Glycemic Status Research Articles

A Study on the Incidence and Impact of Dysglycemia in Non-diabetic Sepsis Patients.

Context Dysglycemia is common in severe sepsis and is associated with a poor prognosis.There is a limited amount of research on stress-induced dysglycemia in non-diabetic sepsis patients. Aim This study aims to estimate the incidence of dysglycemia among non-diabeticpatients presenting with sepsis at the Emergency Departmentand to determine its correlation with gender, age, APACHE II (Acute Physiology and Chronic Health Evaluation) scores, diagnosis, and duration of hospital stay. Materials and methods The study was conducted at a medical college hospital in Kochi from January 1, 2023, to December 31, 2023. A minimum sample size of 77 was derived after a pilot study,with a 95% confidence interval and 10% allowable error. A total of 100 non-diabetic sepsis patients meeting the inclusion and exclusion criteria were analyzed with regard to gender, age, diagnosis,glycemic status (hypo/hyper/normoglycemic),APACHE II scores, and hospital stay duration.Statistical analysis was performed usingIBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York) software.Categorical variables were expressed as frequency and percentage. Continuous variables were presented as mean ± SD (standard deviation) and median (Q1-Q3). To test the statistical significance of the association between the presence of various factors (gender, age, diagnosis) and dysglycemia, the chi-square test was used. To test the statistical significance of the differencein the mean age and APACHE II score values with dysglycemia, an independent sample t-test was used. To test the statistical significance of the difference in the median hospital stay with dysglycemia, the Whitney U test was used.Data were represented as mean ± SD, and a p-value of <0.05 was considered to be statistically significant. Results The incidence of dysglycemia in the inclusion group was 49% (hypoglycemia in 16% and hyperglycemia in 33% of cases), and it increased with age (p=0.002). The majority of the dysglycemic patients fell into the age group >40 years. Dysglycemia was 54.8% in pneumonia and 66.7% in gastrointestinal sepsis ( p=0.138). Dysglycemia increased with an increase in APACHE II scores (p=0.017). The median hospital stay was almost the same in both normoglycemics and dysglycemics. Conclusion Dysglycemia is a frequent complication in non-diabetic patients with sepsis. It increased with age and APACHE II score, but it does notprolong the duration of hospital stay, nor is it associated with the diagnosis.

Results of the implementation of the DP-TRANSFERS project in Catalonia: a translational method to improve diabetes screening and prevention in primary care

IntroductionDP-TRANSFERS is a translational lifestyle intervention project, which follows a previous protocol described in the DE-PLAN-CAT study. ObjectiveAnalyze the feasibility of reproducing the intensive intervention and estimating the effect of translation in real conditions of clinical practice in primary care. MethodologyImplementation of the face-to-face group intervention adjusted to 2 years. After screening, the intervention consisted of a basic module and a continuity module. Stratifying by clusters (health centers), a representative sample (centers, professionals and participants) was evaluated (FINDRISC > 11 and/or prediabetes) from 2016 to 2020. The effect of the intervention on the incidence of diabetes was analyzed. ResultsThe intervention, feasible in 95 of 123 centers, involved 343 of 647 professionals. Of 2381 subjects screened, 1713 participated in the basic module, with 1186 participants completing the first year and 776 completing the second. 121 participants (7.06%) were diagnosed with diabetes: 77 (4.49%) during the first year; 44 (2.57%) during the second.The bivariate analysis showed that those subjects in whom diabetes affected differed in: previous glycemic status, A1c, HDL-cholesterol, FINDRISC score and adherence to the Mediterranean diet, and in the differences between the beginning and end of the study of: body weight, BMI and abdominal circumference. ConclusionsThe intensive intervention substantially reduced (23.6%) the incidence of diabetes compared to that previously estimated in standardized intervention. The following acted as protective factors: a better glycemic status, lower baseline risk, elevated HDL-cholesterol, or achieving a reduction in weight or abdominal circumference during the study.

Exploring protein relative relations in skeletal muscle proteomic analysis for insights into insulin resistance and type 2 diabetes

The escalating prevalence of insulin resistance (IR) and type 2 diabetes mellitus (T2D) underscores the urgent need for improved early detection techniques and effective treatment strategies. In this context, our study presents a proteomic analysis of post-exercise skeletal muscle biopsies from individuals across a spectrum of glucose metabolism states: normal, prediabetes, and T2D. This enabled the identification of significant protein relationships indicative of each specific glycemic condition. Our investigation primarily leveraged the machine learning approach, employing the white-box algorithm relative evolutionary hierarchical analysis (REHA), to explore the impact of regulated, mixed mode exercise on skeletal muscle proteome in subjects with diverse glycemic status. This method aimed to advance the diagnosis of IR and T2D and elucidate the molecular pathways involved in its development and the response to exercise. Additionally, we used proteomics-specific statistical analysis to provide a comparative perspective, highlighting the nuanced differences identified by REHA. Validation of the REHA model with a comparable external dataset further demonstrated its efficacy in distinguishing between diverse proteomic profiles. Key metrics such as accuracy and the area under the ROC curve confirmed REHA’s capability to uncover novel molecular pathways and significant protein interactions, offering fresh insights into the effects of exercise on IR and T2D pathophysiology of skeletal muscle. The visualizations not only underscored significant proteins and their interactions but also showcased decision trees that effectively differentiate between various glycemic states, thereby enhancing our understanding of the biomolecular landscape of T2D.

Relationship Between Food Security, Dietary Intake, Physical Activity Levels and Glycaemic Status of Adults in A Peri-Urban Community in Ghana

Relationship Between Food Security, Dietary Intake, Physical Activity Levels and Glycaemic Status of Adults in A Peri-Urban Community in Ghana

Association of remnant cholesterol with risk of dementia: a nationwide population-based cohort study in South Korea

The association between remnant cholesterol (remnant-C) and cardiovascular disease risk is well established, but its association with dementia remains unclear. We aimed to examine this association using a large-scale population dataset. We did a nationwide, population-based cohort study in which we identified participants aged 40 years and older who underwent the national health examination in 2009 from South Korea's National Health Insurance Service. We excluded people who were younger than 40 years and those with a triglyceride concentration of 400 mg/dL or higher due to concerns regarding the accuracy of calculated low-density lipoprotein cholesterol concentration in individuals with extremely high triglyceride concentrations. People who were previously diagnosed with dementia before the index date, and those who had any missing variables were also excluded. To minimise the influence of possible reverse causation, we excluded individuals who had developed any type of dementia within 1 year of the baseline measurements. We calculated hazard ratios (HRs) for all-cause dementia, Alzheimer's disease, and vascular dementia in each quartile of remnant-C using the Cox proportional hazards model adjusted for age, sex, body-mass index, estimated glomerular filtration rate, income level, smoking status, alcohol consumption, regular exercise, diabetes, hypertension, statin and fibrate use, and total cholesterol concentrations. We also did subgroup analyses to investigate the association between remnant-C and the risk of dementia stratified by age, sex, obesity, glycaemic status (normoglycaemia, impaired fasting glucose, new-onset type 2 diabetes, type 2 diabetes with a duration of less than 5 years, and type 2 diabetes with a duration of 5 years or more), hypertension, chronic kidney disease, and dyslipidaemia, using likelihood ratio tests. 4 234 415 individuals who underwent the national health examination in 2009 were deemed eligible for inclusion. We excluded 1 612 819 individuals on the basis of age, triglyceride concentration, missing variables, or having dementia at baseline. We identified 2 621 596 participants aged 40 years and older (1 305 556 men and 1 316 040 women) who underwent the national health examination and followed them up until the date of any incident of dementia or the end of the study period of Dec 31, 2020. During a median follow-up of 10·3 years (IQR 10·1-10·6), 146 991 (5·6%) participants developed all-cause dementia, 117 739 (4·5%) developed Alzheimer's disease, and 14 536 (0·6%) developed vascular dementia. The risk of dementia increased progressively with higher remnant-C concentrations. Compared with the lowest quartile of remnant-C (quartile 1), HRs in the highest quartile (quartile 4) were 1·11 (95% CI 1·09-1·13) for all-cause dementia, 1·11 (1·08-1·13) for Alzheimer's disease, and 1·15 (1·09-1·21) for vascular dementia. Subgroup analyses revealed that the risk of dementia associated with high remnant-C concentrations was higher in middle-aged people aged 40-59 years than in older people. The risk of dementia associated with high concentrations of remnant-C was notably more pronounced in individuals with diabetes compared with those without diabetes, and the risk increased steeply with a longer duration of diabetes. Results showed that higher remnant-C concentrations were independently associated with increased risks of all-cause dementia, Alzheimer's disease, and vascular dementia. More research is needed to determine the mechanisms underlying this finding. Monitoring and managing higher concentrations of remnant-C might have important implications for reducing the risk of dementia. None.

Sex differences in circulating metabolites across glycemic status and risk of coronary heart disease.

Women with type 2 diabetes (T2D) have a 50% excess risk of coronary heart disease (CHD) than men with T2D. We compared circulating metabolites and their associations with CHD in men and women across glycemic status. We used metabolomic data (lipoproteins, fatty acids, amino acids, glycolysis, ketones, inflammation, and fluid balance) for 87,326 CHD-free UK Biobank participants. We used linear regressions to examine the association of sex and metabolites (log) in newly diagnosed T2D (diagnosis<2 yrs from baseline), prediabetes (A1c 5.7-6.5%), and euglycemia, accounting for age, race, Deprivation Index, income, smoking, alcohol drinking, obesity, physical activity, medications for hypertension, hyperlipidemia, and diabetes. We used Cox models to evaluate the association of metabolites and CHD risk by sex, adjusting the same covariates and menopausal status (women). All analyses were FDR-adjusted. We included 1250 individuals with new T2D, 12,706 with prediabetes, and 83,315 with euglycemia. In adjusted linear regressions, women showed a progressive increase in atherogenic lipid and lipoprotein markers and inflammatory marker, glycoprotein acetyls, compared to men as their glycemic status advanced. However, women had lower levels of albumin during this transition. Menopausal status did not alter these sex differences. In a 10-year follow-up, an SD higher total TG, TG in VLDL, LDL, and HDL, saturated fatty acids (SFA) were positively associated with a higher risk of CHD in women with T2D but not in men (p-interactions 0.03-0.15). With advancing glycemic status, women exhibited higher levels of atherogenic lipids and lipoproteins, as well as inflammatory markers, but lower circulating albumin. Women with T2D appear to be at a higher risk of CHD associated with TG, VLDL-TG, LDL-TG, and HDL-TG, and SFA than men with T2D.

Salivary fructosamine in diabetic and non-diabetic individuals with healthy and diseased periodontium and its changes after non-surgical periodontal therapy.

A bidirectional relationship has been reported between diabetes mellitus and periodontitis. The present study aimed to estimate salivary fructosamine in diabetic and non-diabetic individuals with healthy and diseased periodontium and to measure its changes after non-surgical periodontal therapy. Another aim was to identify the cut-off value of salivary fructosamine to diagnose diabetes mellitus and to correlate it with glycated hemoglobin. Salivary fructosamine and HbA1c were assessed in periodontally healthy individuals and periodontitis patients (n = 60 in each group). Both groups comprised of equal number of patients with and without diabetes mellitus. Salivary fructosamine estimation was repeated 4weeks after non-surgical periodontal therapy in periodontitis patients. HbA1c and Salivary fructosamine were significantly higher in the periodontally diseased compared to the healthy group. Significantly higher values of these biomarkers were noticed in diabetic patients with periodontitis compared to the non-diabetic group. Periodontal therapy significantly reduced salivary fructosamine in both diabetic and nondiabetic periodontitis patients. A significant positive high correlation was noticed between salivary fructosamine and HbA1c (r = 0.76). The cut-off value of salivary fructosamine was found to be 68µg/mL with 95% sensitivity, 81.67% specificity, 83.82% positive predictive value, and 94.23% negative predictive value. Periodontitis can contribute to glycemic control and periodontal therapy can bring about improvement in glycemic status. Salivary fructosamine could be used as an alternate glycemic biomarker and its advantages over HbA1c include simple and non-invasive collection of saliva and it can provide intermediate glycemic status. 2020/11/038496.

A Glycemic Status Classification Model Using a Radiofrequency Noninvasive Blood Glucose Monitor.

Despite significant efforts in the development of noninvasive blood glucose (BG) monitoring solutions, delivering an accurate, real-time BG measurement remains challenging. We sought to address this by using a novel radiofrequency (RF) glucose sensor to noninvasively classify glycemic status. The study included 31 participants aged 18-65 with prediabetes or type 2 diabetes and no other significant medical history. During control sessions and oral glucose tolerance test sessions, data were collected from both a RF sensor that rapidly scans thousands of frequencies and concurrently from a venous blood draw measured with an US Food and Drug Administration (FDA)-cleared glucose hospital meter system to create paired observations. We trained a time series forest machine learning model on 80% of the paired observations and reported results from applying the model to the remaining 20%. Our findings show that the model correctly classified glycemic status 93.37% of the time as high, normal, or low.

Are Sodium-Glucose Cotransporter-2 Inhibitors the Cherry on Top of Cardio-Oncology Care?

The increasing aging of the population combined with improvements in cancer detection and care has significantly improved the survival and quality of life of cancer patients. These benefits are hampered by the increase of cardiovascular diseases being heart failure the most frequent manifestation of cardiotoxicity and becoming the major cause of morbidity and mortality among cancer survivor. Current strategies to prevent cardiotoxicity involves different approaches such as optimal management of CV risk factors, use of statins and/or neurohormonal medications, and, in some cases, even the use of chelating agents. As a class, SGLT2-i have revolutionized the therapeutic horizon of HF patients independently of their ejection fraction or glycemic status. There is an abundance of data from translational and observational clinical studies supporting a potential beneficial role of SGLT2-i in mitigating the cardiotoxic effects of cancer patients receiving anthracyclines. These findings underscore the need for more robust clinical trials to investigate the effect on cardiovascular outcomes of the prophylactic SGLT2-i treatment in patients undergoing cancer treatment.

Thyroid Disorders among Type 2 Diabetes Mellitus: A Cross-sectional Study from a District Hospital in West Bengal.

The coexistence of diabetes mellitus (DM) (both type 1 and type 2) and thyroid dysfunction, two common endocrine problems, is scientifically predictable. The prevalence of thyroid disorders among type 2 diabetics (more prevalent in India) was studied among patients visiting the outpatient department (OPD) of a district hospital in West Bengal to assess its relation with different characteristics of type 2 DM. A total of 120 patients suffering from type 2 DM (already diagnosed and on treatment) were randomly selected from the OPD (irrespective of their glycemic status). The thyroid status of all those patients was assessed. All diabetic patients were studied with a predesigned schedule and lab investigations for the prevalence of thyroid dysfunction and its association with pertinent variables from January to December 2019. This study found a 28.3% prevalence of thyroid dysfunction among diabetics. It was significantly associated with poor glycemic control [rising hemoglobin A1c (HbA1c) level] (actual p-value for HbA1c vs abnormal thyroid status = 2.4 E-21) but not with other variables, including the duration of diabetes. Screening for thyroid dysfunction among diabetic persons should be routine, and strict glycemic control is essential.

Diabetes and Oral Health: Advancements in Prevention, Screening and Treatment of Periodontal Diseases

ABSTRACT Diabetes is a pervasive metabolic disorder that notably impacts various body systems, including oral health. One of the critical manifestations of diabetes in oral health is its exacerbating effect on periodontal diseases. Recent advancements in the prevention, screening, and treatment of periodontal diseases have become increasingly significant due to the bidirectional link between periodontal health and diabetes management. This review explores contemporary strategies and technological innovations in the comprehensive management of periodontal diseases among diabetic patients. It highlights the integration of digital dentistry tools such as artificial intelligence (AI) and teledentistry in enhancing diagnostic precision and treatment outcomes. Preventive measures, including new pharmacological formulations and lifestyle interventions tailored for diabetic individuals, are discussed. Additionally, the review underscores the importance of routine screening protocols that incorporate glycemic control status to refine treatment plans for periodontal therapies. Furthermore, advancements in regenerative therapies, including the application of growth factors and stem cell therapy, are examined for their potential to restore periodontal tissue integrity, offering promising directions for future research and clinical practice. Through a synthesis of recent literature, this review aims to provide insights into effective periodontal disease management strategies that are critical for improving the overall health and quality of life of individuals with diabetes.

The regulatory role of erythropoietin in diabetes mellitus: a focus on oxidative and glycemic statuses

Background and objectives. One of the leading causes of disability and death among the population is type 2 diabetes mellitus (T2DM), which is characterized by persistent hyperglycemia. The disease is associated with disorders including oxidative stress and resistance to insulin action, which are involved in the progression of other diabetic complications. Such complications strongly rationalize the need for advanced treatment strategies. Considering the antioxidant, and anti-inflammatory in addition to cytoprotective properties of erythropoietin (EPO), it may offer a new potential strategy for the management of these disorders in diabetic patients. This review aims to explore the effects of EPO on oxidative stress and insulin resistance and its impact on glucose metabolism to guide healthcare professionals to a novel approach for controlling diabetes complications. Materials and methods. This review was conducted by analyzing studies involved with oxidative stress, resistance to insulin, and glucose metabolism in T2DM published in Cochran Library, PubMed, and Google Scholar until February 2024. Results. EPO shows promising beneficial effects in the management of these diabetes-associated disorders. Conclusion. With this beneficial effect of EPO, it is considered a strong candidate and area of development for the creation of new choices in the management of diabetes.

Risk factors at admission of in-hospital dysglycemia, mortality, and readmissions in patients with type 2 diabetes and pneumonia

AimsIn-hospital dysglycemia is associated with adverse outcomes. Identifying patients at risk of in-hospital dysglycemia early on admission may improve patient outcomes. MethodsWe analysed 117 inpatients admitted with pneumonia and type 2 diabetes monitored by continuous glucose monitoring. We assessed potential risk factors for in-hospital dysglycemia and adverse clinical outcomes. ResultsTime in range (3.9–10.0 mmol/l) decreased by 2.9 %-points [95 % CI 0.7–5.0] per 5 mmol/mol [2.6 %] increase in admission haemoglobin A1c, 16.2 %-points if admission diabetes therapy included insulin therapy [95 % CI 2.9–29.5], and 2.4 %-points [95 % CI 0.3–4.6] per increase in the Charlson Comorbidity Index (CCI) (integer, as a measure of severity and amount of comorbidities). Thirty-day readmission rate increased with an IRR of 1.24 [95 % CI 1.06–1.45] per increase in CCI. In-hospital mortality risk increased with an OR of 1.41 [95 % CI 1.07–1.87] per increase in Early Warning Score (EWS) (integer, as a measure of acute illness) at admission. ConclusionsDysglycemia among hospitalised patients with pneumonia and type 2 diabetes was associated with high haemoglobin A1c, insulin treatment before admission, and the amount and severity of comorbidities (i.e., CCI). Thirty-day readmission rate increased with high CCI. The risk of in-hospital mortality increased with the degree of acute illness (i.e., high EWS) at admission. Clinical outcomes were independent of chronic glycemic status, i.e. HbA1c, and in-hospital glycemic status.

Lycopene Enhances the Beta Cell Capacity and Antihyperlipidemic Effects of Metformin on Type 2 Diabetic Rats

BACKGROUND: Hyperglycemia causes dyslipidemia in type 2 diabetes mellitus (T2DM). Metformin monotherapy is known to be less effective at improving glycemic status, insulin function, and lipid profiles. Lycopene is a potential antioxidant and has been shown to be hypoglycemic and hypocholesterolemic. However, the effects lycopene and metformin combination are still up for debate. This study was conducted to determine the potential of lycopene in enhancing the ability of metformin to improve glycemic status, insulin resistance, beta cell capacity, and lipid profile of T2DM rats.METHODS: Thirty male Wistar rats were randomly divided into six groups: control (N), T2DM-untreated (D), T2DM + metformin (DM), T2DM + metformin + 10 mg/kgBW lycopene (DMLy-10), T2DM + metformin + 20 mg/kgBW lycopene (DMLy-20), and T2DM + metformin + 40 mg/kgBW lycopene (DMLy-40). The treatment was administered once daily through oral route and lasted for 28 days, before blood samples were collected. Fasting blood glucose (FBG) was assessed by oxidase-peroxidase method, fasting serum insulin and HbA1c were measured using enzyme-linked immunosorbent assay (ELISA), while lipid profile was determined using enzymatic methods. The homeostatic model assessment for insulin resistance (Homa-IR) as well as the homeostatic model evaluation of β-cell function (Homa-B) were then calculated.RESULTS: Fasting serum insulin levels increased significantly (p&lt;10.05) in the DMLy-20 and DMLy-40 groups, but Homa-B or high-density lipoprotein (HDL) did not significantly increase. Additionally, the FBG, HbA1c, Homa-IR, total cholesterol, triglyceride, and low-density lipoprotein levels were not significantly decreased than in the group treated with metformin alone.CONCLUSION: Lycopene can enhance the ability of metformin to improve the glycemic status, insulin resistance, beta-cell capacity, and lipid profile of T2DM rats.KEYWORDS: dyslipidemia, Homa-B, insulin resistance, lycopene, metformin, type 2 diabetes mellitus

Drug Exposure and Treatment Outcomes in Patients With Multidrug-Resistant Tuberculosis and Diabetes Mellitus: A Multicenter Prospective Cohort Study From China.

The management of multidrug-resistant tuberculosis (MDR-TB) remains challenging. Treatment outcome is influenced by multiple factors; the specific roles of diabetes and glycemic control remain uncertain. This study aims to assess the impact of glycemic control on drug exposure, to investigate the association between drug exposure and treatment outcomes, and to identify clinically significant thresholds predictive of treatment outcome, among patients with diabetes. This multicenter prospective cohort study involved patients with confirmed MDR-TB and diabetes. Drug exposure level was estimated by noncompartmental analysis. The minimum inhibitory concentrations (MICs) were determined for the individual Mycobacterium tuberculosis isolates. The influence of poor glycemic control (glycated hemoglobin ≥7%) on drug exposure and the associations between drug exposure and treatment outcome were evaluated by univariate and multivariate analysis. Classification and regression tree analysis was used to identify the drug exposure/susceptibility thresholds. Among the 131 diabetic participants, 43 (32.8%) exhibited poor glycemic control. Poor glycemic control was independently associated with decreased exposure to moxifloxacin, linezolid, bedaquiline, and cycloserine, but not clofazimine. Additionally, a higher ratio of drug exposure to susceptibility was found to be associated with a favorable MDR-TB treatment outcome. Thresholds predictive of 6-month culture conversion and favorable outcome were bedaquiline area under the concentration-time curve (AUC)/MIC ≥245 and moxifloxacin AUC/MIC ≥67, demonstrating predictive accuracy in patients, regardless of their glycemic control status. Glycemic control and optimal TB drug exposure are associated with improved treatment outcomes. This dual management strategy should be further validated in randomized controlled trials of patients with MDR-TB and diabetes.

Turmeric as a Gut-Microbiota Modulator for Cardio-Metabolic Risk Factors: An Updated Comprehensive Review

Turmeric is a medicinal herb with antioxidant and anti-inflammatory components that can affect metabolic parameters via various pathways, including the gut-brain axis. Although positive effects of turmeric on health have been reported, findings are conflicting. Accordingly, the current review aimed to provide an overview of the biochemical and biological characteristics of turmeric and examine the impacts of turmeric on cardio-metabolic risk factors with a special focus on its abilities to modulate gut microbiota. In the present comprehensive review, findings of systematic reviews/narrative reviews, clinical trials, animal, and in vitro studies on turmeric in the English language published between 2010 and March 2023 were summarized. Findings revealed that turmeric is a safe medicinal herb with mild gastrointestinal side effects in some cases. It can help improve the glycemic status, lipid profile, and blood pressure. However, food processing and fermentation can affect the bioavailability of its effective components, including curcumin. Several mechanisms, including those affecting intestinal microbiota diversity, intestinal permeability, inflammatory and oxidative pathways, are proposed for their positive effects on metabolic factors. However, due to high between-study heterogeneity, limited high-quality clinical trials, differences in the duration of the intervention, and the form of turmeric supplement, more studies on each metabolic parameter are needed to determine effective dosages and confirm its efficacy as a complementary therapy to modulate microbiota and cardio-metabolic parameters.

Glycemic status, insulin resistance, and mortality from lung cancer among individuals with and without diabetes

BackgroundThe effects of glycemic status and insulin resistance on lung cancer remain unclear. We investigated the associations between both glycemic status and insulin resistance, and lung cancer mortality, in a young and middle-aged population with and without diabetes.MethodsThis cohort study involved individuals who participated in routine health examinations. Lung cancer mortality was identified using national death records. Cox proportional hazards models were used to calculate hazard ratios (HRs) with 95% CIs for lung cancer mortality risk.ResultsAmong 666,888 individuals (mean age 39.9 ± 10.9 years) followed for 8.3 years (interquartile range, 4.6–12.7), 602 lung cancer deaths occurred. Among individuals without diabetes, the multivariable-adjusted HRs (95% CI) for lung cancer mortality comparing hemoglobin A1c categories (5.7–5.9, 6.0–6.4, and ≥ 6.5% or 39–41, 42–46, and ≥ 48 mmol/mol, respectively) with the reference (< 5.7% or < 39 mmol/mol) were 1.39 (1.13–1.71), 1.72 (1.33–2.20), and 2.22 (1.56–3.17), respectively. Lung cancer mortality was associated with fasting blood glucose categories in a dose–response manner (P for trend = 0.001) and with previously diagnosed diabetes. Insulin resistance (HOMA-IR ≥ 2.5) in individuals without diabetes was also associated with lung cancer mortality (multivariable-adjusted HR, 1.41; 95% CI, 1.13–1.75). These associations remained after adjusting for changing status in glucose, hemoglobin A1c, insulin resistance, smoking status, and other confounders during follow-up as time-varying covariates.ConclusionsGlycemic status within both diabetes and prediabetes ranges and insulin resistance were independently associated with an increased risk of lung cancer mortality.

Bariatric surgery modulates plasma levels of antibodies against angiotensin II type 1 and endothelin 1 type A receptor in severe obesity.

The contribution of endothelial-targeted autoantibodies against the angiotensin II type 1 receptor (anti-AT1R) and the anti-endothelin 1 type A receptor (anti-ETAR1) has been proposed in the development of cardiovascular diseases. However, no data have been reported yet in obesity. In this observational study we evaluated the relationship between anthropometric and metabolic parameters and anti-AT1R and anti-ETAR1 concentrations in a cohort of patients with severe obesity and associated comorbidities undergoing bariatric surgery. Clinical evaluation and metabolic assessment were performed in 36 subjects referring to our Center for the Study and Integrated Treatment of Obesity at the University Hospital of Padova. Circulating inflammatory adipocytokines and the endothelial dysfunction marker asymmetric dimethylarginine (ADMA) were evaluated; plasma levels of anti-AT1R and anti-ETAR1 were also determined. 10 normal-weight subjects were considered as a control group. 29 patients out of 36 were re-evaluated after surgery. With respect to normal-weight controls patients showed significantly higher plasma levels of anti-AT1R (28 ± 20.4 vs 13.5 ± 2.8 U/mL, p < 0.005) and ADMA (0.8 ± 0.1 vs 0.54 ± 0.08 uM/L, p < 0.0001) but not anti-ETAR1 (14.2 ± 1.3 vs 13.3 ± 2 U/mL, p = 0.1). Anti-AT1R concentration showed an increasing trend with the worsening of glycemic status, while the presence of arterial hypertension among the patients did not affect autoantibodies levels. One year after surgery, a significant improvement in body weight and metabolic and inflammatory parameters was observed, along with a significant reduction of anti-AT1R (28.1 ± 20.4 U/mL vs 22.6 ± 16 U/mL, p < 0.05) and anti-ETAR1 (14.2 ± 1.3 U/L vs 13 ± 1.6 U/L, p < 0.01). Subjects with obesity present higher plasma levels of anti-AT1R which are more related to glycemic profile than blood pressure levels, and are reduced by bariatric surgery. Considering the detrimental effects of these autoantibodies on vascular health, they should be assessed as potential biomarkers in obesity and metabolic diseases.

Iron Status in Male Type 2 Diabetic Patients and Its Association with Their Glycemic Status

Background &amp; objective: Alteration in iron metabolism may occur in diabetic patients especially those who have poor glycemic control. Serum iron is involved in free radical formation associated with hyperglycemia and causes diabetic complications. The present study was undertaken to observe the iron status and its relation with glycemic control in male type 2 diabetic patients. Methods: This cross-sectional analytical study was carried out in the Department of Physiology, Sir Salimullah Medical College (SSMC), Dhaka from July 2017 to June 2018. A total of 48 diagnosed male type 2 diabetic patients (cases) were recruited from the Out-patient Department (OPD) of Endocrinology based on predefined eligibility criteria. Of them, 24 had good glycemic control (HbA1c level &lt; 7%) (Group B1) and 24 had poor glycemic control (HbA1c level ≥ 7%) (Group B2). To compare the outcome (serum iron status) of these diabetic patients, another 48 age- and BMI-matched healthy non-diabetic male subjects were selected from personal contact as control. While diabetes and glycemic status (fasting blood glucose level, and HbA1c) of the diabetic patients were exposure variables, serum iron, serum total iron binding capacity (TIBC), transferrin saturation, and serum ferritin were the outcome variables. Results: The mean age of the subjects of either study group was around 43 and there was no significant difference between the groups concerning age (p = 0.610). The distribution of BMI and serum creatinine between groups was also similar (p = 0.135 and p = 0.134 respectively). The cases had a significantly higher level of serum iron, transferrin saturation, and an insignificantly lower total iron binding capacity (TIBC) than their non-diabetic peers (p = 0.045, p = 0.036, and p = 0.061 respectively). A comparison of outcome variables among the three groups shows that the groups were significantly heterogeneous in terms of serum iron, TIBC, transferrin saturation, haemoglobin level (p = 0.032, p = 0.012, p = 0.008 and p = 0.018 respectively). The associations were more conspicuous in patients with poor glycemic status. Correlation analyses revealed that while there was a significant linear correlation between serum iron and HbA1c (r = + 0.376, p &lt; 0.01), it was negatively correlated with serum TIBC (r = -0.478, p &lt; 0.001). The glycemic status (HbA1c) was also found to be linearly correlated with serum ferritin and transferrin saturation (r = + 0.354, p = 0.013 and r = + 0.462, p &lt; 0.001 respectively). Conclusion: The study concluded that type 2 diabetic patients have a significantly higher level of serum iron, transferrin saturation, and a lower total iron binding capacity (TIBC) than the non-diabetic healthy subjects, all of which may lead to reduced synthesis of hemoglobin. The compromised iron metabolism is even more evident as the hyperglycemia aggravates. Ibrahim Card Med J 2023; 13 (1&amp;2): 32-39

Antidiabetic Effects of Foeniculum vulgare in Alloxan-induced Diabetic Male Rats

Background &amp; objective: Diabetes mellitus (DM) has become one of the most challenging health problems of the 21st century. Foeniculum vulgare (Mouri in Bengali), an ancient culinary herb, is known to reduce blood glucose levels thus reducing the risk of diabetes. This study was done to observe the antidiabetic role of Mouri in alloxan-induced diabetic male rats. Methods: This experimental study was carried out in the Department of Physiology, Sir Salimullah Medical College (SSMC), Dhaka from July 2018 to June 2019. A total of 30 healthy Wistar albino male rats, 90-120 days old, weighing between 150-180g were included in the study. After acclimatization for 14 days, they were divided into two groups: the control group (Group A) and the experimental group (Group B – diabetic rats treated with Mouri). The control group was again subdivided into Group A1 (normal control group) and Group A2 (alloxan-induced diabetic control group). Each of these groups consisted of 10 rats. All the rats received a basal diet for 21 days. In addition to the basal diet, Group A2 and Group B received a single intraperitoneal injection of alloxan 140 mg/kg on day 1 to induce diabetes. Moreover, Group B received Mouri extract 150 mg/kg/day orally for 21 consecutive days starting from day 1 of the study period. After 12 hours of fasting, blood samples were collected from the tail veins of every rat on day 1 for estimation of Fasting Blood Glucose (FBG) and serum ALT levels. On day 4 FBG levels of all the rats were measured once again. Then all the rats were sacrificed on day 22 and their blood samples were collected from the heart. The outcome variables, such as FBG level, serum levels of insulin, were measured and compared among the study groups. The pancreatic tissue was also collected and histopathology was done by standard laboratory procedure to study their histologic architecture. Result: In this study, fasting blood glucose level in diabetic rats treated with Mouri at the endpoint of the study (on day 22) was significantly lower (5.51 ± 0.47 mmol/L) than that in alloxan-induced diabetic control (13.52 ± 0.76 mmol/L) (p &lt; 0.001) and was almost equal to that in normal control (5.38 ± 0.55 mmol/L) (p = 0.891). The serum insulin level in diabetic rats treated with Mouri (11.52 ± 0.84 mmol/L) was almost similar to that of normal control (12.46 ± 1.07 mmol/L) on day 22, whereas it was much higher than that in alloxan-induced diabetic control (8.51 ± 0.68 mmol/L) (p &lt; 0.001). Histological study of pancreases of the rats, revealed extravasation of blood in the pancreatic acini, reduced area of islets of Langerhans with atrophy, vacuolation, degeneration, and pyknosis of β-cell nuclei and centrilobular necrosis in the alloxan-induced diabetic control rats. Conclusion: Mouri (Foeniculum vulgare) improves the glycemic status of the alloxan-induced diabetic rats. Ibrahim Card Med J 2023; 13 (1&amp;2): 53-59