Blood HbA1c Levels Research Articles

“CROSS- SECTIONAL STUDY OF NON ALCOHOLIC FATTY LIVER DISEASE AND IT'S ASSOCIATION WITH CENTRAL OBESITY, DYSLIPIDEMIA AND IMPAIRED GLUCOSE TOLERANCE.”

Introduction- Non alcoholic fatty liver disease (NAFLD) is dened as accumulation of fat in liver, mainly triglyceride in absence of other possible etiologies, such as viral hepatitis, signicant alcohol intake, autoimmune hepatitis or hepatotoxic drugs. Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in modern societies, affecting as many as 20% to 30% of general population worldwide [1]. Components of metabolic syndrome i.e central obesity, hyperglycemia, dyslipidemia, hypertension are major risk factors for NAFLD. The purpose of the present study is to nd an association of NAFLD with dyslipidemia, central obesity and impaired glucose tolerance, so that the patients can be timely managed and further risk of cardiovascular complications can be reduced. The aim of this study is toAims And Objectives- determine the prevalence of undetected central obesity, dyslipidemia and glucose intolerance in NAFLD patients. In 100Material And Methods- non alcoholic subjects with USG diagnosis of fatty liver, fasting blood sugar, postprandial blood sugar and HbA1C levels, fasting lipid prole were analysed. Waist circumference was measured and BMI calculated. Prevalence of dyslipidemia in NAFLD was 46%, prevalence ofResult- impaired glucose tolerance and diabetes was 36% and 3% respectively and prevalence of central obesity was 83%. There was a positive correlation between FBS and BMI tested by pearson's correlation test that was statistically signicant as P value was 0.046. In our study it isConclusion- found that prevalence of dyslipidemia, prediabetes and central obesity is signicantly higher in NAFLD cases, also there is a statistically signicant correlation between FBS and central obesity.

ASSOCIATION OF ANTI-COXSACKIE VIRUS-B IgG WITH AUTOANTIBODIES RELATED TO TYPE 1 DIABETES MELLITUS

Background: Coxsackievirus B is a virus may cause type 1 diabetes. There are links between Coxsackievirus B infections and type 1 diabetes. The presence of autoantibodies in pancreatic beta cells has been linked to the development of type 1 diabetes following Coxsackievirus B infection. Objective: To detect autoantibodies in patients with type 1 diabetes. Also, to find if there is an association between pancreatic beta cell autoantibodies and Coxsackievirus-B IgG. Methods: This study was done from January to March 2021, it included two groups of 75 children; their ages ranged from one month to fifteen years. Children with type 1 diabetes were admitted to the diabetic and endocrine glands center in Thi-Qar governorate, whereas children without diabetes (control group) were admitted to Bint Al-Huda Children's Hospital in Nasiriyah/Thi-Qar. Venous blood was taken from each person for estimation of random blood sugar, serum fructosamine, and HbA1c in the laboratory of the diabetic and endocrine glands center. Pancreatic beta cell autoantibodies and anti-Coxsackievirus-B IgG was detected by enzyme-linked immunosorbent assay. The statistical analyses were done using SPSS 25. The study population P-values below 0.05 to be statistically significant. The study was authorized by Al-Nahrain University's Institutional Review Board and parental consent was taken. Results: The patients had significantly greater levels of random blood sugar, fructosamine, and HbA1c than healthy controls. Anti-islet antigen, anti-islet cell, anti-glutamic acid decarboxylase, and anti-Coxsackievirus-B IgG antibody titers were greater in patients than controls. The majority of autoantibodies tested correlated with Coxsackievirus-B IgG antibodies. Conclusion: Anti-Coxsackievirus-B IgG antibody positivity was associated with autoantibodies related to type 1 diabetes mellitus. Keywords: Coxsackievirus B, type 1 diabetes, autoantibodies Citation: Hassan HG, Al-Shuwaikh AM, Al-Auqili RKD. Association of Anti-Coxsackie Virus-B IgG with autoantibodies related to type 1 diabetes mellitus. Iraqi JMS. 2022; 20(1): 132-138. doi: 10.22578/IJMS.20.1.17

Pengaruh Ketaatan Terapi menggunakan Metode Medication Possession Ratio pada Penderita Sindrom Metabolik

Metabolic syndrome is still a major problem in developing countries and it has an association with high blood pressure, blood glucose, and lipid profile abnormalities, which can cause cardiovascular disease. This indicates that it is important to provide adequate treatment, but patient compliance has effects on the outcome. Improving patients’ compliance to treatment can provide a better control of the condition. Therefore, this study aimed to determine the association between medication compliance and the therapeutic outcome of metabolic syndrome. This observational analytic study was conducted using a retrospective cohort design for one year of observation, namely April 2020-March 2021. The influence of patient compliance with therapy outcomes in terms of blood pressure, blood glucose, and lipid profile was assessed using the medication possession ratio method. This study was carried out by examining patients’ medical records from the Bethesda Lempuyangwangi Hospital as parameters for compliance, while the outcome parameters were assessed by experts. The data obtained were analyzed using Anova (homogeneous data) or Kruskal-Wallis (not homogeneous data) to determine the differences in the compliance based on patients’ characteristics. The relationship of adherence to therapeutic outcomes was analyzed using logistic bivariate. From 174 patients’ data that was observed, only 151 had a blood test. The average systolic blood pressure, total cholesterol, triglyceride, and HbA1c levels were above the standard threshold. The three levels of compliance had no significant relationship with blood pressure, HbA1c, and lipid profiles (p>0.05). The adjusted data for age and gender on adherence showed patients with low compliance, and they have a 2.08 times risk of having high triglyceride levels compared to others (p<0.05). The results indicated the patients’ low compliance to therapy, hence, health professionals must strengthen education to improve this condition.

Exploring phytochemical constituents of Achillea arabica Kotschy. ethanolic flower extract by LC-MS/MS and its possible antioxidant and antidiabetic effects in diabetic rats.

The aim of this study was to reveal the antidiabetic and antioxidant effects of ethanolic lyophilized extract of Achillea arabica flower extract against streptozotosine (STZ)-induced in diabetic rats and to determine its phytochemical content by liquid chromatography with tandem mass spectrometry (LC-MS/MS). After toxicity test, 35 female rats were divided into five groups. Control, diabetes mellitus (DM), A.arabica (400mg/kg) extract, DM+A.arabica (400mg/kg) extract and DM+Glibenclamide (2mg/kg). It was determined that while diabetic rats treated A.arabica plant extract significantly decreased blood glucose level, serum glucose, HbA1c, liver and kidney damage biomarker levels, and malondialdehyde (MDA) content compared to the DM group, it caused fluctuations in antioxidant enzyme levels. According to LC-MS/MS results of A.arabica flower extract, quinic acid (2439.9μg/g), cyranoside (858.4μg/g), chlorogenic acid (698.7μg/g), and cosmosiin (347.8μg/g) were determined as major compounds, respectively. In addition, two new compounds were determined in this extract according to nuclear magnetic resonance (NMR) and Mass analyses and these compounds were named edremitine and achillosine, respectively. Thus, A.arabica flower extract has possible therapeutic effects to prevent high blood glucose level and oxidative stress caused by DM in liver and kidney via its high phenolic content.

Efek Pemberian Metformin dan Metformin+Glimepiride terhadap Kadar HbA1c pada Pasien Diabetes Mellitus Tipe 2

Diabetes is a chronic metabolic disease and management of DM begins with a helthy lifestyle with early administration of antidiabetic drug. Metformin is the first line therapy in the management of DM. Combination therapy is given if blood sugar level and HbA1c level cannot be controlled with single therapy. This study aimed to determine the effect of giving metformin and metformin+glimepiride on HbA1c levels in DM2 patients. The inclusion criteria were patients DM, received oral antidiabetic at least 6 months, completed medical record, and can speak Indonesia. Exclusion criteria included DM patients receiving insulin therapy, TB patients, patients with mental disorders, and pregnant/breastfeeding women. Sociodemographic data, description of prescribing patterns, and achievement of HbA1c levels were described descriptively. Data analysis using the Wilcoxon test. Respondents in this study were 69 patients, dominated by women (71%). The types of therapy used were metformin (59.4%) and metformin+glimepiride (40.6%). Achievement of metformin + glimepiride HbA1c levels (67.9%), metformin (48.8%). The difference in decreasing HbA1c levels with metformin (-0.31%±0.38 mg/dL) and metformin+glimepiride -0.33%±0.54 mg/dL (p = 0.000). The results of the analysis showed that there is a significant effect of metformin alone on decreasing HbA1c levels and the addition of glimepiride (metformin + glimepiride) on reducing HbA1c levels in diabetes cannot be controlled with metformin. The implication of this study is as input for comprehensive management guidelines that can be used in an effort to reduce the prevalence of DM. Good management is needed to achieve therapeutic outcomes.

Vitamin D and Type 2 Diabetes Mellitus: Role in Insulin Resistance, Glycemic Control and Long Term Complications

Vitamin D has a number of roles in various body systems with receptors scattered in many organs,1,2 showing a link between vitamin D and several chronic diseases such as cancer, diabetes and autoimmune disease.3,4 Several studies have shown the role of vitamin D in type 2 diabetes in controlling blood sugar levels and HbA1c levels. Vitamin D plays a role in increasing insulin sensitivity and secretion and suppressing inflammation in type 2 diabetes. Vitamin D has a protective role in various complications of type 2 diabetes, including diabetic nephropathy, diabetic neuropathy and diabetic retinopathy.5 Monitoring of vitamin D levels and vitamin D supplementation have a therapeutic role to controlling glycemic blood glucose and prevent complications in type 2.6

Correlation of blood sugar and HbA1C levels in different stage of diabetes retinopathy

Objectives: This present study was to evaluate the different parameters and correlation of blood sugar and HbA1C levels for the development of retinopathy in type 2 diabetes mellitus patients. Methods: A complete assessment, general physical examination and routine haematological investigations were performed to all patients. A complete fundus examination was done with the help of direct and indirect Ophthalmoscope. Biochemical investigations (Blood Sugar- Fasting and Post Prandial, HbA1C level) were performed. Patients were called for follow up after 1 month, 3 months and 6 months. Results: A total of 100 patients of diabetes retinopathy were enrolled in this study. Most of the cases 67(67%) were males with age group of 51-60 years. out of 191 eyes, most of the cases 72(37.7%) had PDR. Rest cases had 58(30.36%) severe NPDR, 46(24.08%) moderate NPDR, 9(4.71%) others and 6(3.14%) mild NPDR. HbA1c levels of the most of the cases 94(49.21%) had 6.5-8.5. Most of the patients 170(89.53%) of DR had blood glucose level > 140 mg% on PP.

Study of Irisin Level Hormone and Some Biochemical Parameters in Iraqi Diabetic Type 2 without Hypothyroidism

This case-control study's purpose is to investigate serum irisin. levels and their role in people with type 2 diabetes mellitus (T2DM) who don't have hypothyroidism. A total of 60 patients with T2DM were chosen as the) case group (based on the grounds for inclusion and exclusion, and a 1:1 ratio was determined based on the patients' inclusion rate. This cohort, which was created at the Medical City / Baghdad Teaching Hospital, consisted of adults aged 30 to 60. The control group consisted of 60 healthy volunteers of the same gender and age. Clinical data on the participants was collected in order to determine their medical history, BMI, fasting blood glucose (FBS), hemoglobin (HbA1c), insulin, and serum lipid levels. An enzyme-linked immunosorbent test was used to measure the amount of irisin in the blood (ELISA). The data was analyzed using SPSS 23.0 software. only one variable. The amount of irisin in the T2DM group was substantially higher than in the control group (12.77±2.236 ng /mL and 4.121±0.308 ng /mL, respectively, according to single factor analysis. BMI, fasting blood sugar (FBS), HbA1c, insulin, total cholesterol (TC), and triglyceride (TG) levels were all higher with statistically significant differences, the T2DM group outperformed the control group. Keywords: Irisin; Type 2 diabetic mellitus

Camel Milk Used as an Adjuvant Therapy to Treat Type 2 Diabetic Patients: Effects on Blood Glucose, HbA1c, Cholesterol, and TG Levels

The efficacy of camel milk to treat diabetes has been shown recently, especially in experimental animals and in patients with diabetes type 1 (T1DM), whereas studies on patients with type 2 diabetes mellitus (T2DM) are limited. In this clinical trial, 60 patients with T2DM who used oral antidiabetic drugs were assigned into two groups; group 1 received—in addition to the antidiabetic prescribed medicines—500 mL of raw camel milk divided equally two times/day (fasting in the morning and the night) for three months. Group 2 was treated during the same period only by the oral antidiabetic medicaments without consumption of camel milk. A significant decrease was shown in fasting blood glucose (FBG) (from 9.89 ± 0.98 to 6.13 ± 0.55 mmol/L) and postprandial glucose (PPG) (from 15.89 ± 4.34 to 7.44 ± 1.02 mmol/L) in the group 1. A significant decline ( P < 0.05 ) in HbA1c levels was observed in the group treated with camel milk (from 9.44 ± 0.16 to 6.61 ± 0.14%, with a percentage decrease of 30%). Total cholesterol and TG significantly decreased in group 1. Urea and creatinine showed no statistical differences between the two groups during the trial. Based on this study’s results, camel milk could be useful for glycemic control in T2DM patients using oral hypoglycemic agents.

Prevalence of diabetes in pregnancy and microvascular complications in native Indonesian women: The Jogjakarta diabetic retinopathy initiatives in pregnancy (Jog-DRIP).

To report the prevalence of total diabetes in pregnancy (TDP) and diabetes-related microvascular complications among Indonesian pregnant women. We conducted a community-based cross-sectional study with multi-stage, cluster random sampling to select the participating community health centers (CHC) in Jogjakarta, Indonesia between July 2018-November 2019. All pregnant women in any trimester of pregnancy within the designated CHC catchment area were recruited. Capillary fasting blood glucose (FBG) and blood glucose (BG) at 1-hour (1-h), and 2-hour (2-h) post oral glucose tolerance test (OGTT) were measured. TDP was defined as the presence of pre-existing diabetes or diabetes in pregnancy (FBG ≥7.0 mmol/L, or 2-h OGTT ≥11.1 mmol/L, or random BG ≥11.1 mmol/L with diabetes symptoms). Disc and macula-centered retinal photographs were captured to assess diabetic retinopathy (DR). Blood pressure, HbA1c and serum creatinine levels were also measured. A total of 631/664 (95%) eligible pregnant women were included. The median age was 29 (IQR 26-34) years. The prevalence of TDP was 1.1% (95%CI 0.5, 2.3). It was more common in women with chronic hypertension (p = 0.028) and a family history of diabetes (p = 0.015). Among the TDP group, 71% had a high HbA1c, but no DR nor nephropathy were observed. Although a very low prevalence of TDP and no diabetes-related microvascular complications were documented in this population, there is still a need for a screening program for diabetes in pregnancy. Once diabetes has been identified, appropriate management can then be provided to prevent adverse outcomes.

Ethanol extract of the mushroom Coprinus comatus exhibits antidiabetic and antioxidant activities in streptozotocin-induced diabetic rats

Context Edible mushrooms have a long history of use in traditional Chinese or Japanese medicine. Coprinus comatus (O.F. Müll.) Pers. (Agaricaceae) contains antioxidant and antidiabetic agents. Objective To identify the benefits of ethanol extracts of the C. comatus fruit body in streptozotocin-induced hyperglycaemic rats by evaluating their blood glucose, glycosylated haemoglobin (HbA1c), insulin, glucagon-like peptide-1 (GLP-1), dipeptidyl peptidase-4 (DPP-4), and glutathione (GSH) levels, with and without extract administration. Materials and methods Wistar rats were either left untreated or were administered 45 mg/kg body weight (BW) streptozotocin; 45 mg/kg BW metformin; or 250, 500, or 750 mg/kg BW extract for 14 days. The blood glucose, GLP-1, DPP-4, GSH, insulin, and HbA1c levels were determined. Data were analysed using analysis of variance and Duncan’s multiple range tests. Results Preliminary data showed that administration of C. comatus ethanol extract dose of 250, 500, and 750 mg orally has no toxicity effects after 24 h administration. The ethanolic extract of fruiting body of C. comatus considerably reduced the rat’s fasting blood glucose levels 26.69%, and DPP-4 6.97% at dose of 750 mg. The extract reduced HbA1c 4–4.30%, increased GLP-1 71.09%, GSH 11.19% at dose of 500 mg, and increased insulin levels 13.83%. Extracts contain bioactive compounds such as flavonoid, alkaloid, terpenoids, vitamins C and E, rutin, and saponin. Conclusions The C. comatus extract can be used as herbal medicine that reduces diabetic symptoms. Further investigation on C. comatus extracts should be conducted with gas chromatography-mass spectrometry to characterise the bioactive compounds.

Evaluation of the Effect of Alcoholic Extract of Laurus Nobilis Leaves on Blood Biochemical Parameters and Histological Changes in the Liver and Kidney among Female Wistar Rats Treated with Depakene (Sodium Valproate).

This study aimed to evaluate the effects of Laurus Nobilis (Bay leaves) alcoholic extract on glucose, hemoglobin A1c (HbA1c), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, and urea levels; moreover, it was attempted to examine the histological changes induced in the liver and kidney among female albino rats treated with Depakene (Sodium Valproate). The L. nobilis leaves were dried in the shade, and they were then ground in mechanical processing. The resulting substance (250 gm) was processed in 70% ethanol for 24 h using a Soxhlet extractor at 45°C. Before being measured, the extract was concentrated in vacuo and stored in a vacuum desiccator until the elimination of all the solvents. In total, 20 female adult Wistar rats (230-250 g) were bred in the Animal House Lab at the University of Kufa, Faculty of Education for Girls, Kufa, Iraq. These animals were randomly divided into four groups (n=5), housed in a typical laboratory setting, and given a standard diet and water. Each animal received the treatments intraperitoneally for 30 days. The experimental groups were designed as follows: group 1 (the control) was given only physiological saline solution; group 2 received alcoholic extract of L. nobilis leaves at a dose of 150 mg/kg BW; group 3 received Depakene (Sodium Valproate) at a dose of 500 mg/kg BW; and group 4 received alcoholic extract+Depakene at a dose of 150 mg/kg BW and 500 mg/kg BW. The animals were euthanized following anaesthesia 24 h after the last day of the experiment. Heart blood samples were gathered in gel tubes, the serum was then centrifuged for 15 min at 3000 rpm to measure the biochemical parameter levels, which included glucose, HbA1C, ALT, AST, creatinine, and urea. The liver and kidney organs were removed and placed in a 10% formaldehyde solution instantly. Following fixation, they were processed as usual before being embedded in paraffin for histological analysis. Morphological changes were assessed using hematoxylin and eosin staining techniques. The recorded data showed a major drop (P<0.05) in blood glucose and HbA1c levels in group 2 which was given ethanol extract, compared to the other groups. Interestingly, the level of blood glucose and HbA1c levels reduced significantly in group 4, which was given L. nobilis+Depakene, compared to the control and the animals treated with only Depakene. Moreover, the results showed a major rise (P<0.05) in the liver enzyme among the animals treated with Depakene, compared to other groups. On the other hand, the recorded data showed a substantial drop (P<0.05) in creatinine levels in the animals treated with L. nobilis leaves extract (group 2) and group 4, compared to group 3 and the control group, respectively. However, no changes were recorded in the case of urea levels among the groups. Finally, the findings of this study showed that the ethanol extract of L. nobilis leaves was effectively reduced the adverse effects of Depakene. On the other hand, it had a significant effect on the reduction of blood glucose.

The Role of Diabetes Mellitus in the Malignant Pancreatic Cyst Neoplasm Diagnosis and Prognosis.

PurposePancreatic cyst neoplasm (PCN) is a precursor of pancreatic cancer. Previous studies reported PCN was often concurrent with diabetes. We aim to examine the association between diabetes with PCN malignancy and to detect the potential role of diabetes in PCN management and treatment.Patients and MethodsA total of 224 patients who were diagnosed with the three major types of PCN (IPMN, MCN, and SCN) and underwent surgical resection were selected. Patients were divided into three groups (normal group, new-onset diabetes group (NODM) (<4years), and long-standing diabetes group (LSDM) (>4years)) according to diabetic history and diagnostic time interval. Diabetes, fast blood glucose level, HbA1c, and insulin resistance level were measured. Malignant PCN (mPCN) radiological features (worrisome features and high-risk stigmata) were analyzed. Pathological features (PCN type, dysplasia grade, tumor stage, and tumor volume) and immunohistology of Ki67 and SMAD4 were performed. Diagnostic efficacy of each variable was determined by the ROC curve. mPCN diagnosis was the main outcome in diagnostic prediction and overall survival as the glucose controlling outcome variables.ResultsDiabetes groups (NODM and LSDM) showed difference with the normal group in age, weight loss, malignancy, CA19-9 value, CEA value, Ki-67 value, tumor volume, pathological grade, and a lowered pancreatic fistula risk. NODM was related to insulin resistance, weight loss, and SMAD4 mutation. NODM (87.3%) and high insulin resistance rate (93.6%) significantly increased the sensitivity of radiological evidence-based mPCN diagnosis. Moreover, long-standing diabetes and elevated HbA1c led to reduced survival in mPCN patients than the normal PCN group. Anti-diabetic drugs showed limited influence on PCN malignancy and tumor volume.ConclusionNODM in PCN patients was associated with malignancy, insulin resistance, weight loss, and SMAD4 mutation. Prediabetic status and NODM diagnosis enhanced the diagnostic accuracy of radiological standards (worrisome features and high-risk stigmata). Stable glucose surveillance is necessary for mPCN patients’ survival.

64-OR: Reduction of HbA1c in Adults with Type 2 Diabetes through Sugarfit's Diabetes Reversal Program Using a Coach-Led, Technology-Enabled, and Habit-Based Approach: A Retrospective Analysis

This study aimed to compare the changes in vital variables pertaining to type 2 diabetes (T2D) using Sugarfit’s Diabetes Reversal Program (SDRP) and a group with NO personal coach assistance. This is a retrospective analysis of people with T2D who participated in SDRP compared with those who were not in SDRP. Participants of SDRP were assigned a personal coach with unlimited access via chat messages, audio &amp; video calls. Regular monitoring was done by coaches to swap foods causing sugar spikes to a customised diet based on diabetes plate method using data points from Continuous Glucose Monitor (CGM) . Personalized interventions were advised in view of positive habit formation with frequent reminders. A total of 150 clients self enrolled in SDRP and 1clients were recruited as controls. Weight, Fasting blood sugar (FBS) and Hba1c levels were analysed from baseline to 90 days. In the group of SDRP, the weight from baseline was decreased from 76.94±12.44 kg to 73.87±11.53 kg (mean weight loss of 2.63±2.58 kg) compared to control where the weight from baseline was increased from 73.28±15.28 kg to 73.88±15.20 kg (mean weight gain of 0.50±2.37 kg) . In SDRP, Hba1c levels dropped from 8.7±1.65% to 7±1.32% with a mean change of 1.7±1.56% while the control group showed gain from 7.13±0.5% to 7.18±0.57% with a mean of 0.04±0.29%. FBS levels also showed a significant decrease in SDRP from 172.3±58.mg/dL to 114.03±24.24 mg/dL with mean loss of 61.4±57.7 mg/dL whereas control group saw slight decrease from 142.57±48.mg/dL to 141.15±44.88 mg/dL with a mean of 1.42±25.40 mg/dL. Overall, outcomes from SDRP positively affirm and signify the positive effects of change in behaviour and sustained lifestyle practises in people with T2D using proprietary SDRP methodology. Reduction of Hba1c and FBS through these evidence-based holistic recommendations can be life-altering &amp; highly beneficial for people with T2D. Disclosure C.Goyal mehra: None. A.M.Raymond: None. R.Prabhu: None. A.Tatti: None. V.Goel: None. Y.V.Ramesh: None.

1274-P: Prevalence and Clinical Characteristics of Monogenic Diabetes in Chinese Population

Background: Prognosis of monogenic diabetes in Chinese is not well reported. We identified pathogenic mutations in monogenic diabetes genes in a prospective cohort of Chinese with young-onset diabetes, and compared the clinical characteristics and outcome between patients with and those without mutations. Methods: From patients enrolled in the Hong Kong Diabetes Register between 1995-2012, DNA samples of 1021 Chinese with non-type 1 diabetes diagnosed ≤40 years old were sequenced. The custom targeted panel included 34 genes related to neonatal diabetes, maturity-onset diabetes of the young, syndromes associated with diabetes and severe insulin resistance. Variants were interpreted according to standard guidelines by ACMG. Patients were followed for incident complications until 2019. Results: Pathogenic or likely pathogenic mutations in monogenic diabetes genes were detected in 33 (3.2%) patients. Mutations were more common in HNF1A (n=7) , GCK (n=6) and ABCC8 (n=5) genes. Mutation carriers had a higher female ratio (72.7 vs. 54.6%, p=0.05) and lower age at enrollment (37.9±10.6 vs. 41.5±10.4 years, p=0.05) but were similar age at diagnosis (31.5±7.3 vs. 33.1±6.0 years, p=0.13) and in diabetes duration (5.0[1.0-11.0] vs. 6.0[1.0-13.0] years, p=0.29) at baseline compared to non-carriers. Mutation carriers had lower BMI (23.6±3.5 vs. 26.0±4.8 kg/m2, p&amp;lt;0.01) , systolic blood pressure (119.4±14.9 vs. 125.6±17.4 mmHg, p=0.05) , HbA1c (7.3±1.3 vs. 7.9±2.0%, p=0.01) and triglyceride level (1.01[0.66-1.53] vs. 1.38[0.90-2.17] mmol/L, p=0.01) . Over a median follow-up of 17.1 years, (30.3%) patients with mutation vs. 369 (37.3%) without mutations developed cardiovascular disease, chronic or end-stage kidney disease and/or died (p=0.47) . Conclusion: Around 3% of Chinese with young-onset non-type 1 diabetes had mutation in monogenic diabetes genes. Despite a more favorable metabolic profile, patients with mutation had similar incidence of diabetes complications to those without mutations. Disclosure S.Tsoi: None. C.K.Lim: None. R.C.Ma: Other Relationship; Bayer AG, Boehringer Ingelheim International GmbH, Research Support; AstraZeneca, Bayer AG, Novo Nordisk A/S, Pfizer Inc., Tricida, Inc. E.S.Lau: None. B.Fan: None. E.Chow: Research Support; Hua Medicine, Medtronic, Powder Pharmaceuticals Inc., Speaker's Bureau; Novartis AG, Sanofi. A.P.Kong: Advisory Panel; Abbott, Kyowa Kirin Co., Ltd., Other Relationship; AstraZeneca, Novo Nordisk, Research Support; Boehringer Ingelheim, Speaker's Bureau; AstraZeneca, Bayer, Eli Lilly and Company, Sanofi, Stock/Shareholder; Aptorum Group Limited. J.C.Chan: Board Member; Asia Diabetes Foundation, Consultant; Bayer AG, Boehringer Ingelheim International GmbH, Celltrion, Merck Sharp &amp; Dohme Corp., Roche Diabetes Care, Viatris Inc., Research Support; Applied Therapeutics, AstraZeneca, Eli Lilly and Company, Hua Medicine, Servier Laboratories, Stock/Shareholder; GemVCare Ltd. A.Luk: None. Funding Research Grants Council of Hong Kong (14114918) ; Research Impact Fund (R4012-18)

0545 Metabolic Variables and the severity of Obstructive Sleep Apnea in non-obese children

Abstract Introduction Obstructive sleep apnea (OSA) can be associated with abnormal metabolic variables that may impact the overall health of the child into adulthood. Prior studies have focused on understanding the relationship of obesity, OSA, and metabolic alterations. Understanding the relationship of OSA and metabolic alterations in normal-weight children would improve understanding of the health impact of OSA in and of itself. The Objective of this study was to evaluate the association of OSA and metabolic variables, including lipid levels, blood glucose, and HbA1c in normal-weight children with OSA. Methods Prospective, case-control study performed at a tertiary care children’s hospital. Normal-weight children, aged 2-12 years, undergoing overnight polysomnography (PSG) for assessment of sleep disordered breathing were selected for participation in the study. Laboratory testing for lipid levels, fasting glucose, HbA1c were completed and analyzed relative to the PSG findings. Results A total of 61 patients with a mean age of 4.7±2.5 years were analyzed. Thirty-four (55.7%) patients were male, and 27 (44.3%) were female. The mean body mass index (BMI) z score was 0.5±1.2, and all patients were non-obese (BMI z score &amp;lt;85th percentile). Total cholesterol, fasting blood glucose, HbA1c levels were significantly higher in patients with OSA when compared to those with No-OSA (p&amp;lt;0.01). There was incremental worsening of blood glucose and HbA1c levels with greater severity of OSA. The apnea-hypopnea index (AHI) was positively and significantly correlated with blood glucose and HbA1c (p&amp;lt;0.001). Multiple linear regression analysis showed that the AHI was a predictor of blood glucose (p&amp;lt;0.001) and HbA1c (p&amp;lt;0.001) levels independent of age, gender, total sleep time, and BMI z score. Conclusion Increasing severity of OSA in non-obese children was associated with worsening levels of cholesterol, blood glucose, and HbA1c. This points to the importance of addressing the issue of OSA in children given the potential impact of these elevated levels on the overall health of the child. Support (If Any) None

Gender differences in cardiovascular risk factor awareness. Results from the ESC EORP EUROASPIRE V registry

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Fonds voor hartchirurgie - Fonds pour la Chirurgie Cardiaque Background Risk factor awareness among coronary patients is related to a decreased risk of recurrent coronary events and hence important in the secondary prevention of coronary heart disease (CHD). Whereas previous studies demonstrated gender differences in disfavour of women with regard to patients’ risk factor control, little is known about gender differences in patients’ risk factor awareness. Purpose The aim of this study was to document potential gender differences across Europe in patients’ risk factor awareness and information provided by healthcare professionals. Methods Analyses were based on data from the most recent ESC EORP EUROASPIRE V survey (European Survey Of Cardiovascular Disease Prevention And Diabetes, 2016-17). Consecutive patients hospitalized for a first or recurrent coronary event or surgical procedure between 18-80 years old at the time of identification were retrospectively identified in 27 countries. Awareness of risk factor levels were defined as patients’ self-reported awareness about their latest weight, waist circumference, blood pressure, total cholesterol, blood glucose levels, and HbA1c levels. Data on risk factor awareness and information provided by healthcare professionals were obtained from patient interviews (6 months to 2 years prior to the date of the study visit). Logistic regression analyses were performed adjusting for age and medical history (stroke, heart failure, and diabetes). Results Information was available on 8,261 patients, including 25.8% women. Women were significantly older (65.4 vs. 63.0 years) and were more likely to have a history of stroke (5.3% vs. 3.7%; P=0.002), heart failure (7.6% vs. 5.9%; P=0.006), and self-reported diabetes (33.1% vs. 28.0%; P&amp;lt;0.001). Overall, no significant gender differences were found regarding the information provided by a healthcare professional on overweight, diabetes, and chronic kidney disease, whereas, a higher proportion of women with hypertension (≥140/80 (≥140/85 if diabetes)) (OR=2.07, 95% CI=4.60-2.68) and women with raised cholesterol levels (LDL-C ≥1.8mmol/L) (OR=1.31, 95% CI=1.14-1.51) were informed about their raised risk factor levels. Furthermore, women with obesity were less aware about their actual weight (OR= 0.66, 95% CI=0.52-0.85) and weight target level (OR= 0.66, 95% CI=0.54-0.81) than men. In contrast, no significant gender differences in awareness of waist circumference levels were found in obese patients neither for fasting blood glucose or HbA1c levels in patients with self-reported diabetes. Women with hypertension and those found with raised LDL-C levels were more aware about their target blood pressure level (OR=1.21, 95% CI=1.01-1.46) and actual cholesterol level (OR=1.18, 95% CI=1.02-1.36). Conclusions Our study reveals only little gender differences in disfavour of women in terms of information provided by healthcare professionals and risk factor awareness.

Basal-bolus insulin therapy for the treatment of non-critically ill patients with type 2 diabetes in Vietnam: effectiveness and factors associated with inpatient glycemic control

PurposeThis study assessed the effectiveness of basal-bolus insulin therapy (BBIT) in non-critically ill patients with type 2 diabetes mellitus (DM) and the factors associated with optimal inpatient glycemic control (IGC) with BBIT.MethodsThis prospective study included 103 patients who were admitted to the University Medical Center and were treated with BBIT. Clinical characteristics, glucose, and glycated hemoglobin (HbA1c) levels at admission, renal function tests, basal-bolus insulin dosing, and other treatments were recorded. The optimal IGC was defined and classified for the analysis.ResultsThe mean age of the patients was 67.2 ± 12.0 years. The blood glucose and HbA1c levels at admission were 319.2 ± 184.8 mg/dL and 10.7 ± 2.6%, respectively. Optimal IGC was defined as patients with ≥60% of in-hospital blood glucose values within the target range (3.9–10 mmol/L). Of the 103 patients, 66 patients (64%) achieved optimal IGC and only 5 patients (4.9%) had at least one hypoglycemic episode. The number of patients consuming snacks was higher in the poor than in the optimal IGC group whereas an estimated glomerular filtration rate (eGFR) <45-mL/min/1.73 m2 was predominant in the optimal IGC group. Multivariate analysis revealed that snack consumption and glucocorticoid (GC) use were factors associated with poor IGC, while eGFR <45 mL/min/1.73 m2 was a favorable factor for optimal IGC.ConclusionBBIT is safe and effective for the treatment of IGC in non-critically ill patients. Moreover, eGFR <45 mL/min/1.73 m2 at admission, snack consumption, and GC therapy were independent factors associated with IGC outcomes.

Comparison of the effects of Tai Chi and general aerobic exercise on weight, blood pressure and glycemic control among older persons with depressive symptoms: a randomized trial

BackgroundBlood pressure and glycemic control are associated with the management of depressive symptoms in patients with depression. Previous studies have demonstrated that both Tai Chi and aerobic exercise have positive effects on blood pressure and glycemic control. Few studies have compared the physiological effects of Tai Chi versus aerobic exercise in older adults with depressive symptoms. The objective of this study was to compare the effects of Tai Chi and aerobic exercise on weight, body mass index, blood pressure and glycosylated hemoglobin (HbA1c) level in older persons with mild to moderate-severe depressive symptoms.MethodsA randomized controlled trial was performed. The older persons (age ≥ 60 years old) with depressive symptoms were recruited. Then, participants were randomly allocated to the Tai Chi group and the aerobic exercise group received a 12-week 24-movement Yang’s Tai Chi intervention and aerobic exercise, respectively. Data collection occurred at baseline and after completion of the interventions (week 12).ResultsA total of 238 participants with mild to moderate-to-severe depressive symptoms were included in the final analysis, including 120 in the Tai Chi group and 118 in the aerobic exercise group. The difference in weight and body mass index in the Tai Chi group was 2.0 kg (Z = -4.930, P < 0.001) and 0.77 kg/m2 (Z = -5.046, P < 0.001) higher than that in the aerobic exercise group, respectively. After the 12-week intervention, the systolic pressure and diastolic pressure in the Tai Chi group were 5.50 mmHg (Z = -2.282, P = 0.022) and 8.0 mmHg (Z = -3.360, P = 0.001) lower than that in the aerobic exercise group, respectively. The difference in HbA1c level in the Tai Chi group was 0.50% higher than that in the aerobic exercise group (Z = -4.446, P < 0.001).ConclusionThis study showed that Tai Chi exercise was more effective in improving blood pressure and HbA1c level than general aerobic exercise. It suggested that Tai Chi might be an effective approach for the management of blood pressure and long-term glucose control in older persons with depressive symptoms.Trial registrationTrial registration: ChiCTR, ChiCTR2100042534. Registration date: 23/01/2021, http://www.chictr.org.cn/showproj.aspx?proj=120602.

Correlation between vitamin D and serum brain derived neurotropic factor levels in type 2 diabetes mellitus patients

Diabetes Mellitus (DM) currently ranks as the most common endocrine disorder worldwide. Current opinion views DM as a group of heterogeneous metabolic diseases characterized by hyperglycemia triggered by defects in the ability of the body to produce or use insulin in type 1 and 2 DM, respectively. Brain-derived neurotrophic factor (BDNF), one of the neurotrophin family of growth factors, has been linked to the pathogenesis of DM and insulin resistance. Moreover, vitamin D has been associated with insulin resistance and DM. Recently, the interactions between vitamin D and BDNF have been investigated in diabetic rats. However, this correlation has never been investigated in humans. Thus, the aim of the present study was to assess the alterations in serum BDNF and vitamin D levels in T2DM patients in Jordan, prior to and following vitamin D supplementation. A combination of non-experimental case-control and experimental designed studies were utilized to assess the relationship between serum BDNF and vitamin D levels in T2DM patients. The levels of BDNF and vitamin D were measured using commercially available ELISA kits, and fasting blood glucose (FBG) and HbA1c levels were measured in medical labs. The results showed that diabetic patients had lower levels of serum vitamin D and higher levels of BDNF compared with the healthy controls. Moreover, linear regression analysis indicated that BDNF levels were inversely correlated with serum vitamin D levels. Furthermore, vitamin D supplementation significantly increased vitamin D serum levels and decreased BDNF serum levels in diabetic patients. Intriguingly, FBG and HbA1c levels were significantly improved post vitamin D supplementation. These data demonstrate a positive effect of vitamin D supplementation in diabetic patients suggesting the implementation of vitamin D as part of future T2DM treatment plans. However, additional studies are needed to investigate the direct link between vitamin D, BDNF, and T2DM.