Glycosylated Hemoglobin Concentrations Research Articles

Association between Serum Calcium Concentration and Glycated Haemoglobin in Type II Diabetic Nigerian Patients

Background: Diabetes is a metabolic disease that affects key biochemical parameters in the body. The study was carried out to evaluate the serum calcium concentration and the relationship between serum calcium and glycosylated haemoglobin in type 2 diabetics. Methods: A total of 126 subjects consisting of 63 Diabetic patients and 63 controls participated in this study. Serum calcium and glycosylated haemoglobin concentrations were measured. Fasting blood sugar was also measured. Total calcium was measured using colorimetric determination of plasma total calcium by the o-cresolphthalein o-complexone (CPC) assay principle. Plasma albumin was determined using Bromocresol green (BCG) method, and thus corrected calcium was deduced. Glycosylated haemoglobin (HbA1C) was estimated using an ion-exchange chromatographic method. A semi-structured questionnaire was used for data collection. Results: The mean serum calcium levels of diabetics compared to non-diabetics did not differ statistically even though that of diabetics was in the lower range of normal. There was no statistically significant difference (p=0.099) between the mean serum calcium levels of diabetic patients who had glycosylated haemoglobin values below 6.5 (2.26 mmol/l±0.07) and diabetic patients who had glycosylated haemoglobin values above 6.5 (2.17mmol/l±0.09). Surprisingly, there was a weak positive correlation between glycosylated haemoglobin levels above 6.5 and serum calcium levels (p=0.087) and HbA1C below 6.5 correlated negatively albeit weakly with serum calcium levels though they were both insignificant. Socio-demographic data show that more females were diabetic. Conclusion: Overall, the study reveals that mean serum calcium concentrations in diabetic and non-diabetic patients are not different and this may be due to good blood glucose control in these diabetic patients

Five-year outcomes after surgery for class 1 obesity: a retrospective analysis of a Canadian bariatric centre's experience.

There is a paucity of literature exploring the role of bariatric surgery in class 1 obesity. We evaluated the 5-year outcomes after bariatric surgery in patients with class 1 obesity, assessing weight loss, resolution/reduction of obesity-related comorbidities, morbidity and mortality. We performed a single-centre retrospective analysis of patients who underwent bariatric surgery (laparoscopic sleeve gastrectomy [LSG] or laparoscopic Roux-en-Y gastric bypass [LRYGB)]) for class 1 obesity (body mass index [BMI] 30.0-34.9) between January 2012 and February 2019. Thirty-seven patients (35 [95%] female, mean age 44.5 yr [standard error (SE) 11.3 yr], mean preoperative BMI 33.1) were included, of whom 32 underwent LSG and 5 underwent LRYGB. Thirty-five patients were followed for 5 years post-operatively, achieving a mean BMI of 25.6 (SE 1.2) and excess weight loss of 89.4% (SE 15.1%). Remission of hypertension was achieved in 5 of 12 patients (42%), and remission of dyslipidemia was achieved in 7 of 11 patients (64%). Of the 11 patients with diabetes, 7 underwent LSG and 4, LRYGB. At 5 years postoperatively, the mean glycosylated hemoglobin concentration was 6.3%. Four patients in the LSG group developed de novo reflux, 1 patient required conversion to LRYGB, and 1 patient with sleeve stenosis required endoscopic dilatation. There were no deaths in either patient group. At our centre, bariatric surgery for class 1 obesity was safe and had long-term efficacy, with remission or reduction of related comorbidities. Prospective controlled trials are required to confirm these results.

Experimental Correction of Homeostasis Changes during Alloxan-Induced Diabetes by Implantation of Islet Cells Cultured in Fibrous TiNi-Based Scaffold.

The use of fibrous scaffolds made of titanium nickelide and carrying islet cells (IC) after a course of alloxan administration was studied in vivo. Scanning electron microscopy showed good adhesion of IC in the pore space of the scaffolds. In 28 days, mature tissue comprising both cellular and fibrous components filled the inner space of the scaffold by 90%. The advantage of intraperitoneal implantation of IC in vitro seeded in fibrous titanium nickelide scaffolds in comparison with injection of IC (6×105 cells) to Wistar rats was demonstrated in the dynamics of pancreatic function recovery (normalization of blood glucose and glycosylated hemoglobin concentrations by day 21 of the experiment), regeneration of the white hematopoietic lineage cells, and lengthening (by 2 times) of the lifespan of animals with alloxan-induced diabetes. Injection of IC improved rat survival by only 40%. Thus, the hybrid tissue-engineered construct (fibrous titanium nickelide scaffold+IC) is biocompatible when administered intraperitoneally, stimulates regeneration in rats with alloxan-induced diabetes, improves blood glucose utilization processes, and restores suppressed leukopoiesis. It is assumed that hepatocytes can be the main target cells of the hybrid tissue-engineering construct.

Demographic and clinical characteristics of a Spanish population of people living with type 1 diabetes who practice nonprofessional sports: The DIABESPORT survey

AimTo determine the characteristics of people with type 1 diabetes mellitus (T1D) who practice sports, the support they receive, and the way in which they manage their disease during sports. MethodsAn observational cross-sectional study designed as a web-based survey released through social media was carried out, directed to physically active people with T1D. ResultsA total of 342 subjects completed the survey (16 children; 67.5% males). The duration of living with T1D was 18.6 ± 11.4 years. The mean glycosylated hemoglobin concentration (HbA1c) was 6.7 ± 0.8%, and the mean time in range (TIR) was 72.9 ± 15.8%. Only 27.2% started sports activity following the diagnosis of T1D. The most frequently used basal insulin was insulin degludec (38.6%). The usual treatment modification before doing sports consisted of bolus reduction (42.5%) or only the adjustment of nutritional supplements (19.7%). In cases of long-acting insulin users, the basal dose usually remained unchanged during sports. One-quarter of the participants were insulin pump users, and of these, 12.5% always disconnected the pump during physical activities. Severe hypoglycemia on the day of physical activity was experienced by 5% of the participants in the last 6 months. One-third reported a lack of support from their physician, and 61% had learned to manage glycemic control during sports by themselves. ConclusionsThis study highlights the adjustments made by people living with T1D during sports practice, and the lack of support received from healthcare professionals.

Sports and exercise medicine clinic in public hospital settings: a real-life concept and experiences of the treatment of the first 1151 patients

ABSTRACT Objective Physical exercise has been shown to have a variety of health-promoting effects, including improvements in cardiorespiratory and muscular fitness, symptoms and risk factors such as LDL and HDL cholesterol, triglyceride and glycosylated hemoglobin concentrations. Regular physical exercise may slow down or even reverse the progression of various non-communicable diseases (NCDs). Despite the overwhelming evidence, physical exercise is not comprehensively used as a treatment component either in primary care or in hospital settings. Methods The outpatient Sports and Exercise Medicine Clinic (SEMC) is the first specialized clinic in Finland to use physical exercise as a part of the public health care system. Patients needing specialist attention due to NCDs, usually combined with sedentary lifestyles, are referred to the clinic. Results The prerequisites for patient referral are the known efficacy of physical exercise intervention in the treatment of disease and the need for sports and exercise medicine expertise. The focus of the clinic is to implement physical activity into daily life with other health-promoting habits such as diet, rest and the reduction of substance use. In addition, SEMC promotes the inclusion of physical exercise in several local treatment guidelines in the hospital district. The advisory treatment protocol of SEMC consists of a baseline evaluation, face-to-face visits with a physician and/or physiotherapist at 3, 6 and 9–12 months, and contacts via phone between hospital visits. Laboratory tests, body composition, walking tests, and measurements of muscle strength and balance are performed at baseline, and body composition and physical tests are repeated after 6 and 9–12 months. Conclusions At the core of the treatment is individualization, using motivational interviewing, considering the patients’ personal interests and resources, and encouraging the patient to be an active member of our multi-professional team. We reported the first results in the SEMC with future development plans for the clinic.

Does diabetes mellitus increase the incidence of early thrombosis in deep vein following unicompartmental knee arthroplasty: a retrospective cohort study

BackgroundMany patients following unicompartmental knee arthroplasty (UKA) also suffer from diabetes mellitus, which may lead to an increased likelihood of postoperative deep venous thrombosis (DVT). Therefore, we evaluated whether DVT incidence would increase 3 days following UKA in diabetic patients.MethodsPatients who underwent UKA from August 2018 to September 2021 in our hospital were retrospectively included. Age, gender, body mass index, hypertension, mode of anesthesia, surgery time, intraoperative blood loss, tourniquet pressure and time, and glycosylated hemoglobin concentration were recorded as confounders. We compared the incidence and type of DVT between non-diabetic and diabetic patients and evaluated the effect of glycosylated hemoglobin levels on DVT.ResultsOf all the 224 patients, 96 had diabetes and 128 did not. Within 3 days after surgery, DVT occurred in 25 cases in the diabetic group and 17 cases in the non-diabetic group (p < 0.05), and the difference mainly exists in the lower limbs on the surgical side. Logistic regression analysis demonstrated that the risk of DVT in the diabetic group was 4.50 times higher compared with the non-diabetic group. For every 1 unit increase of glycosylated hemoglobin, the incidence of DVT increased 2.35 times. Differences in age, gender, body mass index, hypertension, mode of anesthesia, surgery time, intraoperative blood loss, tourniquet pressure, and time between the two groups were not significant.ConclusionsThe incidence of DVT in diabetic patients within 3 days after UKA was significantly higher than that in non-diabetic patients and was proportional to the concentration of glycosylated hemoglobin.

Creatine Supplementation in Type 2 Diabetic Patients: A Systematic Review of Randomized Clinical Trials.

Type 2 Diabetes Mellitus (DM) is the most common form of diabetes. The initial treatment of type 2 DM consists of the adoption of healthy lifestyle habits together with several classes of hypoglycemic agents. However, these medications are not always able to reduce the blood glucose levels in all patients. Therefore, creatine supplementation has emerged as a new putative candidate for type 2 DM treatment. This systematic review aimed to investigate the effects (benefits and harms) of creatine supplementation in patients with type 2 diabetes through a systematic review. The studies were searched in MEDLINE, EMBASE, LILACS, CENTRAL, SPORTDiscus, and CINAHL databases, without date or language restrictions. Methodological quality was assessed using the Cochrane risk-of-bias table. The certainty of the evidence was classified using the Grading of Recommendations Assessment, Development and Evaluation approach. Three randomized controlled trials (RCTs) were included (87 participants). Overall, the methodological quality was classified as unclear to a high risk of bias. Each trial compared creatine supplementation with a different control group (placebo, metformin, and glibenclamide). Creatine supplementation seems to be effective in decreasing glycemic levels and glycosylated hemoglobin concentrations compared to placebo. No difference was observed compared to metformin or glibenclamide with creatine, and all treatments were able to reduce blood glucose levels. No major adverse effects were observed. Based on the low certainty of evidence, creatine supplementation was shown to be a hypoglycemic intervention for patients with type 2 diabetes, without major adverse events reported. However, well- designed RCTs with larger sample sizes and long-term outcomes are needed to support this evidence.

Epidemiology of uncorrected refractive errors in type 2 diabetics aged 50 and above in Funing County, China: the Jiangsu Diabetic Eye Study

Objective: To estimate the prevalence of uncorrected refractive errors among people aged 50 years and above in Funing county, Jiangsu province. Methods: Randomly cluster sampling was used in selecting individuals aged ≥50 years in 82 clusters from Funing County Center for Disease Prevention and Control. Uncorrected refractive error was defined as an improvement of at least 2 lines in best corrected visual acuity compared with presenting visual acuity in the better eye. The mean±standard deviation was used to describe the continuous data, and the rate or composition ratio was used to represent the classified data. Univariate and multivariate logistic regression analyses were used to analyze the prevalence of uncorrected refractive errors in different ages, genders, educational levels, durations of diabetes and levels of glycosylated hemoglobin. Statistical significance was defined as P<0.05. Results: A total of 2 067 persons were enumerated, and 1910 (92.4%) participants were in the statistical analyses. The prevalence of uncorrected refractive error was 25.63%. The prevalence of uncorrected refractive error for myopia only, hyperopia only, astigmatism only, myopia with astigmatism and hyperopia with astigmatism was 72.55% (37/51), 46.77% (58/124), 17.81% (13/73), 63.95% (94/147) and 51.98% (100/194), respectively. The results showed that the older age, level of glycosylated hemoglobin, myopia and lens state were the independent influencing factors of uncorrected refractive error. The odds ratio (OR) for people aged 70 to<80 years and ≥80 years was 1.81 and 1.90, respectively, with statistical significance compared to people younger than 60 years. Compared with the level of glycosylated hemoglobin less than 5.6%, the OR with glycosylated hemoglobin from7.1% to 8.0% and more than 10% was 1.84 (P<0.05) and 1.82 (P<0.05), respectively. The OR of myopia, low myopia, moderate myopia and high myopia was 2.98 (P<0.01), 6.94 (P<0.01), 42.43 (P<0.01) and 77.85 (P<0.01), respectively. The OR of opacity of the eye lens was 7.60 (P<0.01). Conclusions: Uncorrected refractive error is one of the important causes of visual impairment in diabetic patients aged 50 and above in Funing county, Jiangsu province; the important influencing factors were age, glycosylated hemoglobin concentration, myopia and lens status. Relevant health departments should popularize the eye health for diabetic patients and conduct regular optometry and fundus examination. (Chin J Ophthalmol, 2021, 57: 757-765).

Zinc transporter 8 autoantibody in the diagnosis of type 1 diabetes in children.

Background Type 1 diabetes (T1D) is an organ-specific autoimmune disease related to the autoimmune response against pancreatic β-cells. Zinc transporter 8 (ZnT8), an islet-specific gene product localized to the β-cell insulin granule, was recently identified as an autoantigen in T1D.Purpose To evaluate the use of ZnT8 autoantibody (ZnT8A) for diagnosing T1D.Methods This case-control study was conducted at Dr. Soetomo General Hospital, Surabaya, Indonesia, from March to May 2019. Children younger than 18 years of age with T1D based on the International Society for Pediatric and Adolescent Diabetes guideline and healthy controls were included. We measured ZnT8A level using enzyme-linked immunosorbent assay (cutoff value, 0.315).Results There were 30 children with T1D (50.0% boys; mean age, 11.3±3.7 years) and 18 healthy controls (44.4% boys; mean age, 8.3±3.1 years); 1 patient in each group was Madurese, while the others were Javanese. Twenty-two of 30 subjects with T1D (73.3%) tested positive for ZnT8A compared to 5 of 18 controls (27.8%) (P=0.02; odds ratio, 7.15; 95% confidence interval, 1.93–26.52). When ZnT8A-positive and -negative T1D cases were compared, no differences were detected in age at diagnosis, duration of diabetes, presence of ketoacidosis, body mass index, glycosylated hemoglobin concentration, or C-peptide concentrations.Conclusion ZnT8A may be useful in the diagnosis of T1D.

Comparison of Analogue insulin with other insulins in patients with type 1 diabetes in Ahmedabad, Western India: A Rretrospective study

Background & aimType of insulin is prescribed according to the glycaemic status of the patient, affordability, and preference of the patient. Analogues are considered to be the good therapeutic treatment for patients with type 1 diabetes, as they closely mimic physiological insulin kinetics and minimize the risk of hypoglycemia as compared to other insulin formulations. In this study, we aimed to assess the effectiveness of different insulin regimen (analogue insulins, regular insulins, and NPH insulins) in patients with type 1 diabetes in Ahmedabad, western India. MethodA retrospective study was carried out on patients with type 1 diabetes aged below 18 years. They were categorized into three groups as per their insulin regimen-on analogues, on regular insulin and on premix insulin. Their mean HbA1c was extracted from the database in order to know the effectiveness of their respective insulin regimen. Only those patients were studied who had undergone HbA1c from January 2018 to January 2020, who were regular in their visit to the clinic (>3 visits/year in past 2 years), were on stable insulin regimen and had absence of lipodystrophy.Outcome was analyzed based on glycosylated hemoglobin concentration. Because of retrospective nature of the analysis, accurate capture of hypoglycemia data was not possible. Results.450 patients were studied and out of that 180 were on analogue insulin, 210 were on regular insulin and, 60 patients were on premix insulin. Mean duration of diabetes 7.7 years, 8.2 years and 8.5 years, respectively. The mean Hba1c value in the corresponding insulin regimen was 9.37%, 9.3%, and 9.7% respectively. The difference in HbA1C values was statistically not significant. ConclusionThere is no difference in HbA1c levels with the use of any three insulin regimens in patients with type 1 diabetes. Further prospective studies are required in a controlled manner in Indian patients to corroborate these preliminary findings and also compute the risk of hypoglycaemia.

Efficacy of Diabetes Education in Adults With Diabetes Mellitus Type 2 in Primary Care: A Systematic Review.

To analyze the effect of different diabetes education methods on metabolic control, body mass index (BMI), and blood pressure. A systematic review was carried out. PubMed, Medline, Embase, Cochrane, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), CUIDEN, Ibecs, and Scopus databases were consulted. The search was done in May 2018. Studies included controlled clinical trials on diabetes education in primary care that were published in English and Spanish during the years 2011 to 2018. The post-intervention results were as follows: glycosylated hemoglobin concentration (HbA1c) ranged between -1.6% (individual education [IE]) and + 0.05% (mixed education [ME]). The values of BMI varied from -0.7% (group education [GE]) to -0.3% (GE). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) fluctuated. SBP varied from -8.5 mmHg (GE) to +2.9 mmHg (GE); DBP varied from -3.1 mmHg (GE) to -0.9 mmHg (GE). Total cholesterol ranged from -15.9/dL (GE) to +2 mg/dL (GE). LDL cholesterol ranged from -18.3 mg/dL (GE) to -7 mg/dL (ME). HDL cholesterol ranged from +0.8 mg/dL (IE) to +8.12 mg/dL (GE). Triglycerides varied from -21.1 mg/dL (GE) to +11.0 (GE). The most profound decrease in HbA1c was achieved using individual education. However, to decrease BMI, SBP, DBP, total cholesterol, LDL cholesterol, and triglycerides, group education was the most effective intervention. To obtain good metabolic control, it is necessary to address both clinical and psychological aspects, including modifying nutritional and dietary habits, monitoring medication, increasing knowledge of diabetes, and combining theoretical content with physical exercise programs. Reinforcement strategies are very important to achieve the objectives of educational programs.

Comparative Assessment of Methanolic Extracts of Hog Plum (&lt;i&gt;Spondias mombin linn.&lt;/i&gt;) Leaves and Turmeric (&lt;i&gt;Curcuma longa L.&lt;/i&gt;) Rhizomes on Blood Glucose and Glycosylated Haemoglobin in Male Wistar Rats

Comparative assessment of methanolic extracts of Spondias mombin leaves and Curcuma longa rhizomes on Blood Glucose and Glycosylated Haemoglobin using male wistar rats as models was attempted. 90 rats divided into 9 groups of 10 rats each were used. Groups: 1: Untreated non diabetic; 2: Untreated diabetic; 3: diabetic + low dose (200mg/kg/b.w) Spondias mombin; 4: diabetic + high dose (400mg/kg/b.w) Spondias mombin; 5: diabetic + low dose (500mg/kg/b.w) Curcuma longa; 6: diabetic + high dose (1000mg/kg/b.w) Curcuma longa; 7: diabetic + low dose combined (200mg/kg/b.w) Spondias mombin and (500mg/kg/b.w) Curcuma longa; 8: diabetic + high dose combined (400mg/kg/b.w) Spondias mombin and (1000mg/kg/b.w) Curcuma longa; and diabetic + (0.6mg/kg/b.w) glibenclamide. Diabetes was induced intraperitonially using alloxan at 200mg/kg. Treatments with extracts were orally and for 42days. Blood was collected on day 43 by cardiac puncture for determination of blood glucose and glycosylated haemoglobin. A significant decrease in blood glucose and glycosylated haemoglobin concentrations was observed in all the treated groups compared to group 2 (p&lt; 0.05). Groups 7 and 8 rats showed a significant reduction in blood glucose and glycosylated haemoglobin compared to groups 3 to 6 (p&lt; 0.05). Spondias mombin apparently showed better anti-diabetic effects compared to Curcuma longa as seen amongst Groups 3 and 4 rats compared to Groups 5 and 6 rats. Result suggest that combined treatment with Spondias mombin and Curcuma longa may possess better anti-diabetic effects compared to administration of each singly. We recommend further studies in this regard.Keywords: Spondias mombin, curcuma longa, diabetes mellitus, alloxan

Hypoglycemic, antidyslipidemic, hepatoprotective and antilipid peroxidation activities of hydromethanol leaf extract of &lt;i&gt;Helianthus annuus&lt;/i&gt; in alloxan-induced diabetic rats

Purpose: To investigate the hypoglycemic, antidyslipidemic, hepatoprotective and anti-lipid peroxidation effects of hydromethanol leaf extract of Helianthus annuus (HLEHA) in alloxan-induced diabetic rats. Methods: The extract was administered once daily at 150, 300 and 600 mg/kg for 21 consecutive days. Glibenclamide (GLB) 2 mg/kg was used as a reference drug (positive control) and 5 % Tween-20 solution in water was used as negative control. The fasting blood glucose (FBG) and body weights were measured on days 7, 14 and 21 while glycosylated haemoglobin concentration (HbA1c), serum markers of liver function, lipid profile, antioxidant status, histopathological changes in pancreas and liver were determined 24 h after the last dosing on day 21. Results: The GLB and HLEHA caused significant (p < 0.05) time-dependent weight gains in the treated rats when compared with 5 % Tween-20 treated rats. The HLEHA and GLB caused significant (p < 0.05) decreases in FBG, HbA1c, malondialdehyde, and lipid profile levels in the treated rats when compared with rats in 5% tween-20 treated group. Alloxan-induced pancreatic and hepatic degeneration were reversed in GLB- and HLEHA-treated rats. Conclusion: Helianthus annuus demonstrates potent antidiabetic, antioxidant and antidyslipidemic activities in rats. Keywords: Antidiabetic, Antidyslipidemic, Helianthus annuus , Medicinal plant, Traditional medicine

Increased circulating magnesium concentrations after Roux-en-Y gastric bypass surgery in patients with type 2 diabetes

BackgroundLow circulating magnesium concentrations predict cardiovascular and all-cause mortality in patients with type 2 diabetes (T2D). Epidemiologic and clinical studies have indicated lower extra- and intracellular magnesium concentrations in patients with diabetes. ObjectiveWe aimed to describe alterations, if any, in circulating magnesium concentrations after laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in patients with obesity and T2D. SettingOutpatient clinic of obesity and central hospital. MethodsRetrospective analysis of 1-year outcome of plasma magnesium (p-Mg) and glucometabolic status in all consecutive patients who underwent primary LRYGBP and who completed the follow-up visits, including biochemical test panels 6 and 12 months after surgery. ResultsLRYGBP and complete follow-up visits were performed in 51 patients with T2D and 86 patients without T2D. All patients were given similar dietary advice and multivitamin and mineral supplementation after surgery. Before RYGB, the patients with T2D showed lower p-Mg compared with patients without T2D (.79 ± .06 mM and .82 ± .05 mM, respectively, P<.01). P-Mg was inversely correlated to fasting blood glucose and glycosylated hemoglobin levels. After surgery, mean p-Mg increased by 5.2% in the group with T2D compared with 1.4% in the patients without T2D (P<.01), ending at an equal level of .83 mM. The alterations in p-Mg were inversely related to the changes in fasting glucose and glycosylated hemoglobin concentrations. ConclusionThe lowered p-Mg associated with impaired glucometabolic status in patients with T2D was increased after LRYGBP, reaching similar concentrations as in patients without T2D.

Carbohydrate Counting in Children and Adolescents with Type 1 Diabetes.

Carbohydrate counting (CC) is a meal-planning tool for patients with type 1 diabetes (T1D) treated with a basal bolus insulin regimen by means of multiple daily injections or continuous subcutaneous insulin infusion. It is based on an awareness of foods that contain carbohydrates and their effect on blood glucose. The bolus insulin dose needed is obtained from the total amount of carbohydrates consumed at each meal and the insulin-to-carbohydrate ratio. Evidence suggests that CC may have positive effects on metabolic control and on reducing glycosylated haemoglobin concentration (HbA1c). Moreover, CC might reduce the frequency of hypoglycaemia. In addition, with CC the flexibility of meals and snacks allows children and teenagers to manage their T1D more effectively within their own lifestyles. CC and the bolus calculator can have possible beneficial effects in improving post-meal glucose, with a higher percentage of values within the target. Moreover, CC might be integrated with the counting of fat and protein to more accurately calculate the insulin bolus. In conclusion, in children and adolescents with T1D, CC may have a positive effect on metabolic control, might reduce hypoglycaemia events, improves quality of life, and seems to do so without influencing body mass index; however, more high-quality clinical trials are needed to confirm this positive impact.

Frequency of Polycythemia and Other Abnormalities in a Tibetan Herdsmen Population Residing in the Kham Area of Sichuan Province, China

The Kham Tibetans are one of several Tibetan ethnic subgroups living in the Kham area of China. Because studies on the high-altitude adaptation of the Kham people are scant, the main aim of this study is to investigate whether the response to hypoxia, especially polycythemia status, in the Kham Tibetans is different from other Tibetan ethnic subgroups. The primary investigation was conducted on 346 native Kham Tibetan adults (268 men and 78 women) from 3 herdsmen villages located in Hongyuan County situated at an altitude of greater than 3600 m. The participants were aged 46.2±14.1 (21-82; mean±SD with range) years. Anthropometric measurements such as weight, height, waist circumference, body mass index, and blood pressure, as well as laboratory blood tests such as glycosylated hemoglobin, hemoglobin, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and uric acid were analyzed. The concentrations of hemoglobin were 171.3±12.9 (66-229) mg·L-1 and 151.4±16.4 (86-190) mg·L-1 in men and women, respectively. The frequency of polycythemia was found to be 25.5 and 21.8% in men and women, respectively. Polycythemia was found to be significantly associated with glycosylated hemoglobin concentrations, hypertension, and hyperuricemia (P=0.002, 0.023, and 0.009, respectively). There is a higher frequency of polycythemia in the Kham Tibetans when compared with reported studies from other Tibetan ethnic subgroups living on the Qinghai-Tibet plateau.

Dapagliflozin- Induced Severe Ketoacidosis Requiring Hemodialysis

The availability of novel classes of medication for the treatment of type 2 Diabetes mellitus (type 2 DM) provides doctors with options to choose individualized treatments based on patient and agent characteristics beyond metformin therapy, as per current guidelines. Independent of impaired beta-cell function and insulin resistance, sodium glucose cotransporter type 2 (SGLT2) inhibitors represent a different treatment strategy for reducing plasma glucose levels and glycosylated hemoglobin concentrations by increasing urinary glucose excretion through reduced renal glucose reabsorption. However, metabolic acidosis may arise with such novel drugs through a different mechanism, which can produce a life-threatening condition requiring hemodialysis.

Relationship between time spent eating and nutritionally related blood metabolites of growing pigs fed on diets containing graded levels of fibre

The objective of the study was to determine the relationship between time spent on eating and nutritionally related blood metabolites in growing pigs fed on fibrous diets. Eighteen growing pigs (initial bodyweight 14.2 ± 1.20 kg) were used in a 5-week study period. The pigs were penned in metabolism crates and subjected to different treatment diets with maize cob included at 0, 80, 160, 240, 320 and 400 g/kg in a diet. Time spent eating and drinking was observed by use of video cameras. Blood was collected from the jugular vein at the end of the trial for determination of glycosylated haemoglobin, total protein, urea, uric acid, albumin and creatinine kinase concentrations. Glycosylated haemoglobin, albumin, globulin, total protein and uric acid concentrations in blood influence time spent eating (P &lt; 0.05). Time spent eating increased linearly with an increase in uric acid, total protein, albumin and globulin concentrations and started decreasing at higher concentrations (P &lt; 0.05). A negative relationship was observed between time spent eating and glycosylated haemoglobin concentration. There were curvilinear responses between time spent drinking and concentration of the nutritional metabolites (albumin, globulin and total protein) (P &lt; 0.05). In conclusion, the blood metabolites can be used to predict time spent eating by pigs fed on fibrous diets. They have a direct relationship with pigs’ nutritional status. The nature of the relationships may allow feed compounders to determine the quantity of maize cobs to include in diets by focusing on feeding patterns and metabolism of pigs.

Combined Effects of a Dietary Fiber Mixture and Wheat Albumin in a Rat Model of Type 2 Diabetes Mellitus.

As bioactive ingredients of functional foods, dietary fiber and wheat albumin (WA) are known to suppress hyperglycemia in patients with type 2 diabetes mellitus. The combined effects of these bioactive ingredients were examined using an animal model of type 2 diabetes mellitus. First, oral starch tolerance tests (OSTTs) with the simultaneous intake of a dietary fiber mixture (DF) and WA were performed as an acute study. Male Goto-Kakizaki rats received a soluble starch solution [700 mg/kg body weight (bw)] containing DF and/or WA (each 300 mg/kg bw). In these OSTTs, the combined intake of DF and WA suppressed hyperglycemia much more effectively than each separate intake. Second, in a chronic intake study, diets containing DF and/or WA were administered to male Zucker diabetic fatty rats over 84 d. The combined effects of DF and WA were not observed in glycosylated hemoglobin concentration levels or fasting blood glucose levels, but appeared as an improvement in liver lipid contents. Variations in the liver lipid contents were similarly reflected in those of the plasma lipid concentrations. In conclusion, this study found that the simultaneous intake of bioactive DF and WA improved the postprandial hyperglycemia and the chronic lipid metabolism disorders in rat models of type 2 diabetes mellitus.

Minimization of the Risk of Diabetic Microangiopathy in Rats by Nigella sativa.

Background:Microangiopathy is a chronic diabetic complication resulting from metabolic derangements, oxidative stress, and increased pro-inflammatory cytokine production. Nigella sativa Linn. is used as an herbal medicine that exerts hypoglycemic, antilipidemic, anti-inflammatory, and antioxidant effects.Objective:To examine the effects of N. sativa extract on cutaneous microvascular changes in diabetic rats.Materials and Methods:Sprague-Dawley rats were randomly assigned into the following four groups: Untreated and N. sativa-treated normal controls and untreated and N. sativa-treated rats with streptozotocin-induced diabetes. A cold-pressed N. sativa extract was then orally administered (1000 mg/kg/day). After 8 weeks of treatment, the glucose, glycosylated hemoglobin (HbA1c), tumor necrosis factor-alpha (TNF-α), insulin levels, and lipid profile were determined in cardiac blood. Dermal capillary wall thickness was measured in tail skin sections stained with periodic acid-Schiff. Endothelial apoptosis was morphologically evaluated by hematoxylin and eosin staining.Results:Diabetes significantly reduced the circulating insulin and low-density lipoprotein levels and caused elevations in the glucose, HbA1c, and triglyceride levels, accompanied by a slight increase in total cholesterol levels and no change in the high-density lipoprotein and TNF-α levels. Capillary basement membrane thickening and a decreased capillary luminal diameter despite no evidence of endothelial cell apoptosis were also observed. N. sativa treatment of diabetic rats reduced the mean HbA1c concentration by 1.4%, enlarged the capillary lumens, and tended to attenuate dermal capillary basement membrane thickening without affecting the lipid profile or TNF-α level.Conclusion:Our results indicate that N. sativa may be used to minimize the risk of diabetic microangiopathy, potentially due in part to its glycemic control activity.SUMMARY Diabetes causes dermal capillary basement membrane thickening and a decreased capillary luminal diameterNigella sativa treatment of diabetic rats enlarged the capillary lumens and tended to attenuate dermal capillary basement membrane thickeningN. sativa treatment of diabetic rats reduced the mean glycosylated hemoglobin concentration by 1.4%, which exceeds the necessary reduction previously described to decrease the risk of diabetic microangiopathy, without affecting the lipid profile or tumor necrosis factor-alpha levelN. sativa improves rat diabetic microangiopathy, potentially due in part to its glycemic control activity. Abbreviations used: H and E: Hematoxylin and eosin, HbA1c: Glycosylated hemoglobin, HDL-C: High-density lipoprotein cholesterol, LDL-C: Low-density lipoprotein cholesterol, PAS: Periodic acid-Schiff, STZ: Streptozotocin,