Impaired Glucose Levels Research Articles

FREQUENCY OF UNIDENTIFIED DIABETES MELLITUS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Objective: To determine the frequency of unidentified Diabetes Mellitus in Acute Myocardial Infarction.
 Study Design: Descriptive cross-sectional study.
 Place and Duration of Study: Army Cardiac Centre Lahore, Lahore, from Jan 2020 to Feb 2020.
 Methodology: Patients (male and females) with acute myocardial infarction both ST Elevation MI and non-ST Elevation MI presenting to cardiac centre were included through consecutive non probability sampling technique. Patients with gestation diabetes mellitus and diabetes type I were excluded. Data was collected through detailed questionnaire covering the necessary variables. Distribution of unrecognized diabetes in these patients were determined through Blood Sugar Fasting and HBA1c levels undersigned by the classified Pathologist.
 Results: Over the study period, a total of 150 patients were included. 68.6% were males with 40.6% patients suffering from STEMI and 28% with NSTEMI. Among 31.2% females, 12.6% patients had STEMI and 18.6% had NSTEMI. Out of total patients, 40% were known case of diabetes, 26.6% were newly diagnosed diabetics, normoglycemic were 23.3% and impaired fasting blood glucose levels was present in 10% patients. Total 40 (26.6%) patients were those who were first diagnosed diabetes during admission for acute MI management. In unidentified diabetic group STEMI was more common than NSTEMI with male predominance.
 Conclusion: There is a high frequency of unrecognized diabetes mellitus in patients with acute Myocardial infarction in our population. Therefore, in high risk patients for ischemic heart disease, screening for diabetes is routinely suggested to take timely preventive efforts and avoid complications.

Association of low total testosterone levels and impaired blood glucose levels in middle aged men - A cross-sectional study

Background: Recent studies have shown that men with impaired glucose levels (pre-diabetes)/diabetes have lower serum total testosterone (TT) levels as compared to normoglycemic men. India has a high incidence and prevalence of diabetes mellitus (DM)/pre-diabetes in the middle aged population too. Most studies have researched about the serum TT levels in elderly pre-diabetic/diabetic men, but there is lack of information about such association in middle aged men. Aims and Objectives: These objectives of this study are to study the levels of serum TT in middle aged men with DM/pre-diabetes; to compare the serum TT levels in men with DM/ pre-diabetes with normoglycemic men; and to observe the correlation between fasting blood glucose (FBG) and serum TT, body mass index (BMI), and waist circumference (WC). Materials and Methods: It is a cross-sectional, observational study. The study subjects were 150 nonsmoking, nontobacco addict, and nonalcoholic men aged between 31 and 60 years. Anthropometric measurements, serum FBG levels, and serum TT were measured. Results: The pre-diabetic and diabetic men had significantly low levels of serum TT as compared to non-diabetic men. Furthermore, serum TT levels correlated negatively with WC, BMI and blood sugar levels, but significant correlation was found only in the case of WC. Conclusion: Low serum TT levels are associated with pre-diabetes as well as diabetes. Whether the association is casual or not requires prospective study.

CHARACTERISTICS OF PATIENTS WITH TYPE 2 DIABETES MELLITUS AT SURABAYA HAJI GENERAL HOSPITAL

Diabetes mellitus is a chronic disease due to impaired blood glucose levels. Type 2 diabetes mellitus dominantly causes most deaths in the world. The number of patients with type 2 diabetes mellitus (DM) was ranked the second highest at the Surabaya Haji General Hospital. Purpose: This study described characteristics of patients with type 2 DM at the Surabaya Haji General Hospital. Methods: This study was descriptive and used a cross-sectional research design. This study’s population were patients with type 2 DM who visited Diabetes Unit at Surabaya Haji General Hospital. This study was conducted in the Diabetes Unit at the Surabaya Haji General Hospital by involving 114 respondents as the samples. These respondents were interviewed using questionnaires from 11 March to 11 April 2019. The study’s variables were patients’ characteristics including age, gender, family history, and disease duration. Data were analyzed using a univariate analysis with a frequency table. Results: Almost all of patients with type 2 DM at Surabaya Haji General Hospital were aged ≥40 years (94.7%) and female (71.9%). The majority of patients had a family medical history of type 2 diabetes mellitus disease (60.5%) and long disease duration of >5 years (5.,4%). Conclusion: Almost patients with type 2 DM in Surabaya Haji General Hospital were elderly who had a family medical history of diabetes mellitus and had suffered from type 2 diabetes mellitus for >5 years.Keywords: diabetes mellitus, characteristics, hospital, descriptions.

Plasma concentrations of glutamate, serine, citrulline, arginine, glycine and threonine are predictive of impaired fasting glucose in COPD patients

Rationale: Impaired blood glucose level is frequently observed in COPD patients and has been associated with decreased quality of life and increased disease progression. Therefore, we explore metabolic pathways potentially up- or downregulated in COPD in relation to (pre)diabetes to develop new clinical nutrition approaches.

Diabetes Mellitus in the Middle-Aged and Elderly Population (>45 Years) and Its Association With Pancreatic Cancer: An Updated Review.

Diabetes mellitus (DM) and pancreatic cancer (PC) in the elderly are widely considered to be interrelated. New-onset diabetes (NOD) patients are considered a high-risk group for the development of PC within three years of diagnosis. We reviewed the literature to determine the pathophysiological association between DM and PC, which can help in the development of screening tests for early PC diagnosis in the elderly with NOD. We also studied the potential associations between them after pancreaticoduodenectomy (PD) or pancreatic resection. We collected studies published in the last five years in PubMed that are relevant to DM and PC in the elderly. We mainly focused on the pathophysiology and intracellular mechanisms involved between NOD and PC. We illustrated the clinical signs and immunological and metabolic biomarkers that can be used to diagnose early PC in the elderly with NOD. In the 34 studies we reviewed, five showed that long-term diabetes mellitus (LTDM) increases the risk of PC. Six studies showed that NOD in the elderly is an early sign of PC. Fourteen studies proposed that clinical signs and biomarker levels should be used to determine the high-risk risk group for PC among NOD patients. Six studies reported that NOD is associated with the worst outcomes postoperatively, and three studies showed that patients developed DM after pancreatic resection. LTDM is considered an independent risk factor for PC development in the elderly. NOD is a consequence and maybe the only early presenting sign of PC. Screening protocols and tests should be used in clinical practice to determine the proportion of NOD patients who should undergo further testing for early diagnosis of PC. DM and PC are also co-related postoperatively and patients should be monitored for impaired glucose levels, overall survival, and mortality.

Serum insulin levels are associated with vulnerable plaque components in the carotid artery: the Rotterdam Study.

BackgroundTo investigate the association between fasting serum insulin and glucose levels with atherosclerotic plaque composition in the carotid artery. Impaired insulin and glucose levels are implicated in the etiology of cardiovascular disease; however, their influence on the formation and composition of atherosclerotic plaque remains unclear.MethodsIn 1740 participants (mean age 72.9 years, 46% women, 14.4% diabetes mellitus) from the population-based Rotterdam Study, we performed carotid MRI to evaluate the presence of calcification, lipid core, and intraplaque hemorrhage in carotid atherosclerosis. All participants also underwent blood sampling to obtain information on serum insulin and glucose levels. Using logistic regression models, we assessed the association of serum insulin and glucose levels (per s.d. and in tertiles) with the different plaque components, while adjusting for sex, age, intima-media thickness, and cardiovascular risk factors.ResultsSerum insulin levels were associated with the presence of intraplaque hemorrhage (adjusted odds ratio (OR): 1.42 (95% CI: 1.12–1.7)) We found no association with the presence of calcification or lipid core. Sensitivity analyses restricted to individuals without diabetes mellitus yielded similar results. No associations were found between serum glucose levels and any of the plaque components.ConclusionsSerum insulin levels are associated with the presence of vulnerable components of carotid plaque, specifically with intraplaque hemorrhage. These findings suggest a complex role for serum insulin in the pathophysiology of carotid atherosclerosis and in plaque vulnerability.

Screening of newly-diagnosed adults with Tuberculosis for Diabetes mellitus and Impaired Glucose Tolerance in a Local Government Area in Ogun State, Nigeria

Background: Emerging patterns in epidemiological transitions have led to increased risk for Non-Communicable Diseases and infectious conditions globally. Diabetes mellitus (DM) in a population is one such risk factor that could lead to the development of Tuberculosis (TB) due to weakened immune functions in affected persons, with implications for mortality. If not diagnosed early, DM also leads to poor treatment outcomes in TB. Objective: To assess the prevalence of DM and impaired glucose tolerance (pre-diabetes) among newly diagnosed tuberculosis cases in Ijebu-Ode Local Government Area of Ogun State, Nigeria. Methods: This cross-sectional study was conducted among 100 newly diagnosed Pulmonary TB patients in ljebu-Ode LGA. The patients were selected from four health facilities and were screened for elevated Fasting Blood Glucose levels using a laboratory spectrophotometer (glucose oxidase method). Results: The mean age of the 100 study participants was 33 years (± 9.82), with ages within 19 -62 years. Eleven (11.0%) had elevated blood glucose levels suggestive of DM, while 20 (20.0%) had impaired fasting blood glucose levels. Among these 31 patients, 18 (58.0%) were males while 13 (42.0%) were females. The modal ages were within 20-39 years. Conclusion: Screening for DM by healthcare providers should be routinely conducted before commencing TB patients on treatment. This will aid early detection, improve treatment outcomes of TB and prevent mortality among patients with these co-morbidities.

Effects of different tube types on patient classification using current diabetes decision limits

Management of diabetes is a challenge starting in the pre-analytical phase with selecting the most appropriate glycolysis inhibitor. Study goal was to calculate the impact of tubes with different glycolysis inhibitors on the classification of the glycemic control of 157,415 consecutive hospital patients according to current WHO diabetes criteria. MethodsGlucose and lactate were measured in parallel in samples from 68 healthy subjects collected and stored in different sample tubes from Sarstedt and Greiner. Bias to baseline conditions (fluoride heparin (FH) tubes, centrifugation within 1 h) was determined. ResultsIn baseline samples, glucose concentration in fluoride/EDTA/citrate (FC) plasma was ~13% higher and lactate concentration ~20% lower compared to FH, fluoride oxalate, and fluoride EDTA plasma, and in serum. Glucose recovery after storage up to 48 h was 99–101% in the different tubes, but the effectiveness of glycolysis inhibition by FC was inconsistent. Based on the observed mean bias of 12% when FC tubes are used, we estimate an increase of 48.4–55.8% in the frequency of patients with impaired glucose levels using current WHO criteria. ConclusionUsing current established decision limits, the number of patients with impaired glucose levels in the hospital would increase substantially with a strong impact on patient treatment and consumption of resources. The unpredictable failure of glycolysis inhibition in FC tubes does not allow to adjust the decision limits by a fixed factor. In the absence of prospective outcome studies with FC tubes, we recommend to measure glucose in samples containing FH.

The Effect of Long-Term Second-Generation Antipsychotics Use on the Metabolic Syndrome Parameters in Jordanian Population.

Objectives: The aim of this study was to determine the incidence of metabolic syndrome in patients treated with second-generation antipsychotics (SGAs). Methods: In this retrospective study, we reviewed patients’ electronic medical records (EMRs) of all patients who received one SGA for at least six months, excluding patients who were taking other medications that are associated with significant effect on metabolic syndrome. Relevant clinical information was collected prior to starting the SGA and after six months of continuous use of the same SGA. Results: A total of 91 patients were included in the study. The majority of patients (72%) were diagnosed with schizophrenia. After six months of taking the SGA, 44% of patients experienced elevated systolic pressure, 54.9% had elevated triglyceride, and 31.9% had impaired glucose levels (p value < 0.05). Prior to initiating SGA therapy, 14.3% of patients had metabolic syndrome, while 37.4% had metabolic syndrome after six months of therapy, and it was more prominent in males compared to female patients (p value < 0.05). Conclusion: This study found a strong correlation between SGA use and the appearance of metabolic alterations, such as weight gain, glucose intolerance, and increased triglyceride levels. These findings highlight the importance of assessing metabolic deregulations to minimize SGA associated metabolic abnormalities.

Effect of 8 Weeks of Zinc Supplementation and Yoga Exercise on Plasma Apelin Level and Kidney Performance in Women with Type 2 Diabetes

Background: Diabetes mellitus is a metabolic disorder associated with impaired serum lipid and glucose levels. Objectives: The present study aimed to compare the effects of zinc supplementation, yoga exercise, and zinc supplementation plus yoga exercise on serum apelin level and kidney function among women with type II diabetes mellitus. Methods: This was a four-group pretest-posttest quasi-experimental study. Thirty two women were selected and randomly allocated to either of the following four groups: control; yoga exercise (thrice weekly for eight weeks); zinc supplementation; and zinc supplementation plus yoga exercise. Body composition, insulin resistance, and serum levels of glucose, insulin, creatinine, urea nitrogen, and apelin were measured before and after the study intervention. Data were analyzed through the one-way analysis of variance and the least significant difference post hoc test at a significance level of less than 0.05. Results: There were significant differences among the study groups concerning the serum levels of glucose (P = 0.001), insulin (P = 0.012), apelin (P = 0.001), and urea nitrogen (P = 0.02) as well as insulin resistance (P = 0.016) after the intervention. However, groups did not significantly differ from each other concerning the serum level of creatinine (P = 0.264). Conclusions: Eight-week yoga exercise and zinc supplementation are useful to women with type II diabetes mellitus.

Joint analysis of fasting and postprandial plasma glucose and insulin concentrations in Venezuelan women

AimsPlasma glucose and insulin concentrations in fasting and postprandial reflect the metabolism of glucose by the human body and are useful in the diagnosis of metabolic diseases, such as diabetes and insulin resistance. In this work, these concentrations are jointly analyzed in Venezuelan women and 28 classes that better specify each metabolic condition are generated. Materials and methodsEach class comprises a combination of fasting and postprandial ranges of glucose and insulin concentrations defined in the literature as normal, impaired and diabetic. A hypothesis test was used to find statistically significant differences between the classes, and confidence intervals for age and glucose and insulin concentrations were defined for each class. Results and conclusionThe process of deterioration of glucose metabolism advances with the age of the subject, more than half of the prediabetics have impaired glucose levels in fasting but normal in postprandial and normal insulin levels in fasting and postprandial, and one third of diabetics have diabetic glucose levels in fasting and postprandial and normal insulin levels in fasting and postprandial. This categorization of subjects would allow the application of a more specific treatment and the possibility of predicting the progress of the metabolic disorder.

The incidence of hyperglycemia during the induction phase of chemotherapy in patients with acute lymphoblastic leukemia

Background: Hyperglycemia is one of the most complications of corticosteroid and asparaginase during induction phase of chemotherapy in children suffering from acute lymphoblastic leukemia (ALL). This study was carried out to evaluate the incidence of hyperglycemia and associated risk factors during chemotherapy induction phase at Amirkola Children's Hospital. Materials and Methods: In this cross-sectional (retrospective) study, 150 children (mean age: 79.16±42.68 months) with ALL were evaluated (2000- 2011). Hyperglycemia was described as random blood glucose level more than 200mg/dl in patients less than 2 years old. In patients older than 2 years, fasting blood glucose level more than 110-125 mg/dl was considered as impaired glucose level and fasting blood glucose level more than 126 mg/dl was defined as diabetes mellitus. The data were analyzed using SPSS (version 18) and running chi square test, pearson Ccorrelation, and logistic regression. P-values less than0.05 was considered statistically significant. Results: Out of 150 children with ALL, 21 (14%) of them had hyperglycemia, but none of them had diabetic ketoacidosis. Hyperglycemia was significantly associated with gender (P=0.014) and age. (P=0.000) which was more likely in patients older than 10 years. The incidence of hyperglycemia was also related to BMI (P=0.000). Relapse rate for ALL was 14.7%, which was not significantly associated with hyperglycemia. Conclusion: Hyperglycemia was common and transient during induction phase of chemotherapy and it was correlated with age, sex, and weight.

Impaired blood glucose levels in patients with dyslipidemia: what are the therapeutic implications? The PREVENDIAB study.

Aim:Dyslipidemia and diabetes are two of the main cardiovascular risk factors due to their impact and high prevalence. The aim of this study was to analyze the prevalence of impaired glucose metabolism in dyslipidemic patients attending the cardiology department. Patients & methods: This was a multicenter, cross-sectional, observational epidemiological study that consecutively enrolled the first ten dyslipidemic patients who attended the cardiology outpatient clinic. To find associated factors between variables, a bivariate analysis was performed, using a Student's t-test and a Fisher's exact test. Results: From the 490 analyzed patients, 67.4% of them presented impaired blood glucose levels, 39.2% with DM and28.1% with prediabetes. Conclusion: More than half of the patients presented alterations of the glucose metabolism, very few reached a good metabolic control and a great number were found polymedicated.

Metabolic Syndrome - A New Paradigm: Need for Capacity Building of Health Care Workers for Early Screening in the Rural Indian Population

Background: We continue to experience an inexorable transition from communicable to chronic non-communicable diseases (NCD), worldwide. This is especially true in India, where it appears that metabolic syndrome (MetS) is increasing in prevalence due to rapid economic growth, change in food intake and physical inactivity have lead to increase in MetS. However access to health service is poor in India and proper assessment for metabolic disease is often lacking. Accredited Social Health Activists(ASHA) are available throughout India for doing house to house assessment and providing health care, a potential solution for identifying people with abnormal metabolic factors. The aim of this study was to conduct capacity building of ASHA workers for screening of metabolic syndrome in rural India and identify people in rural India with features of MetS. Methods: After obtaining approval from institutional ethics committee 300 ASHAs were trained under World Diabetes Foundation fundedproject (WDF15-941) about aspects ofMetS, diabetes mellitus and diabetic foot. Hand holding training activities were held for each ASHA intheir respective area of practice. This was conducted by project staffs. Participants over the ageof 30 years were screened for the presence of MetS. Random blood glucose (RBS), blood pressure, body mass index (BMI) and waist circumference were measured. Results: A total of 38,346 people were screened for the presence of metabolic syndrome,of which13,911(36.3%) were found to have MetS of which 4200(35.9%) were male and 9,711(37.2%) were female. Those with type 2 diabetes mellitus(T2DM) 1,555(36.7%) also had MetS. Among 3 diagnostic criteria, waist circumference was the highest with 34.1%. Individual with impaired random glucose levels have 1.5 times more risk of developing metabolic syndrome adjusted for age and gender. Conclusion: In conclusion, MetS was present in 36.3% participants residing in rural part of Indiai.e one third of the population. Amongst people with T2DM 36.7% had MetS. The result suggest better screening and early identification of these people will help in proper treatment which might reduce the risk of cardiovascular diseases. Funding: The field screening was conducted as a part of ongoing project funded by World Diabetes Foundation WDF 15-941 “Diabetic Foot care: Stepping Ahead”. Declaration of Interest: The author(s) declare no potential conflict of interest with respect to the research, authorship, and/or publication of this article. Ethical Approval: The study was initiated after obtaining the approval from institutional research committee and institutional ethics committee (IEC 700/2015).

Pioglitazone provides beneficial effect in metabolic syndrome rats via affecting intracellular Na+ Dyshomeostasis.

Metabolic syndrome, is associated impaired blood glucose level, insulin resistance, and dyslipidemia caused by abdominal obesity. Also, it is related with cardiovascular risk accumulation and cardiomyopathy. The hypothesis of this study was to examine the effect of thiazolidinediones such as pioglitazone on intracellular Na+ homeostasis in heart of metabolic syndrome male rats. Abdominal obesity and glucose intolerance had measured as a marker of metabolic syndrome. Intracellular Na+ concentration ([Na+]i) at rest and [Na+]i during pacing with electrical field stimulation were determined in freshly isolated cardiomyocytes. Also, TTX-sensitive Na+- channel current (INa) density and I-V characteristics of these channels were measured to understand [Na+]i homeostasis. We determined the protein levels of Na+/Ca2+ exchanger and Na+-K+ pump to understand the relation between [Na+]i homeostasis. High sucrose intake significantly increased body mass and blood glucose level of the rats in the metabolic syndrome group as compared with control group. There was a decrease in INa density and there were differences in points on activation curve of INa. Basal [Na+]i in metabolic syndrome group significantly increased but there was a significantly decrease in [Na+]i in stimulated cardiomyocytes in metabolic syndrome. Furthermore, pioglitazone induced decreases in the basal [Na+]i and preserved the decrease in INa and [Na+]i in stimulated cardiomyocytes to those of controls. Histologically, metabolic syndrome affected heart and associated tissues together with many other organs. Results of the present study suggest that pioglitazone has significant beneficial effects on metabolic syndrome associated disturbances in the heart via effecting Na+ homeostasis in cardiomyocytes.

Clinical implication of fasting glucose and systolic/diastolic blood pressure on the prevalence of periodontitis in non-diabetic and non-hypertensive adults using nationally representative data.

The prevalence of diabetes mellitus and hypertension is increasing worldwide and an association between fasting glucose/blood pressure and periodontitis has been suggested. The present study was performed to assess the association between fasting glucose and systolic/diastolic blood pressure on the prevalence of periodontitis in non-diabetic and non-hypertensive adults using nationally representative data. Subgroup analysis was performed to evaluate the combined effects of obesity/abdominal obesity and impaired fasting glucose. This study involved a cross-sectional analysis using data from the Republic of Korean National Health and Nutrition Examination Survey from 2013 to 2015. A total of 8,341 respondents without diabetes and hypertension over 19 years old without missing values were included in the present study. A significant increase was observed in the prevalence of periodontitis with increasing systolic blood pressure and diastolic blood pressure. The percentage of periodontitis increased with increased glucose levels, with similar trends in glycated hemoglobin. The odds ratios (ORs) and 95% confidence intervals (CIs) for systolic blood pressure of 90≤x<100, 100≤x<110, 110≤x<120, 120≤x<130 and 130≤x<140 were 1.116 (0.591-2.107), 1.165 (0.624-2.175), 1.238 (0.673-2.278), 1.008 (0.538-1.888) and 1.042 (0.545-1.993), respectively, when systolic blood pressure <90 was considered as a reference. The ORs and 95% CIs for glucose of 90≤x<100, 100≤x<110 and 110≤x<126 were 1.074 (0.92-1.253), 1.214 (0.986-1.494) and 1.358 (1.005-1.834), respectively when glucose <90 was considered as a reference. The association between fasting glucose/blood pressure and periodontitis was confirmed by multiple logistic regression analyses after adjusting for confounding factors among non-diabetic and non-hypertensive Republic of Korean adults. Subgroup analysis revealed that higher ORs of periodontitis were observed in participants with impaired glucose level and obesity when compared with individuals without impaired glucose level or obesity. The results of the present study suggest that detection of fasting glucose and blood pressure may serve as a risk indicator for periodontal disease.

Lower protein and higher carbohydrate intake are related with altering metabolic syndrome components in elderly women: A cross-sectional study

BackgroundMetabolic Syndrome (MetS) is an energy-disturbance disease associated with insulin resistance. Hence, the intake of energy-rich macronutrients might affect some MetS components. The aim of this study was to explore the association of ingested macronutrients with MetS components in older women. MethodsA cross sectional study was conducted in 245 older women (≥60 years). Whole-body dual-energy X-ray absorptiometry was used to assess total body fat, percentage body fat (absolute and relative), and skeletal muscle mass. Venous blood samples were collected after a 12 h fasting to determine glucose, high-density lipoprotein (HDL-c), and triglycerides. Anthropometric measurements and resting blood pressure were also evaluated. Food consumption was assessed through the 24-hour dietary recall method, and the macronutrients were distributed by tertiles of consumption. The Student t-test, Mann–Whitney U test, and logistic regression analysis were used for statistical analysis. ResultsThe MetS and non-MetS groups demonstrated similar food-energy intake and fat consumption. The MetS group presented lower protein and higher carbohydrate intake than the non-MetS group. Individuals in the lowest protein intake (<0.72 g/kg/d) had greater odds of presenting abdominal obesity and impaired glucose levels. Higher consumption of carbohydrates was associated with lower HDL levels and higher hypertriglyceridemia. The chances of having MetS were increased by three times when ingesting either a low protein or high carbohydrate diet. ConclusionEither high carbohydrate or low protein intake would be risk factors for altering MetS components and the presence of MetS in elderly women.

Oral glucose tolerance test and continuous glucose monitoring to assess diabetes development in cystic fibrosis patients

IntroductionPatients with cystic fibrosis (CF) undergo a slow and progressive process toward diabetes. Oral glucose tolerance test (OGTT) is recommended to diagnose impaired glucose levels in these patients. Continuous glucose monitoring (CGM) measures glucose profiles under real-life conditions. ObjectiveTo compare OGTT and CGM results in CF patients. MethodsPaired OGTT and 6-day CGM profiles (146.2±9.1h/patient) were performed in 30 CF patients aged 10–18 years. ResultsAccording to OGTT, 14 patients had normal glucose tolerance (NGT), 14 abnormal glucose tolerance (AGT), and two cystic fibrosis-related diabetes (CFRD). In 27 patients (13 NGT, 13 AGT, 1 CFRD), CGM showed glucose values ranging from 140 to 200mg/dL during similar monitoring times (2%–14% with NGT, 1%–16.9% with AGT, and 3% with CFRD). Glucose peak levels ≥200mg/dL were seen in seven patients (3 NGT, 3 AGT, 1 CFRD).According to CGM, two patients had all glucose values under 140mg/dL (1 NGT, 1 AGT). Seventeen patients had glucose levels ranging from 140 to 200mg/dL (10 NGT, 6 AGT, 1 CFRD). Ten patients (3 NGT, 7 AGT) had glucose values ≥200mg/dL for ≤1% of the monitoring time and one (CFRD) for >1% of the monitoring time. ConclusionsOGTT results did not agree with those of the CGM. CGM allows for diagnosis of glucose changes not detected by OGTT. Such changes may contribute to optimize pre-diabetes management in CF patients.

Oral glucose tolerance test and continuous glucose monitoring to assess diabetes development in cystic fibrosis patients

IntroductionPatients with cystic fibrosis (CF) undergo a slow and progressive process toward diabetes. Oral glucose tolerance test (OGTT) is recommended to diagnose impaired glucose levels in these patients. Continuous glucose monitoring (CGM) measures glucose profiles under real-life conditions. ObjectiveTo compare OGTT and CGM results in CF patients. MethodsPaired OGTT and 6-day CGM profiles (146.2±9.1h/patient) were performed in 30 CF patients aged 10–18 years. ResultsAccording to OGTT, 14 patients had normal glucose tolerance (NGT), 14 abnormal glucose tolerance (AGT), and two cystic fibrosis-related diabetes (CFRD). In 27 patients (13 NGT, 13 AGT, 1 CFRD), CGM showed glucose values ranging from 140 to 200mg/dL during similar monitoring times (2%–14% with NGT, 1%–16.9% with AGT, and 3% with CFRD). Glucose peak levels ≥200mg/dL were seen in seven patients (3 NGT, 3 AGT, 1 CFRD).According to CGM, two patients had all glucose values under 140mg/dL (1 NGT, 1 AGT). Seventeen patients had glucose levels ranging from 140 to 200mg/dL (10 NGT, 6 AGT, 1 CFRD). Ten patients (3 NGT, 7 AGT) had glucose values ≥200mg/dL for ≤1% of the monitoring time and one (CFRD) for >1% of the monitoring time. ConclusionsOGTT results did not agree with those of the CGM. CGM allows for diagnosis of glucose changes not detected by OGTT. Such changes may contribute to optimize pre-diabetes management in CF patients.

The MST3/STK24 kinase mediates impaired fasting blood glucose after a high-fat diet.

The identification of mediators in the pathogenesis of type 2 diabetes mellitus is essential for the full understanding of this disease. Protein kinases are especially important because of their potential as pharmacological targets. The goal of this study was to investigate whether mammalian sterile-20 3 (MST3/STK24), a stress-regulated kinase, is involved in metabolic alterations in obesity. Glucose regulation of Mst3 (also known as Stk24)-knockout mice was analysed both in 129;C57 mixed background mice and in C57/BL6J mice fed normally or with a high-fat diet (HFD). This work was complemented with an analysis of the insulin signalling pathway in cultured human liver cells made deficient in MST3 using RNA interference. MST3 is phosphorylated in the livers of mice subject to an obesity-promoting HFD, and its deficiency lowers the hyperglycaemia, hyperinsulinaemia and insulin resistance that the animals develop with this diet, an effect that is seen even without complete inactivation of the kinase. Lack of MST3 results in activation of the insulin signalling pathway downstream of IRS1, in both cultured liver cells and the liver of animals after HFD. This effect increases the inhibition of forkhead box (FOX)O1, with subsequent downregulation of the expression of gluconeogenic enzymes. MST3 inhibits the insulin signalling pathway and is important in the development of insulin resistance and impaired blood glucose levels after an HFD.