Increased Blood Glucose Levels Research Articles

Ramadan Fasting Practice Trend in Muslim Patients with Diabetes: A Nationwide Survey in Bangladesh

ABSTRACT Background: Despite health concerns, practicing Muslims with diabetes around the world observe fast during this month. This study aimed to explore the pattern of fasting behavior and associated factors among Muslim diabetic patients during Ramadan in Bangladesh. Methods: A cross-sectional survey was carried out among Muslim adult (>18 years) patients with diabetes attending in the private chamber of endocrinologists registered with Bangladesh Endocrine Society in different parts of Dhaka city, the Capital of Bangladesh between January 2022 and March 2022. A short pretested structured interviewer-administered survey questionnaire was used. Data from a total of 5324 patients were analyzed using SPSS (version 26). Results: Of all, 92% of patients observed fast during Ramadan. The mean age of the patients was 52.30 ± 11.26 (standard deviation) years and more than half were aged between 41 and 60 years. Those who did not fast were significantly older (P = 0.005). Approximately 51% were male and no sex difference exists in relation to fasting. The median duration of disease was 7 (0–65) years and those with longer duration were less likely to fast (P = 0.001). Among the diabetic patients, 54.5% had comorbidities and proportionately lower number of comorbid patients fasted (P = 0.006). 20.2% and 19.5% of patients experienced reduced and increased blood glucose level, respectively. Those who experienced such events were less likely to fast (P < 0.001). More than three-quarter of patients (77.2%) underwent checkup before Ramadan and 71.8% consulted doctors to modify their prescribed medicines before fasting has started. Nearly one-quarter of patients (24.8%) incorrectly believed that pricking their finger would break the fast (P < 0.001). Approximately 68% of patients believed that fasting will help them to control blood sugar. Nearly three-fourth (73.9%) of the participants believed they can fast in all days in the coming Ramadan. Conclusions: This study observed that a significant portion of Muslim adults with diabetes mellitus in Bangladesh tend to fast during Ramadan. Factors such as age, disease duration, and comorbidities influence their fasting behavior, whereas many of them believe fasting aids in blood sugar control and consult healthcare professionals to adjust medications.

PM2.5 Exposure Induces Glomerular Hyperfiltration in Mice in a Gender-Dependent Manner

As one of the most common air pollutants, fine particulate matter (PM2.5) increases the risk of diseases in various systems, including the urinary system. In the present study, we exposed male and female C57BL/6J mice to PM2.5 for 8 weeks. Examination of renal function indices, including creatinine (CRE), blood urea nitrogen (BUN), uric acid (UA), and urinary microalbumin, indicated that the kidneys of female mice, not male mice, underwent early renal injury, exhibiting glomerular hyperfiltration. Meanwhile, pathological staining showed that the kidneys of female mice exhibited enlarged glomerulus that filled the entire Bowman’s capsule in the female mice. Afterward, we explored the potential causes and mechanisms of glomerular hyperfiltration. Variations in mRNA levels of key genes involved in the renin–angiotensin system (RAS) and kallikrein–kinin system (KKS) demonstrated that PM2.5 led to elevated glomerular capillary hydrostatic pressure in female mice by disturbing the balance between the RAS and KKS, which in turn increased the glomerular filtration rate (GFR). In addition, we found that PM2.5 increased blood glucose levels in the females, which enhanced tubular reabsorption of glucose, attenuated macular dense sensory signaling, induced renal hypoxia, and affected adenosine triphosphate (ATP) synthesis, thus attenuating tubuloglomerular feedback (TGF)-induced afferent arteriolar constriction and leading to glomerular hyperfiltration. In conclusion, this study indicated that PM2.5 induced glomerular hyperfiltration in female mice by affecting RAS/KKS imbalances, as well as the regulation of TGF; innovatively unveiled the association between PM2.5 subchronic exposure and early kidney injury and its gender dependence; enriched the toxicological evidence of PM2.5 and confirmed the importance of reducing ambient PM2.5 concentrations.

Effects of a Short-Term High-Fat Diet on Microbiota Biodiversity of the Small and Large Intestines of C57BL/6SPF Mice.

Long-term high-fat diet (HFD) promotes the formation of excess body weight and disorders of lipid metabolism and causes persistent dysbiotic changes in the intestinal microbial community. Changes in eating behavior, endocrine and immune functions of the host are associated with changes in the structure and functional activity of microbial communities. Short-term HFD may also influence the composition and function of the intestinal microbiota, but data on this issue are limited, and most papers are focused on the study of the large intestinal microbiota. The present study examined the effect of short-term HFD (4 weeks) on the structure of microbial communities in the small and large intestines of 24 mice. High-throughput metagenomic sequencing was performed on 48 samples of small and large intestine contents. It was revealed that short-term HFD in mice contributed to impaired glucose tolerance and increased the diversity of microbiota in the colon, but not of the small intestine, and also led to changes in the representation of certain microbial taxa (in particular Tenericutes and Verrucomicrobia). Furthermore, short-term HFD increased blood glucose levels compared to control mice (fed a normal diet), but did not affect lipid metabolism. The results will help to assess the contribution of environmental factors to the structure of microbial communities of the small and large intestines and may also be useful for correcting dysbiotic conditions, including when prescribing therapeutic diets (for example, a ketogenic diet).

Alpha-glucosidase inhibitory activity of Balakka (Phyllanthus emblica) bark and fruit

Abstract The increased blood glucose level as a consequence of insufficient insulin synthesis or ineffective insulin use is a degenerative disease known as diabetes mellitus. Prevention involves inhibiting the α-glucosidase enzyme, which hydrolyzes carbohydrates into glucose. The Balakka plant (Phyllanthus emblica Linn.), growing in South Tapanuli, potentially inhibits α-glucosidase due to its bioactive compounds. This study examined the sustainability of functional food potential by analyzing the inhibitory effect of Palakkad bark and fruit extracted using N-hexane and ethanol on the α-glucosidase enzyme. Ethanol and N-hexane were utilized for extraction, and the results were analyzed for α-glucosidase inhibitory activity and qualitative phytochemicals. Results showed that n-hexane extracts of Balakka bark and fruit were positive for steroids. Ethanol extracts of bark contained tannins and saponins, while fruit extracts contained flavonoids, tannins, and saponins. Ethanol extracts of bark and fruit demonstrated the best α-glucosidase enzyme inhibitory activity at 62.08 ± 1.05% and 64.48 ± 0.38% respectively, at 200 ppm. Thus, the Balakka plant, especially its bark and fruit, shows potential as an antihyperglycemic agent.

Host Genetics Background Affects Intestinal Cancer Development Associated with High-Fat Diet-Induced Obesity and Type 2 Diabetes.

Obesity and type 2 diabetes (T2D) promote inflammation, increasing the risk of colorectal cancer (CRC). High-fat diet (HFD)-induced obesity is key to these diseases through biological mechanisms. This study examined the impact of genetic background on the multimorbidity of intestinal cancer, T2D, and inflammation due to HFD-induced obesity. A cohort of 357 Collaborative Cross (CC) mice from 15 lines was fed either a control chow diet (CHD) or HFD for 12 weeks. Body weight was tracked biweekly, and blood glucose was assessed at weeks 6 and 12 via intraperitoneal glucose tolerance tests (IPGTT). At the study's endpoint, intestinal polyps were counted, and cytokine profiles were analyzed to evaluate the inflammatory response. HFD significantly increased blood glucose levels and body weight, with males showing higher susceptibility to T2D and obesity. Genetic variation across CC lines influenced glucose metabolism, body weight, and polyp development. Mice on HFD developed more intestinal polyps, with males showing higher counts than females. Cytokine analysis revealed diet-induced variations in pro-inflammatory markers like IL-6, IL-17A, and TNF-α, differing by genetic background and sex. Host genetics plays a crucial role in susceptibility to HFD-induced obesity, T2D, CRC, and inflammation. Genetic differences across CC lines contributed to variability in disease outcomes, providing insight into the genetic underpinnings of multimorbidity. This study supports gene-mapping efforts to develop personalized prevention and treatment strategies for these diseases.

Cardiac corin and atrial natriuretic peptide regulate liver glycogen metabolism and glucose homeostasis

BackgroundCardiovascular function and metabolic homeostasis are closely linked, but the underlying mechanisms are not fully understood. Corin is a protease that activates atrial natriuretic peptide (ANP), an essential hormone for normal blood pressure and cardiac function. The goal of this study is to investigate a potential corin and ANP function in regulating liver glycogen metabolism and glucose homeostasis.MethodsLiver glycogen and blood glucose levels were analyzed in Corin or Nppa (encoding ANP) knockout (KO) mice. ANP signaling was examined in livers from Corin and Nppa KO mice and in cultured human and mouse hepatocytes by western blotting.ResultsWe found that Corin and Nppa KO mice had reduced liver glycogen contents and increased blood glucose levels. By analyzing conditional KO mice lacking either cardiac or renal Corin, we showed that cardiac corin and ANP act in an endocrine manner to enhance cGMP-protein kinase G (PKG)-AKT-GSK3 signaling in hepatocytes. In cultured hepatocytes, ANP treatment stimulated PKG signaling, glucose uptake, and glycogen production, which could be blocked by small molecule PKG and AKT inhibitors.ConclusionsOur results indicate that corin and ANP are important regulators in liver glycogen metabolism and glucose homeostasis, suggesting that defects in the corin and ANP pathway may contribute to both cardiovascular and metabolic diseases.

The relationship of diabetes knowledge and self-care practices among patients with type 2 diabetes mellitus

Background: Diabetes Mellitus (DM) is a disease characterized by increased blood glucose levels and cannot be cured so it requires self-care. DM self-care is a program that must be carried out throughout the life of DM sufferers. DM self-care aims to optimize metabolic control, optimize quality of life, and prevent acute and chronic complications. Good knowledge and self-care consisting of good diet, physical exercise, medication, and education can control blood sugar levels and prevent complications of type 2 DM. Purpose: To determine the relationship between knowledge and self-care in patients with type 2 diabetes mellitus. Method: Descriptive correlational research design with a cross-sectional approach. The study population was patients with type 2 diabetes mellitus in the work area of ​​the Pasar Rebo District Health Center, East Jakarta, totaling 690 patients, carried out in November-December 2023. The sampling technique used the Accidental Sampling technique with the Slovin formula and a sample of 87 respondents was obtained. The research instrument used the Diabetes Knowledge Questionnaire (DKQ-24) for the knowledge questionnaire and the Summary of Diabetes Self Care Activity (SDSCA) for the self-care questionnaire. Data analysis used the univariate and bivariate Chi Square alternative tests. Results: Respondents with poor knowledge resulted in poor self-care of 30 respondents (53.6%), while respondents with good knowledge resulted in good self-care of 16 respondents (51.6%). The results of the Chi-Square test showed a significant p value of 0.001 (<0.05). Conclusion: There is a significant relationship between knowledge and self-care in type 2 DM patients with a p value of 0.001.

Antidiabetic, antihyperlipidemic effects and quantification of bioactive compounds by HPLC from Crassula ovata leaves extracts on streptozotocin induced diabetic Wistar rats

Background: Crassula ovata have been recommended in ethno medicines for the treatment of diabetes. In this research the scientific claim is studied and validated. Objective: Objective of the current study has been focused to assess the traditional use of Crassula ovata to heal diabetes, hyperlipidemia and to check the presence of constituents responsible for these actions. Methods: The approved plant's ethanol, acetone, and chloroform extracts were prepared by maceration. For in vivo activity, the model of streptozotocin induced diabetes mellitus in rats was chosen, wherein antidiabetic parameters such as body weight, urine volume, blood glucose level, and lipid profile parameters were evaluated. Quantification of bioactive compounds was done by a high-performance liquid chromatographic technique using diode-array detection. Results: The ethanolic extract noticeably depleted increased blood glucose levels and has positive effects on altered lipid profile after administering a dose of 200 mg/kg orally compared with oral hypoglycemic drug metformin. HPLC analysis of ethanolic extract identified several secondary metabolites in Crassula ovata, including Gallic acid, Rutin, Luteolin, Caffeic acid, Catechin, Kaempferol and Quercetin. These compounds have been reported for their potential antidiabetic effects. The analytical data on the chemical composition supported its traditional use in diabetes management. Conclusion: From the results, it can be concluded that, Crassula ovata ethanolic extract can be ideal for the treatment of diabetes and hyperlipidemia. Further studies are required to locate the active pharmaceutical ingredient for the said actions.

The Effect of Sociodemographic Characteristics on The Lifestyle Among Type 2 Diabetic Patients in Mosul City

Introduction: Diabetes Mellitus is a condition that causes persistently increased blood glucose levels in the body. It is the second leading cause of years spent disabled globally and is a major cause of death with high mortality rates. Objective: To identify the effect of sociodemographic characteristics on the lifestyle among type 2 diabetes mellitus in Mosul City. Methods and materials: A non-experimental cross-sectional study design was implemented on a total of 400 Type II Diabetic Patients who make periodic visits to Al-Wafaa Specialized Centre for Diabetes and Endocrinology by A non-probability sample. A developed interviewing questionnaire was used to collect information related to sociodemographic, and lifestyle was assessed by using HPLP-II, from October 15th, 2023, to June 1st, 2024. The collected data were compiled and analysed using percentages, mean, standard deviation, minimum, maximum, Spearman’s Correlation and Chi Square using SPSS version 26. P values of 0.05 were used as a cut-off point for the significance of the statistical test. Results: Majority of participants were female, reside in urban areas, married, unable to read and write, unemployed and never smoked (52.3%, 78.7%, 79.0%, 29.7%, 57.4%, and 44.2%) respectively. In addition to that, there was a significant correlation between the sociodemographic characteristics and lifestyle among the participants. The patients scored highest in the interpersonal relations and scored lowest in the physical activity factors. Finally, most of the patients practiced health-promoting lifestyle pattern moderately (63.5%). Conclusions: The study showed that, there is a significant correlation between lifestyle and sociodemographic characteristics of the study participants.

Implementasi Senam Kaki Untuk Menurunkan Kadar Gula Darah pada Penderita Diabetes Melitus Tipe 2 di Rumah Sakit Tentaratk Iv 01.07.01 Pematangsiantar

Diabetes is a chronic metabolic disease characterized by increased blood glucose levels, which over time causes serious damage to the heart, blood vessels, eyes, kidneys and nerves. The aim of this study is to describe nursing care in the application of foot exercises to reduce blood sugar levels in patients with type 2 diabetes mellitus. Diabetes is a chronic metabolic disease characterized by elevated blood glucose levels, which over time causes serious damage to the heart, blood vessels, eyes, kidneys and nerves. The aim of this study is to describe nursing care in the application of foot exercises to reduce blood sugar levels in patients with type 2 diabetes mellitus. leg exercises can reduce blood sugar levels. The application of foot exercises can reduce blood sugar levels in type 2 diabetes mellitus patients.

Various Approaches and Future Prospective for Therapies for Diabetes: A Review

The global prevalence of diabetes mellitus disease marked by increased blood glucose levels, has reached epidemic proportions. This review provides a comprehensive assessment of the current landscape of diabetes therapies and outlines future prospects for improving the management and treatment of this condition. The current scenario highlights a multifaceted approach to diabetes management, with a focus on lifestyle interventions, oral antidiabetic drugs, insulin therapy, and emerging technologies like continuous glucose monitoring and closed-loop systems. While these approaches have significantly improved the lives of people with diabetes, several challenges persist. These include medication adherence, hypoglycemia risk, and the financial burden of diabetes care. Innovative treatments that improve glucose regulation, improve cardiovascular health, and help patients lose weight—like SGLT-2 inhibitors and GLP-1 receptor agonists—have showed promise in treating these issues. The future prospects for diabetes therapies are exciting, with ongoing research into cell-based therapies, including pancreatic islet transplantation and stem cell-derived beta cells. Personalized medicine approaches, driven by genetics and artificial intelligence, hold the potential to optimize treatment regimens and predict individual responses to various therapies. Furthermore, advancements in telemedicine and digital health technologies will enhance patient self-management and remote monitoring.

Hypoglycemic and Antioxidant Activity of Ficus arnottiana Leaves: Insights into Diabetes Management and Oxidative Stress Mitigation.

Objective:To investigate the hypoglycaemic properties of a methanolic extract from Ficus arnottiana leaves in rodent models. Results: The findings revealed that F. arnottiana leaves key active components (psoralen), notably coumarins, attributing to its prowess in combating hyperglycemia. In addition, the study observed that methanolic extract displayed the highest activity, specifically at a dosage of 500 mg/kg. This was in comparison to the standard reference, glimepiride, which exhibited activity at a dosage of 5 mg/kg. This finding suggests a potentially enhanced or superior effect associated with the methanolic extract in the context of the study, Furthermore,the finding of the result showed that the application of methanolic extract at a concentration of 500 mg/kg resulted in a noteworthy mitigation of oxidative stress and increased blood glucose levels. This was demonstrated by a significant decrease in oxidative stress markers, fasting blood glucose levels, OGT, and tissue damage in the experimental model, the control group was compared. Conclusion: Methanolic extract of F. arnottiana exhibits efficacious hypoglycemic activity alongside ensured safety”.

Validation of a refined protocol for mouse oral glucose tolerance testing without gavage.

A glucose tolerance test (GTT) is routinely used to assess glucose homeostasis in clinical settings and in preclinical research studies using rodent models. The procedure assesses the ability of the body to clear glucose from the blood in a defined time after a bolus dose. In the human clinical setting, glucose is ingested via voluntary consumption of a glucose-sweetened drink. Typically, in the rodent GTT oral gavage (gavage-oGTT) or (more commonly) intraperitoneal injection (IPGTT) are used to administer the glucose bolus. Although used less frequently, likely due to investigator technical and experience barriers, the former is the more physiologically relevant as it integrates the gastrointestinal tract (GI), including release of key incretin hormones. However, orally gavaging glucose in the GTT is also not without its limitations: gavaging glucose straight into the stomach bypasses potentially critical early glucose-sensing via the mouth (cephalic phase) and associated physiological responses. Furthermore, gavaging is stressful on mice, and this by itself can increase blood glucose levels. We have developed and validated a refined protocol for mouse oral GTT which uses a voluntary oral glucose dosing method, micropipette-guided drug administration (MDA), without the need for water deprivation. This approach is simple and non-invasive. It is less stressful for the mice, as evidenced by lower circulating corticosterone levels 10 minutes after glucose-dosing compared to oral gavage. This is significant for animal and investigator welfare, and importantly minimising the confounding effect of stress on mouse glucose homeostasis. Using a randomised cross-over design, we have validated the MDA approach in the oGTT against oral gavage in male and female C57BL/6J and C57BL/6N mice. We show the ability of this method to detect changes in glucose tolerance in diet-induced obese animals. Compared to oral gavage there was lower inter-animal variation in the MDA-oGTT. In addition to being more representative of the human procedure, the MDA-oGTT is easy and has lower barriers to adoption than the gavage oGTT as it is non-invasive and requires no specialist equipment or operator training. The MDA-oGTT a more clinically representative, accessible, and refined replacement for the gavage-oGTT for mouse metabolic phenotyping, which is simple yet overcomes significant deficiencies in the current standard experimental approaches.

Synbiotic supplementation ameliorates anxiety and myocardial ischaemia-reperfusion injury in hyperglycaemic rats by modulating gut microbiota.

Hyperglycaemia, hyperlipidaemia, hypertension and obesity are the main risk factors affecting the development and prognosis of ischaemic heart disease, which is still an important cause of death today. In our study, male Sprague-Dawley rats were fed either a standard diet (SD) or a high fat and high carbohydrate diet (HF-HCD) for 8weeks and streptozotocin (STZ) was injected at the seventh week of the feeding period. In one set of rats, a mixture of a prebiotic and probiotics (synbiotic, SYN) was administered by gavage starting from the beginning of the feeding period. Experimental myocardial ischaemia-reperfusion (30min/60min) was induced at the end of 8weeks. Hyperglycaemia, hypertension and increased serum low-density lipoprotein levels occurred in SD- and HF-HCD-fed and STZ-treated rats followed for 8weeks. Increased density of the Proteobacteria phylum was observed in rats with increased blood glucose levels, indicating intestinal dysbiosis. The severity of cardiac damage was highest in the dysbiotic HF-HCD-fed hyperglycaemic rats, which was evident with increased serum creatine kinase-MB (CK-MB), cardiac troponin I (cTnI), tumour necrosis factor-α, and interleukin-6 levels, along with a decrease in ST-segment resolution index. SYN supplementation to either a normal or a high-fat high-carbohydrate diet improved gut dysbiosis, reduced anxiety, decreased CK-MB and cTnI levels, and alleviated myocardial ischaemia-reperfusion injury in hyperglycaemic rats.

Early senescence of pancreatic β cells induced by unfolded protein response deficiency prevents type 1 diabetes.

Type 1 diabetes (T1D) is a T lymphocyte-mediated autoimmune disease caused by pancreatic β‍-cell destruction, which eventually leads to reduced insulin level and increased blood glucose level (Syed, 2022). As a multifactorial disease, T1D is characterized by a genetic predisposition associated with various environmental and cellular elements (Syed, 2022). Pancreatic β cells have long been considered the "innocent victims" in T1D pathogenesis since the pancreas is attacked by the immune cells, resulting in a process known as insulitis, in which the immune cells infiltrate pancreatic islets and secrete pro-inflammatory cytokines. However, growing evidence suggests that various β‍-cell stresses, dysfunction, and death contribute to T1D pathogenesis, as it has been observed that β‍-cell dysfunction in autoantibody-positive (Aab+) individuals exists long before T1D diagnosis (Evans-Molina et al., 2018).

Study of risk factors for insulin resistance in women with a burdened metabolic history

Insulin Resistance (IR) is a state of insufficient biological response of the body's cells to insulin, which leads to further disruption of carbohydrate metabolism and increased blood glucose levels. Early detection of IR risk factors improves the prognosis and prevention of severe metabolic syndrome, preservation and restoration of women's reproductive potential, and becomes the foundation for the health of the future generation. Aim of the study was the influence of potential risk factors on the development of latent IR manifestations 82 women of early reproductive age who signed an informed consent for the study were examined. A specially designed questionnaire was used for the study, and anthropometric parameters and laboratory data (including insulin, glucose tolerance test), and calculation of indices (HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) and Matsuda). According to the results of the study, in accordance with the indicators of Relative Risk (RR) and Odds Ratio (OR), we consider the following potential factors to be developmental bad habits (tobacco smoking regardless of the amount, regular alcohol abuse) (RR=1.299; p=0.00321), burdened hereditary history of cardiovascular diseases (essential hypertension, heart attacks and strokes) (RR=1.313; p=0.0041), type I and type II diabetes mellitus (RR=1.340; p=0.0038), obesity (RR=1.641; p=0.0043), thyroid diseases (hypothyroidism, hyperthyroidism, hyperparathyroidism) (RR=1.565; RR=1.565; p=0.00284) and adrenal (Itzen-Cushing's syndrome, adrenal cortex insufficiency) (RR=1.348; p=0.0025). The manifestations of IR should be skin rashes (OR=3.542; p=0.0033) and unwanted hair growth (OR=3.670; p=0.0029). Keywords: overweight, obesity, metabolic syndrome, vaginal microbiome, ovulation, infertility.

Walking away from depression: the mediating role of walking activity in depression impacting blood glucose levels of people with diabetes or prediabetes.

Depression can exacerbate diabetes by impairing self-care behaviors and increasing the risk of complication; however, the underlying mechanism is still unclear. Given the suggested associations between walking activity, depression status, and blood glucose levels this study explores the intricate relationship between depression and blood glucose (BG) control, with a focus on walking activity as a behavioral mediator. The purpose of this study is to examine walking activity's mediating role in depression's impact on BG levels, investigating and validating the non-linear association between BG levels and walking activity. This retrospective real-world study demonstrates the potential of regular walking activity as a simple and accessible intervention to mitigate the negative effects of depression on BG levels in T2D and prediabetes. A cohort of 989 users with T2D and prediabetes, who regularly tracked their steps levels and BG levels for 12 months using the Dario digital health platform was evaluated. The mediating role of the monthly average number of steps on the relationship between the self-reported depression status and lagged monthly average BG was assessed. Additionally, the association between monthly walking activity and monthly average BG was tested using a piecewise linear mixed effects model. Users with self-reported depression demonstrated increased BG levels compared to users without depression (B=8.00, P=.01). The association between depression and monthly average number of steps was significant (B=-.27, P<.005) and monthly average number of steps significantly predicted the following months' average BG (B=-.81, P=.001), adjusting for depression. The monthly average number of steps significantly mediated the effect of self-reported depression on the following month's average BG (M=.22, P<.005). Further sensitivity analysis demonstrated model robustness over various periods. Finally, non-linear dynamics of walking activity over time was validated using unseen data showing a decrease in monthly average BG for users with over an average of 400 steps per day (B=-1.87, P<.01). This study shows how regular walking may reduce the negative impact of depression on BG levels in people with T2D. Our findings advocate for the integration of walking activity into treatment protocols as a cost-effective, accessible intervention strategy to improve glycemic management and depressive symptoms in this population.

The effect of the fat to starch ratio in young horses' diet on plasma metabolites, muscle endurance and fear responses.

High-starch diets may affect equine hindgut microbiota and increase blood glucose levels, which may cause unwanted physiological changes, but may also elicit behavioural changes such as increased fear reactions. The purpose of the current study was to feed a high starch (300) and low fat (43; HS_LF) or a low starch (60) and high fat (85; LS_HF, g/kg of DM) concentrate within the available commercial range and investigate how muscle endurance and fear reactions of horses respond to different diets. Twenty Danish Warmblood stallions (4 years) were randomly allocated to two treatments: LS_HF (n = 10) and HS_LF (n = 10) for 9 weeks. During the two last weeks, a single step exercise test was performed, and plasma metabolites and blood gases were measured before and after exercise in a 2 × 2 factorial design. The effect of two diets on fearfulness was tested by exposing the horses to novel objects test (T1 and T2). Plasma metabolites was not affected by diets. However, plasma level of glucose post-exercise (4.9) was lower than pre-exercise (5.6 mmol/L; p < 0.001). Similarly, plasma level of insulin post-exercise (4.2) was lower than pre-exercise (13.1 pmol/L; p < 0.001). Plasma level of lactate dehydrogenase (p < 0.001), non-esterified fatty acids (p = 0.002), β-hydroxybutyrate (p = 0.001), and fructosamine (p = 0.01) post-exercise was higher than pre-exercise. Regardless of type of diets, RRR-α-tocopherol was the dominance α-tocopherol stereoisomers in plasma. In conclusion, during aerobic exercise, fat to starch ratio in horse diets within the normal range had no significant effect on plasma metabolites. However, horses fed LS_HF tended to show more investigative behaviour than horses fed HS_LF.

Impact of Intraoperative Dexamethasone on Perioperative Blood Glucose Levels: Systematic Review and Meta-Analysis of Randomized Trials.

Dexamethasone is associated with increased blood glucose levels that could impact patient outcomes or management. This study aimed to synthesize the available evidence regarding the impact of an intraoperative single dose of dexamethasone on blood glucose levels. We searched CENTRAL, MEDLINE, and clinicaltrials.gov for randomized controlled trials (RCTs) comparing a single intraoperative dose of dexamethasone to control in adult patients who underwent noncardiac surgery. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the review was registered in PROSPERO (CRD42023420562). Data were pooled using a random-effects model. We reported pooled dichotomous data using odds ratios (OR) and continuous data using the mean difference (MD), reporting 95% confidence intervals (95% CIs), and corresponding P-values for both. Confidence in the evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. As primary outcomes we assessed maximum blood glucose levels measurement and variation from baseline within 24 hours of surgery; blood glucose levels measurement and variation from baseline at 2, 4, 8, 12, and 24 hours after dexamethasone administration. As secondary outcomes, we evaluated insulin requirements and hyperglycemic events. We included 23 RCTs, enrolling 11,154 participants overall. Dexamethasone was associated with a significant increment in blood glucose levels compared to control at all timepoints. The results showed an increase compared to control of 0.37 mmol L-1 (6.7 mg dL-1) at 2 hours (95% CI, 0.16-0.58 mmol L-1 or 2.9-10.5 mg dL-1), 0.97 mmol L-1 (17.5 mg dL-1) at 4 hours (95% CI, 0.67-1.25 mmol L-1 or 12.1-22.5 mg dL-1), 0.96 mmol L-1 (17.3 mg dL-1) at 8 hours (95% CI, 0.55-1.36 mmol L-1 or 9.9-24.5 mg dL-1), 0.90 mmol L-1 (16.2 mg dL-1) at 12 hours (95% CI, 0.62-1.19 mmol L-1 or 11.2-21.4 mg dL-1) and 0.59 mmol L-1 (10.6 mg dL-1) at 24 hours (95% CI, 0.22-0.96 mmol L-1 or 4.0-17.3 mg dL-1). No difference was found between subgroups regarding diabetic status (patients with diabetes versus patients without diabetes) in all the outcomes except 2 (maximum blood glucose levels variation within 24 hours and variation at 4 hours) and dexamethasone dose (4-5 mg vs 8-10 mg) in all the outcomes except 2 (blood glucose levels at 24 hours and hyperglycemic events). Mean blood glucose levels rise between 0.37 and 1.63 mmol L-1 (6.7 and 29.4 mg dL-1) within 24 hours after a single dose of dexamethasone administered at induction of anesthesia compared to control, but in most patients this difference will not be clinically relevant.

Relationship Between Artificial Sweeteners Intake With Diabetes in Experimental Rats

The artificial sweeteners have been used in many food industries and young and adults' ones accept the taste of very sweet taste and low calories compared to natural sweeteners and became marketed on the basis that it is possible to control and reduce diabetes and the effects of these artificial sweeteners, But the manufacturers are unaware of the side effects that may be caused in the long term. Methods: The current research was carried out to know the effect of artificial sweeteners on low blood sugar in experimental rats. For this purpose, rats were divided to three groups with adding different artificial sweeteners (Aspartame, sucralose, saccharine) at the same dose level (10 gm/kg fed basal); the control group of rats was fed a basal diet without any sweeteners for 8 weeks. Results: The feeding of rats on sucralose and aspartame led to a high significant with statistically significant increase in the level of Blood glucose (125±7 mg/dL, 123±10 mg/dL) compared to the control group, while the saccharin group was not affected by the blood glucose level after the 8 weeks study period. Conclusion: It was concluded that artificial sweeteners had an effect on increasing blood glucose levels in male rats, and therefore they could not be included in the diets, especially for diabetic patients.