Increase In Blood Glucose Concentration Research Articles

Molecular Insights and Pharmacotherapy of Diabetic Neuropathy

Background: Diabetes mellitus is a chronic disorder of energy metabolism caused by lack or decrease in the effectiveness of insulin, and is characterised by an abnormally elevated blood glucose concentrations and the development of macrovascular, microvascular and/or neuropathic complications. Diabetic neuropathy (DN) is one of the most debilitating outcomes of diabetes mellitus, and may cause pain, decreased mobility as well as amputation. Diabetes can damage the peripheral nervous system (PNS), through the induction of de-myelination in neurones, precipitated by chronic hyperglycaemia-induced oxidative stress, and causing a condition that involves the upper and lower limbs. Objective: The study discussed the risk factors for insulin resistance and pre-diabetes, type II diabetes mellitus and vascular complications, cellular and molecular basis of DN, physiopathological mechanisms, and the pharmacological treatment of DN. Method: The study examined journal articles and standard textbooks, as it relates to diabetes mellitus and its complications. Search for articles on DN was carried out in the literature. These were identified and reviewed for selection using chemical abstracts service, pubmed, google scholar, crossreference, web of science, pubmed central free article, and scopus. The key words used for search were: diabetic neuropathy; diabetic peripheral neuropathy; peripheral neuropathy; microvascular complications of diabetes mellitus; and neuromuscular complications of diabetes mellitus. Result & Discussion: Two hundred and fifty (250) articles and other works were identified, while ninety-seven (97) articles and non-journal materials were extracted and reviewed, taking into account the criteria for selection. Studies done in the last 4.5 decades were included, while works written on other languages, outside English were excluded. Findings indicate that DN is a complex disorder that affects the peripheral and/or cranial nerves, which is caused by unattended or poorly attended, long-term increase in blood glucose concentrations. It relatively manifests early, affecting a significant proportion of the micro-blood vessels in the middle-aged and elderly diabetic patients. DN causes numbness, loss of sensation, and sometimes pain in the feet, legs, arms or hands. Hyperglycaemia causes the activation and inhibition of several molecular pathways that are crucial for homeostasis in neuronal and neuroglial cells. Conclusion: DN is the commonest complication of diabetes mellitus. It has no known definitive therapy. Treatment is essentially symptomatic with huge economic and psychological burden, hence the rationale for a cost effective and targeted therapies. Achieving euglycaemia using anti-diabetic regimens (i.e., insulin and oral hypoglycaemic agents), foot care, changes in feeding habits and lifestyle modification are critical to holistically address the problem.

Effect of Single Low-Dose Dexamethasone on Peri-operative Blood Glucose Levels

Background: Post-operative nausea and vomiting (PONV) is the second most common complaint reported after surgery with an incidence of 30%-80%. PONV is associated with numerous morbidities, hence prevention is beneficial. Dexamethasone is used as a prophylactic anti-emetic agent, however, being a corticosteroid, it could cause hyperglycaemia which is associated with a number of other adverse effects. Objectives: To study the effect of a single low-dose intravenous dexamethasone given as a prophylactic anti-emetic agent on perioperative blood glucose levels. Methods: Eighty-eight women who had elective myomectomy or hysterectomy under combined spinal-epidural (CSE) anaesthesia were randomised into two groups of 44 each. Following baseline blood glucose estimation, one group had 4 mg (1 ml) of intravenous dexamethasone 1-2 seconds after blood glucose check while the control group had 1 ml of normal saline. Blood glucose was measured every hour intra-operatively and two-hourly post-operatively till 12 hours after drug administration. Nausea, vomiting, dyspepsia, pain, motor block duration and urinary output were assessed hourly. Results: The mean maximum change in blood glucose from baseline in the dexamethasone group was statistically significantly higher than in the control group, 51.00±26.57 mg/dl vs. 35.80±25.71 mg/dl (p = 0.007) so also was the mean maximum blood glucose, 153.93±31.63 mg/dl vs. 139.52±28.95 mg/dl (p = 0.028) respectively. Conclusion: Intravenous dexamethasone at a single, low-dose (4 mg) used as a prophylaxis for nausea and vomiting is associated with significant increase in blood glucose concentration.

The sodium correction factor for dogs undergoing treatment for a hyperglycemic crisis is a 1.6-mEq/L decrease in sodium per 100-mg/dL increase in glucose.

To determine the sodium correction factor for clinical use in hyperglycemic diabetic dogs. Retrospective analysis of 76 hospitalization episodes from 67 different dogs presenting to the University of Georgia Veterinary Teaching Hospital between January 1, 2015, and January 1, 2023. For each hospitalization episode, paired blood sodium and glucose concentration measurements were recorded from the time of presentation until glucose concentration was ≤ 201 mg/dL. Therapies administered, primary diagnosis, and concurrent diseases were also recorded for each episode. A linear mixed model was used to determine the sodium correction factor per 100-mg/dL increase in glucose. Piecewise linear mixed models were also constructed for blood glucose measurements ≤ 400 mg/dL and > 400 mg/dL to explore potential correction factor differences between low and high glucose concentrations. A sodium correction factor of a 1.6-mEq/L (95% CI, 1.3 to 1.9 mEq/L) decrease in sodium concentration per 100-mg/dL increase in blood glucose concentration was calculated. Differences in the correction factor between conditions of low and high glucose concentrations could not be determined due to a small sample size of blood glucose values > 400 mg/dL. Most dogs received similar treatments throughout the study period, including balanced isotonic crystalloids (97% [74/76]), electrolyte supplementation (84% [64/76]), and regular insulin (97% [74/76]). Almost all patients (93% [71/76]) had 1 or more concurrent diseases. A sodium correction factor of 1.6 mEq/L (decrease in sodium per 100-mg/dL increase in glucose) is recommended for clinical use in hyperglycemic diabetic dogs.

Production Responses of Multiparous Dairy Cattle with Differing Prepartum Muscle Reserves and Supplementation of Branched-Chain Volatile Fatty Acids

Periparturient dairy cattle undergo physiological adaptations to support fetal growth and colostrum synthesis in late gestation and milk production in early lactation. To support energy and protein demands dairy cattle mobilize body tissue reserves. The objective of this study was to determine the effects of prepartum skeletal muscle reserves and supplementation of branched-chain volatile fatty acids (BCVFA) on body composition measurements, metabolic markers related to health, protein, and energy status, and subsequent milk yield in multiparous dairy cows. Skeletal muscle reserves were assessed by 3 ultrasounds of the longissimus dorsi muscle depth (LDD) measured 42 d before expected calving (BEC), and cows (n = 48) were assigned to either high muscle (HM; > 4.6 cm) or low muscle (LM; ≤ 4.6 cm) groups. Cows were then randomly assigned to either control (CON) of soyhull pellets (80 g/d) or BCVFA treatment which contained isobutyrate (40 g/d), isovalerate (20 g/d), and 2-methylbutyrate (20 g/d) calcium salt products. Treatments were top dressed from 42 BEC until parturition, resulting in 4 combinations of muscle groups and treatments: HM-CON (n = 13), HM-BCVFA (n = 13), LM-CON (n = 11), and LM-BCVFA (n = 11). Measurements of the LDD, BW, and BCS were taken on the following days relative to calving -42, -35, -21, -7, 0, 7, 14, 21, 28. Weekly blood samples were taken to measure glucose, BHB, and insulin concentrations, and 5 of the blood sample time points were utilized to determine 3-methylhistidine and creatinine blood concentrations. Milk yield was recorded daily for the first 28 d of lactation, and samples were taken from both milkings once a wk for the first 4 wk to determine components. The statistical model included the fixed effects of treatment, group, time, their interactions, and the random effect of cow nested within group and treatment. Prepartum muscle mobilization varied between muscle groups, as LM cows accreted muscle prepartum, and HM cows mobilized muscle. The HM cows had higher milk fat, protein, lactose, and energy corrected milk yields. The BCVFA supplementation tended to increase blood glucose concentrations both prepartum and postpartum and decreased milk urea nitrogen concentrations. Higher prepartum skeletal muscle reserves improve productivity of early lactation cows likely due to differences in muscle mobilization, and BCVFA supplementation improves glucose dynamics during the transition period, which may improve the metabolic health of the periparturient dairy cow.

Effects of corn grain processing and phosphorus content in calf starters on intake, growth performance, nutrient digestibility, blood metabolites, and urinary purine derivatives

Corn grain with a high phosphorus (P) content (mainly in the form of phytate-P) may need to be processed to improve the digestibility of nutrients for young calves. Processing corn grains can improve the accessibility of phytate-P to the rumen enzymes and increase the bioavailability of P, which benefits the growth and development of calves. The objective of this study was to investigate the effects of feeding starter diets with steam-flaked corn (SFC) compared with ground corn (GC) with 2 P contents of 0.4% and 0.7% DM basis on intake, growth performance, nutrient digestibility, blood metabolites and urinary purine derivatives in dairy calves. A total of 48 female Holstein dairy calves (3 d old; average initial weight 39.7 ± 3.9 kg) were randomly assigned to a 2 × 2 factorial arrangement of treatments (12 calves/treatment) in a randomized complete block design. The treatment groups were: 1) a starter diet of GC with 0.4% P (GC-0.4P); 2) a starter diet of GC with 0.7% P (GC-0.7P); 3) a starter diet of SFC with 0.4% P (SFC-0.4P); 4) a starter diet of SFC with 0.7% P (SFC-0.7P). Calves received 6 L/d of transition milk on d 2-3 and 5 L/d of whole milk on d 4-30, which was increased to 7 L/d on d 31-45, then decreased to 5 L/d on d 46-60 and reduced to a single feeding of 2 L on d 61-62. All calves had free access to starter feed and water. All calves were weaned on d 63 and remained in the study until d 83. Rumen fluid samples were collected on d 38 (pre-weaning) and d 76 (post-weaning). Blood samples were collected on d 40 and 80 and urine samples were collected on 4 consecutive days from d 79 to 82 to analyze urinary excretion of PD. The phytate-P content ranged from 0.23 to 0.17 for GC and SFC, respectively. In particular, the interaction between corn processing method and P content showed that the SFC-0.7P diets had a greater intake of starter feed during the pre- and post-weaning periods compared with the other experimental groups. In addition, calves fed the SFC-0.7P diet had greater average daily gain, body weight, withers height at weaning, better organic matter digestibility, higher blood β-hydroxybutyrate levels and higher microbial protein synthesis compared with all other groups. Feeding the SFC diet also resulted in improved feed efficiency, improved P digestibility and a tendency toward a lower rumen pH, albeit with a tendency toward an increase in blood glucose concentration during the pre-weaning period. In addition, the inclusion of 0.7% P to the starter diet resulted in increased fiber digestibility and a slight improvement in growth performance, which was particularly evident in hip height. Overall, the inclusion of SFC in the calf starter diet, especially in combination with a 0.7% DM basis P supplement, improved growth performance and nutrient utilization in dairy calves compared with GC.

Liver electrical activity upon epinephrine action

The electrical potential of the liver is an integrative indicator the activity of the cells in this organ. Here we tried to elucidate a link between liver functional state and its electrical activity. For that, electrical potential of the liver, the content of bile acid and blood glucose concentration were measured in control conditions and after intravenous epinephrine administration. Epinephrine at dose 0.2 µg/kg body weight caused short-term increase in blood glucose concentration and a decrease in hydroxylation ratio of bile acids. The administration also resulted in an increase in power spectral density (PSD) of liver electric potential in a frequency range of 1.6-2.5 Hz. In addition, a trend to increasing in PSD at 0.6-1.5 and 2.6-10 Hz ranges and decreasing in conjugation ratio of bile acids were shown. Correlation between liver electrical activity and blood glucose concentration observed in control conditions vanished upon epinephrine administration. In contrast, epinephrine administration potentiated correlation between liver electrical activity and content of bile acids. Thus, we conclude that the liver electrical activity could reflect its secretory processes.

Liver electrical activity upon epinephrine action

The electrical potential of the liver is an integrative indicator the activity of the cells in this organ. Here we tried to elucidate a link between liver functional state and its electrical activity. For that, electrical potential of the liver, the content of bile acid and blood glucose concentration were measured in control conditions and after intravenous epinephrine administration. Epinephrine at dose 0.2 µg/kg body weight caused short-term increase in blood glucose concentration and a decrease in hydroxylation ratio of bile acids. The administration also resulted in an increase in power spectral density (PSD) of liver electric potential in a frequency range of 1.6-2.5 Hz. In addition, a trend to increasing in PSD at 0.6-1.5 and 2.6-10 Hz ranges and decreasing in conjugation ratio of bile acids were shown. Correlation between liver electrical activity and blood glucose concentration observed in control conditions vanished upon epinephrine administration. In contrast, epinephrine administration potentiated correlation between liver electrical activity and content of bile acids. Thus, we conclude that the liver electrical activity could reflect its secretory processes.

Between Medicines and Nutraceuticals in the Control of Diabetes Mellitus

Diabetes is a type of metabolic disease such as insufficient insulin secretion or poor functioning. It is characterized by high blood sugar, which increases blood glucose concentration, causes various symptoms and signs due to high blood sugar, and excrete glucose from urine.Diabetes mellitus is divided into types 1 and 2, and type 1 diabetes was previously called 'juvenile diabetes', and it is a disease caused by the inability to produce any insulin. Type 2 diabetes, which is relatively deficient in insulin, is characterized by insulin resistance.Insulin treatment is required for type 1 diabetes, but type 2 diabetes is based on lifestyle correction and may require additional drug administration. In addition, many patients or people concerned about diabetes use dietary supplements to control their blood sugar, but because of the side effects of prescription drugs and the lack of definitive clinical trials of dietary supplements, it is important to choose wisely between prescription drugs and dietary supplements with the advice of a physician or expert to treat or prevent diabetes.

Alterations of whole body glucose metabolism in a feline SARS-CoV-2 infection model.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been especially devastating to patients with comorbidities, including metabolic and cardiovascular diseases. Elevated blood glucose during SARS-CoV-2 infection increased mortality of patients with COVID-19, although the mechanisms are not well understood. It has been previously demonstrated that glucose transport and utilization is a crucial pathway for other highly infectious RNA viruses. Thus, we hypothesized that SARS-CoV-2 infection could lead to alterations in cellular and whole body glucose metabolism. Specific pathogen-free domestic cats were intratracheally inoculated with USA-WA1/2020 (wild-type) SARS-CoV-2 or vehicle-inoculated, then euthanized at 4- and 8-days postinoculation (dpi). Blood glucose and cortisol concentrations were elevated at 4 and 8 dpi. Blood ketones, insulin, and angiotensin II concentrations remained unchanged throughout the experimental timeline. SARS-CoV-2 RNA was detected in the lung and heart, without changes in angiotensin-converting enzyme 2 (ACE2) RNA expression. In the lung, SARS-CoV-2 infection increased glucose transporter 1 (GLUT1) protein levels at 4 and 8 dpi, whereas GLUT4 level was only upregulated at 8 dpi. In the heart, GLUT-1 and -4 protein levels remained unchanged. Furthermore, GLUT1 level was upregulated in the skeletal muscle at 8 dpi, and AMPK was activated in the hearts of infected cats. SARS-CoV-2 infection increased blood glucose concentration and pulmonary GLUT protein levels. These findings suggest that SARS-CoV-2 infection induces metabolic reprogramming primarily in the lung to support viral replication. Furthermore, this translational feline model mimicked human COVID-19 and could be used to explore novel therapeutic targets to treat metabolic disease during SARS-CoV-2 infection.NEW & NOTEWORTHY Our study on a feline model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, mirroring human COVID-19, revealed alterations in whole body and cellular glucose metabolism. Infected cats developed mild hyperglycemia, increased protein levels of glucose transporters in the lung, and AMPK activation in the heart. These findings suggest that SARS-CoV-2 infection induces metabolic reprogramming in the cardiorespiratory system to support viral replication. Understanding these mechanisms could lead to novel antiviral therapeutic strategies.

Impact of Delta SARS-CoV-2 Infection on Glucose Metabolism: Insights on Host Metabolism and Virus Crosstalk in a Feline Model.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes enhanced mortality in people with metabolic and cardiovascular diseases. Other highly infectious RNA viruses have demonstrated dependence on glucose transport and utilization, so we hypothesized that SARS-CoV-2 infection could lead to alterations in cellular and whole-body glucose metabolism. Twenty-four healthy domestic cats were intratracheally inoculated with B.1.617.2 (delta) SARS-CoV-2 and samples were collected at 4- and 12-days post-inoculation (dpi). Blood glucose and circulating cortisol concentrations were elevated at 4 and 12 dpi. Serum insulin concentration was statistically significantly decreased, while angiotensin 2 concentration was elevated at 12 dpi. SARS-CoV-2 RNA was detected in the pancreas and skeletal muscle at low levels; however, no change in the number of insulin-producing cells or proinflammatory cytokines was observed in the pancreas of infected cats through 12 dpi. SARS-CoV-2 infection statistically significantly increased GLUT protein expression in both the heart and lungs, correlating with increased AMPK expression. In brief, SARS-CoV-2 increased blood glucose concentration and cardio-pulmonary GLUT expression through an AMPK-dependent mechanism, without affecting the pancreas, suggesting that SARS-CoV-2 induces the reprogramming of host glucose metabolism. A better understanding of host cell metabolism and virus crosstalk could lead to the discovery of novel metabolic therapeutic targets for patients affected by COVID-19.

Family support among patients with diabetic foot ulcer

Background: Non-Communicable Diseases (NCDs) are a common cause of death in Indonesia, with Diabetes Mellitus (DM) being one of them. Diabetes Mellitus is a disease that occurs when the pancreas cannot produce insulin, or it is a chronic condition where the body cannot effectively use insulin, leading to increased blood glucose concentration or hyperglycemia, which is a characteristic of diabetes mellitus. The prevalence of diabetes mellitus has been increasing year by year, causing serious health issues in both developed and developing countries.Purpose: To identify the relationship between family support and injury incidents in patients with DM in the working area of the Cibiru Community Health Center, Bandung City in 2023.Method: This study is correlational in nature, utilizing a quantitative method conducted analytically and observationally, with cross-sectoral data collection. Chi-square analysis using Bivariate Test was employed, with a total of 40 respondents.Results: The mean age of the respondents was 59.5 with a standard deviation of 8.108 in the range of 45-75 years. The age group of 46-60 years constituted 55.5%, while the age group of 60-75 years was 45.0%. About 82.5% had high family support, 12.5% had moderate family support, and 5% had low family support. The bivariate analysis yielded a p-value of 0.027 when correlated with the occurrence of injuries. Thus, there is a relationship between family support and injury incidents in diabetic patients.Conclusion: Family support significantly influences the management or care of DM patients to minimize the occurrence of injuries.

Songbirds avoid the oxidative stress costs of high blood glucose levels: a comparative study.

Chronically high blood glucose levels (hyperglycaemia) can compromise healthy ageing and lifespan at the individual level. Elevated oxidative stress can play a central role in hyperglycaemia-induced pathologies. Nevertheless, the lifespan of birds shows no species-level association with blood glucose. This suggests that the potential pathologies of high blood glucose levels can be avoided by adaptations in oxidative physiology at the macroevolutionary scale. However, this hypothesis remains unexplored. Here, we examined this hypothesis using comparative analyses controlled for phylogeny, allometry and fecundity based on data from 51 songbird species (681 individuals with blood glucose data and 1021 individuals with oxidative state data). We measured blood glucose at baseline and after stress stimulus and computed glucose stress reactivity as the magnitude of change between the two time points. We also measured three parameters of non-enzymatic antioxidants (uric acid, total antioxidants and glutathione) and a marker of oxidative lipid damage (malondialdehyde). We found no clear evidence for blood glucose concentration being correlated with either antioxidant or lipid damage levels at the macroevolutionary scale, as opposed to the hypothesis postulating that high blood glucose levels entail oxidative costs. The only exception was the moderate evidence for species with a stronger stress-induced increase in blood glucose concentration evolving moderately lower investment into antioxidant defence (uric acid and glutathione). Neither baseline nor stress-induced glucose levels were associated with oxidative physiology. Our findings support the hypothesis that birds evolved adaptations preventing the (glyc)oxidative costs of high blood glucose observed at the within-species level. Such adaptations may explain the decoupled evolution of glycaemia and lifespan in birds and possibly the paradoxical combination of long lifespan and high blood glucose levels relative to mammals.

Effect of hydroalcoholic extract of Trigonella foenum-graecum leaves on wound healing in type 1 diabetic rats.

Diabetes describes a group of metabolic disorders characterised by increased blood glucose concentration. People living with diabetes have a higher risk of morbidity and mortality than the general population. In 2015 it was estimated that there were 415 million (uncertainty interval: 340-536 million) people with diabetes aged 20-79 years, and 5.0 million deaths attributable to diabetes. When diabetic patients develop an ulcer, they become at high risk for major complications, including infection and amputation. The pathophysiologic relationship between diabetes and impaired healing is complex. Vascular, neuropathic, immune function, and biochemical abnormalities each contribute to the altered tissue repair. The use of herbal medicine has increased and attracted the attention of many researchers all over the world. In this study, we have evaluated the effect of 500mg/kg hydroalcoholic extract of Trigonella foenum-graecum leaves (TFG-E) on wound healing in diabetic rats using a full-thickness cutaneous incisional wound model. Wounds of treated animals showed better tensiometric indices, accelerated wound contraction, faster re-epithelialisation, improved neovascularisation, better modulation of fibroblasts and macrophage presence in the wound bed and moderate collagen formation.

High-fat, high-carbohydrate diet-induced prediabetes preconception in Sprague-Dawley rats as a risk factor for the development of preeclampsia: assessing changes in placental metabolic insults.

Hyperglycemia preconception deranges the establishment of a functional placenta; however, the risk of developing preeclampsia (PE) in prediabetic patients remains obscure. The aim was to assess abnormal placental changes as a risk factor for the development of PE in high-fat, high-carbohydrate (HFHC) diet-induced prediabetic (PD) rats. HFHC diet-induced female prediabetic Sprague-Dawley rats were mated, and blood glucose concentrations, mean arterial pressure (MAP), and body weights were monitored on gestational days (GNDs) 0, 9, and 18. On GND 18, animals were euthanized. Blood and placentas were collected for biochemical analysis. Prediabetic rats showed significantly increased blood glucose concentration, proinflammatory cytokines, MAP, placental weight, and fetoplacental ratio compared with non-prediabetic (NPD) rats. Prediabetic rats showed significantly decreased placental vascular endothelial growth factor receptor 1 (VEGFR1) and placental growth factor (PLGF) and plasma nitric oxide (NO) compared with NPD. Prediabetes may have promoted endothelial dysfunction in the placenta and hypoxia, thus reducing PLGF and VEGFR1, which may have promoted proinflammation, endothelial dysfunction associated with NO decline, and hypertension, which is also observed in preeclamptic patients. Prediabetes may have promoted lipogenesis in placentas and fetuses that may have induced macrosomia and IUGR, also observed in preeclamptic patients. The findings from this study highlight the need for screening and monitoring of prediabetes during pregnancy to reduce the risk of developing preeclampsia.

Effect of Neck-Deep Immersion in Cool or Thermoneutral Water on Blood Glucose Levels in Individuals With Type 1 Diabetes.

It is unclear whether immersion in cool water, typical of many beaches, increases the concentration of blood glucose in individuals with type 1 diabetes mellitus (T1DM). To test the hypothesis in individuals with T1DM that immersion neck-deep in cool water (COOL) causes an increase in blood glucose concentration, but not exposure to thermoneutral water (THERMO) or thermoneutral air. Eight overnight-fasted participants with T1DM were exposed for 60 minutes on separate days to 3 experimental conditions: cool water (COOL, 23 °C); thermoneutral water (THERMO, 33.5 °C); or thermoneutral air (24 °C). They then recovered for 60 minutes on land at 24 °C. At time intervals, we measured: blood glucose and plasma insulin concentration, rate of carbohydrate and fat oxidation, skin and core temperature, subcutaneous blood flow, and shivering via electromyography. There was no change in blood glucose concentration during the 3 experimental conditions (P > .05). During recovery after COOL, blood glucose increased (P < .05) but did not change in the other 2 conditions. The rate of carbohydrate oxidation during and early after COOL was higher than in the other 2 conditions (P < .05), and COOL led to a decrease in subcutaneous blood flow and the concentration of plasma insulin (P < .05). Cool or thermoneutral neck-deep immersion in water does not cause a change in the concentration of blood glucose in people with T1DM, but on-land recovery from COOL causes an increase in blood glucose that may be due, at least in part, to the accompanying decrease in plasma insulin.

Calving prediction with continuous measurement of subcutaneous tissue glucose concentration in pregnant cows.

To reduce losses of dams and calves due to unfortunate events, such as dystocia and freezing to death, identifying the onset of calving and providing necessary assistance are crucial. Prepartum increase in blood glucose concentration is a known indicator to detect labor in pregnant cows. However, some issues, including the need for frequent blood sampling and stress on cows, must be resolved before establishing a method for anticipating calving using changes in blood glucose concentrations. Herein, instead of measuring the blood glucose concentrations, subcutaneous tissue glucose concentration (tGLU) was measured in peripartum primiparous (n=6) and multiparous (n=8) cows at 15min intervals using a wearable sensor. A transient increase in tGLU was observed in the peripartum period, with peak individual concentrations occurring between 2.8h before and 3.5h after calving. tGLU in primiparous cows was significantly higher than that in multiparous cows. To account for individual variations in basal tGLU, the maximum relative increase in the 3-h moving average of tGLU (Max MA) was used to predict calving. Cutoff points for Max MA were established by parity, with receiver operating characteristic analysis predicting calving within 24, 18, 12, and 6h. Except for one multiparous cow that showed an increase in tGLU just before calving, all cows reached at least two cutoff points and calving was predicted successfully. The time interval between reaching the tGLU cutoff points that predicted calving within 12h and actual calving was 12.3±5.6h. In conclusion, this study demonstrated the potential role of tGLU as a predictive indicator of calving in cows. Advancements in machine learning-based prediction algorithms and bovine-optimized sensors will help in increasing the accuracy of calving prediction using tGLU.

The multiscale characterization and constitutive modeling of healthy and type 2 diabetes mellitus Sprague Dawley rat skin.

In type 2 diabetes mellitus (T2DM), elevated glucose level impairs the biochemistry of the skin which may result in alteration of its mechanical and structural properties. The several aspects of structural and mechanical changes in skin due to T2DM remain poorly understood. To fill these research gaps, we developed a non-obese T2DM rat (Sprague Dawley (SD)) model for investigating the effect of T2DM on the in vivo strain stress state, mechanical and structural properties of skin. In vivo strain and mechanical anisotropy of healthy and T2DM skin were measured using the digital imaging correlation (DIC) technique and DIC coupled bulge experiment, respectively. Fluorescence microscopy and histology were used to assess the collagen and elastin fibers microstructure whereas nanoscale structure was captured through atomic force microscopy (AFM). Based on the microstructural observations, skin was modeled as a multilayer membrane where in and out of plane distribution of collagen fibers and planar distribution of elastin fibers were cast in constitutive model. Further, the state of in vivo stresses of healthy and T2DM were measured using model parameters and in vivo strain in the constitutive model. The results showed that T2DM causes significant loss in in vivo stresses (p < 0.01) and increase in anisotropy (p < 0.001) of skin. These changes were found in good correlation with T2DM associated alteration in skin microstructure. Statistical analysis emphasized that increase in blood glucose concentration (HbA1c) was the main cause of impaired biomechanical properties of skin. The presented data in this study can help to understand the skin pathology and to simulate the skin related clinical procedures. STATEMENT OF SIGNIFICANCE: Our study is significant as it presents findings related to the effect of T2DM on the physiologic stress strain, structural and mechanical response of SD rat skin. In this study, we developed a non-obese T2DM SD rat model which mimics the phenotype of Asian type 2 diabetics (non-obese). Several structural and mechanical characterization techniques were explored for multiscale characterization of healthy and T2DM skin. Further, based on microstructural information, we presented the constitutive models that incorporate the real microstructure of skin. The presented results can be helpful to simulate the realistic mechanical response of skin during various clinical trials.

Effects of co-ingesting glucose and whey protein on blood glucose, plasma insulin and glucagon concentrations, and gastric emptying, in older men with and without type 2 diabetes.

To investigate whether co-ingestion of dietary protein with, or before, carbohydrate may be a useful strategy to reduce postprandial hyperglycaemia in older men with type 2 diabetes (T2D). Blood glucose, plasma insulin and glucagon concentrations were measured for 180 minutes following ingestion of a drink containing 30 g of glucose (G; 120 kcal), 30 g of whey protein (120 kcal), 30 g of glucose plus 30 g of whey protein (GP; 240 kcal), or control (~2 kcal) in older men with T2D (n=10, 77 ± 1 years; 31 ± 1.7 kg/m2 ) and without T2D (n=10, 78 ± 2 years; 27 ± 1.4 kg/m2 ). Mixed model analysis was used. GP versus G markedly reduced the increase in blood glucose concentrations (P < .001) and had a synergistic effect on the increase in insulin concentrations (P < .001), in men both with and without T2D. Glucose concentrations were higher in men with T2D compared with those without T2D, whereas insulin and glucagon concentrations were largely unaffected by the presence of T2D. Gastric emptying was faster in men with T2D than in those without T2D. The ability of whey protein to reduce carbohydrate-induced, postprandial hyperglycaemia is retained in older men with T2D compared with those without T2D, and whey protein supplementation may be a useful strategy in the prevention and management of T2D in older people.

Effects of liraglutide on weight control and blood pressure in type 2 diabetes mellitus Iraqi patients

Background: Diabetes mellitus is the most common endocrine illness, affecting an increasing number of people all over the world. It is caused by a lack, or inadequate synthesis of insulin by the pancreas leading to an increase in blood glucose concentrations. Type 2 diabetes mellitus is the most strongly linked disease to obesity of all disorders. The number of obesity-related diabetes is predicted to reach 300 million by 2025. The term 'diabesity' was coined as a result of this strong link, therefore, weight loss is seen as a key therapeutic goal in the prevention and management of type 2 diabetes mellitus. Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that stimulates insulin secretion in a glucose-dependent manner. Also, it has weight-losing benefits which is assumed to be due to appetite suppression and delayed gastric emptying. Objectives: To evaluate the effectiveness of Liraglutide on weight management, body mass index, renal function and blood pressure in type 2 diabetic mellitus obese patients in Iraq. Methods: An open-label therapeutic trial was conducted from November 2021 to June 2022 at Baquba Teaching Hospital/ Diyala. (23 males and 27 females) with Type 2 Diabetes mellitus for 2 - 4 years were included in the study. They were obese, hypertensive and dyslipidemic. They received metformin and liraglutide for 12 weeks as 0.6 mg/day during the first week, which was gradually increased to 1.2 mg and up to 1.8 mg/day according to patient tolerance and requirement for control at the beginning the study. The patients had their height as well as body weight measured, calculated, blood pressure measured and renal functions tested. The statistical analysis was performed using SAS (Statistical Analysis System - version 9.1). Two-way ANOVA and Least significant differences (LSD) post hoc test were performed as well as paired t-test. P&lt; 0.05 was considered statistically significant. Results: Treatment with liraglutide for 12 weeks has resulted in a significant decrease in body weight, BMI, and blood pressure (P&lt;0.05). The changes in the results of renal function test of liraglutide-treated patients were not significant. Conclusion: In obese type 2 diabetic patients, liraglutide has the potential of reducing body weight, body mass index and blood pressure. It seemed safe in terms of its systemic effects

Diabetes mellitus: definition, classification, diagnosis, screening and prevention (Update 2023)

Diabetes mellitus comprises of agroup of heterogeneous disorders, which have an increase in blood glucose concentrations in common. The current classification for diabetes mellitus is presented and the main features of type1 and type2 diabetes are compared. Furthermore, the criteria for the correct biochemical diagnosis during fasting and oral glucose tolerance tests as well as the use of hemoglobin A1c (HbA1c) are summarized. The increasing prevalence of diabetes requires targeted screening for detecting diabetes and prediabetes in risk groups. This forms the basis for the early initiation of measures to prevent the onset of diabetes in these risk groups and to delay the progression of diabetes.