Higher Blood Glucose Concentrations Research Articles

Prevalence of risk factors for non-communicable diseases in a rural population of Bangladesh: a cross-sectional study

BackgroundNon-communicable diseases (NCDs) account for 67% of annual deaths in Bangladesh. Behavioural and clinical risk factors such as high blood pressure, high blood glucose concentrations, dietary habits, physical inactivity, tobacco use, and alcohol consumption contribute to the prevalence of NCDs. In this study, we aim to estimate the prevalence of NCD risk factors and relevant characteristics in rural adult residents of Bangladesh. MethodsIn this cross-sectional survey, we included participants aged 18 years and older who resided in Parbatipur subdistrict of Bangladesh. We used a modified WHO STEPS tool to collect data. Additionally, questions were included on hypertension and diabetes within the questionnaire to evaluate participants' knowledge about NCDs and health-care-seeking practice. Standard bowl, teaspoon, and show cards were shown to respondents while asking about fruit, vegetables, salt, tobacco, and alcohol consumption. We used calibrated instruments to measure blood pressure, height, weight, and waist-hip circumference and asked respondents to self-report information about diabetes and lipid profile. To calculate the prevalence of hypertension, we considered participants with a previous diagnosis of hypertension and also those who had diastolic blood pressure ≥90 mm Hg or systolic blood pressure ≥140 mm Hg, or both, measured during the study. We used STATA (version 13.0) for data analysis. FindingsBetween Nov 17 and Dec 4, 2018, we collected data from 421 participants; median age was 41·9 years (SD 15·7) and 50·1% of participants (n=211) were women. Nearly half (41·6%) of respondents had hypertension. Self-reported prevalence of diabetes and high cholesterol was 4·3% and 1·0% respectively. Prevalence of physiological risk factors such as overweight (BMI 25·0–29·9 kg/m2), obesity (BMI ≥30 kg/m2), high waist circumference (≥100 cm for men and ≥90 cm for women), and high waist-hip ratio (≥0·90 for men and ≥0·80 for women) were 32·5%, 10·5%, 11·6%, and 87·4%, respectively. Other risk factors included smoking or consumption of smokeless tobaccos, or both (49·9%), inadequate physical activity (56·3%), inadequate consumption of fruits and vegetables (76·0%), and intake of extra salt in food (35·1%). Although most respondents had heard about hypertension (93·1%) and diabetes (94·3%), knowledge and practice of NCD prevention were found to be poor. Regarding the risk factors of developing hypertension and diabetes, most respondents mentioned that they did not know (46·8% and 64·4%, respectively) about this. InterpretationEven in a rural setting, lifestyle and dietary habits may be responsible for the high prevalence of NCDs that hinders people's quality of life and productivity. A comprehensive behaviour modification intervention should be undertaken by the public and private sectors to address the reduction of risk factors for NCDs. A limitation of this study was that it took place in the harvesting season when respondents were mostly busy and anxious about collecting their crops. FundingMasters dissertation funded by BRAC James P Grant School of Public Health, BRAC University.

Remission of autoimmune diabetes by anti-TCR combination therapies with anti-IL-17A or/and anti-IL-6 in the IDDM rat model of type 1 diabetes

BackgroundThe cytokine IL-17 is a key player in autoimmune processes, while the cytokine IL-6 is responsible for the chronification of inflammation. However, their roles in type 1 diabetes development are still unknown.MethodsTherefore, therapies for 5 days with anti-IL-17A or anti-IL-6 in combination with a T cell-specific antibody, anti-TCR, or in a triple combination were initiated immediately after disease manifestation to reverse the diabetic metabolic state in the LEW.1AR1-iddm (IDDM) rat, a model of human type 1 diabetes.ResultsMonotherapies with anti-IL-6 or anti-IL-17 showed no sustained anti-diabetic effects. Only the combination therapy of anti-TCR with anti-IL-6 or anti-IL-17 at starting blood glucose concentrations up to 12 mmol/l restored normoglycaemia. The triple antibody combination therapy was effective even up to very high initial blood glucose concentrations (17 mmol/l). The β cell mass was raised to values of around 6 mg corresponding to those of normoglycaemic controls. In parallel, the apoptosis rate of β cells was reduced and the proliferation rate increased as well as the islet immune cell infiltrate was strongly reduced in double and abolished in triple combination therapies.ConclusionsThe anti-TCR combination therapy with anti-IL-17 preferentially raised the β cell mass as a result of β cell proliferation while anti-IL-6 strongly reduced β cell apoptosis and the islet immune cell infiltrate with a modest increase of the β cell mass only. The triple combination therapy achieved both goals in a complimentary anti-autoimmune and anti-inflammatory action resulting in sustained normoglycaemia with normalized serum C-peptide concentrations.

Non classic presentations of a genetic mutation typically associated with transient neonatal diabetes.

SummaryThis case report describes a family pedigree of a mother and her children with an E227K mutation in the KCNJ11 gene. People with this particular gene mutation typically present with transient neonatal diabetes; with more than half the cohort relapsing into permanent diabetes in adolescence or early adulthood. However, the mother developed diabetes as an adolescent and thus was initially diagnosed as having Type 1 Diabetes. All her children have inherited the same genetic mutation but with differing presentations. Her second, third and fourth child presented with transient neonatal diabetes which remitted at varying times. Her first child is 16 years old but had not developed diabetes at the time of writing. The KCNJ11 gene codes for the KIR6.2 subunit of the KATP channels of the pancreatic beta cells. Mutations in this gene limit insulin release from beta cells despite high blood glucose concentrations. Most people with diabetes caused by this genetic mutation can be successfully managed with glibenclamide. Learning of the genetic mutation changed the therapeutic approach to the mother’s diabetes and enabled rapid diagnosis for her children. Through this family, we identified that an identical genetic mutation does not necessarily lead to the same diabetic phenotype. We recommend clinicians to consider screening for this gene in their patients whom MODY is suspected; especially in those presenting before the age of 25 who remain C-peptide positive.Learning points:KATP channel closure in pancreatic beta cells is a critical step in stimulating insulin release. Mutations in the KIR6.2 subunit can result in the KATP channels remaining open, limiting insulin release.People with KCNJ11 mutations may not present with neonatal diabetes as the age of presentation of diabetes can be highly variable.Most affected individuals can be treated successfully with glibenclamide, which closes the KATP channels via an independent mechanism.All first degree relatives of the index case should be offered genetic testing, including asymptomatic individuals. Offspring of affected individuals should be monitored for neonatal diabetes from birth.Affected individuals will require long-term follow-up as there is a high risk of recurrence in later life.

Modelling of dysregulated glucagon secretion in type 2 diabetes by considering mitochondrial alterations in pancreatic α-cells.

Type 2 diabetes mellitus (T2DM) has been associated with insulin resistance and the failure of β-cells to produce and secrete enough insulin as the disease progresses. However, clinical treatments based solely on insulin secretion and action have had limited success. The focus is therefore shifting towards α-cells, in particular to the dysregulated secretion of glucagon. Our qualitative electron-microscopy-based observations gave an indication that mitochondria in α-cells are altered in Western-diet-induced T2DM. In particular, α-cells extracted from mouse pancreatic tissue showed a lower density of mitochondria, a less expressed matrix and a lower number of cristae. These deformities in mitochondrial ultrastructure imply a decreased efficiency in mitochondrial ATP production, which prompted us to theoretically explore and clarify one of the most challenging problems associated with T2DM, namely the lack of glucagon secretion in hypoglycaemia and its oversecretion at high blood glucose concentrations. To this purpose, we constructed a novel computational model that links α-cell metabolism with their electrical activity and glucagon secretion. Our results show that defective mitochondrial metabolism in α-cells can account for dysregulated glucagon secretion in T2DM, thus improving our understanding of T2DM pathophysiology and indicating possibilities for new clinical treatments.

The Association of Blood Glucose and Diabetes with Abdominal Aortic Aneurysm, Carotid Stenosis and Peripheral Arterial Disease: An Observational Study of 630,000 Patients Attending Vascular Screening

Introduction - Diabetes is an important risk factor for atherosclerotic vascular disease, and previous studies have also shown a positive continuous association between blood glucose concentrations throughout the “normal” reference range and cardiovascular disease. However, diabetes appears to be inversely associated with abdominal aortic aneurysm (AAA). This study reports associations between blood glucose concentration and diabetes with AAA, carotid stenosis and peripheral arterial disease (PAD). Methods - Between 2008 and 2013, 3.3 million self-referred individuals attended cardiovascular screening clinics (Life Line Screening) in the US and UK. Assessments included an aortic ultrasound scan, a carotid duplex, and ankle-brachial pressure index (ABPI). Major cardiovascular risk factors and medical history were recorded, and approximately one fifth of participants also underwent blood glucose assays. Diabetes was defined according to previous diagnosis or treatment. Participants with incomplete data or prior cardiovascular disease were excluded, yielding 628 246 individuals in the current report. Results - The mean age at screening was 63 ± 10 years, and 64% of attendees were women. The following prevalences were observed: AAA (infra-renal aorta ≥ 30mm) = 0.5%; carotid artery stenosis (peak systolic velocity generally ≥110cm/s) = 3.5%; PAD (ABPI <0.9) = 2.6%. A prior diagnosis of diabetes was associated with higher risk of PAD (OR, 95%CI: 1.77, 1.71-1.84) and carotid stenosis (1.71, 1.66-1.76), and among participants without a prior diagnosis of diabetes the prevalence of carotid stenosis and PAD increased with higher blood glucose levels across the normal reference range. For AAA, a prior diagnosis of diabetes was associated with a significantly lower risk (0.83 0.77-0.90), however among attendees without diabetes, the prevalence of AAA increased with higher blood glucose levels across the normal reference range. Conclusion - Across the normal reference range, higher blood glucose concentrations are associated with increased risk of carotid stenosis, PAD and AAA, but a diagnosis of diabetes was associated with a lower risk of AAA. This raises the possibility that the “protection” conferred by diabetes against AAA could be due to a treatment effect, but this hypothesis needs to be tested in randomised trials.

Prognostic indicators in cats with septic peritonitis (2002-2015): 83 cases.

To identify physical exam findings, clinicopathological parameters, time to surgery, empirical antimicrobial use, and culture results that could be associated with outcome in cats with septic peritonitis (SP). Retrospective cohort study of cats from 2002 to 2015. Four university teaching hospitals. Eighty-three cats diagnosed with SP by cytology or culture. None MEASUREMENTS AND MAIN RESULTS: Fifty-eight cats survived to discharge (69.9%); 1 cat was euthanized in surgery; 20 were euthanized postoperatively; 4 cats suffered cardiac arrest after surgery. The most common etiology of SP was secondary SP due to gastrointestinal perforation (49.4%), followed by primary SP (22.3%). Mean blood glucose concentration was significantly different between survivors and nonsurvivors (P=0.006). Cats that received appropriate empirical antibiotic therapy were 4.4 times more likely to survive than cats that did not receive appropriate antibiotics (P=0.018). As previously documented, SP secondary to gastrointestinal leakage was the most common etiology. In this population, cats with a higher blood glucose concentration on presentation had a worse prognosis. Cats that received appropriate empirical antimicrobial therapy were more likely to survive.

Correlation Between Ocular Rigidity With Intraocular Pressure In Patient With Type 2 Diabetes Mellitus

ABSTRACT&#x0D; Introduction and Objectives: Diabetes mellitus (DM) is known to have a biomechanical effect on tissue. High blood glucose concentrations that lead to increased production of free radical intermediates causes ocular rigidity (OR) changes. This change can effect intraocular pressure (IOP) in patients with type 2 DM. This study to determine correlation between ocular rigidity with IOP in patients with type 2 DM.&#x0D; Methods: A cross-sectional study with a correlation test design of OR with IOP in type 2 DM patients was conducted in RSUP dr. Mohammad Hoesin Palembang from January until June 2018. Eighty eye samples consist of 60 type 2 DM and 20 control group. IOP examination was performed using a Goldmann applanation tonometer and OR measurements using schiotz tonometer with two loads then assessed in Friedenwald differential tables.&#x0D; Result: There was a significant correlation between diabetic retinopathy and OR (p=0,000). There was a significant correlation between OR and IOP in NPDR and PDR group (p=0,000). There was a significant relationship between patient age with OR and IOP (p&lt;0,05).&#x0D; Conclusion: There is a significant correlation between ocular rigidity and IOP in people with type 2 DM.

Maximal Exercise Blood Pressure and Glycemic Responses: Association with Resting Parameters in Healthy Young Adults.

Hypertension and hyperglycemia are known components of the metabolic syndrome. Massive adrenergic stimulation during high-intensity exercise has been associated to high blood pressure (BP) and blood glucose concentration. The predictive value of exercise-induced hypertension is an area of active research. An exaggerated and persistent hyperglycemia induced by intense exercise has been described in type-1 diabetics. For healthy subjects is not clear if BP and glycemic responses during maximal exercise are correlated with resting BP and glycemic values within the span of normal range. PURPOSE: To find the association between resting and maximal exercise BP and glycemic responses in healthy young adults. METHODS: An exploratory analysis was conducted on 145 young adults (63 female) aged 18-25 deemed healthy by medical and anthropometric evaluation (body mass index 18.4 - 24.9) as well as laboratory tests, including a complete metabolic profile. All subject had normal resting BP, glycated hemoglobin A1c (HbA1c) and fasting glucose concentration (FG) values. On a separate day subjects performed a maximal ramp cardiopulmonary exercise test (CPET) on a cycle ergometer; capillary blood glucose concentration (cBG) and BP were measured every 2.5 minutes. Pearson product-moment correlations between resting and exercise parameters were assessed with a significance level <0.05. Separate analysis were made for males and females. RESULTS: The analysis for the female group is presented: at maximal workload, cBG was correlated with HbA1c (r=0.29, p= 0.016) while diastolic BP was correlated with resting diastolic BP (r=0.26, p=0.034). Overall, maximal cBG was correlated with HbA1C (r= 0.27, p= 0.025) and FG (r=0.27, p=0.026) and maximal systolic BP was correlated with resting systolic BP (r=0.27, p=0.0009). CONCLUSIONS: For healthy young females BP and glycemic parameters at rest were positively associated with cBG and BP responses at or near maximal workloads during CPET. In otherwise healthy adults with resting BP and BG values in the upper limit of normal, acute intense exercise could play a role unmasking early subclinical cBG and BP changes in the metabolic syndrome continuum. The predictive and prognostic role of these findings remains to be determined. Supported by COLCIENCIAS Grant number 120356934972, 713-2013.

1807-P: Central Leptin Administration Attenuates the Glucose Responsiveness to Epinephrine

Central leptin administration in streptozotocin-induced diabetic rats leads to normalization of blood glucose concentrations, independent of insulin. In previous studies, we observed that leptin-treated rats couldn’t maintain their blood glucose concentration during a short-term fast as well as control rats. We hypothesize that chronic central leptin administration inhibits the ability of counterregulatory hormones to increase hepatic glucose production and blood glucose concentrations by attenuating gluconeogenesis through the inhibition of the cAMP-CREB pathway in the liver. To test this hypothesis, we determined the glucose responsiveness of leptin-treated nondiabetic and diabetic rats to epinephrine (EPI) injections during the fed and fasted states and whether alterations in blood glucose levels were associated with biochemical changes in the cAMP-CREB pathway in the liver. Baseline blood glucose levels were determined followed by an intraperitoneal injection of EPI or saline to each rat during both the fasting and fed states. Blood glucose levels were monitored for 3 hours post-injection. The area under the curve (AUC) was calculated for each EPI-treated animal and subtracted from the AUC during a saline injection in the same animal. Leptin normalized the daily blood glucose levels in diabetic rats. Leptin attenuated the effect of EPI during fasting. In the fed state, leptin inhibited the glucose responsiveness to EPI in nondiabetic rats. (The responsiveness to EPI couldn’t be determined in fed diabetic rats due to the high blood glucose concentrations.) Diabetes increased hepatic phosphoenolpyruvate carboxykinase (PEPCK), glucose 6-phosphatase, and CREB. Leptin treatment of diabetic rats negated the increases in PEPCK and CREB. These results support the hypothesis that chronic central leptin treatment inhibits the cAMP-CREB pathway in diabetic rats and attenuates the effects of counterregulatory hormones to increase hepatic glucose production. Disclosure Y. Qi: None. B. White: None. Funding Alabama Agricultural Experiment Station (ALA043-1-13014)

Clinical Relevance of Blood Glucose Concentration and Hyperglycemia Management in Neurocritical Care Patients

AbstractIn patients admitted to a neurocritical care (NCC) unit, management of blood glucose concentration (BGC) is a challenging clinical task. Several studies have shown that episodes of hypo- and hyperglycemia and high BGC variability are associated with poor short- and long-term outcomes. Optimal BGC target-range and BGC management in NCC patients have dramatically evolved in the past decades and new insulin infusion and adequate nutrition protocols are now available. The aim of this narrative review is to report the state-of-the-art on clinical relevance on BGC and hyperglycemia management in NCC patients.

Does Cellular Metabolism from Primary Fibroblasts and Oxidative Stress in Blood Differ between Mammals and Birds? The (Lack-thereof) Scaling of Oxidative Stress.

As part of mitonuclear communication, retrograde and anterograde signaling helps maintain homeostasis under basal conditions. Basal conditions, however, vary across phylogeny. At the cell-level, some mitonuclear retrograde responses can be quantified by measuring the constitutive components of oxidative stress, the balance between reactive oxygen species (ROS) and antioxidants. ROS are metabolic by-products produced by the mitochondria that can damage macromolecules by structurally altering proteins and inducing mutations in DNA, among other processes. To combat accumulating damage, organisms have evolved endogenous antioxidants and can consume exogenous antioxidants to sequester ROS before they cause cellular damage. ROS are also considered to be regulated through a retrograde signaling cascade from the mitochondria to the nucleus. These cellular pathways may have implications at the whole-animal level as well. For example, birds have higher basal metabolic rates, higher blood glucose concentration, and longer lifespans than similar sized mammals, however, the literature is divergent on whether oxidative stress is higher in birds compared with mammals. Herein, we collected literature values for whole-animal metabolism of birds and mammals. Then, we collected cellular metabolic rate data from primary fibroblast cells isolated from birds and mammals and we collected blood from a phylogenetically diverse group of birds and mammals housed at zoos and measured several parameters of oxidative stress. Additionally, we reviewed the literature on basal-level oxidative stress parameters between mammals and birds. We found that mass-specific metabolic rates were higher in birds compared with mammals. Our laboratory results suggest that cellular basal metabolism, total antioxidant capacity, circulating lipid damage, and catalase activity were significantly lower in birds compared with mammals. We found no body-size correlation on cellular metabolism or oxidative stress. We also found that most oxidative stress parameters significantly correlate with increasing age in mammals, but not in birds; and that correlations with reported maximum lifespans show different results compared with correlations with known aged birds. Our literature review revealed that basal levels of oxidative stress measurements for birds were rare, which made it difficult to draw conclusions.

First aid glucose administration routes for symptomatic hypoglycaemia.

First aid glucose administration routes for symptomatic hypoglycaemia.

Higher blood glucose and larger fluctuations detected postoperatively using continuous glucose monitoring: a preliminary study following total knee or hip arthroplasty

sBackgroundThe control of diabetes mellitus (DM) should help reduce the incidence of periprosthetic joint infection (PJI). Self-monitoring of blood glucose (SMBG) concentration is usually undertaken at fixed time-points. Therefore, the extent of postoperative blood glucose fluctuation might be underestimated. To provide a more comprehensive assessment, continuous glucose monitoring (CGM) is beginning to be used. However, no previous studies have evaluated blood glucose concentrations using CGM following orthopedic surgery. Therefore, the differences between the maximum blood glucose concentrations measured using SMBG and CGM, and the mean amplitude of the glycemic fluctuation in patients with frank diabetes mellitus (DM) or pre-diabetes were evaluated.Blood glucose was measured in 20 patients who had undergone total hip or total knee arthroplasty (12 patients with DM and eight with pre-diabetes). Patients were fitted with a CGM device in the operating room, which was worn for 6 days postoperatively, and used to evaluate blood glucose concentration continuously. SMBG was performed simultaneously for the same period.ResultsThe mean difference between the maximum blood glucose concentrations measured using SMBG and CGM was 25.0 ± 20.3 mg/dl (range, − 17 to 81 mg/dl), with the concentrations measured using CGM tending to be higher than those measured using SMBG (P = 0.04). Blood glucose concentrations measured using CGM tended to be higher than those measured using SMBG until postoperative day 2, and to decrease gradually after postoperative day 4. There were no significant differences in the standard deviation of the blood glucose concentrations between the two groups.ConclusionsBlood glucose concentrations > 200 mg/dl and larger fluctuations were more frequently recorded using CGM than SMBG, especially until postoperative day 2. Thus, CGM is more useful for the identification of high blood glucose concentrations and larger fluctuations. However, this information was not provided in real time.

First aid glucose administration routes for symptomatic hypoglycaemia

First aid glucose administration routes for symptomatic hypoglycaemia

Individual glucose responses to prolonged moderate intensity aerobic exercise in adolescents with type 1 diabetes: The higher they start, the harder they fall.

To evaluate the pattern of change in blood glucose concentrations and hypoglycemia risk in response to prolonged aerobic exercise in adolescents with type 1 diabetes (T1D) that had a wide range in pre-exercise blood glucose concentrations. Individual blood glucose responses to prolonged (~60 minutes) moderate-intensity exercise were profiled in 120 youth with T1D. The mean pre-exercise blood glucose concentration was 178 ± 66 mg/dL, ranging from 69 to 396 mg/dL, while the mean change in glucose during exercise was -76 ± 55 mg/dL (mean ± SD), ranging from +83 to -257 mg/dL. Only 4 of 120 youth (3%) had stable glucose levels during exercise (ie, ± ≤10 mg/dL), while 4 (3%) had a rise in glucose >10 mg/dL, and the remaining (93%) had a clinically significant drop (ie, >10 mg/dL). A total of 53 youth (44%) developed hypoglycemia (≤70 mg/dL) during exercise. The change in glucose was negatively correlated with the pre-exercise glucose concentration (R2 = 0.44, P < 0.001), and tended to be greater in those on multiple daily insulin injections (MDI) vs continuous subcutaneous insulin infusion (CSII) (-98 ± 15 vs -65 ± 7 mg/dL, P = 0.05). No other collected variables appeared to predict the change in glucose including age, weight, height, body mass index, disease duration, daily insulin dose, HbA1c , or sex. Youth with T1D have variable glycemic responses to prolonged aerobic exercise, but this variability is partially explained by their pre-exercise blood glucose levels. When no implementation strategies are in place to limit the drop in glycemia, the incidence of exercise-associated hypoglycemia is ~44% and having a high pre-exercise blood glucose concentration is only marginally protective.

Hyperpolarized [1-13 C]pyruvate MRI can image the metabolic shift in cardiac metabolism between the fasted and fed state in a porcine model.

Owing to its noninvasive nature, hyperpolarized MRI may improve delineation of myocardial metabolic derangement in heart disease. However, consistency may depend on the changeable nature of cardiac metabolism in relation to whole-body metabolic state. This study investigates the impact of feeding status on cardiac hyperpolarized MRI in a large animal model resembling human physiology. Thirteen 30-kg pigs were subjected to an overnight fast, and 5 pigs were fed a carbohydrate-rich meal on the morning of the experiments. Vital parameters and blood samples were registered. All pigs were then scanned by hyperpolarized [1-13 C]pyruvate cardiac MRI, and results were compared between the 2 groups and correlated with circulating substrates and hormones. The fed group had higher blood glucose concentration and mean arterial pressure than the fasted group. Plasma concentrations of free fatty acids (FFAs) were decreased in the fed group, whereas plasma insulin concentrations were similar between groups. Hyperpolarized MRI showed that fed animals had increased lactate/pyruvate, alanine/pyruvate, and bicarbonate/pyruvate ratios. Metabolic ratios correlated negatively with FFA levels. Hyperpolarized MR can identify the effects of different metabolic states on cardiac metabolism in a large animal model. Unlike previous rodent studies, all metabolic derivatives of pyruvate increased in the myocardium of fed pigs. Carbohydrate-rich feeding seems to be a feasible model for standardized, large animal hyperpolarized MRI studies of myocardial carbohydrate metabolism.

Silver Nanoparticles Synthesized Using Eysenhardtia polystachya and Assessment of the Inhibition of Glycation in Multiple Stages In Vitro and in the Zebrafish Model

The aim was to investigate the inhibitory activities on AGE formation by testing silver nanoparticles fabricated using a methanol extract of Eysenhardtia polystachya (EP–AgNPs) and characterized using various physicochemical techniques. The in vitro glucose-albumin assay was used, and cell viability was carried out in RAW264.7 cells. For In vivo testing, we induced diabetes in adult zebrafish with by providing a high blood glucose concentration. EP–AgNPs showed an absorption peak at 413 nm in the UV–Vis spectrum, indicating surface plasmon resonance of the nanoparticles. TEM indicated that most of the particles were spherical, with a diameter of 10–12 nm, a polydispersity index of 0.197, and a zeta potential of − 32.25 mV, suggesting high stability of the nanoparticles. The biocompatible nature of the EP–AgNPs was demonstrated in RAW264.7 cells. EP–AgNPs markedly reduced the formation of AGEs, Amadorin-product/fructosamine, Ne-(carboxymethyl)-lysine, amyloid cross β-structure, and protein carbonyl content in BSA-glucose system and increased total thiol-group after 4 weeks in hyperglycemic zebrafish, EP–AgNPs provided a protective effect against glycation. Data suggest that the inhibitory activity of EP–AgNPs on formation of AGEs is developed through a multiple-stage mechanism of glycation. EP–AgNPs could therefore be an antiglycation agent for prevention diabetic complications.

Incubation and water temperatures influence the performances of loggerhead sea turtle hatchlings during the dispersal phase

Artificial manipulation of incubation temperature has been proposed as a potential strategy for mitigating the effects of climate change on sea turtles for which sex determination is temperature-dependent, but thermal manipulation may also affect hatchling survival. Here, we demonstrated that incubation and water temperatures influenced several performance traits that contribute to the survival of loggerhead sea turtles (Caretta caretta) during the post-hatchling dispersal phase. Hatchlings from warm incubation temperatures (31 °C) had significantly shorter incubation periods, higher initial swimming performance, lower sustained swimming performance, and lower growth rates during the first three weeks post-hatching, as well as higher blood glucose concentrations, than those from cool incubation temperatures (27.5 °C). Hatchlings in warm water temperatures (30 °C) exhibited significantly greater swimming performance than those in cool water temperatures (27 °C). Our results indicated that altering incubation temperatures indirectly influences the survival of loggerhead hatchlings by modifying their swimming performance and growth rates, which may affect hatchling predator-avoidance capability. Moreover, thermal manipulation may alter the incubation period, exposing hatchling to water temperatures that they would not otherwise normally experience, which may affect swimming performance. Our results suggest that such conservation strategies may influence their survival, and thus should be carefully considered.

MicroRNA‑152 regulates insulin secretion and pancreatic β cell proliferation by targeting PI3Kα.

An increasing number of microRNAs (miRNAs/miRs) are reported to have important roles in diabetes. Glucose‑stimulated insulin secretion and pancreatic β cell proliferation are essential in the control of metabolic disorder, however, the underlying molecular mechanisms remain unclear. The present study investigated the function of miR‑152 in diabetes. The results of reverse transcription‑quantitative polymerase chain reaction demonstrated that miR‑152 levels in the blood were markedly reduced in patients with diabetes compared with nondiabetic controls. In addition, a high blood glucose concentration was significantly associated with reduced miR‑152 expression. Furthermore, overexpression of miR‑152 using miR‑152 mimics promoted the proliferation of INS‑1 and MIN6 cells, as determined by an MTT assay, in addition to insulin secretion, while knockdown of miR‑152 using an inhibitor led to the opposite effects. Phosphatidylinositol 3‑kinase (PI3K) signaling has been reported to inhibit insulin secretion, however, the regulation of PI3K in the pancreatic β cell is poorly understood. The present study identified that PI3K catalytic subunit α (PI3Kα) was a direct target gene of miR‑152 using a luciferase reporter assay, and miR‑152 inhibited the expression of PI3Kα at the protein level, which was determined by western blotting. Therefore, the regulation of insulin secretion and pancreatic β cell proliferation may occur via the miR‑152/PI3Kα axis. The overexpression of PI3Kα in INS‑1 and MIN6 cells partially reduced the effects of miR‑152 overexpression on insulin secretion. Consistently, PI3Kα levels were reduced in murine pancreatic islets following treatment with 20mM glucose, and increased in blood samples from patients with diabetes compared with healthy individuals. In conclusion, the results of the present study demonstrate that miR‑152 may have an important role in pancreatic β cell function, and established an association between miR‑152 and the PI3Kα axis. Therefore, targeting PI3Kα may be a potential therapeutic option for diabetes.

Association between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients \u2013 a retrospective Analysis

BackgroundDeranged glucose metabolism is frequently observed in trauma patients after moderate to severe traumatic injury, but little data is available about pre-hospital blood glucose and its association with various cardiac rhythms and cardiac arrest following trauma.MethodsWe retrospectively investigated adult trauma patients treated by a nationwide helicopter emergency medical service (34 bases) between 2005 and 2013. All patients with recorded initial cardiac rhythms and blood glucose levels were enrolled. Blood glucose concentrations were categorised; descriptive and regression analyses were performed.ResultsIn total, 18,879 patients were included, of whom 185 (1.0%) patients died on scene. Patients with tachycardia (≥100/min, 7.0 ± 2.4 mmol/L p < 0.0001), pulseless ventricular tachycardia (9.8 ± 1.8, mmol/L, p = 0.008) and those with ventricular fibrillation (9.0 ± 3.2 mmol/L, p < 0.0001) had significantly higher blood glucose concentrations than did patients with normal sinus rhythm between 61 and 99/min (6.7 ± 2.1 mmol/L). In patients with low (≤2.8 mmol/L, 7/79; 8.9%, p < 0.0001) and high (> 10.0 mmol/L, 70/1271; 5.5%, p < 0.0001) blood glucose concentrations cardiac arrest was more common than in normoglycaemic patients (166/9433, 1.8%). ROSC was more frequently achieved in hyperglycaemic (> 10 mmol/L; 47/69; 68.1%) than in hypoglycaemic (≤4.2 mmol/L; 13/31; 41.9%) trauma patients (p = 0.01).ConclusionsIn adult trauma patients, pre-hospital higher blood glucose levels were related to tachycardic and shockable rhythms. Cardiac arrest was more frequently observed in hypoglycaemic and hyperglycaemic pre-hospital trauma patients. The rate of ROSC rose significantly with rising blood glucose concentration. Blood glucose measurements in addition to common vital parameters (GCS, heart rate, blood pressure, breathing frequency) may help identify patients at risk for cardiopulmonary arrest and dysrhythmias.