Glycemic Test Research Articles

Reframing prediabetes: A call for better risk stratification and intervention.

Prediabetes is an intermediate state of glucose homeostasis whereby plasma glucose concentrations are above normal but below the threshold of diagnosis for diabetes. Over the last several decades, criteria for prediabetes have changed as the cut points for normal glucose concentration and diagnosis of diabetes have shifted. Global consensus does not exist for prediabetes criteria; as a result, the clinical course and risk for type 2 diabetes vary. At present, we can identify individuals with prediabetes based on three glycemic tests (hemoglobin A1c, fasting plasma glucose, and 2-h plasma glucose during an oral glucose tolerance test). The majority of individuals diagnosed with prediabetes meet only one of these criteria. Meeting one, two, or all glycemic criteria changesrisk for type 2 diabetes, but this information is not widely known and does not currently guide intervention strategies for individuals with prediabetes. This review summarizes current epidemiology, prognosis, and intervention strategies for individuals diagnosed with prediabetes and suggests a call for more precise risk stratification of individuals with prediabetes as elevated (one prediabetes criterion), high risk (two prediabetes criteria), and very high risk (three prediabetes criteria). In addition, the roles of oral glucose tolerance testing and continuous glucose monitoring in the diagnostic criteria for prediabetes need reassessment. Finally, we must reframe our goals for prediabetes and prioritize intensive interventions for those at high and very high risk for type 2 diabetes.

Coenzyme Q: food sources, adequate and clinically effective doses

Coenzyme Q (CoQ) plays a key role in cell bioenergetics; it is not only supplied with food, but also synthesized in the body. Endogenous CoQ synthesis decreases with age, with statin use, with cardiovascular, neurodegenerative, and other diseases. In this regard, specialized food products (SFP) enriched with CoQ are being developed. Aim of the review – compare the CoQ doses allowed for use as part of dietary supplements and SFP with doses that provide a clinical effect. Literature review was carried out using the RSCI, Pubmed databases and Google Scholar, ReserchGate systems for the keywords “ubiquinone”, “coenzyme Q10”. The amount of CoQ contained in SFP is set by domestic regulatory documents based on an adequate daily intake for adults (30 mg) and the upper allowable intake level as part of SFP and dietary supplements – 100 mg/day. Actually used doses of CoQ range from 60 to 500 mg/day. Various ways to increase the bioavailability of CoQ have been described. When patients take CoQ, a U-shaped dose-effect relationship is observed, an effective dose that significantly reduces systolic blood pressure, fasting glucose and insulin levels, the degree of hemoglobin glycation, the HOMA-IR glycemic test is in the range of 100–200 mg / day. An improvement in the antioxidant status and a decrease of pro-inflammatory cytokines concentration in the blood plasma of athletes is provided by CoQ doses of 60–300 mg/day, in patients with type 2 diabetes mellitus and coronary heart disease, doses of 100–150 mg/day. Clinically effective doses of CoQ (100–200 mg/day) when used for at least 12 weeks correspond to or are 1.5–2 times higher than the upper allowable consumption level in the composition of SFP and dietary supplements. The inclusion of CoQ in the dietary therapeutic SFP in an amount that does not reach doses that are effective in a certain pathology does not achieve the expected result. A possible way to solve the problem is to increase the acceptable levels of consumption of CoQ in SFP, as well as increasing the bioavailability of CoQ in the composition of emulsions, liposomes, phytosomes and oleogels.

Glycaemic monitoring and control among high-risk patients with type 2 diabetes in Australian general practice during COVID-19

BackgroundThe COVID-19 pandemic disrupted general practice worldwide, primarily due to public health measures that restricted access to care for chronic diseases, such as type 2 diabetes. These measures disproportionately affected...

Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients?

Hyperglycemia has been suggested as a risk factor for poor outcomes in coronavirus disease 2019 (COVID-19). The aim of our work was to evaluate the association between blood glucose levels at admission (BGA) and disease outcomes in hospitalized COVID-19 patients. Retrospective study including all adult COVID-19 patients admitted to a Portuguese hospital from March to August 2020 with BGA measurement. Subjects were categorized into two groups: BGA < 140 mg/dL and ≥ 140 mg/dL. Statistical analysis was performed using SPSSv26® (significance defined as p < 0.05). We included 202 patients: median age 74 (60-86) years; 43.1% female; 31.2% with diabetes. The median BGA was 130.5 (108-158) mg/dL. When compared to normoglycemic, patients with BGA ≥ 140 mg/dL were older (p = 0.013), more vaccinated for influenza (p = 0.025) and had more comorbidities (hypertension, heart failure and peripheral arterial disease, p < 0.05). The last group presented higher leucocyte and neutrophile count, higher procalcitonin and prothrombin time, and lower lymphocyte count. Concerning prognosis, BGA ≥ 140 mg/dL was associated with higher rates of mechanical ventilation requirement and intensive care unit admission (p < 0.001), shock (p = 0.011), in-hospital mortality (p = 0.022) and 30-day mortality (p = 0.037). Considering only non-diabetic patients (n = 139), those with hyperglycemia presented higher rates of severity indicators (polypnea, SatO2 ≤ 93% and PaO2/FiO2 ≤ 300) and an association with poor outcomes was also found, namely mechanical ventilation requirement and in-hospital/30-day mortality (p < 0.05). Hyperglycemia at admission was associated with poor outcomes in COVID-19 patients, even in those without known pre-existing diabetes. Glycemic testing should be recommended for all COVID-19 patients.

1214-P: Trends in the Use of Glycemic Testing for Diabetes among Medicare Fee-for-Service Beneficiaries, 2001–2018

Glycemic tests are an important tool in screening patients for diabetes and prediabetes but there is little literature describing changes in patterns of glycemic testing over time. Using claims data for Medicare Fee-for-Service (FFS) beneficiaries without diabetes, we examined trends and demographic variation in the use of glycemic screening tests. Beneficiaries with diabetes were identified by ICD diagnosis codes while tests were identified with HCPCS/CPT procedure codes. The number of fully enrolled Medicare FFS beneficiaries without diagnosed diabetes ranged from 17.1 million in 2001 to 14.6 million in 2018. The total number of tests ranged from 2.7 million in 2001 to 4.8 million in 2018, and after 2009, the majority administered were HbA1c tests. The rate of glycemic testing was calculated as the percent of beneficiaries without diagnosed diabetes having at least one of any glycemic test per year. Testing rates were calculated by sex, age, race/ethnicity and state. The annual percentage of beneficiaries without diabetes who had any glycemic test increased from 10.6% in 2001 to 22.5% in 2018. Testing rate varied little across sex, age and race/ethnicity groups with 2 exceptions: beneficiaries age 85+ had a much lower testing rate (17.8% in 2018) than other age groups (23.6%); and beneficiaries of Asian or Pacific Islander descent had a much higher testing rate (31.7% in 2018) than other race/ethnicity groups (between 22.0–24.8%). However, testing rates did vary considerably among states: in 2018, ranging from a low of 11.1% in Wyoming to a high of 33.9% in Hawaii. Glycemic testing for diabetes has increased steadily since 2010, largely due to increased use of HbA1c tests. However, fewer than 1 in 4 Medicare FFS beneficiaries were tested in 2018, suggesting that opportunities remain to improve screening and diagnosis of diabetes among older adults. Disclosure L.J.Andes: None. S.R.Benoit: None. D.B.Rolka: None. G.Imperatore: None. C.S.Holliday: None.

Access to diabetes diagnosis in Brazil based on recent testing and consultation: The Brazilian national health survey, 2013 and 2019.

Screening for undiagnosed diabetes using glucose testing is recommended globally to allow preventive action among those detected. Our aim was to evaluate the access to glucose testing to screen for diabetes in Brazil using self-reported information on recent testing and medical consultation from national surveys of Brazilian adults. The Pesquisa Nacional de Saúde (PNS) was conducted in 2013 and 2019 drawing probabilistic samples of Brazilians aged 18 years and above. To evaluate glucose testing among those undiagnosed, we excluded those self-reporting a previous diagnosis of diabetes. We then defined recent access to diabetes diagnosis by considering the previous two years and choosing the last blood glucose test and the proximal medical consultation reported. We used Poisson regression with robust variance to assess correlates of access, expressing them with adjusted prevalence ratios (PR) and their 95% confidence intervals. Access to recent glucose testing documented that over 70% reported a recent glycemic test, 71% in 2013, and 77% in 2019. These findings are consistent with a wide recent access to medical consultation, 86% and 89% in 2013 and 2019, respectively. Reporting recent glucose testing and medical consultation may better reflect the actual access to medical diagnostic testing. When analyzing this joint outcome, diagnostic access was still wide, 67% and 74%, respectively. Greater access (p< 0.001) was seen for women (PR=1.16; 1.15-1.17), older individuals (PR=1.25; 1.22-1.28), and those with higher education (PR=1.17; 1.15-1.18), obesity (PR=1.06; 1.05-1.08), and hypertension (PR=1.12; 1.11-1.13). In contrast, lower access (p<0.001) was seen for those declaring being Black (PR=0.97; 0.95-0.99) or of mixed-race (PR=0.97; 0.96-0.98), those residing in rural areas (PR=0.89; 0.87-0.90), and not having a private health insurance plan (PR=0.85; 0.84-0.86). Although access to diagnostic testing for diabetes is high in Brazil, partly due to its universal health system, social inequities are still present, demanding specific actions, particularly in rural areas and among those self-declaring as being Black or mixed-race.

Trends in glucose testing among individuals without diabetes in Ontario between 2010 and 2017: a population-based cohort study.

Background:Early identification of people with diabetes or prediabetes enables greater opportunities for glycemic control and management strategies to prevent related complications. To identify gaps in screening for these conditions, we examined population trends in receipt of timely glucose testing overall and in specific clinical subgroups.Methods:Using linked administrative databases, we conducted a retrospective cohort study of people aged 40 years and older without diabetes at baseline. Our primary outcome was up-to-date glucose testing, defined as having received testing at least once in the 3 years before each index year from 2010 to 2017, using linked administrative databases of people residing in Ontario, Canada. We calculated rates of up-to-date testing by age group, sex, ethnicity (South Asian, Chinese, general population) and comorbidities (hypertension, hyperlipidemia, cardiovascular disease).Results:Over the 8-year study period, up-to-date glucose testing rates were stable at 67% for men and 77% for women (both relative risk 1.00 per year; 95% confidence interval 1.00–1.00). Testing rates were significantly lower in men than in women (all age groups p < 0.001) and lower in younger than older age groups (except those aged ≥ 80 yr). South Asian people had the highest testing rates, although among people aged 70 years or older, testing was highest in the general population (p < 0.001). Among people with hypertension, hyperlipidemia and cardiovascular disease, annual testing rates were also stable, but only 58% overall among people with hypertension.Interpretation:We found lower glucose testing rates in younger men and people with hypertension. Our findings reinforce the need for initiatives to increase awareness of glycemic testing.

914-P: Are Longitudinal Success in Glycemic Control and Long-Term A1C Testing Different by Race Groups?

The purpose of this study is to test whether race is associated with longitudinal success in glycemic control or consecutive years of A1c testing. A retrospective cohort study of 531,995 adults with type 2 diabetes who received care between 20 and 2018 was conducted. The independent variable was race (white, black, Hispanics, and other) . Dependent variables were (1) success rate for glycemic control (A1c &amp;lt;7 [&amp;lt;65 y/o] or &amp;lt;8 [&amp;gt;=65 y/o]) , defined as (number of A1c tests meeting target) / (number of A1c tests) ; and (2) the number of three consecutive years of A1c testing. Confounder variables were age, gender, first year, last year, and health service utilization (yearly rate of outpatient, emergency department, hospitalization and home care visits) . We used generalized linear regression (GLM) to analyze the success rate of glycemic control, and GLM with negative binomial to analyze the number of years of A1c testing. Ten-year level observations (N=531,995) summarized from 3,044,247 year-level electronic medical-record observations showed mean observed years of 5.2, median years of A1c tested of 3.5, and mean fraction of years tested A1c over observed of 69%. Mean success rate of glycemic control was 67% in a 10-year period (IQR of 67%) . The success rate of glycemic control differed by race (P&amp;lt;0.001) : estimates were lower for black (-0.037) , other (-0.066) , and Hispanics (-0.089) compared to white. Controlled for confounders, black had 4% lower success rate of glycemic control than white. The number of three consecutive years of A1c testing differed by race (P&amp;lt;0.001) : estimates were lower for black (-0.100) and other (-0.146) , compared to white. Controlled for covariate plus the success rate for glycemic control, blacks had mean count ratio = 0.9 in the number of 3 consecutive years of A1c testing. Ten-year longitudinal glycemic control was worse among black adults with type 2 diabetes. Greater understanding of the disparities in glycemic control and long-term monitoring of A1c testing is needed. Disclosure H.N.Fu: None. T.Schleyer: None. J.Wolfson: None. T.S.Hannon: Advisory Panel; Eli Lilly and Company. P.Balius: None. M.Weiner: Stock/Shareholder; AbbVie Inc., Accuray, Inc., Allscripts Healthcare Solutions, Amgen Inc., Boston Scientific Corporation, Bristol-Myers Squibb Company, Crispr Therapeutics Ag Com, Express Scripts Hdlg Co, General Electric Co., Globus Med, Inc., IBM, Integer Hldgs Corp Com, Integra Lifesciences Holdings Corp, Johnson &amp; Johnson, Mallinckrodt PLC, Mead Johnson &amp; Company, LLC., Medtronic, Metlife Inc Com, Mylan N.V., Novo Nordisk A/S, Nuvasive, Inc., Orthofix Medical Inc., Perspecta Inc Com, Pfizer Inc., Resmed, Inc., Roche Pharmaceuticals, Seaspine Hldgs, Inc., Senseonics, Stryker Corp., Teva Pharmaceutical Industries Ltd., Varex Imaging Corp., Varian Med Sys, Inc., Walgreens Boots Alliance, Inc. Funding T15LM012502, UL1TR002529, the Lilly Endowment Physician Scientist Initiative

Utility of an Electronic Health Record Report to Identify Patients with Delays in Testing for Poorly Controlled Diabetes.

Reducing hemoglobin A1c (HbA1c) is essential for patients with poorly controlled diabetes. However, delays in HbA1c testing are common, and incomplete electronic health record (EHR) reports hinder identification of patients who are overdue. This study sought to quantify how often an EHR report correctly identifies patients with HbA1c testing delays and to describe potential contributing factors. Using an EHR report, the researchers identified adult patients who had an HbA1c > 9.0% between October 2017 and March 2018 and a suspected delay (for example, another HbA1c had not resulted within six months). A retrospective chart review of 200 randomly selected records was performed to confirm delays in testing. Secondary measures were collected from 93 charts to evaluate associated factors. A total of 685 patients with suspected delays were identified. On chart review (N = 200), 82.0% were confirmed. Nine percent of patients had a timely repeat result, but the result was not in a discrete field within the EHR. Another 8.5% were never expected to return. Among a subset of confirmed delays, patients often received lifestyle counseling, but less than half had documented discussions about repeat glycemic testing. Also, 74.2% had a timely follow-up appointment scheduled but the majority (85.5%) were missed. Most suspected delays in HbA1c testing were confirmed; however, a substantial minority were misclassified due to missing data or follow-up care outside the health system. Current solutions to improve data quality for HbA1c are labor intensive and highlight the need for better integration of health care data. Missed appointments were commonly noted among patients with delays in care and are a potential target for improvement.

Clinical Care Among Individuals with Prediabetes in Primary Care: a Retrospective Cohort Study.

BackgroundThe incidence of diabetes in the general US population (6.7 per 1000 adults in 2018) has not changed significantly since 2000, suggesting that individuals with prediabetes are not connecting to evidence-based interventions.ObjectiveWe sought to describe the clinical care of individuals with prediabetes, determine patient factors associated with this care, and evaluate risk for diabetes development.DesignRetrospective cohort study using linked claims and electronic health record data.ParticipantsWe created a cohort of adults with prediabetes based on laboratory measures. We excluded patients with a prior history of diabetes, pregnancy in prior 6 months, or recent steroid use.Main MeasuresWe measured ordering and completion of clinical services targeting prediabetes management and diabetes incidence within 12 months following cohort entry. We tested the strength of the association between individuals’ characteristics and outcomes of interest using bivariate and multiple logistic regression.ResultsOur cohort included 3888 patients with a laboratory diagnosis of prediabetes (incident or prevalent prediabetes). Within 12 months, 63.4% had repeat glycemic testing, yet only 10.4% had coded diagnoses of prediabetes, 1.0% were referred for nutrition services, and 5.4% were prescribed metformin. Most patients completed labs and nutrition visits when referred and filled metformin when prescribed. Individuals with a higher glycemic level or BMI were more likely to receive prediabetes clinical care. Six percent of individuals developed diabetes within 12 months of cohort entry and had higher glycemic levels and BMI ≥ 30 kg/m2. In the adjusted model, Black individuals had 1.4 times higher odds of developing diabetes than White individuals.ConclusionsRates of prediabetes clinical care activities are low and have not improved. Strategies are urgently needed to improve prediabetes care delivery thereby preventing or delaying incident diabetes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-022-07412-9.

Rice Bran Substitution to Vitabran as A Snackyfication Trend Model and Diabetes Mellitus Prevention

Snackyfication is a trend where snacks as a substitute for staple food are more efficient. On the other hand, the Diabetes Mellitus case increases, and it is related to unhealthy foods, so there is a need for healthy foods on the market. The research objective was to find which product formula would be recommended as Vitabran. Vitabran is made from rice bran, while additional ingredients are yellow sweet potato pulp, cornstarch, soy milk, flour, eggs, honey, baking powder, margarine, and oats. The formula tested consists of 2 variations of bran content (20% and 30%). The product was made of biscuits in the form of bars. The tests consisted of 1) organoleptic test 2) hedonic test. 3) proximate test and 4) Glycemic Index test. The final result of functional food substitution is a synergistic effect of the functional substances contained therein.

Diagnosis and Management of Gestational Diabetes Mellitus: An Overview of National and International Guidelines.

Gestational diabetes mellitus (GDM) represents one of the most frequent complications of pregnancy and is associated with increased maternal and neonatal morbidity. Its incidence is rising, mostly due to an increase in maternal age and maternal obesity rate. The aim of this study was to review and compare the recommendations of the most recently published guidelines on the diagnosis and management of this condition. A descriptive review of guidelines from the National Institute for Health and Care Excellence (NICE), the International Federation of Gynecology and Obstetrics, the Australasian Diabetes in Pregnancy Society (ADIPS), the Society of Obstetricians and Gynecologists of Canada (SOGC), the American College of Obstetricians and Gynecologists (ACOG), the American Diabetes Association, and the Endocrine Society on gestational diabetes mellitus was carried out. The NICE guideline recommends targeted screening only for women with risk factors, whereas the International Federation of Gynecology and Obstetrics, ADIPS, SOGC, and the ACOG recommend screening for all pregnant women at 24 to 28 weeks of gestation in order to diagnose and effectively manage GDM; they also state that women with additional risk factors should be screened earlier (ie, in the first trimester) and retested at 24 to 28 weeks, if the initial test is negative. These guidelines describe similar risk factors for GDM and suggest the same thresholds for the diagnosis of GDM when using a 75-g 2-hour oral glucose tolerance test. Of note, the NICE only assesses the fasting and the 2-hour postprandial glucose levels for the diagnosis of GDM. Moreover, the SOGC and the ACOG do not recommend this test as the optimal screening method. The Endocrine Society alone, on the other hand, recommends the universal testing of all pregnant women for diabetes before 13 weeks of gestation or as soon as they attend the antenatal service and retesting at 24 to 28 weeks if the initial results are normal. In addition, there is a general consensus on the appropriate ultrasound surveillance of pregnancies complicated with GDM, and all the medical societies, except the ADIPS, recommend self-monitoring of capillary glucose to assess the glycemic control and set the same targets for fasting and postprandial glucose levels. There is also agreement that lifestyle modifications should be the first-line treatment; however, the reviewed guidelines disagree on the medical management of GDM. In addition, there are controversies regarding the timing of delivery, the utility of hemoglobin A1c measurement, and the postpartum and lifelong screening for persistent hyperglycemia and type 2 diabetes. However, all the guidelines state that all women in pregnancies complicated by GDM should undergo a glycemic test at around 6 to 12 weeks after delivery. Finally, there is a universal consensus on the importance of breastfeeding and preconception screening before future pregnancies. As GDM is an increasingly common complication of pregnancy, it is of paramount importance that inconsistencies between national and international guidelines should encourage research to resolve the issues of controversy and allow uniform international protocols for the diagnosis and management of GDM, in order to safely guide clinical practice and subsequently improve perinatal and maternal outcomes.

Longitudinal Observation of Outcomes and Patient Access to Integrated Care Following Point-of-Care Glycemic Screening in Community Health Center Dental Safety Net Clinics.

Introduction: Rates of diabetes/prediabetes continue to increase, with disparity populations disproportionately affected. Previous field trials promoted point-of-care (POC) glycemic screening in dental settings as an additional primary care setting to identify potentially at-risk individuals requiring integrated care intervention. The present study observed outcomes of POC hemoglobin A1c (HbA1c) screening at community health center (CHC) dental clinics (DC) and compliance with longitudinal integrated care management among at-risk patients attending dental appointments.Materials and Methods: POC HbA1c screening utilizing Food and Drug Administration (FDA)-approved instrumentation in DC settings and periodontal evaluation of at-risk dental patients with no prior diagnosis of diabetes/prediabetes and no glycemic testing in the preceding 6 months were undertaken. Screening of patients attending dental appointments from October 24, 2017, through September 24, 2018, was implemented at four Wisconsin CHC-DCs serving populations with a high representation of disparity. Subjects meeting at-risk profiles underwent POC HbA1c screening. Individuals with measures in the diabetic/prediabetic ranges were advised to seek further medical evaluation and were re-contacted after 3 months to document compliance. Longitudinal capture of glycemic measures in electronic health records for up to 2 years was undertaken for a subset (n = 44) of subjects with available clinical, medical, and dental data. Longitudinal glycemic status and frequency of medical and dental access for follow-up care were monitored.Results: Risk assessment identified 224/915 (24.5%) patients who met inclusion criteria following two levels of risk screening, with 127/224 (57%) qualifying for POC HbA1c screening. Among those tested, 62/127 (49%) exhibited hyperglycemic measures: 55 in the prediabetic range and seven in the diabetic range. Moderate-to-severe periodontitis was more prevalent in patients with prediabetes/diabetes than in individuals with measures in the normal range. Participant follow-up compliance at 3 months was 90%. Longitudinal follow-up documented high rates of consistent access (100 and 89%, respectively), to the integrated medical/DC environment over 24 months for individuals with hyperglycemic screening measures.Conclusion: POC glycemic screening revealed elevated HbA1c measures in nearly half of at-risk CHC-DC patients. Strong compliance with integrated medical/dental management over a 24-month interval was observed, documenting good patient receptivity to POC screening in the dental setting and compliance with integrated care follow-up by at-risk patients.

The effect of the Covid-19 shutdown on glycemic testing and control

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic caused a halt to in-person ambulatory care. We evaluated how the reduction in access to care affected HbA1c testing and patient HbA1c levels. MethodsHbA1c data from 11 institutions were extracted to compare testing volume and the percentage of abnormal results between a pre-pandemic period (January-June 2019, period 1) and a portion of the COVID-19 pandemic period (Jan-June 2020, period 2). HbA1c results greater than 6.4% were categorized as abnormal. ResultsHbA1C testing volumes decreased in March, April and May by 23, 61 and 40% relative to the corresponding months in 2019. The percentage of abnormal results increased in April, May and June (25, 23, 9%). On average, we found that the frequency of abnormal results increased by 0.31% for every 1% decrease in testing volume (p < 0.0005). ConclusionHbA1c testing volume for outpatients decreased by up to 70% during the early months of the pandemic. The decrease in testing was associated with an increase in abnormal HbA1c results.

Effects of moderate intensity endurance training and high-intensity interval training on the reproductive parameters of wistar rats overfed in infancy.

Studies indicate that rapid weight gain at critical development stages, such as the lactation period, is associated with the development of obesity, cardiovascular diseases, and diabetes in the long term. In addition to metabolic changes during adulthood, overweight/obesity may influence reproductive function. Human and animal studies suggest that lifestyle changes through exercise and/or controlled diet result in improved semen quality in obese individuals. However, the relationship between exercise volume/intensity and reproductive capacity effects remains inconclusive. The present study aimed to evaluate the effects of moderate intensity endurance training and high-intensity interval training (HIIT) on the reproductive parameters of lactating overfed male Wistar rats. Postnatal overfeeding was induced by applying the litter size reduction method. Forty males Wistar rats were used, divided into four groups: one with control litters (CLs) (10 animals/litter-sedentary) and three with small litters (SLs) (4 animals/litter), divided into sedentary, moderate endurance training, and HIIT. Morphologic, metabolic, and reproductive variables were analyzed. SL sedentary group showed increased body weight, adiposity, and decreased relative weight of the seminal vesicle, prostate, and epididymis as well as changes in the insulin tolerance and oral glucose tolerance tests glycemic tests compared to CL sedentary group. Endurance and HIIT protocols were efficient in improving the glycemic metabolism, central fat accumulation of trained groups and did not affect reproductive parameters. Endurance and HIIT protocols proved to be effective in reversing these metabolic changes without impairing the evaluated reproductive parameters.

Antibiotic Resistance Pattern of Staphylococcus aureus and Associated Risk Factors in the Adamaoua and Far North Regions of Cameroon

Background: Infections due to Staphylococcus aureus (S. aureus) have been recognized as an important public health problem worldwide. Resistant S. aureus strains emerged and its prevalence has been on the rise. Many risk factors were identified as comorbidities and impact seriously the health state of infected individual by resistant Staphylococcus aureus. We focus our study on two of these risk factors (HIV-infection and diabetes) which may constitute high potential health conditions for emergence of resistant S. aureus strains. &#x0D; Methods: A Cross sectional study was conducted during 19 months in five laboratories in the northern Cameroon. Collection of clinical samples from nine different types of specimens and first identifications were conducted in the various sites of study. Selected strains were transported in Yaoundé using standard procedure. Identification and drug susceptibility testing was performed using the disk diffusion method. Questionnaires were submitted to all the participants after an approved written and oral consent. HIV and Glycemia test were carried out on each patient in case their status was not known. During the study, 380 strains of Staphylococcus aureus were identified. Antimicrobial test was achieved using 16 different antibiotics.&#x0D; Results: Result showed that 202/380 (53.2 %) of Staphylococcus aureus were resistant to at least three antibiotics (multiresistant) from three different families. Multiresistant strains displayed high resistance to cotrimoxal (76.7 %) followed by penicillin (66.8 %), tetracyclin (57.4 %) and oxacillin (51.5%). While high rate of sensitivity were obtained for rifampicin (78.7 %), fusidic acid (65.8 %), lincomycin (60.5 %) and minocyclin (58.9 %). Few participants 8.9 % were tested HIV positive and 7.9% were living with diabetes. Strains isolated from participants living with these diseases presented higher rate of resistance to antibiotics.&#x0D; Conclusion: The rate of multiresistant Staphylococcus aureus are constantly in progress in northern Cameroon, most of the strains originated from community. These strains exhibited high resistance level to cotrimoxazol while displaying high sensitivity to rifampicine. People living with chronic diseases presented high resistance to antibiotic recommended for S. aureus infection treatment.

PSVI-32 The effects of varying amylose levels in different diets on digestibility and glycemic response in canines

Abstract This study was conducted to compare the digestibility of pulse-based diets to grain-based diets based on varying levels of amylose and study how changes in digestibility impacts glycemic response in dogs. To establish glycemic response, six diets were formulated at an inclusion level of 20% available starch with varying amylose content. A grain-based diet was formulated using rice, while pulse-based diets consisted of smooth pea, wrinkled pea (4140–4 and Amigold varieties), faba bean, or lentil. Beagles (n = 8, 4 females, 4 males) were fed the 6 different test diets for 7 days in a randomized, cross-over, blinded design. At the end of each feeding period, fecal samples were collected and beagles were fasted overnight and subjected to a glycemic test (1g/kg of diet or glucose fed). Data collected were statistically analyzed using SigmaPlot 12.0 and significance was declared at P ≤ 0.05. Amylose levels of diets varied from 4.64% to 14.82% on a dry basis. The rice-based diet had the lowest amylose content, while the wrinkled pea (Amigold variety) diet had the highest amylose content. Following the collection of glycemic response and fecal data, repeated-measures, 1-way ANOVA’s were conducted. There were significant differences observed between diets based on peak glucose levels (mmol/L, P = 0.01). The rice diet had the highest peak in glucose, while the lentil-based diet had the lowest glucose peak. Significant differences were also seen between diets based on their digestibility (P &amp;lt; 0.001). Rice, lentil, faba bean and smooth pea-based diets had the highest levels of digestibility, while wrinkled pea varieties had decreased digestibility. Furthermore, varying amylose found in diets can be viewed as an impacting factor on glycemic response and digestibility. Incorporating pulses with higher amounts of amylose could be utilized in dog diets to promote a low glycemic response through decreased rates of digestibility.

Salud familiar y nivel glucémico en mujeres durante el segundo y tercer trimestre de embarazo

&lt;p&gt;Objetivo: analizar la salud familiar y el nivel glucémico en mujeres que cursan el segundo y tercer trimestre de embarazo. &lt;strong&gt;Métodos:&lt;/strong&gt; estudio transversal analítico. Participaron 230 gestantes del segundo y tercer trimestre de la Unidad de Medicina Familiar (umf) No. 75 del Instituto Mexicano del Seguro Social (imss), Estado de México. Se evaluó salud familiar en gestación mediante el cuestionario isf:ges-17 y el nivel glucémico mediante la glucosa capilar preprandial. &lt;strong&gt;Resultados:&lt;/strong&gt; 45% (n=103) de las participantes mostraron buen nivel glucémico en el tercer trimestre y 22% (n=50) en el segundo trimestre, mientras que el mal nivel glucémico se reportó para el tercer trimestre con 19% (n=44) y en el segundo trimestre con 14% (n=33). Existió una asociación entre la salud familiar saludable y el buen nivel glucémico en 33% de las gestantes. &lt;strong&gt;Conclusiones:&lt;/strong&gt; existió asociación entre salud familiar saludable y el buen nivel glucémico. Es importante implementar medidas para un apropiado entorno familiar, empoderando a la gestante en estilos de vida saludable y promoviendo evaluaciones oportunas del nivel glucémico.&lt;/p&gt;

Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study.

Aims/hypothesisHyperglycaemia is associated with an elevated risk of mortality in community-acquired pneumonia, stroke, acute myocardial infarction, trauma and surgery, among other conditions. In this study, we examined the relationship between fasting blood glucose (FBG) and 28-day mortality in coronavirus disease 2019 (COVID-19) patients not previously diagnosed as having diabetes.MethodsWe conducted a retrospective study involving all consecutive COVID-19 patients with a definitive 28-day outcome and FBG measurement at admission from 24 January 2020 to 10 February 2020 in two hospitals based in Wuhan, China. Demographic and clinical data, 28-day outcomes, in-hospital complications and CRB-65 scores of COVID-19 patients in the two hospitals were analysed. CRB-65 is an effective measure for assessing the severity of pneumonia and is based on four indicators, i.e. confusion, respiratory rate (>30/min), systolic blood pressure (≤90 mmHg) or diastolic blood pressure (≤60 mmHg), and age (≥65 years).ResultsSix hundred and five COVID-19 patients were enrolled, including 114 who died in hospital. Multivariable Cox regression analysis showed that age (HR 1.02 [95% CI 1.00, 1.04]), male sex (HR 1.75 [95% CI 1.17, 2.60]), CRB-65 score 1–2 (HR 2.68 [95% CI 1.56, 4.59]), CRB-65 score 3–4 (HR 5.25 [95% CI 2.05, 13.43]) and FBG ≥7.0 mmol/l (HR 2.30 [95% CI 1.49, 3.55]) were independent predictors for 28-day mortality. The OR for 28-day in-hospital complications in those with FBG ≥7.0 mmol/l and 6.1–6.9 mmol/l vs <6.1 mmol/l was 3.99 (95% CI 2.71, 5.88) or 2.61 (95% CI 1.64, 4.41), respectively.Conclusions/interpretationFBG ≥7.0 mmol/l at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes. Glycaemic testing and control are important to all COVID-19 patients even where they have no pre-existing diabetes, as most COVID-19 patients are prone to glucose metabolic disorders. Graphical abstract

Added values of DXA-derived visceral adipose tissue to discriminate cardiometabolic risks in pre-pubertal children.

BackgroundThe new generation of dual energy X-ray absorptiometry (DXA) scanners provide visceral adipose tissue (VAT) estimates by applying different algorithms to the conventional DXA-derived fat parameters such as total fat, trunk fat and android fat for the same image data.ObjectiveThis cross-sectional study aimed to investigate whether VAT estimates from Hologic scanners are better predictors of VAT than conventional DXA parameters in pre-pubertal children, and to explore the discrimination ability of these VAT methods for cardiometabolic risks.MethodsHealthy pre-pubertal children aged 7–10 years were recruited for basic anthropometric, DXA and magnetic resonance imaging (MRI) measurements. Laboratory tests included lipid profile, glycaemic tests and blood pressure.ResultsAll VAT methods had acceptable to excellent performance for the diagnosis of dyslipidaemia (area under the curve [AUC] = 0.753–0.837) and hypertensive risk (AUC = 0.710–0.821) in boys, but suboptimal performance for these risks in girls, except for VAT by MRI in the diagnosis of dyslipidaemia. In both sexes, all VAT methods had no or poor discrimination ability for diabetes risk.ConclusionsDXA-derived VAT estimates are very highly correlated with standard methods but has equivalent discrimination abilities compared to the existing DXA-derived fat estimates.