Glycemic Control In Diabetic Patients Research Articles

Correlation of Fasting and Postprandial Blood Glucose with Hba1c in monitoring Glycemic Control of Diabetic Patients in FCT Abuja, Nigeria

Achieving glycemic control or reduction of hyperglycemia would significantly decrease most of the complications associated with hyperglycemia in diabetes mellitus. It has been stated that measurement of glycosylated hemoglobin (HbA1C) remains the gold standard for the assessment of glycemic control; there is no consensus whether the Fasting or Postprandial is a better predictor of glycemic control in poor resource setting where HbA1C is not easily accessed or available. The aim of this research is to determine fasting and postprandial plasma glucose and their correlation with HbA1C in glycemic control. A cross sectional case control study was carried out from January, 2023 to July, 2023; a total of 203 participants were recruited into the study. Fasting blood glucose (FBG), 2 hours post prandial blood glucose (2HPBG) were determined in all the subjects using the enzymatic glucose oxidase method for glucose estimation according to the instruction of the manufacturer, while HbA1C was determined using Boroaffinity Chromatographic method according to the instruction of the manufacturer. Statistical data analysis was carried out using SPSS software (Version 25.0, IBM Corp., Armonk, New York USA), and p<0.001 were defined as statistically significant; the correlation between the parameters was carried out using Pearson’s correlation. Both the FBG and the 2HPBG showed positive correlation with HbA1C in the diabetic and control subjects; however, the level of correlation varies. The correlation of FBG and 2HPBG with HbA1C is directly proportional to the concentration of blood glucose level. The FBG for the control and the subjects are 7.40±1.59 and 143.67±5.01, with HbA1C of 4.45±0.05; 6.26±1.47 respectively. The 2HPBG for the control and the subjects are 120.70±1.75 and 192.92±7.05, with HbA1C of 5.56±0.07; 7.82±0.22 respectively. The FBG correlation to HbA1C is r= 0.875, p<0.001; while 2HPBG is r= 0.908, NEWPORT INTERNATIONAL JOURNAL OF PUBLIC HEALTH AND PHARMACY (NIJPP) Volume 4 Issue 2 2023 OPEN ACCESS ©NIJPP ONLINE ISSN: 2992-5479 Publications 2023 PRINT ISSN: 2992-605X Page | 10 p<0.001. The study showed positive correlation of FBG and 2HPBG with HbA1C, since HbA1C is the value of the percentage concentration of glucose at a given period of time; FBG, 2HPBG and HbA1C can be used to evaluate the degree of glycemic control in diabetic patients’ management, in order to minimize or avoid diabetic complications. Keywords: FBG, PBG, Diabetes, HbA1C, Correlation, Complications

Glycemic Control in Diabetic Patients During COVID-19 Pandemic, A Study from North Al-Batinah, Oman

Glycemic Control in Diabetic Patients During COVID-19 Pandemic, A Study from North Al-Batinah, Oman

IBC-Oxford University2023_BJSOral_3Tailored Bilio-Pancreatic Limb Length and Haemoglobin A1c Levels 10 years following Mini-Gastric Bypass Original Technique of One Anastomosis Gastric Bypass

Abstract Introduction The need for or the ideal length of the Biliopancreatic Bypass limb (BPL) length is a controversial topic. The Mini Gastric Bypass original technique (MGB-OT) version of the One Anastomosis Gastric Bypass (OAGB) includes a “Tailored” BPL length. This study aimed to investigate the 1 to 10-year outcomes of the “Tailored’ BPL length in patients undergoing MGB-OT in diabetic patients with Class III obesity. Methods The study is a retrospective chart review of 114 patients who underwent the Mini Gastric Bypass original technique (MGB-OT) with a tailored Biliopancreatic Limb length as described by Rutledge et al. These cases were performed between June 2008 and December 2009. The study investigated the relationship between the length of the BPLL and glycaemic control, primarily as measured by the change in (Delta) HbA1c levels, in morbidly obese diabetic patients undergoing the MGB-OT. The mean BPL length in the study was 185 cms, with a range of 120-350 cms. The study analysed preoperative, post-operative, and Delta HbA1c levels as the primary outcomes. The critical outcome goal for the study was HbA1c levels of less than 7%, which is a commonly used target for glycaemic control in diabetic patients. Results Only 89 of 114 (78%) patients completed the 10-year follow-up. The mean preoperative HbA1c was 9.2+/-1.6 (range 6.8-14.7). Longer BPL length were selected for patients based on a variety of patient factors including the patient’s preoperative HbA1c levels. Patients with longer BPL length had greater weight loss (R2 0.8.) The mean HbA1c levels were 5.50+/-0.36, 5.65+/-0.35, and 5.82+/-0.41 at 1, 5, and 10 years post-op. 100% of patients evaluated at 1 and 5 years had HbA1c levels below 7%, and only 1 out of 89 patients at 10 years had HbA1c levels above 7%. The correlation between BPL length and the 10-year Delta HbA1c was high, with a correlation coefficient (r) of 0.8. The Delta HbA1c was significantly greater in the patients with BPL length > 150 cm (3.99 +/- 1.87 vs 2.08 +/- 0.71 in the BP150 patients difference 1.91, SEM 0.40, 95% CI 1.12 to 2.69, P < 0.0001) i.e., longer BPL length (> 150cms) had significantly greater Delta HbA1c than 150 cm BPL length. Conclusions The study suggests that individualized tailoring of the biliopancreatic limb length in the OAGB procedure can potentially lead to a combination of excellent weight loss and near-complete normalization of HbA1c levels for up to 10 years. However, this a small and incomplete study and the optimal length may vary based on individual patient factors. Further research is needed to confirm these findings and establish standardized guidelines for determining the appropriate BPL length. Overall, the study highlights the importance and potential value of continued research and individualized treatment approaches for patients with obesity and diabetes.

Reducing Hemoglobin A1C Levels in Type II Diabetes: A Retrospective Analysis of the Renew Procedure.

Periodontal disease and type 2 diabetes are interrelated, with inflammation playing a significant role in the progression of both conditions. Previous research has demonstrated the potential of various treatments, such as diet, exercise, and periodontal therapies, to improve glycemic control in diabetic patients. This study proposed a novel surgical approach, the Renew Procedure, as a potential solution to enhance glycemic control in type 2 diabetic patients with periodontal issues. The procedure involves the removal of all teeth, the elimination of oral and maxillofacial infections, the placement of dental implants, and the provision of implant-supported and implant-retained removable dentures. Preliminary findings indicated a significant reduction in HbA1c levels post-surgery, suggesting that this approach may improve overall oral health, reduce inflammation, and consequently lower HbA1c levels. Further research is necessary to confirm the efficacy of the proposed solution, but these initial results highlight the importance of addressing oral health through comprehensive strategies for diabetic and periodontitis patients.

Why and by How Much is Insulin Absorption Reduced by Insulin-derived Amyloidosis? A Scoping Review.

Insulin therapy is one of the central treatments for diabetes mellitus. Insulin-derived localized amyloidosis (IDLA) is a known skin-related complication of insulin injection. This is one of the causes of poor glycemic control in diabetic patients on insulin therapy. The aim of this study was to review and update the findings on the extent and mechanism of reduced insulin absorption in IDLA. A literature search was conducted on decreased insulin absorption and its mechanisms, and nine references were selected, with seven of these on decreased insulin absorption and four on mechanisms. Insulin absorption at IDLA sites was reported to be 27-94% lower compared with normal sites. In addition, a comparison between nonpalpable and palpable IDLA sites revealed a significant decrease in insulin absorption at the palpable IDLA site. The mechanism of insulin malabsorption was found to be a reduction in insulin absorption at the palpable IDLA sites. Four mechanisms of decreased insulin absorption were identified: decreased subcutaneous blood flow, adsorption of administered insulin onto insulin amyloid fibers, impaired diffusion of insulin subcutaneously, and physical factors such as shaking of the insulin preparation. These mechanisms should be investigated in vivo in the future.

Continuous insulin infusion versus sliding scale for perioperative glycemic control in diabetic patients undergoing elective hip arthroplasty

Continuous insulin infusion versus sliding scale for perioperative glycemic control in diabetic patients undergoing elective hip arthroplasty

B-033 Impact of Red Blood Cell Sediment on HbA1c Measurement

Abstract Background HbA1c testing using EDTA whole blood as specimens is essential for monitoring glycemic control in diabetic patients. In the laboratory that using total laboratory automation system, the transportation process might be impact the quality of HbA1c result according to red blood cell sedimentation. This study, we aimed to evaluate the impact of HbA1c result from red blood cell sediment which happen in transportation process of total laboratory automation system. Methods HbA1c samples (n = 50) were mixed once and HbA1c levels were determined by using an Alinity c analyzer at an initial time point (T0 = 0 min.), followed by three additional time points (T1 = 7 min., T2 = 15 min., and T3 = 30 min.). The HbA1c levels and samples analyzed at each time point were then used to calculate correlation coefficient, slope, intercept values. The percent difference in these parameter values from all time points was calculated using the analytical criteria of 5% bias according to the National Glycohemoglobin Standardization Program (NGSP) criteria. Results We discovered that the correlation coefficient, slope, and intercept values obtained from the samples at T1 are 0.999, 0.994, 0.008, respectively, T2 are 0.999, 0.982, 0.042, respectively and T3 are 0.999, 0.979, 0.028, respectively. The percent difference of all criteria was 0.00% which were not significantly different from those at the initial time point (T0). Conclusion This study shows that, the time that using in transportation process in total laboratory automation system at 7, 15 and 30 minutes will not impact quality of HbA1c result even though red blood cell might be sediment before aspirate in the analyzer.

Characterization of structural changes occurring in insulin at different time intervals at room temperature by surface-enhanced Raman spectroscopy

BackgroundInsulin storage above the temperature recommended by food and drug administration (FDA) causes decrease in its functional efficacy due to degradation and aggregation of its protein based active pharmaceutical ingredient (API) that results poor glycemic control in diabetic patients. The aggregation of protein causes serious neurodegenerative diseases such as type-2 diabetes, Huntington disease, Parkinson's disease, and Alzheimer's disease. Surface-enhanced Raman spectroscopy (SERS) has been employed for the denaturation study of many proteins at the temperature above the recommendations of food and drug administration (FDA) (above 30 °C) which indicates potential of technique for such studies. ObjectiveSERS along with multivariate discriminating analysis techniques-based analysis of degradation of liquid pharmaceutical insulin protein after regular intervals of time at room temperature to analyze the structural changes in this protein during the storage of insulin pharmaceutical at room temperature. MethodsSilver nanoparticles (Ag-NPs) prepared by chemical reduction method are used as SERS active substrate for the surface enhancement of the insulin spectral signal. SERS spectral measurements of insulin were collected from eight different samples of insulin in the time range of 7 pm to 7 am first at fridge temperature (5 °C), second after half hour and next six with the time difference of 2 h each time at room temperature. The acquired SERS spectral data was preprocessed and analyzed. SERS structural transformations detection and discrimination potential in insulin was further confirmed by applying multivariate discriminating analysis techniques including principal component analysis (PCA) and Partial least square regression analysis (PLSR). ResultsSERS significantly detects the structural changes produced in insulin even after 2 h of insulin placement at room temperature. PCA successfully differentiates the insulin spectral data obtained after regular intervals of time according to PC-1 (77 %) explained variance. Application of PLSR model provides quantitative confirmation of SERS efficiency, by providing insulin data regression coefficients plot, efficient prediction of time with calibration data set having 0.77 mean square absolute error of calibration (RMSAEC), validation data set with 0.80 mean square absolute error of prediction (RMSAEP) and 0.98 coefficient of determination (R2) for both calibration and validation data set. ConclusionSERS is proved as a highly sensitive and discriminating technique to detect and discriminate insulin structural changes after regular intervals of time at room temperature.

Relationship between the levels of awareness and knowledge of periodontitis in diabetic patients at a Dental Hospital during the COVID-19 pandemic

Background: Diabetes mellitus (DM) and periodontitis are the most prevalent human diseases. Diabetes worsens the periodontal condition, but periodontitis also hampers glycemic control in diabetic patients. Based on staging and grading, the latest periodontitis classification puts DM as one of the grade modifiers. Periodic periodontal maintenance prevents reinfection and could help people with diabetes maintain effective glycemic control. Dental health education and periodontal disease awareness are crucially needed for diabetic patients, especially during the pandemic. Purpose: This study aimed to examine the relationship between levels of awareness and knowledge of periodontitis in diabetic patients during the COVID-19 pandemic. Methods: A closed-ended questionnaire was distributed to new patients referred to the Periodontology Clinic of the Dental Hospital of Universitas Indonesia. Patients’ data were collected during the COVID-19 pandemic from January to June 2021. Results: Eighty-four patients participated, of which 34.5 % were diabetic patients with periodontitis. Statistically, significant differences (P < 0.05) were found between levels of awareness and knowledge of periodontitis among diabetic patients and nondiabetic patients (both groups are suffering periodontitis). Awareness and knowledge of periodontitis are inversely correlated with their current clinical periodontal status, therefore patients with less awareness and knowledge have more severe periodontitis. Conclusion: Lack of awareness and knowledge of periodontitis was found among both nondiabetic and diabetic periodontitis patients. Dental health education is required to improve understanding and awareness of the relationship between periodontitis and DM.

Comparison of Total Iron Binding Capacities between Type 2 Diabetes Mellitus Patients and Healthy Individuals

Background: Worldwide, diabetes mellitus (DM) is a leading cause of death and disability. Iron overload is increasingly being connected to insulin resistance in patients with type 2 diabetes mellitus (T2DM). Free iron causes the assembly of reactive oxygen species that invariably steer the body’s homeostasis toward oxidative stress-mediated diabetic complications. We have very limited research-based data regarding the total iron binding capacities in type 2 diabetes mellitus patients. Aim of the study: The aim of the study was to compare the total iron binding capacities (TIBC) between type 2 diabetes mellitus patients and healthy individuals. Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College (DMC), Dhaka, Bangladesh from July 2015 to June 2016. In total 100 participants were enrolled in 2 groups as the study subjects. In group A, in total 50 diagnosed patients with type 2 diabetes mellitus (T2DM) were included. On the other hand, in group B, 50 age and sex-matched healthy individuals were included. Properly written consent was taken from all the participants before data collection. All the demographic and clinical information of the participants was recorded. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, the mean serum iron in group A and group B were 112.7 μg/dl and 87.6 μg/dl respectively. The mean serum ferritin concentration in group A and group B were 199.3 μg/dl and 107.0 μg/dl respectively. There was a statistically significant increase in serum iron and serum ferritin concentrations in group A compared to group B. Both serum ferritin and serum iron levels showed strong positive correlations with HbA1C ((r=0.724, p<0.001, r=0.724, p<0.001) and FPG (r=0.724, p<0.001, r= 0.724, p<0.001). The mean TIBC level was found 184 μg/dl in group A and 318.8 μg/dl in group B. In analyzing the total iron binding capacities (TIBC) between the groups we observe that the TIBC (µg/dl) levels in group A and group B were 184.0±79.5 and 318.8 ± 14.0 µg/dl respectively. The TIBC levels were significantly lower in group A than in group B (<0.001). Conclusion: The total iron binding capacity level is significantly lower in type 2 diabetes mellitus (T2DM) patients than that in healthy individuals. Routine screening for iron status along with glycemic control in diabetic patients might help prevent complications in such patients.

Effects of Nonsurgical Periodontal Therapy on Glycemic Control in Diabetic Patients under Systemic Administration of Antidiabetic Ayurvedic Drug.

This study aimed to monitor the metabolic response of nonsurgical periodontal therapy in type-2 diabetic patients with chronic periodontitis under systemic administration of antidiabetic ayurvedic drug. About 90 newly diagnosed mild-to-moderate forms of type-2 diabetes mellitus (DM) subjects with generalized chronic periodontitis were selected according to the inclusion and exclusion criteria and were randomly divided into group A and group B with 45 patients in each group. Clinical parameters, including plaque index, probing pocket depth, clinical attachment level, and glycemic status, were assessed at baseline. Following initial periodontal clinical examination, the drug Nishamalaki (NA) 2 gm twice daily for 3 months was prescribed after food by an Ayurvedic physician to all the patients enrolled in group A and group B, and scaling and root planing were completed only for group B patients. Patients were recalled for review, and all the parameters were reassessed at the end of the 1st, 2nd, and 3rd months following interventions. Regarding clinical and metabolic parameters at baseline, no statistically significant differences were displayed between the two groups. However, at the 3-months follow-up period, the patients in group B demonstrated significantly better clinical and metabolic outcomes than patients in group A. Periodontal therapy improved glycemic control in patients with type-2 DM in both groups; however, the reduction in FBS values reached statistical significance only in the group receiving scaling and root planing alone. Nonsurgical periodontal therapy may have a beneficial effect on the periodontal clinical and glycemic levels in type-2 diabetic patients with chronic periodontitis.

Glycemic control and cardiovascular complications of type 2 diabetes mellitus

Over the past few decades, the prevalence of diabetes in developed and developing countries has increased dramatically, making diabetes a key health priority worldwide. It can be assumed that an increase in the life expectancy of patients with diabetes significantly affects the prevalence of diabetes, maintaining the trend of its increase. Patients with type 2 diabetes mellitus (DM2) are at higher risk for cardiovascular disease and its adverse outcomes compared to the general population. The pathophysiological relationship between hyperglycemia and cardiovascular disease is beyond doubt. Glycemic control per se remains essential for the successful management of diabetes, prevention of chronic complications of the disease and death. Diabetes control involves, first of all, the achievement of target indicators of carbohydrate metabolism. The use of glycated hemoglobin (HbA1c), despite known sensitivity limitations, has become the standard for assessing glycemic control in diabetic patients. Early achievement of the target HbA1c level reduces the risk of diabetic complications, increases the likelihood of long-term sustainable disease control. Numerous clinical studies have demonstrated that higher HbA1c and greater HbA1c variability are manageable risk factors for adverse cardiovascular events. Optimal hypoglycemic therapy for diabetes in order to reduce cardiovascular risks should ensure the achievement of the target level of glycemic control as soon as possible (the first 3 months of therapy), maintaining the target level of glycemia with the lowest possible HbA1c variability in subsequent years and therapy should be safe. Timely intensification of therapy, including the use of insulin, can prevent the negative consequences of prolonged hyperglycemia. Glar-100 has a high efficacy and safety in comparison with other insulin preparations at the initiation and intensification of DM2 therapy. RingGlar® and Lantus® are equivalent drugs.

Diabetes Self-Care Activities and Their Relationship With Glycemic Control in Patients Visiting Hayatabad Medical Complex, Peshawar.

Background A significant portion of the Pakistani population is affected by diabetes, which has emerged as a global healthcare concern. Objective This study aimed to assess the correlation between glycemic control in diabetes patients and their engagement in diabetes self-care activities (DSCA). Methodology Cross-sectional research was conducted at Hayatabad Medical Complex in Peshawar between June 2019 and May 2020. A total of 280 carefully selected patients with type 2 diabetes mellitus (T2DM) were included. Data collection involved an interviewer-administered questionnaire encompassing sociodemographic information, diabetes-related data, and the summary of the Diabetes Self-Care Activities (SDSCA) scale. Descriptive statistics and Pearson's chi-square test were employed for data analysis. Results The study observed that the majority of participants (40.36%) were females, and the age range of the participants was between 42 and 53 years (68.22%).According to the study, 55.00% of participants had a normal body mass index (BMI), and 71.08% of participants had diabetes in their family. Regarding glycemic control, 55.71% of individuals exhibited good control based on fasting blood sugar (FBS) levelswhile 74.64% showed poor control according to hemoglobin A1C (HbA1c) values. HbA1c was substantially linked with a general diet (healthy eating plan), physical activities, and adherence to medication ((odds ratios (OR): 3.12), (95% confidence interval (CI): 1.02 - 8.78), (P value: 0.031)); ((OR: 2.19, 95%), (CI:1.18 - 3.79), (P value: 0.003)); ((OR: 2.85), (95% CI: 1.22 - 6.59), P value: 0.021)). Conclusion The findings indicated that health professionals need to create health education programs on DSCA in order to increase DSCA adherence in people with T2DM while maintaining glycemic control.

1087-P: Managing Diabetes in the Delta—Effect of Access to Endocrinology Services in an Underserved Area

Background: The Mississippi Delta has one of the highest rates of diabetes in the nation, but patients in these rural, minority-majority counties have lower access to specialty care. At the start of a hybrid diabetes management program at two rural health clinics in the Delta, 53.1% of patients with diabetes had uncontrolled HbA1c levels. We analyze the specific effect of integrating endocrinology specialists into this intervention. Patients could access this care via telemedicine or in-person. Methods: We conducted a quasi-experimental study with clinical data from electronic health records for patients diagnosed with diabetes or prediabetes (aged ≥ 18). We followed two cohorts of the same patients over time for the first 18 months of the program, each matched on elevated HbA1c levels (≥8% at baseline). The treatment group comprised program participants; the control group comprised general clinic patients at-risk of diabetes. We also followed patients in the treatment group who received endocrine services in addition to other program benefits. Results: Among the control group, HbA1c increased an average of 0.04 points; the treatment group saw an average decrease of 0.42 points. The treatment group's endocrinology subset saw an even greater decrease of 0.85 points. The average HbA1c score for this group went down three points in a two-year period (7/20-7/22). Conclusions: The study results indicate that receiving coordinated endocrinology services has been especially effective in reducing HbA1c levels among program participants. As care continuity is associated with better glycemic control for diabetic patients, sustained program participation will likely help the patient population best manage their diabetes and avoid further adverse health outcomes. Additionally, as this diabetes program takes place in a rural, low-income minority area with low access to specialty care, the results demonstrate promising practices for strengthening the rural health care system. Disclosure C.Brindley: None. W.James: None. J.R.Bennett: None. K.F.Matthews: None. Funding Health Resources and Services Administration, Federal Office of Rural Health Policy (HRSA-20-025, D06RH37500)

Comprehensive review of current management guidelines of chronic kidney disease.

Chronic kidney disease (CKD) is a prevalent and progressive condition affecting millions worldwide. It is a long-term condition characterized by gradual loss of kidney function over time. The management of CKD is complex and requires a multidisciplinary approach. This review aims to outline the current management guidelines for CKD. The study included a comprehensive search of various PubMed, Embase, and the Cochrane Library databases for articles published between 2010 and 2023. The search terms used were "chronic kidney disease," "management," and "guidelines." The inclusion criteria were articles that provided management guidelines for patients with CKD. A total of 23 articles were included in the review. Most articles were based on the Kidney Disease Improving Global Outcomes guidelines, the most widely recognized and used guidelines for managing CKD. The study found that the guidelines emphasize the importance of early detection and management of CKD and the need for an approach that involves multiple disciplines in its management. The guidelines recommend several interventions to slow the progression of CKD, including blood pressure control, glycemic control in diabetic patients, and reduce proteinuria. Other interventions include lifestyle modifications such as dietary changes, physical activity, and smoking cessation. The guidelines also recommend regular monitoring of kidney function and referral to a nephrologist for patients with advanced CKD or other complications. Overall, the current management guidelines for CKD emphasize the importance of early detection and a multidisciplinary approach to its management.

Evaluasi Kadar Kreatinin dan Mikroalbumin dengan HbA1C <6% pada Pasien Diabetes Mellitus di Samarinda

Diabetes Mellitus (DM) is a metabolic disease caused by high blood glucose levels (hyperglycemia). Hyperglycemia is caused due to lack of insulin secretion in the body. Glycemic control in diabetic patients is seen in HbA1C levels. One of the complications of DM is diabetic nephropathy. Renal function abnormalities associated with diabetic nephropathy are indicated by increased levels of creatinine and microalbumin. This shows that it is necessary to monitor kidney function in DM. Monitoring DM patients with HbA1C levels <6.5% is desirable, with these levels indicating that glycemic control is good. This study aimed to determine the relationship between creatinine and microalbumin levels with HbA1C <6.5% in Diabetes Mellitus patients in Samarinda. This type of research is analytic with a cross-sectional design. Spearman correlation statistical test. The sample of this study was 107 DM patients with HbA1C levels <6.5% who did medical checkups at the Media Farma Clinic, Samarinda. Sampling is done by Total Sampling. HbA1C examination method with turbidimetry. Method of checking creatinine by Jaffe reaction. Method of examination of microalbumin with immunoturbidimetry. All parameters are quality controlled before measurement. The measurement results were validated by a clinical pathologist. The results showed that the correlation of creatinine with HbA1C <6.5% obtained p value = (0.826), microalbumin with HbA1C <6.5% obtained p value = (0.146), and creatinine with microalbumin obtained p value = (0.082). All these results indicate that H0 is accepted and Ha is rejected. This study concludes no significant relationship exists between creatinine and microalbumin values with HbA1C levels <6.5% in Diabetes Mellitus in Samarinda, especially Media Farma Clinic.

1,5-Anhydro-D-Fructose Exhibits Satiety Effects via the Activation of Oxytocin Neurons in the Paraventricular Nucleus.

1,5-Anhydro-D-fructose (1,5-AF) is a bioactive monosaccharide that is produced by the glycogenolysis in mammalians and is metabolized to 1,5-anhydro-D-glucitol (1,5-AG). 1,5-AG is used as a marker of glycemic control in diabetes patients. 1,5-AF has a variety of physiological activities, but its effects on energy metabolism, including feeding behavior, are unclarified. The present study examined whether 1,5-AF possesses the effect of satiety. Peroral administration of 1,5-AF, and not of 1,5-AG, suppressed daily food intake. Intracerebroventricular (ICV) administration of 1,5-AF also suppressed feeding. To investigate the neurons targeted by 1,5-AF, we investigated c-Fos expression in the hypothalamus and brain stem. ICV injection of 1,5-AF significantly increased c-Fos positive oxytocin neurons and mRNA expression of oxytocin in the paraventricular nucleus (PVN). Moreover, 1,5-AF increased cytosolic Ca2+ concentration of oxytocin neurons in the PVN. Furthermore, the satiety effect of 1,5-AF was abolished in oxytocin knockout mice. These findings reveal that 1,5-AF activates PVN oxytocin neurons to suppress feeding, indicating its potential as the energy storage monitoring messenger to the hypothalamus for integrative regulation of energy metabolism.

Impact of [ldquo]Taraweeh[rdquo] prayer on glycemic control in diabetic patients during ramadan

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

A potential role for GPR107 in hypoglycemia unawareness

Hypoglycemia unawareness (HU) is a major barrier to achieving glycemic control in diabetic patients and remains a severe complication for type 1 and many type 2 diabetics. Due to the limited availability of animal models and significant variations between existing models, our understanding is limited regarding the cellular mechanisms and neural pathways responsible for this loss of metabolic control in the setting of recurrent hypoglycemia. Our group has recently identified GPR107 as a receptor for neuronostatin (NST), a 13 amino acid peptide derived from the somatostatin prepro-hormone. In our novel rat model of HU, we show that GPR107 expression is dramatically increased in the hypothalamus of rats exhibiting loss of hypoglycemia-induced food intake. Using a GPR107-flox rat model, we evaluated the effect of loss of GPR107 in the hypothalamus on the development of HU. Our preliminary data indicate that knockdown of hypothalamic GPR107 protects rats against HU induced by exposure to recurrent hypoglycemia. Future work will focus on the mechanisms underlying the role of GPR107 in the development of this dangerous clinical entity. National Institute of Health (NIH) This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Glycemia-Induced miRNA Changes: A Review.

Diabetes is a rapidly increasing global health concern that significantly strains the health system due to its downstream complications. Dysregulation in glycemia represents one of the fundamental obstacles to achieving glycemic control in diabetic patients. Frequent hyperglycemia and/or hypoglycemia events contribute to pathologies that disrupt cellular and metabolic processes, which may contribute to the development of macrovascular and microvascular complications, worsening the disease burden and mortality. miRNAs are small single-stranded non-coding RNAs that regulate cellular protein expression and have been linked to various diseases, including diabetes mellitus. miRNAs have proven useful in the diagnosis, treatment, and prognosis of diabetes and its complications. There is a vast body of literature examining the role of miRNA biomarkers in diabetes, aiming for earlier diagnoses and improved treatment for diabetic patients. This article reviews the most recent literature discussing the role of specific miRNAs in glycemic control, platelet activity, and macrovascular and microvascular complications. Our review examines the different miRNAs involved in the pathological processes leading to the development of type 2 diabetes mellitus, such as endothelial dysfunction, pancreatic beta-cell dysfunction, and insulin resistance. Furthermore, we discuss the potential applications of miRNAs as next-generation biomarkers in diabetes with the aim of preventing, treating, and reversing diabetes.