots obtained from locusts

In this study, nitrogen-doped carbon dots (N-CDs) with excellent peroxidase-like activity were prepared using locust powder as the carbon source by a self-exothermic reaction. The obtained N-CDs could catalyze the oxidation of the chromogenic substrate 3,3′,5,5′-tetramethylbenzidine (TMB) in the presence of H2O2 to generate a blue oxidized product (TMBox) with a maximum absorption peak at 654 nm. The catalytic reaction conditions were optimized; furthermore, steady-state kinetic analysis indicated that N-CDs exhibited high affinity toward both TMB and H2O2, and the Michaelis-Menten constant (km) values were 0.115 mM (TMB) and 0.764 mM (H2O2). A smartphone-based colorimetric method was developed for quantitative detection. The 1/L values (L stands for lightness in HSL color space) of the TMBox solution were recorded via an iPhone application Color Analyzer. Since H2O2 is the by-product of glucose (Glu) oxidation in the presence of glucose oxidase (GOx), a simple, sensitive, and selective smartphone-based colorimetric method was developed for the determination of Glu, and the detection limit was 1.09 μM. The smartphone-based method was successfully applied to determine Glu in different food samples with recoveries in the range of 88.5–109.0 %.

Effect of the Lingzi or Reishi Medicinal Mushroom Ganoderma lucidum (Agaricomycetes) on Hyperglycemia and Dyslipidemia with Experimental Metabolic Syndrome.

The effect of Ganoderma lucidum hot water extract of submerged cultivated mycelium suspensia on carbohydrate metabolism and lipid profile during fructose-induced metabolic syndrome in rats was studied. The outbred white male Wistar rats, in which metabolic syndrome was induced by consuming a 10% fructose solution instead of drinking water for 42 days, were used. After the induction of metabolic syndrome, the mycelium of G. lucidum in the form of water suspension (a dose of 1 g/kg of the animal's body weight) was administered to animals per os for 7 and 14 days. Glucose concentration was determined using the glucose oxidase method. The content of glycosylated hemoglobin in erythrocytes was determined by the colorimetric method. The concentration of triglycerides, cholesterol, high-density lipoproteins, and low-density lipoproteins in blood plasma was determined by enzymatic methods. A significant decrease in the content of glycosylated hemoglobin was established in animals with metabolic syndrome against the background of administration of the studied suspension. Under the conditions of experimental metabolic syndrome, the administration of mycelium for 7 and 14 days led to a decrease in the concentration of triglycerides by 17.8 and 44.8%, cholesterol by 10.7 and 21.3%, low-density lipoproteins by 14.8 and 28.4%, and to an increase in high-density lipoproteins concentration by 11.9 and 21.5%, compared with metabolic syndrome. The obtained results demonstrate the corrective effect of the suspension of the G. lucidum powdered mycelium on carbohydrate and lipid metabolism, which was directly proportional to the duration of administration.

The association of I/D polymorphism of ACE gene with metabolic factors of cardiovascular risk, structural and functional state of left cardiac chambers in patients with diabetic nephropathy and essential hypertension

Objective — to reveal an association of I/D polymorphism of ACE gene with metabolic factors of cardiovascular risk (CVR) such as visceral obesity (VO), insulin resistance (IR), dyslipidemia (DLP) as well as with indices characterized structural and functional state of left cardiac chambers in patients (pts) with diabetic nephropathy (DN) and essential hypertension (EH).
 Materials and methods. The investigation was conducted at the Clinical Department of Arterial Hypertensions and Kidney Diseases in L. T. Mala National Therapy Institute of NAMS of Ukraine (Kharkiv). Clinical examinations involved 82 pts, 42 (51.2 %) females and 40 (48.8 %) males with DN of I — IV stage and EH of II — III stage, aged 31 to 82 years old (an average age is (61.65 ± 1.28) years old). Three genotypes of I/D polymorphism of ACE gene included II — 18 (24.7 %), ID — 32 (43.8 %) and DD — 23 (31.5 %) of cases correspondingly were investigated in 73 (89.0 %) pts. Anthropometric measurements with calculations of body mass index (BMI), body fat percentage (BFP), body fat mass (BFM), fat mass index (FMI) were conducted by known formulas in all pts. Blood lipids were detected by enzyme method with measuring of total cholesterol, high‑density lipoprotein cholesterol (HDL‑C) and triglycerides (TG). Levels of cholesterol of very low density and low‑density lipoprotein (VLDL‑C, LDL‑C) were calculated by standard formulas. Blood glucose level was measured by glucose oxidase method and serum insulin was detected by immunoassay method. IR indices such as HOMA‑IR, triglyceride glucose index (TGGI) and METS‑IR (metabolic score for insulin resistance) were obtained by known formulas. I/D polymorphism of ACE gene (rs 4646994) was investigated with a usage of polymerase chain reaction. Structural and functional state of left cardiac chambers was estimated using transthoracic echocardiography. Systolic and diastolic blood pressure (SBP and DBP) were measured by Korotkov’s method. The results were statistically obtained with computer programs Microsoft Office Excel 2003 and Statistica 23.0.
 Results. In pts with II genotype, LDL‑C levels positively correlated with BFP (r = 0.490; p = 0.046) and BFM (r = 0.484; p = 0.049) in conditions with hypertriglyceridemia due to activation of visceral fat lipolysis in which a reverse correlation between relative thickness of left ventricle wall (RTLVW) and serum TG concentration (r = –0.540; p = 0.02) could be explained. In pts with ID genotype, presence of D allele in genotype was associated with an increase in RTLVW due to SBP influence (r = 0.358; p = 0.045). In genotype ID there was a relationship between IR index HOMA‑IR and BMI (r = 0.399; p = 0.029) and HOMA‑IR and FMI (r = 0.402; p = 0.025) that demonstrated VO participation of in the development of IR in pts with DN and EH and genotype ID. In pts with DN and EH, who had DD genotype, SBP level reversely correlated with HDL‑C (r = –0.498; p = 0.018) that could be explained by influence of IR on elevation of SBP and reduction of HDL‑C. In pts with DD genotype both SBP and DBP almost equally influenced on the left atrial diameter (r = 0.460; p = 0.036 and r = 0.453; p = 0.034 correspondingly). In pts with DN and EH whose had DD genotype IR index METS‑IR positively correlated with RTLVW (r = 0.419; p = 0.047) and left ventricle myocardial mass index (r = 0.518; p = 0.011) that confirmed an association of D allele of ACE gene with left ventricle hypertrophy caused both by EH and IR.
 Conclusions. It has been established that in patients with diabetic nephropathy and essential hypertension, the I/D polymorphism of ACE gene was associated with such metabolic factors of cardiovascular risk as visceral obesity, insulin resistance, dyslipidemia, and pathological left ventricle remodeling.

Frequency of Gestational Diabetes Mellitus in Pregnant Women Reporting to a Public Sector Tertiary Care Hospital of Quetta

Objective: To determine the frequency of gestational diabetes mellitus in pregnant women reporting to a public sector tertiary care hospital and find the association of gestational diabetes mellitus with age.
 Study Design: Comparative cross-sectional study.
 Place and Duration of Study: Pathology Department, Combined Military Hospital, Quetta Pakistan, from Jan 2016 to Mar2017.
 Methodology: Five hundred and thirty pregnant women who reported to the Pathology Department of the hospital for an Oral Glucose Tolerance Test at 24-28 weeks of gestation were included. The blood samples were taken after ten hours off fasting and one hour and two hours after loading with 75g of anhydrous glucose and analyzed using the enzymatic (Glucose Oxidase) method. Gestational diabetes mellitus was diagnosed using guidelines recommended by the International Association for Diabetes and Pregnancy Study Group /American Diabetic Association for a one-step diagnosis of gestational diabetes mellitus according to the new criteria.
 Results: The frequency of gestational diabetes mellitus was quite high 190(35.8%). Of these 530 pregnant women, 162(85.3%)women were diagnosed with Fasting Plasma Glucose, and 28 women were diagnosed with 1-hour or 2-hour after the glucose load test. Age-group of ≥ 30 years had the highest number of women with gestational diabetes mellitus.
 Conclusion: The frequency of gestational diabetes mellitus in our hospital-reported sample of pregnant women was 35.8%,associated with advanced age. The maximum number of women were diagnosed as having gestational diabetes mellitus based on the fasting Plasma Glucose cut-off value.

GAMBARAN KADAR GLUKOSA DARAH SEWAKTU PADA LANSIA DI DESA ADAT TAMPUAGAN KECAMATAN KARANGASEM KABUPATEN KARANGASEM

Background: The aging process is a factor that causes a decrease in pancreatic function cells and insulin secretion in the elderly. As a result of this aging process, the risk of increased blood glucose levels and impaired glucose tolerance will be higher.Purpose: This study aimed to find out the description of random blood glucose levels in the elderly in the Traditional Village of Tampuagan, Karangasem District, Karangasem Regency.Method: The type of research used is descriptive research with simple random sampling techniques. The sample used 39 samples obtained through interviews and checking random blood gluc.ose levels while using the glucose oxidase method using the POCT toolResult: Obtained the highest random blood glucose levels of respondents who had normal random blood glucose levels. Based on characteristics found most in the age range of 60-74 years, female gender, and no history of DM.Conclusion: The description of blood glucose levels in the elderly in the Traditional Village of Tampuagan, Karangasem District, Karangasem Regency, mostly have normal blood glucose levels. Keywords: Random Blood Glucose, Elderly, POCT.

Effects of Rosa roxburghii on insulin resistance in obese rats and its mechanisms

Objective: To investigate the effects of Rosa roxburghii on insulin resistance in obese rats and the regulation of phosphatidylinositol 3-kinase (PI3K)/ protein kinase Bβ(PKBβ/Akt2)/ glucose transporter 4(GLUT4) signaling pathway. Methods: Five-week-old male SD rats were randomly divided into normal control group (NC), model group (M), positive control group (PC), low-dose rosa roxburghii group (LD) and high-dose rosa roxburghii group (HD), with 10 rats in each group. The rats in the NC group were fed with normal diet, while those in the M, PC, LD and HD groups were fed with high-fat diet. From the 13th week, according to the dose standard of 6 ml/kg, rats in the LD group were intragastrically administered with 100 mg/kg Rosa roxburghii Tratt, the HD group were treated with 300 mg/kg Rosa roxburghii Tratt, the PC group were treated with 0.11 g/kg Chiglitazar sodium, and the NC and M groups were intragastrically administered with the same volume of normal saline. The body weight was measured every week until 20 weeks. The rats were sacrificed 24 h after the last experiment. Blood and skeletal muscle were collected. Serum total cholesterol (TC) and triglyceride (TG) contents were detected by colorimetric method, serum superoxide dismutase (SOD) activity was detected by xanthine oxidase method, serum malondialdehyde (MDA) content was detected by thiobarbituric acid method, blood glucose (FBG) value was detected by glucose oxidase method, insulin (FINS) content was detected by ELISA, and PI3K, Akt2, and GLUT4 protein and gene expressions were detected by Western blot and reverse transcription-polymerase chain reaction (RT-PCR). Results: Compared with the NC group, the body weight, serum MDA, TG, TC, FBG, FINS, HOMA-IR levels in the M group were significantly increased (P＜0.01), while SOD activity, PI3K、Akt2、GLUT4 protein and mRNA expression levels were significantly increased(P＜ 0.01). Compared with group M, the body weight, serum MDA, TG, TC, FBG, FINS, and HOMA-IR were decreased significantly in LD group, HD group and PC group (P＜0.05 or P＜0.01), while SOD activity, PI3K, Akt2, GLUT4 protein and mRNA expression levels were increased significantly (P＜0.05 or P＜0.01). Conclusion: Rosa roxburghii can improve insulin resistance in obese rats by antioxidant stress and up-regulating the expressions of PI3K, Akt2, and GLUT4 proteins and genes, which may be related to the PI3K/Akt2/GLUT4 signaling pathway.

Serum uric acid level among type-2 diabetes subjects attending in a tertiary hospital of Bangladesh

Introduction: Type 2 Diabetes mellitus (T2DM) is a heterogeneous disease which is characterized by variable degrees of insulin resistance, impaired insulin secretion and increased glucose production. Serum uric acid, an end product of purine metabolism, has been shown to be associated with an increased risk of insulin resistance and components of the metabolic syndrome in previous epidemiological studies. However, the putative association of serum uric acid levels with type 2 diabetes mellitus is not clear. Therefore, the present study has been undertaken to determine the levels of explore the association of serum uric acid among male and female type 2 diabetic subjects. Materials and Method: Under an observational analytical design a total of 104 T2DM (M/F, 40/64; age in years, 45±9; M±SD) were recruited. Among laboratory investigations, serum glucose was measured by glucose-oxidase method, lipid profile and serum uric acid by enzymatic colorimetric method. Results: In male T2DM subjects, mean±SD fasting serum glucose (mmol/l) and 2hr after breakfast serum glucose were 7.99±1.45 and 10.93±2.24 respectively. In female T2DM subjects, mean±SD fasting serum glucose (mmol/l) and 2hr after breakfast serum glucose were 58.44±14.63 and 9.65±4.16 respectively. The 2hr after breakfast serum glucose was significantly higher in male T2DM subjects compared to female counteracts (p=0.026). In male T2DM subjects, mean±SD total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and very low-density lipoprotein cholesterol (VLDL-c) levels were 07.57±48.96, 144.30±72.20, 36.71±8.30, 137.80±34.14 and 28.86±14.44 respectively. In female T2DM subjects, these values were 186.21±47.946, 207.81±158.12, 39.43±13.12, 108.31±37.11 and 41.56±31.62 respectively. Among these lipidemic variables serum LDL-c was significantly higher in male T2DM subjects compared to female counterparts (p=0.050). Serum uric acid levels was significantly higher in male T2DM subjects compared to female counteracts (4.38±1.96 vs. 5.73±1.34, p=0.013). Conclusion: From the above result it can be concluded that elevated level of serum uric acid is common in female T2DM subjects compared to male counterparts. Further studies with large sample size are warranted to explore the causal effects of this elevation. Therefore, uric acid serves as a potential biomarker of the glucose metabolism.

Comparison of point-of-care glucometers and laboratory based glucose oxidase test in determining blood glucose levels

Alterations in blood glucose levels are common and an important determinant of a patient's admission outcomes, point-of-care glucometers, which are affected by a variety of factors, are increasingly used in clinical care. In this study we compared blood glucose levels determined by two commonly used glucometers (One Touch® and Accu-check®) with those of a standard laboratory method and determined the effect of haematocrit on glucose readings. Blood glucose levels were measured with One Touch® and Accu-Check® glucometers and the glucose oxidase method at the same time in 295 children aged 0 to 15 years over a 6-month period. Bland-Altman and correlation analysis were used to explore biases among the three methods. For all statistical tests, a p-value of less than 0.05 was considered statistically significant. Most were males (51.2%) and the median (range) age was 1 year (1 day, 12 years). There was a significant correlation between each of the glucometer methods and laboratory blood sugar, and the correlation between the two glucometers was strong and significant. This correlation remained statistically significant even after controlling for haematocrit values. There was an acceptable level of bias (3.9 mg/dL) between the One Touch® and Accu-check® glucometers, but each had a remarkably large bias compared with the glucose oxidase method. The use of a tested glucometer in clinical settings can aid in rapid decision-making, but there is a need to periodically cross-check with the glucose oxidase method in the laboratory to optimise treatment outcomes for children with dysglycaemia.

Hormonal regulation of the concentration of glucose and its derivatives in the blood of dairy cows during the transit period

In dairy cows, metabolic disorders are mainly found in the last weeks of the dry period and the first weeks after calving (transit period). Therefore, the purpose of this study was to investigate the hormonal regulation of the concentration of glucose and its derivatives in the blood of dairy cows during the transit period. The study was conducted on cows of 2-4 lactations, with a capacity of 7.8-8.2 thousand kg of milk for previous lactation. Blood for research was taken from cows 7-10 days before calving and Days 2-4, Days 10-14, and Days 30-40 after calving. The concentration of glucose in blood plasma was determined by the glucose oxidase method, pyruvate − by the modified Umbright method, lactate – by reaction with paraoxydyphenyl, and hormone content – by enzyme-linked immunosorbent assay. It was established that high-performance dairy cows during the transit period experience substantial changes in carbohydrate metabolism and the functional state of organs and systems, which are aimed at ensuring high productivity. Thus, hypoglycaemia is found in cows within two weeks after calving. At the same time, with a decrease in the concentration of glucose in the blood plasma of cows, the content of pyruvate and lactate increases, as well as the lactate/pyruvate ratio, which indicates an increase in gluconeogenesis. Negative energy balance and increased gluconeogenesis lead to a decrease in the synthesis of insulin and insulin-like growth factor. Compared to the final dry period, on Days 2-4 of lactation, the concentration of leptin in the blood plasma of cows decreased threefold and stayed at a low level until Day 40 of lactation. Plasma cortisol levels were highest on Days 2-4 and 10-14 of lactation. Intensive cortisol synthesis during the period of energy deficiency increases gluconeogenesis, which is possible due to lipolysis and proteolysis. In the first days after calving, the content of thyroxine and triiodothyronine in the blood plasma of cows decreased. Inhibition of thyroid hormone production is a consequence of the physiological regulatory features of this period. Thus, in highly productive cows during the transit period, attention should be paid to maintaining vital body functions and their well-coordinated endocrine regulation, which will ensure a physiologically balanced metabolic rate, successful calving, high milk productivity, and animal health

Glucose Monitoring System using Machine Learning

Bio-medical analysis is an indispensable procedure for identifying health-related diseases like diabetes. Monitoring the glucose level in our body regularly helps us identify hyperglycemia and hypoglycemia which can cause severe medical problems like nerve damage or kidney diseases. This paper outlines a technique for predicting the Glucose concentration in blood samples utilizing Image Processing and Machine Learning Algorithms. The glucose solution is prepared by the Glucose Oxidase (GOD) and Peroxidase (POD) method. Experimental database is generated based on colorimetric technique. The image of the glucose solution is captured by the raspberry pi camera and analyzed using Image Processing by extracting the RGB, HSV, LUX color space values. Regression algorithms like Multiple Linear Regression, Decision Tree, RandomForest, and XGBoost were used to predict the unknown glucose concentration. Since multiple linear regression yields the best results when compared to other models, with the highest accuracy of 96.56% for selected features and 89.73% for all features, it should be used to predict blood sample glucose levels. The image processing and machine learning based approach reduces the hardware complexities of the existing platforms.

A model for predicting acute heart failure in patients with acute myocardial infarction by taking into account energy and adipokine metabolism indicators

Acute heart failure (AHF) is one of the most common complications of acute myocardial infarction (AMI). Currently, adropin, irisin, fatty acid binding protein 4 (FABP 4) and C1q/TNF-binding protein 3 (CTRP 3) are considered to be valid markers of energy homeostasis and the adipokine system in AMI patients. The aim of the study was to predict the development of AHF in AMI patients by taking into account indicators of energy homeostasis and adipokine system using generalized linear mixed model. The study examined 189 patients with acute ST-segment elevation myocardial infarction. Concentrations of adropin, irisin, insulin, FABP4 and CTRP3 were determined by enzyme-linked immunosorbent assay. Fasting capillary blood glucose level was measured by glucoseoxidase method. Insulin resistance (IR) was assessed using homeostasis model assessment of insulin resistance (HOMA-IR). The study identified thrombolysis in myocardial infarction (TIMI) grade before intervention. A generalized linear mixed model was used to develop a method for predicting AHF in AMI patients. The study showed decreased levels of adropin, irisin and CTRP3 and increased levels of FABP4 in AMI patients. A mathematical model for predicting AHF development in AMI patients was proposed. The model consisted of fixed effects, namely, two one-factor indicators (HOMA-IR and systolic blood pressure (BP)), one two-factor indicator (systolic and diastolic BP) and one three-factor indicator (adropin, irisin and CTRP3) and random effects such as four one-factor indicators (FABP4, TIMI Grade Flow, platelets, total cholesterol). The accuracy of predicting the absence of Killip class I AHF was 100%, Killip class II AHF – 0%, Killip class III AHF – 11%, Killip class IV AHF – 82%. It should be noted that systolic BP on day 1 was a strong negative prognostic factor, while HOMA-IR, the combined effect of adropin, irisin and CTRP3, the combined effect of systolic and diastolic BP were positive prognostic factors. Thus, the model showed a very high sensitivity in predicting Killip class IV AHF. The overall accuracy of the model was 89.4%.

Association Between Glycemic Control Status and Serum Level of Vitamin D3 in Patients with Type 2 Diabetes: A Cross-Sectional Study

Objective: This study aimed to assess the association between glycemic control status and serum levels of vitamin D3 in Iranian patients with type 2 diabetes (T2D). Materials and methods: This was a cross-sectional study on 452 patients with T2D in Tehran, Iran, performed between September 2019 and September 2020. We assessed the diabetes laboratory test and vitamin D3 level in all participants using the Enzymatic Glucose Oxidase method. Data were analyzed using SPSS version 24. Results: a total of 452 patients were enrolled in this study (mean age: 59.4 ± 11.4 years, 63.5% females). Vitamin D deficiency was reported in half of the participants. Deficient vitamin D was significantly associated with higher mean level of hemoglobin A1c, fasting plasma glucose, total cholesterol, and low-density lipoprotein-cholesterol (p < 0.05). Multiple regression showed that the level of vitamin D3 could be a good predictor of hemoglobin A1c after adjusting for confounding variables affecting the hemoglobin A1c (regression coefficient: 0.442, 95% CI, 0.072–0.811, p = 0.063). Conclusions: With the alarming rates of vitamin D deficiency in patients with T2D, there was a significant direct association between vitamin D3 and hemoglobin A1c levels before and after adjusting for the associated factors.

ASSESSMENT OF INULA CAPPA LEAVES EXTRACTS FOR ANTIDIABETIC POTENTIAL IN EXPERIMENTAL ANIMALS

Diabetes mellitus (DM) is a long-term disease that can be caused by a lack of insulin production by the pancreas, or by the ineffectiveness of the insulin produced. For the study, the antidiabetic effects of methanolic and 50% v/v hydroalcoholic methanolic and extracts of the leaves of Inula cappa were used as oral doses at 100, 200, and 400 mg/kg and Metformine (50 mg/kg) were administered continuously for 21 days as a single morning dose. 18 hours of fasting was used to assess the drug's anti-diabetic effects in normoglycemic rats. On the 0th, 10th, and 21st days of the experiment, glucose oxidase method readings were collected using an autoanalyzer to assess fasting blood glucose levels. Anti-oxidant parameters were determined including, total phenolic content, total flavonoid concentration, DPPH free radical scavenging activity, Hydroxyl radical scavenging activity, Scavenging of Hydrogen Peroxide, Superoxide radical scavenging assay, Nitric oxide scavenging activity and Reducing power assay. The methanolic (ICME) and hydroalcoholic (ICHE) extracts of Inula cappa leaves (100, 200, and 400 mg/kg, p.o.) passes the Oral Glucose Tolerance Test. Both extracts had a greater impact in lowering blood glucose levels. Out of which ICHE at all doses showed significant effect (P<0.05-P<0.001) when compared with control. ICME in terms of glucose tolerance at all doses had significant effects. Keywords: Diabetes mellitus, insulin, metformine, scavenging, Inula cappa.

Serum Zinc Level in Children Suffering from Type 1 Diabetes Mellitus and Its Relationship with Glycemic Control: An Experience from A Tertiary Level Specialized Diabetic Hospital in Bangladesh

A cross-sectional study was conducted in the Department of Biochemistry and Molecular Biology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh, between July 2016 and June 2017, to evaluate serum zinc level and its relationship with glycemic control in type 1 diabetic children. A total of 160 participants (all aged between 1 and 18 years) were selected from the outpatient department (OPD) of BIRDEM General Hospital-2, Dhaka – 80 type 1 diabetic children as cases and 80 apparently healthy children as controls. We measured anthropometric parameters all study subjects. Serum zinc level was assessed using colorimetric method. Fasting plasma glucose level was estimated using enzymatic glucose-oxidase method. Glycemic control was evaluated through estimation of HbA1c using a high-performance liquid chromatographic method. The mean serum zinc levels were significantly lower in patient with type 1 DM compared to control (72.5±16.5 vs. 82.4±13.3 μg/dl; P<0.001). Lower levels of zinc were found in subjects with poor glycemic control compared to good glycemic control (62.8±14.6 vs. 78.8±14.6 μg/dl; P<0.001). Moreover, serum zinc levels were significantly lower in patients who have duration of diabetes mellitus for 5 years or more (P<0.05). To summarize, serum zinc level is lower in type 1 diabetic children in comparison to its healthy counterpart and this lower zinc level is strongly associated with poor glycemic control which may potentially contribute to the early development of diabetic complications in children.
 CBMJ 2022 July: vol. 11 no. 02 P: 80-85

THE FUNCTIONAL STATE OF LIVER IN PATIENTS WITH METABOLIC SYNDROME WITH TYPE 2 DIABETES

One of the pathogenetic mechanisms of the development of insulin resistance (IR) in type 2 diabetes mellitus (type 2 DM) is the formation of non-alcoholic fatty liver disease (NAFLD). DM and liver pathology can be considered as interrelated processes. The aim of the study was to evaluate the indicator, secretory and excretory enzymes of blood serum in the development of IR in patients with metabolic syndrome (MS) with type 2 DM. The distribution of patients with MS with type 2 DM was carried out, depending on the presence of non-alcoholic steatohepatitis (NASH): a group of patients with NASH - 36, a group of patients without NASH - 32. The degree of IR was determined by the size of the waist circumference, IR indices: HOMA-IR index and Caro index. The obligatory volume of laboratory researches included: the general clinical analysis of blood and urine, research of fasting blood glucose and postprandial glycemia, glycemic profile of blood by glucose oxidase method by means of the «Exan» device was carried out. Glycated hemoglobin (HbA1c) was determined by chromatographic method using a test system (fully automated analyzer) to determine the content of hemoglobin D-10TM by "Bio-Rad" company (USA). Determination of the activity of aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, arginase, cholinesterase was performed by diagnostic kits of the Czech company "Lachema" on a spectrophotometer Sf-46. Alkaline phosphatase activity was determined by Phillips-Diagnostic reagent kits. The concentration of endogenous insulin was determined by DRG reagent kit (USA), by enzyme-linked immunosorbent assay using an analyzer "StatFax - 303. To determine the presence of structural changes in the liver the ultrasound on the device "Elegra" Simens Medicol Systems was used. Wefound that the metabolic prerequisites for the development of NASH of the liver are fasting and postprandial hyperglycemia, hyperinsulinemia. The increase in the degree of glycation of hemoglobin and increase in IR. The results of the study of the degree of hemoglobin glycation showed a reliable increase in the relative content of HbA1c in patients with NASH and MS with type 2 diabetes without NASH - 2.1 and 1.9 times, compared with healthy individuals. A study of the content of endogenous insulin in the blood on an empty stomach revealed reliable hyperinsulinemia - in patients with NASH, the content of endogenous insulin on an empty stomach exceeded the norm by 4.3 times. Increased levels of alanine aminotransferase, sorbitol dehydrogenase, arginase, lactate dehydrogenase, alkaline phosphatase and decreased cholinesterase in patients with MS with NASH detected which display the damage of detoxification and synthetic function of the liver and glycogenization. The connection of IR with the deepening of the phenomena of hepatocyte damage, suppression of the synthetic function of hepatocytes, with markers of nonspecific hepatodepsy, reduction of liver detoxification function, glycolysis processes, predictors of necrosis hepatocytes in NASH on the background of MS with type 2 DM determined.

Glucose measurement: Comparison of venous and capillary glucose measurements in type II diabetes mellitus.

Objective: To determine the comparison between the capillary glucose and venous plasma glucose in type II diabetic patients. Study Design: Cross Sectional Observational study. Setting: Al–Tibri Medical College and Hospital Karachi. Period: 1st January 2020 to 30th April 2020. Material & Methods: A total of 86 diabetic patients from the out-patient department with non-probability consecutive sampling were selected. Subjects were diagnosed cases of type II diabetes based on the screening recommendation by the American Diabetes Association between 35-75 years of age of either gender included in this study. Patients with type I diabetes, pregnant females and hematocrit of more than 55% or less than 35%, and patients taking medications like Acetaminophen, and Ascorbic acid were excluded from the study. Each participant was measured for the capillary blood glucose levels by using Accu Chek, Easy max and On-call EZII, using strips by Glucose Oxidase Method. A venous sample was collected within 5 minutes of finger-prick test in a sodium fluoride tube. A Statistical Package for Social Sciences version 22 was used for data analysis. Results: Out of 86 patients in the study, 48(55.8%) were females and 38((44.2%) were males with a mean age of 47.16±9.916. The mean blood sugars by venous plasma glucose were 249.58±110.75 mg/dl, by Accu Chek 250.47±117.071 mg/dl, by EasyMax 259.26±119.751 mg/dl, and by On-call EZII 249.33±124.380 mg/dl which shows statistically significant correlation with a p value of <0.001. The glucometers accuracy was determined by using Error grid analysis showed a strong positive correlation between the Accu Chek R2= 0.917, EasyMax R2= 0.917, and Oncall glucometers R2= 0.868 with venous plasma glucose with a statistically significant (p <0.001). Conclusion: This study shows a strong positive correlation between capillary and venous glucose measurements.

Role of Salivary Glucose in the Diagnosis and Monitoring of Type 2 Diabetes Mellitus

Objectives: To determine the correlation of fasting salivary glucose with fasting plasma glucose (FPG) and glycated hemoglobin A1c (HbA1c) for the diagnosis and monitoring of type 2 diabetes mellitus (T2DM). Methods: A case - control study was carried out from 11th March to 30th August 2021, involving 88 participants out of which 44 were healthy controls and 44 participants were known T2DM who had FPG ≥ 126 mg/dl or 7.0 mmol/L. FPG was measured by Glucose oxidase method and HbA1c by National Glycohemoglobin Standardization Program (NGSP) certified chromatography. Results: T2DM group had significantly higher FPG, HbA1c and salivary glucose values. Both diabetics and healthy controls showed a positive correlation of fasting salivary glucose with FPG. The correlation coefficient (r) was 0.689 and 0.477 for cases and control groups respectively. Similarly, a positive correlation of fasting salivary glucose with HbA1c was observed with the value of r 0.433 and 0.498 for diabetic and healthy control groups respectively, when measured separately. For both groups linear regression equations were derived and scatter dot plots were plotted. P value < 0.001 Conclusion: A positive correlation of fasting salivary glucose with FPG and HbA1c was found. As a result, fasting salivary glucose can be utilized instead of plasma glucose for T2DM patients’ screening, diagnosis, and monitoring thereby eliminating the repeated pricks and mental trauma of patients. Keywords: Blood glucose, glycemia, glycated hemoglobin, salivary glucose, Type 2 diabetes mellitus

Estimation & comparison of salivary glucose with blood glucose in diabetic individuals

Aim: Saliva play a diagnostic tool for oral and systematic diseases has multiple advantages over other body fluids especially . The aim of this study was to explore the potential of salivary glucose as a marker in diagnosis and monitoring of diabetes mellitus using glucoseoxidase method, and as a non-invasive method replacing an invasive blood glucose estimation method. Materials and methods: Fasting blood and unstimulated whole saliva were collected from 50 controls, 50 newly diagnosed diabetics, and 50 diabetics under treatment. Blood and salivary glucose were analyzed in the samples by glucose-oxidase method. Results: The mean level of salivary glucose was reported to be 0.53 ± 0.4mg/dl in controls, 1.14 ± 1.55mg/dl in newly diagnosed diabetics, and 1.22 mg/dl ± 1.99 in diabetics under treatment. Conclusion: The mean level of salivary glucose in diabetics was significantly higher than that in non-diabetics. A positive, linear and significant, yet weak correlation between salivary and blood glucose suggests some potential for saliva as a marker in diagnosis and monitoring of diabetes mellitus.

Overweight and Type II Diabetes among the Elderly Middle Belt Nigerians

Background: The increasing rate of obesity and type-2 diabetes (T2DM) are impending major threats to the health of African Population but the magnitude of the two in middle age Nigerians is not known. We assessed the burden of obesity and T2DM among elderly middle belt Nigerians. Methods: A cross sectional prospective study was conducted among the population living in Lafia town. After biodata and clinical examination, including arthrometric measurements of weight and height was conducted. Standard BMI was calculated. A casual glucose and fasting blood glucose was determined using serum enzymatic glucose oxidase method. The diagnostic criteria were taken as fasting glucose at ≥ 7.0mmol/L and casual glucose at ≥ 11.1mmol/L. Results: In Lafia town the prevalence of Class I obesity was 62.6% there is a perfect correlation of 1.000 between BMI and glucose, meaning that as the BMI of a person increases, blood glucose concentration always increases and vice versa. The correlation between age and glucose concentration (0.0447) reflects a very weak positive relationship, indicating that BMI may differ at different ages. i.e. as the age of a patient increases, there is a slight tendency that the BMI may also increase. Conclusion: This study showed high risk of T2DM and obesity among middle belt Nigerians living in Lafia town due to sedentary lifestyle and lack of exercise in addition to indiscriminate diet. There is need for regular screening for diabetes and hypertension. Use of portable electronic BP machine is advocated. There should be lifestyle modification like regular exercise, control of excessive alcohol intake and dietary advice.