Higher Fasting Blood Glucose Levels Research Articles

Glycemic control and risk factors of mortality in patients with diabetes mellitus and COVID-19: A single center experience from Pakistan.

Objective: To highlight the effect of COVID-19 and DM on each other by studying glycemic control and risk factors for mortality. Study Design: Retrospective Observational Review. Setting: Sindh Institute of Urology and Transplantation Karachi Pakistan. Period: March 2020 till March 2021. Methods: Covid-19 diagnosed patients admitted were enrolled. They were divided into DM and non-DM. Demographics, clinical variables and outcome were compared. Glycemic control during hospitalization was noted. Fasting glucose level >120 mg/dl, and random >200 mg/dl were considered as poor glycemic control. Survivors and non- survivors among DM patients were compared. Results: A total of 366 patients were included, 113(30.87%) DM and 253(69.12%) non-DM. Mean age was higher in DM group (58yrs vs 49.6yrs p <0.001). Significantly more patients with hypertension (p <0.001) and ischemic heart disease (p=0.001) developed Covid-19 in DM group. There was no difference in mortality (p = 0.295). In DM patients, the significant risk factors for mortality were age >60years, hypertension and chronic kidney disease. The mean high fasting and pre-dinner blood glucose levels at admission and day 5 were significantly associated with mortality. Conclusion: Diabetic patients with advanced age, hypertension and chronic kidney disease were associated with increased risk of death. More attention should be focused on dynamic monitoring and strict glycemic control as uncontrolled diabetes is associated with severe infection and mortality.

Glycemic indicators and mental health symptoms: results from the greater Beirut area cardiovascular cohort.

Depression and anxiety present high and complex comorbidity with diabetes. One proposed explanation is that glycemic dysregulations and diabetes-related processes can influence mental health risk. We examined the associations of concurrent and prior glycemic indicators (Hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) levels) with depression and anxiety symptoms in a community-based sample of middle-aged Lebanese adults. Data come from the Greater Beirut Area Cardiovascular Cohort (GBACC), with baseline and 5-year assessments of sociodemographic, lifestyle, and biological factors (n=198). Depression (Patient Health Questionnaire-9) and anxiety (General Anxiety Disorder-7) symptoms were assessed at follow-up. We investigated associations between glycemic indicators and continuous mental health scores using first linear and then piecewise regression models. Adjusted piecewise regression models showed different associations with mental outcomes across glycemic indicators in the diabetic/clinical compared to the non-diabetic range: Among participants with <126 mg/dl baseline FBG, higher FBG levels in this range were significantly associated with lower depressive (beta=-0.12, 95%CI= [-0.207, -0.032]) and anxiety symptoms (beta=-0.099, 95%CI= [-0.186, -0.012]). In contrast, among participants with baseline FBG levels ≥126 mg/dl, higher FBG levels were significantly associated with higher anxiety symptoms (beta=0.055; 95%CI= 0.008, 0.102). Higher baseline FBG levels in the ≥126 mg/dl range showed a not statistically significant trend for higher depressive symptoms. Although not significant, baseline HbA1c levels showed similar patterns with negative associations with mental health symptoms in the <6.5% range. Results show that FBG levels were associated with poorer mental health symptoms only in the clinical/diabetic range, and not in the normal range. Associations were observed with baseline glycemic indicators, highlighting potentially early and prolonged associations with mental health. Findings highlight the importance of clinical changes in glycemic indicators for mental health and motivate further research into the transition toward adverse associations between diabetes and mental health.

Exercise intensities and metabolic health: Targeting blood glucose, insulin, and C-peptide levels in adults with prediabetes in the postprandial state

ObjectiveExercise improves postprandial glycemia and insulin sensitivity in individuals with prediabetes, but the optimal intensity for this metabolic regulation remains unclear. The current study explored the impact of various exercise intensities on blood glucose, insulin, and C-peptide levels in prediabetic individuals to identify the optimal intensity for improving these metabolic indicators. MethodsIn this crossover study, 25 individuals with prediabetes participated in exercise sessions at four different intensities 50 %, 60 %, 70 %, and 80 % of their predicted maximum heart rate using a treadmill. Each session lasted 30 min, including a 5-min warm-up and 5-min cool-down period. Blood samples were collected at four time points: during fasting, immediately before exercise, and 30 and 60 min post-exercise. These samples were analyzed for glucose, insulin, and C-peptide levels. The effects of exercise intensity on these parameters were evaluated using repeated measures analysis of variance (ANOVA), with post hoc tests conducted to determine specific differences between the intensities. ResultsThe participants had an average age of 34.88 years, mean height of 170 cm, and body mass index of 30.34 kg/m2. A significant reduction in insulin and glucose levels post-exercise was observed at 70 % intensity (p ≤ 0.001). Despite high fasting blood glucose levels (110–115 mg/dL), significant reductions were noted at 30 and 60 min post-exercise (p ≤ 0.001). Insulin levels approached near baseline at 70 % intensity, from fasting (26.74 ± 20.83) to 60 min post-exercise (28.47 ± 20.79), indicating a positive response at this intensity. C-peptide levels also showed significant changes, with 70 % intensity exercise bringing them closest to fasting levels by 60 min post-exercise. ConclusionThis study highlights the importance of exercise intensities in enhancing metabolic parameters in individuals with prediabetes. Specifically, 70 % of the predicted maximum heart rate was beneficial, optimizing insulin sensitivity and potentially reducing the risk of progressing from prediabetes to diabetes.

Intestinal Motility Dysfunction in Goto-Kakizaki Rats: Role of the Myenteric Plexus.

The morpho-quantitative analysis of myenteric plexus neurons in the small and large intestines of 120-day-old male GK rats was investigated. The diabetes was confirmed by high fasting blood glucose levels. The myenteric plexus was evaluated through wholemount immunofluorescence. The morpho-quantitative analyses included evaluating neuronal density (neurons per ganglion) of the total neuronal population, the cholinergic and nitrergic subpopulations, and enteric glial cells per ganglion. The cell body area of 100 neurons per segment per animal was measured. The total neurons and nitrergic subpopulation were unaltered in the GK rats' small and large intestines. The cholinergic subpopulation exhibited decreased density in the three segments of the small intestine and an increased number in the proximal colon of the GK rats. The number of enteric glial cells increased in the ileum of the GK rats, which could indicate enteric gliosis caused by the intestinal inflammatory state. The area of the cell body was increased in the total neuronal population of the jejunum and ileum of the GK rats. Frequency histograms of the cell body area distribution revealed the contribution of cholinergic neurons to larger areas in the jejunum and nitrergic neurons in the ileum. The constipation previously reported in GK rats might be explained by the decrease in the density of cholinergic neurons in the small intestine of this animal model.

Bidirectional association between type 2 diabetes and irritable bowel syndrome: A large-scale prospective cohort study.

To examine the bidirectional association between type 2 diabetes (T2D) and irritable bowel syndrome (IBS) in a large prospective population cohort. Participants free of IBS at baseline in the UK Biobank were included in the analysis of T2D and incident IBS (cohort 1), with 11 140 T2D patients and 413 979 non-T2D patients. Similarly, those free of T2D at baseline were included in the analysis of IBS and incident T2D (cohort 2), with 21 944 IBS patients and 413 979 non-IBS patients. Diagnoses of T2D and IBS were based on International Classification of Disease-10 codes. The Cox proportional hazards model was used to estimate adjusted hazard ratios (HRs). In cohort 1, 8984 IBS cases were identified during a median 14.5-year follow-up. Compared with non-T2D, T2D patients had a 39.0% increased risk of incident IBS (HR = 1.39, 95% confidence interval [CI]: 1.23-1.56, P < .001), with a higher IBS risk in those with higher fasting blood glucose levels (HR = 1.43, 95% CI: 1.19-1.72, P < .001) or longer T2D duration (HR = 1.47, 95% CI: 1.23-1.74, P < .001). In cohort 2, 29 563 incident T2D cases were identified. IBS patients had an 18.0% higher risk of developing T2D versus non-IBS patients (HR = 1.18, 95% CI: 1.12-1.24, P < .001). A similar excess T2D risk was observed in IBS patients with a duration of either less than 10 years, or of 10 years or longer. Further sensitivity analysis and subgroup analysis indicated consistent findings. T2D and IBS exhibit a bidirectional association, with an increased risk of co-morbidity. Awareness of this association may improve the prevention and management of both diseases.

Intergenerational metabolism-disrupting effects of maternal exposure to plasticizer acetyl tributyl citrate (ATBC)

Environmental chemicals and pollutants are increasingly recognized for their potential transgenerational effects. Acetyl tributyl citrate (ATBC), a widely used plasticizer substituting di-(2-ethylhexyl) phthalate (DEHP), was identified as an inducer of lipogenesis in male mice by our previous research. This study aimed to investigate the impact of ATBC exposure on the metabolic homeostasis of female mice and simultaneously evaluate its intergenerational effects.Female C57BL/6J mice were orally exposed to ATBC (0.01 or 1 μg/kg/day) for 10 weeks before mating with unexposed male mice. The resulting F1 female mice were bred with unexposed males to generate F2 offspring. Our results indicated that 10-week ATBC exposure disrupted glucose metabolism homeostasis and the reproductive system in F0 female mice. In F1 female mice, elevated liver lipid levels and mild insulin resistance were observed. In the F2 generation, maternal ATBC exposure resulted in increased weight gain, elevated liver triglycerides, and higher fasting blood glucose levels, primarily in F2 male mice. These findings suggest that maternal ATBC exposure may exert intergenerational disturbing effects on glucose metabolism across generations of mice. Further investigation is needed to evaluate the health risks associated with ATBC exposure.

Diabetes and long duration leading to speech-, low/mid-, and high- frequency hearing loss: current evidence from the China National Health Survey 2023.

To examine the effect of diabetes, duration of diabetes, and blood glucose on speech-, low/mid-, and high-frequency hearing loss. In this cross-sectional study, 2821 participants aged 20-87years in the China National Health Survey were included.Diabetes was defined as valid fasting blood glucose (FBG) of ≥ 7.0mmol/L, a self-reported history of diabetes or the use of anti-diabetic medications. Speech-(500, 1000, 2000, and 4000Hz), low/mid- (500, 1000 and 2000Hz), and high-frequency (4000, 6000, and 8000Hz) hearing loss was defined as pure tone average of responding frequencies > 20dB HL in the better ear, respectively. In fully adjusted models, for speech-, low/mid-, and high-frequency hearing loss, compared with no diabetes, those with diabetes (OR[95%CI]: 1.44 [1.12, 1.86], 1.23 [0.94, 1.61], and 1.75 [1.28, 2.41], respectively) and with diabetes for > 5years duration (OR[95%CI]: 1.63 [1.09, 2.42], and 1.63 [1.12, 2.36], 2.15 [1.25, 3.70], respectively) were at higher risk. High FBG level was associated with a higher risk of speech-, low/ mid-, and high-frequency hearing loss. And there were stronger associations between HL and diabetes, longer duration and higher in "healthier population" (no hypertension, no dyslipidemia and younger age). Diabetes, longer duration, and higher FBG level were independently associated with hearing loss for speech-, low/mid- and high-frequency hearing loss, particularly in higher frequency and "healthier population". Paying more attention to hearing loss in those populations could lower the burden of hearing loss.

U-shaped association between fasting blood glucose and suicide attempts in Chinese patients with first-episode drug-naïve major depressive disorder

BackgroundEvidence regarding the relationship between fasting blood glucose (FBG) and suicide attempts (SA) in patients with major depressive disorder (MDD) was limited. Therefore, the objective of this research was to investigate whether FBG was independently related to SA in Chinese patients with first-episode drug-naïve (FEDN) MDD after adjusting for other covariates.MethodsThe present study was a cross-sectional study. A total of 1718 participants (average age: 34.9 ± 12.4 years, 65.8% females) with FEDN MDD were involved in a hospital in China from September 2016 to December 2018. Multiple logistic regression analysis and smooth curve fitting were used to estimate the association between FBG and the risk of SA. The threshold effect was examined by the two-piecewise linear regression model. Interaction and stratified analyses were conducted according to sex, education, marital status, comorbid anxiety, and psychotic symptoms.ResultsThe prevalence of SA in patients with FEDN MDD was 20.1%. The result of fully adjusted binary logistic regression showed FBG was positively associated with the risk of SA (odds ratio (OR) = 1.62, 95% CI: 1.13–2.32). Smoothing plots also revealed a nonlinear relationship between FBG and SA, with the inflection point of FBG being 5.34 mmol/l. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.53 (0.32–0.88, P = 0.014) and 1.48 (1.04–2.10, P = 0.030), respectively.ConclusionsA U-shaped relationship between FBG and SA in FEDN MDD patients was found, with the lowest risk of SA at a FBG of 5.34 mmol/l, indicating that both the lower and higher FBG levels may lead to an increased risk of SA.

Effects of Heavy Alcohol Use on Fasting Glucose and Insulin Resistance in Mid-Life Adults

Introduction: As our population ages, type 2 diabetes has become more prevalent in the United States and one in five mid-life adults (50-64 years) have type 2 diabetes. Unhealthy and heavy alcohol use (that exceeds recommended drinking limits) causes dysfunction of the liver and pancreas that can impact glucose control and thereby increase risks of type 2 diabetes. In young adults, we previously found that fasting glucose and insulin resistance were not associated with heavy alcohol use. However, it remains unclear if heavy alcohol use contributes to the development of type 2 diabetes in an aged population. Therefore, the purpose of this study is to determine the effect of heavy alcohol use on fasting glucose and insulin resistance in apparently healthy mid-life adults. Methods: Mid-life men (n=21) and postmenopausal women (n=28), non-smokers, free of obesity and major clinical diseases, were recruited from the community around the Dallas—Fort Worth metroplex. All participants underwent physical exam and fasting blood sampling. Alcohol use was assessed by the US Alcohol Use Disorders Identification Test (USAUDIT) and a dried blood spot phosphatidylethanol (PEth) test. A PEth cutoff of 20 ng/mL was used to define heavy drinkers. Insulin resistance was assessed by calculating HOMA-IR (Homeostatic model assessment for insulin resistance) as insulin (μU/L) x glucose (nmol/L)/22.5. Results: A total of 24 participants had PEth levels of &lt;20 ng/mL (non-heavy drinkers; PEth ranged from &lt;limit of quantification to 13 ng/mL; mean ± SEM for age: 58±1 years and body mass index: 25.2±0.6 kg/m2) and the other 25 participants had PEth levels ≥20 ng/mL (heavy drinkers; PEth ranged from 20 to 665 ng/mL; age: 57±1 years and body mass index: 25.7±0.5 kg/m2). Heavy drinkers had higher USAUDIT scores than non-heavy drinkers (11.3±1.4 vs. 3.3±0.5, p&lt;0.001). No significant difference between these two groups were found in lipid values (P≥0.1) as well as renal (P≥0.3) and liver function values (P≥0.08). Compared to non-heavy drinkers, heavy drinkers had a higher level of fasting blood glucose (96±2 vs. 91±1 mg/dL, P=0.02), but similar blood insulin (9.2±2.5 vs. 5.5±0.5 μIU/L, P=0.2) and HOMA-IR (2.23±0.64 vs. 1.23±0.11, P=0.1). The results for stepwise linear regression model indicate that only USAUDIT score was an independent factor of fasting glucose (B=0.59, p&lt;0.001). Conclusion: Our results indicate that compared to mid-life adult non-heavy drinkers, heavy drinkers had higher fasting blood glucose levels, despite similar renal and liver function. Our results also indicate that higher risks of alcohol use disorder were associated with higher levels of fasting glucose. These data suggest that heavy alcohol use may have negative effects on glucose regulation in aged populations and increase risks of type 2 diabetes. This work was supported by NIAAA AA028537 to CLH. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Alterations in gut microbiota and bile acids by proton-pump inhibitor use and possible mediating effects on elevated glucose levels and insulin resistance.

Several observational studies have suggested that proton-pump inhibitor (PPI) use might increase diabetes risk, but the mechanism remains unclear. This study aimed to investigate the effects of PPI use on gut microbiota and bile acids (BAs) profiles, and to explore whether these changes could mediate the association of PPIs use with fasting blood glucose (FBG) levels and insulin resistance (IR) in Chinese population. A cross-sectional study was conducted in Shenzhen, China, from April to August 2021, enrolled 200 eligible patients from the local hospital. Participants completed a questionnaire and provided blood and stool samples. Gut microbiome was measured by16S rRNA gene sequencing, and bile acidswere quantified by UPLC-MS/MS. Insulin resistance (IR) was assessed using the Homeostasis Model Assessment 2 (HOMA2-IR). PPI use was positively associated with higher levels of FBG and HOMA2-IR after controlling for possible confounders. PPI users exhibited a decreased Firmicutes and an increase in Bacteroidetes phylum, alongside higher levels of glycoursodeoxycholic acid (GUDCA) and taurochenodeoxycholic acid (TCDCA). Higher abundances of Bacteroidetes and Fusobacterium as well as higher levels of TCDCA in PPI users were positively associated with elevated FBG or HOMA2-IR. Mediation analyses indicated that the elevated levels of FBG and HOMA2-IR with PPI use were partially mediated by the alterations in gut microbiota and specific BAs (i.e., Fusobacterium genera and TCDCA). Long-term PPI use may increase FBG and HOMA2-IR levels, and alterations in gut microbiota and BAs profiles may partially explain this association.

Serum tumor markers expression (CA199, CA242, and CEA) and its clinical implications in type 2 diabetes mellitus.

Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus (T2DM) is associated with the levels of serum tumor markers of the digestive tract, such as cancer antigen (CA)199. Therefore, tumor markers in T2DM are important. To evaluate the expression of serum tumor markers [CA199, CA242, and car-cinoembryonic antigen (CEA)] and the clinical implications of the expression in T2DM. For this observational study conducted at Hefei BOE Hospital, China, we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020. Levels of fasting blood glucose (FBG), tumor markers (CA199, CEA, and CA242), glycosylated hemoglobin (HbA1c), etc. were measured and group index levels were compared. Moreover, FBG and HbA1c levels were correlated with tumor marker levels. Tumor markers were tested for diagnostic accuracy in patients with > 9% HbA1c using the receiver operating curve (ROC) curve. The T2DM group had high serum FBG, HbA1c, CA199, and CEA levels (P < 0.05). A comparative analysis of the two groups based on HbA1c levels (Group A: HbA1c ≤ 9%; Group B: HbA1c > 9%) revealed significant differences in CEA and CA199 levels (P < 0.05). The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809, respectively. CA199, CEA, and CA242 levels positively correlated with HbA1c (r = 0.308, 0.426, and 0.551, respectively) and FBG levels (r = 0.236, 0.231, and 0.298, respectively). As compared to controls, serum CEA and CA199 levels were higher in patients with T2DM. HbA1c and FBG levels correlated with CA199, CEA, and CA242 levels. Patients with poorly controlled blood sugar must be screened for tumor markers.

Effect of nutrition education on serological variables of type 2 diabetes mellitus patients attending Nigerian National Petroleum Company Limited Clinic Warri, Delta State Nigeria

Background: The increasing prevalence of diabetes mellitus around the world appears as dramatic as to have been characterized as an epidemic. Diabetes mellitus causes prolonged ill-health, imposes morbidity and mortality risks, and necessitates a change in lifestyle, with a meticulous daily routine and long-term self-care. Objective: The objective of the study was to assess the effect of nutrition education on serological variables of the type 2 diabetes mellitus patients. Methodology: Two Hundred and Thirty (230) out of 258 subjects who participated in the longitudinal study were confirmed Type 2 diabetics. One hundred and Fifty (150) subjects were grouped into education group and Eighty (80) subjects into control group. Information on socio-demographic, life-style characteristics, and management regimens of the diabetes were collected using structured, validated and pretested questionnaire. Subject’s serological variables such as glycated hemoglobin (HbA1c), Fasting Blood Glucose (FBG), 2-hours post prandial and fasting lipid profile were collected. Nutrition education was instituted and was performed in a group of 15 patients per session in 2 hours. Results: Most of the subjects (70.0%) in the education group at baseline had elevated HbA1c with a mean baseline HbA1c level of 8.08+1.88%. While most of the subjects (65.00%) in the control group at baseline had normal HbA1c with a mean baseline glycated hemoglobin level of 7.01+1.86%. However, there was a significant difference (P&lt;0.05) in the mean and percentage number of HbA1c of the subjects in education and control group. Only 6.7% of the subjects had low Fasting Blood Glucose (&lt;4.2mmol/l), 58.0% had high Fasting Blood Glucose (&gt;7.0mmol/l) and 35.3% had normal Fasting Blood Glucose (4.2-5.9mmol/l). After three months follow up, the number of subjects who had normal FBG increased from 35.3% to 54.7%, the low FBG levels increased from 6.5% to 10.0% but high Fasting Blood Glucose levels reduced from 58.0% to 35.3%. Conclusion: There was significant reduction in the glycated hemoglobin (HbA1c) and Fasting Blood Glucose (FBG) of the subjects after nutrition education and follow up, indicating that nutrition education and follow up has positive impact the serological variables of the subjects who are diabetics.

A Comparative Study Between The Levels of Adropin in Iraqi Women with Metabolic Syndrome and Diabetes

By measuring Adropin, fasting blood glucose (FBG), cholesterol, high-density lipoprotein (HDL), triglycerides (TG), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) in the sera of Iraqi patients with MetS and type 2 diabetes mellitus (T2DM), the current study was designed to compare some crucial markers in metabolic syndrome (MetS) sera and diabetic patients (T2DM) with control. Twenty female subjects were divided into three groups: group I=40 with MetS and group II=40 with T2DM, and 40 healthy subjects were employed as a control group. Compared to the control group, Adropin levels in the Mets group and T2DM group decreased significantly (p &lt; 0.05). In contrast, none of the patient groups (MetS and T2DM) showed any change compared to themselves. In conclusion, according to the present data, higher levels of FBG, lipid profile, and increased blood pressure (BP) were found in patients with MetS and T2DM. A drop in level could be considered a novel indicator of MetS and T2DM. Compared to T2DM patients, Adropin levels are thought to have a more sensitive diagnostic function than those with MetS and newly diagnosed DM.

Food Consumption Habits Among Black African Adolescents With Metabolic Syndrome In Lagos State, Nigeria

Introduction: Metabolic syndrome (MetS), a cluster of metabolic abnormalities characterized by dyslipidemia, high blood pressure, high fasting blood glucose level and abdominal obesity is becoming a public health concern in sub-Saharan Africa. Very few studies have linked intake of certain food items to the occurrence of MetS among Nigerian adolescents despite abundance of these food items in the country during the study period.

Impacts of Tocolytics on Maternal and Neonatal Glucose Levels in Women With Gestational Diabetes Mellitus.

We investigated the impacts of tocolytic agents on maternal and neonatal blood glucose levels in women with gestational diabetes mellitus (GDM) who used tocolytics for preterm labor. This multi-center, retrospective cohort study included women with GDM who were admitted for preterm labor from twelve hospitals in South Korea. We excluded women with multiple pregnancies, anomalies, overt DM diagnosed before pregnancy or 23 weeks of gestation, and women who received multiple tocolytics. The patients were divided according to the types of tocolytics; atosiban, ritodrine, and nifedipine group. We collected baseline maternal characteristics, pregnancy outcomes, maternal glucose levels during hospitalization, and neonatal glucose levels. We compared the frequency of maternal hyperglycemia and neonatal hypoglycemia among three groups. A multivariate logistic regression analysis was performed to evaluate the contributing factors to the occurrence of maternal hyperglycemia and neonatal hypoglycemia. A total of 128 women were included: 44 (34.4%), 51 (39.8%), and 33 (25.8%) women received atosiban, ritodrine, and nifedipine, respectively. Mean fasting blood glucose (FBG) (112.3, 109.6, and 89.5 mg/dL, P < 0.001) and 2-hour postprandial glucose (PPG2) levels (145.4, 148.3, and 116.5 mg/dL, P = 0.004) were significantly higher in atosiban and ritodrine group than those in nifedipine group. Even after adjusting for covariates including antenatal steroid use, gestational age at admission, and pre-pregnancy body mass index, there was an increased risk of high maternal mean FBG (≥ 95 mg/dL) and PPG2 (≥ 120 mg/dL) levels in the atosiban and ritodrine group than in nifedipine group. The atosiban and ritodrine groups are also at increased risk of neonatal hypoglycemia (< 47 mg/dL) compared to the nifedipine group with the odds ratio of 4.58 and 4.67, respectively (P < 0.05). There is an increased risk of maternal hyperglycemia and neonatal hypoglycemia in women with GDM using atosiban and ritodrine tocolytics for preterm labor compared to those using nifedipine.

Metabolic syndrome and breast cancer risk

BackgroundLimited data are available on metabolic syndrome and its relation to breast cancer risk in Egypt. We aimed to study metabolic syndrome and its individual components as risk of breast cancer.MethodsThis case–control study recruited 112 breast cancer cases and 112 age-matched controls from Assiut University. In addition to demographic, clinical, and anthropoemetric characteristics, blood samples were collected from both study groups to evaluate metabolic syndrome and its individual components.ResultsMean age of breast cancer cases and control groups was 46.10 ± 4.34 and 45.66 ± 4.68 years, respectively. According to Joint Interim Statement (JIS) criteria for clinical diagnosis of metabolic syndrome, the overall prevalence of metabolic syndrome in all participants was 42.9%, and prevalence in breast cancer cases and control group was 57.14% and 28.6%, respectively, OR 33.33, 95% CI (1.91–5.81). BMI was more likely to be higher in breast cancer patients with a linear trend, p < 0.001. For individual components of metabolic syndrome, breast cancer cases were more likely to have high fasting blood glucose level, systolic and/or diastolic blood pressure, high triglycerides level, and low HDL-C as compared to the control group.ConclusionMetabolic syndrome and its components were found to be associated with the risk of breast cancer. We believe that prevention or reversal of metabolic syndrome by raising community awareness for lifestyle changes could be an effective way in minimizing the toll of the disease.

Fasting blood glucose predicts high risk of in-stent restenosis in patients undergoing primary percutaneous coronary intervention: a cohort study

Objectives. Studies have shown that fasting blood glucose (FBG) is closely associated with poor prognosis in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI), but its association with in-stent restenosis (ISR) is still unclear. Therefore, this study was to explore the association between FBG with ISR in patients with CHD after PCI. Design. In this cohort study, we included 531 patients with CHD who underwent PCI. Logistic regression, receiver operating characteristic (ROC), subgroup analysis and restricted cubic spline (RCS) were used to assess the association between FBG with ISR. Results. A total of 124 (23.4%) patients had ISR. Patients with higher levels of FBG had higher incidence of ISR compared to those with lower levels of FBG (p = 0.002). In multivariable logistic regression analyses, higher levels of FBG remained strongly associated with higher risk of ISR (as a categorical variable, OR: 1.89, 95% CI: 1.21–2.94, p = 0.005; as a continuous variable, OR: 1.12, 95% CI: 1.03–1.23, p = 0.011). ROC analysis also showed that FBG might be associated with the occurrence of ISR (AUC = 0.577, 95% CI: 0.52–0.64, p = 0.013). Subgroup analyses showed the association of FBG with ISR was also stable in several subgroups (< 60 years or ≥ 60 years, male, with or without smoking, without diabetes and without hypertension). And RCS analysis showed that FBG was linearly and positively associated with the risk of ISR. Conclusions. Higher levels of FBG were closely associated with higher risk of ISR in patients with CHD after PCI.

Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis

BackgroundTransitioning from marriage to widowhood presents inevitable and significant challenges for many older adults. This study explored the impact of widowhood on a range of mental health outcomes, including pulse pressure and fasting blood glucose levels, among older adults in nursing homes.MethodsThis cross-sectional study utilized cluster random sampling to recruit participants, with data analyzed from 388 older Chinese adults. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety symptoms, and the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms and suicidal ideation. Propensity score matching (PSM) was employed to control for confounding factors. A multivariate linear regression analysis was performed to explore the relationship between widowhood, mental health outcomes, pulse pressure, and fasting blood glucose levels.ResultsAfter applying PSM, the sample size was refined to 268 (N = 134 for both married and widowed groups) from the initial 388, excluding 120 unmatched cases. Widowed older adults were found to have notably lower family support (β = −0.81, p = 0.002), increased depressive symptoms (β = 1.04, p = 0.043), elevated pulse pressure (β = 8.90, p &amp;lt; 0.001), and higher fasting blood glucose levels (β = 3.22, p = 0.027). These associations exhibited greater beta values compared to pre-matching analysis.ConclusionOur findings revealed that widowed participants had reduced family support, an increased risk of depressive symptoms, heightened pulse pressure, and elevated fasting blood glucose in comparison to their married counterparts. Interventions focusing on social support, mental health, and cardiovascular well-being could be advantageous for this at-risk group.

Value of Hcy combined with Framingham score for predicting macrovascular disease in elderly patients with type 2 diabetes.

To analyze the predictive value of homocysteine (Hcy) combined with the Framingham risk score for cardio- and cerebrovascular disease in elderly patients with type 2 diabetes mellitus (T2DM) to provide a reference for clinical treatment. We retrospectively reviewed the clinical data of 1036 elderly patients with T2DM admitted to our hospital between July 2017 and July 2022. The patients were divided into occurrence (n = 438) and control (n = 598) groups based on the incidence of cardio- or cerebrovascular disease. Univariate and multivariate logistic analyses were used to analyze the factors associated with cardio-cerebral small-vessel disease in the elderly patients with T2DM. The predictive value of Hcy combined with the Framingham score for cardio- and cerebrovascular diseases in elderly patients with T2DM was determined using receiver operating characteristic curves. Univariate analysis showed that the occurrence group had significantly higher Framingham score, systolic blood pressure (SBP), total cholesterol (TC), fasting blood glucose (FBG), 2-hour postprandial plasma glucose, Hcy, glycated hemoglobin, smoking history, and disease duration than the control group (all P < .05). Food preferences, sleep duration, physical exercise, high density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol levels were significantly lower in the occurrence group than in the control group (all P < .05). Multivariate logistic analysis showed that smoking history, duration of diabetes, Framingham score, SBP, TC, FBG, HDL-C, 2h postprandial plasma glucose, and Hcy levels were risk factors for cardio- and cerebrovascular disease in elderly patients with T2DM. The area under the curve for Hcy and Framingham scores was 0.741 (95% confidence interval [CI]: 0.635-1.871) and 0.717 (95% CI: 0.601-0.856), respectively. Hcy combined with the Framingham score demonstrated a significantly higher predictive value (0.852, 95% CI: 0.741-0.979). Long smoking history, long diabetes duration, high Framingham score, high SBP, high TC, high FBG, low HDL-C, and high Hcy levels are risk factors for cardio-cerebrovascular disease in elderly patients with T2DM. In addition, Hcy level combined with the Framingham score demonstrated superior predictive power for cardio- and cerebrovascular disease in elderly patients with T2DM.

If You Give a Mouse a Cookie: Quantification of Metabolic and Neurologic Changes in Murine Model for Charcot Arthropathy

Category: Basic Sciences/Biologics; Diabetes Introduction/Purpose: Charcot arthropathy (Charcot) is a significant complication of diabetes mellitus thought to occur as a result of repetitive microtrauma to the insensate foot. We previously developed a murine model of diet-induced obese mice with peripheral neuropathy which underwent a high-intensity treadmill protocol designed to induce metabolic, neurologic, radiographic, and histopathologic features similar to Charcot in humans. Using this model, we aimed to further characterize the metabolic and sensory changes that occur in these diet-induced obese mice subjected to various high-intensity exercise protocols designed to induce repetitive microtrauma to the hind paws similar to Charcot. Methods: Forty-nine wild-type C57BL/6J mice were randomized to receive either a standard or high-fat diet and exposed to a high-intensity treadmill running protocol for various lengths of time as described in Figure 1A. Group 1 received a standard low-fat (10% kcal from fat) mouse diet and did not participate in the treadmill protocol. Groups 2, 3, 4, and 5 were fed a high-fat (60% kcal from fat) diet ad libidum to facilitate diet-induced obesity (DIO) and completed the treadmill protocol for various lengths of time. Initial body weights, DEXA scans, hind-paw Von-Frey filament sensory testing, and hot plate sensory testing following the previously published murine model were performed prior to the start of the running protocol and repeated at weeks 4, 8, 12, and 16. Plantar temperatures were measured initially and at 16 weeks. Paired-t-Test and one-way ANOVA were utilized to determine the significance of observed results. Results: Bodyweights are represented in Figure 1B. Plantar temperature was not significantly different between treadmill running groups at week 0 or 16 (Figure 1C). Hot plate testing demonstrated no significant difference in the number of responses between groups at week 0. By week 16, groups 3 and 5 demonstrated decreased hind-paw sensitivity to hot plate testing, suggestive of decreased sensation. Von Frey sensory testing also showed more force was required to induce a positive response, indicating decreased hind-paw sensation in high-fat diet groups (Figure 1D). By weeks 12 and 16, high-fat diet groups had significantly higher fasting blood glucose levels than group 1(Figure 1E). Additionally, high-fat diet groups demonstrated a significantly higher body fat percentage and lower bone mineral density (BMD) at weeks 0 and 16. Conclusion: Decreased sensitivity to hot plate and Von Frey testing demonstrate decreased sensation in the hind paws of DIO mice fed a high-fat diet. DIO mice also have significantly higher fasting blood glucose levels than mice fed a regular diet indicating impaired glucose tolerance. These metabolic and sensory changes suggest this is a reliable murine model of diabetic neuropathy. This model of diabetic neuropathy provides an avenue to study the radiographic and histologic changes that occur in these mice when exposed to repetitive exercise-induced microtrauma similar to Charcot arthropathy in humans.