Glycemic Levels Research Articles

Revealing the Hidden Impacts: Insights into Biological Aging and Long-Term Effects in Pauci- and Asymptomatic COVID-19 Healthcare Workers.

This study explores the role of inflammation and oxidative stress, hallmarks of COVID-19, in accelerating cellular biological aging. We investigated early molecular markers-DNA methylation age (DNAmAge) and telomere length (TL)-in blood leukocytes, nasal cells (NCs), and induced sputum (IS) one year post-infection in pauci- and asymptomatic healthcare workers (HCWs) infected during the first pandemic wave (February-May 2020), compared to COPD patients, model for "aged lung". Data from questionnaires, Work Ability Index (WAI), blood analyses, autonomic cardiac balance assessments, heart rate variability (HRV), and pulmonary function tests were collected. Elevated leukocyte DNAmAge significantly correlated with advancing age, male sex, daytime work, and an aged phenotype characterized by chronic diseases, elevated LDL and glycemia levels, medications affecting HRV, and declines in lung function, WAI, lymphocyte count, hemoglobin levels, and HRV (p < 0.05). Increasing age, LDL levels, job positions involving intensive patient contact, and higher leukocyte counts collectively contributed to shortened leukocyte TL (p < 0.05). Notably, HCWs exhibited accelerated biological aging in IS cells compared to both blood leukocytes (p ≤ 0.05) and NCs (p < 0.001) and were biologically older than COPD patients (p < 0.05). These findings suggest the need to monitor aging in pauci- and asymptomatic COVID-19 survivors, who represent the majority of the general population.

The impact of glucagon-like peptide-1 receptor agonists in the patients undergoing anesthesia or sedation: systematic review and meta-analysis

BackgroundGlucagon-like peptide-1 agonist receptors (GLP-1RAs), medications used for glycemic control and weight loss, are increasing worldwide. In the perioperative period, the major concern related to GLP-1RA is gastric emptying delay and risk of aspiration. This meta-analysis and systematic review compared the risks and benefits of using GLP-1 agonist receptors and control in surgical and nonsurgical procedures under anesthesia or sedation.MethodsWe systematically searched MEDLINE, Embase, and Cochrane for randomized controlled trials and observational studies involving patients > 18 years undergoing elective surgeries or procedures. Outcomes of interest were pre-procedural gastrointestinal (GI) symptoms, residual gastric content assessed by endoscopy, pulmonary aspiration during anesthesia/sedation, perioperative glycemic control, postoperative inotropic support, nausea/vomiting (PONV), atrial fibrillation, and 30-day mortality rate. We used a random effects model, with odds ratio and mean difference computed for binary and continuous outcomes, respectively.ResultsFourteen randomized and observational studies with 2143 adult patients undergoing elective surgeries and procedures were included. GLP-1RA resulted in increased pre-procedural GI symptoms (OR 7.66; 95% CI 3.42, 17.17; p < 0.00001; I2 = 0%) and elevated residual gastric content (OR 6.08; 95% CI 2.86, 12.94; p < 0.00001; I2 = 0%). GLP-1RA resulted in lower glycemic levels (MD − 0.73; 95% CI − 1.13, − 0.33; p = 0.0003; I2 = 90%) and lower rate of rescue insulin administration (OR 0.39; 95% CI 0.23, 0.68 p = 0.0009; I2 = 35%). There was no significant difference in rate of perioperative hypoglycemia (OR 0.60; 95% CI 0.29, 1.24; p = 0.17; I2 = 0%), hyperglycemia (OR 0.89; 95% CI 0.59, 1.34; p = 0.58; I2 = 38%), need for postoperative inotropic support (OR 0.57; 95% CI 0.33, 1.01; p = 0.05; I2 = 0%), atrial fibrillation (OR 1.02; 95% CI 0.52, 2.01; p = 0.95; I2 = 16%), rate of PONV (OR 1.35; 95% CI 0.82, 2.21; p = 0.24; I2 = 0%), and 30-day mortality rate (OR 0.54; 95% CI 0.14, 2.05; p = 0.25; I2 = 0%).ConclusionCompared to control, pre-procedural GLP-1RA increased the rate of GI symptoms and the risk of elevated residual gastric content despite adherence to fasting guidelines. GLP-1RA improved glycemic control and decreased the rate of rescue insulin administration. There was no significant difference in the rates of perioperative hypo or hyperglycemia, postoperative inotropic support, PONV, atrial fibrillation, and 30-day mortality.

Reg2 treatment is protective but the induced Reg2 autoantibody is destructive to the islets in NOD mice

Regenerating family protein 2 (Reg2) is a trophic factor which stimulates β-cell replication and resists islet destruction. However, Reg2 also serves as an islet autoantigen, which makes it complicated to judge the effectiveness in treating diabetes. How Reg2 treatment behaves in non-obese diabetic (NOD) mice is to be investigated. NOD mice were treated with recombinant Reg2 protein, Complete Freund’s adjuvant (CFA) + PBS and CFA+Reg2 vaccinations, CFA+PBS- and CFA+Reg2-immunized antisera, and single chain variable fragment (scFv)-Reg2 and mIgG2a-Reg2 antibodies. Glycemic level, bodyweight, serum Reg2 antibody titer, glucose tolerance, and insulin secretion were determined. Islet morphological characteristics, insulitis, cell apoptosis, islet cell components, and T cell infiltration were analyzed by histological examinations. The autoantigenicity of constructed Reg2C and Reg2X fragments was determined in healthy BALB/c mice, and the bioactivity in stimulating cell proliferation and survival was assessed in insulinoma MIN6 cells. Reg2 administration alleviated diabetes in NOD mice with improved glucose tolerance and insulin secretion but elevated serum Reg2 autoantibodies. Histomorphometry showed reduced inflammatory area, TUNEL signal and CD8 + T cell infiltration, and increased β-cell proportion in support of the islet-protective effect of Reg2 treatment. CFA+PBS and CFA+Reg2 immunizations prevented diabetic onset and alleviated insulitis while injections of the antisera offered mild protections. Antibody treatments accelerated diabetic onset without increasing the overall incidence. Reg2C fragment depletes antigenicity, but reserves protective activity in streptozotocin (STZ)-treated MIN6 cells. In conclusion, Reg2 treatment alleviates type 1 diabetes (T1D) by preserving islet β-cells, but induces Reg2 autoantibody production which poses a potential risk of accelerating diabetic progression.

The Physiological Association Between Mean Platelet Volume and Diabetes Mellitus Type 2: Correlation Between HbA1c Score and MPV Index

Objective: To evaluate difference in mean platelet volume between non-diabetics and diabetics individual and to find the relationship between Hba1c level and MPV among type 2 diabetic individuals. Methodology: This was a retrospective study conducted from December 2022 to November 2023 in Muhammad Medical College and Hospital with prior approval from ethical committee via letter No: Physiol dated 10-03-20. By random sampling 370 participants were selected in which 214 were diabetics and 156 were non-diabetics. Their blood pressure, BMI, Hba1c level, fasting and post prandial glucose level was measured. For evaluation of complete blood picture and MPV an automatic (Beckman coulter) machine was used. Statistical analysis was done by Graph Pad Prism 9. Results: it was noted that both male and female show significant association between raised MPV and increased serum glycemic level (P value less than 0.05). In male MPV increased in 21.89% patients (x2 =33.96, df=3 and P value= 0.0001). In female MPV increased in 17.29% patients (Odd ratio3.07 and P value= 0.0006). Conclusion: Mean platelet volume in diabetics was found to be higher as compared to non-diabetic subjects. In diabetic patients with Hba1c less than 6.5% had less raised MPV as compare to diabetics with Hba1c level greater than 6.5%.

Association between glycemia and multi-vessel lesion in participants undergoing coronary angiography: a cross-sectional study.

This study aims to elucidate the association between glycemia and the occurrence of multi-vessel lesions in participants undergoing coronary angiography. We analyzed 2,533 patients with coronary artery disease who underwent coronary angiography. Of these, 1,973 patients, identified by the endpoint of multi-vessel lesions, were examined using univariate and multivariate logistic regression analyses to determine the relationship between glycemia levels and multi-vessel lesion occurrence. The analysis included 1,973 participants, among whom 474 patients were identified with coronary multi-vessel lesions. Univariate logistic regression analysis demonstrated a positive correlation between glycemia and the occurrence of coronary multi-vessel lesions (OR 1.04; 95% CI 1.01-1.08; p = 0.02). The adjusted model indicated that for each unit increase in glycemia, the risk of developing coronary multi-vessel lesions increased by 4%, showing a significant correlation (p < 0.05). Subgroup analyses revealed that the impact of glycemia on multi-vessel lesions in patients with PCI varied according to gender, age, and smoking status, with the effect being more pronounced in men, older patients, and smokers. Our findings establish a significant association between glycemia and the incidence of multi-vessel lesions, particularly pronounced in male patients, individuals over 45, and smokers.

Grape Seed Proanthocyanidin Extract Attenuates Cafeteria-Diet-Induced Liver Metabolic Disturbances in Rats: Influence of Photoperiod.

This study investigated the influence of photoperiod (day length) on the efficacy of grape seed proanthocyanidin extract (GSPE) in mitigating metabolic disorders in obese rats fed a cafeteria diet. Rats were exposed to standard (L12), long (L18), or short (L6) photoperiods and treated with GSPE or vehicle. In the standard photoperiod, GSPE reduced body weight gain (50.5%), total cholesterol (37%), and triglycerides (34.8%), while increasing the expression of hepatic metabolic genes. In the long photoperiod, GSPE tended to decrease body weight gain, increased testosterone levels (68.3%), decreased liver weight (12.4%), and decreased reverse serum amino acids. In the short photoperiod, GSPE reduced glycemia (~10%) and lowered triglyceride levels (38.5%), with effects modified by diet. The standard photoperiod showed the greatest efficacy against metabolic syndrome-associated diseases. The study showed how day length affects GSPE's benefits and underscores considering biological rhythms in metabolic disease therapies.

Diabetic Heart Disease: An Intricate Interplay of a Widespread Metabolic Disorder with the Cardiovascular System.

Diabetes is a chronic medical condition that causes high glycaemic levels, leading to damage to vital organs over time. It is a common disease worldwide, affecting around 422 million individuals living in middle- and low-income countries, which make up most of the population. Unfortunately, diabetes results in 1.5 million deaths annually. Diabetic patients are at a higher risk for developing cardiovascular conditions. Diabetic heart disease constitutes multiple genres, including diabetic cardiomyopathy, coronary artery disease, and heart failure. Hypoglycaemic agents aim to prevent these metabolic issues however some of these are cardiotoxic in nature. In contrast, other hypoglycaemic agents work beyond controlling glycaemic levels with their cardioprotective properties. Given that there is an alarming increase in diabetic heart disease cases universally, we have attempted to review the existing data on the topic and the effects of hypoglycaemic drugs on heart diseases.

Oral Anti-Diabetic Semaglutide: A GLP-1 RA Peptide

T2DM has emerged as a global disorder. Although there are many treatment options available for T2DM patients, still several patients complaint about inadequate blood sugar levels. Diabetes management is not limited to just lowering of blood glucose level, it needs a multifactorial approach in treatment. Glucagon- like peptide-1 receptor agonists (GLP-1RA) are a new category of T2DM drugs that acts on various targets such as body weight reduction, renal and cardiovascular benefits. Despite of being so beneficial the major drawback of semaglutide has been its subcutaneous route of administration. Majority of the patients are unable to continue semaglutide for long because of their reluctance towards daily injectable. To avoid this oral semaglutide is introduced. Oral semaglutide is a GLP- 1RA which is displays high glycaemic control. However, in order to increase its bioavailability, it needs to be co formulated with sodium N-(8-[2-hydroxybenzyol] amino) caprylate (SNAC). Oral semaglutide has gone through a very intense series of clinical trials known as, Peptide Innovation for Early Diabetes Treatment (PIONEER). These trials have established benefits of oral semaglutide regarding reduction in glycaemic levels and body weight. It is deemed to be fit for regular consumption. In this review we discuss many aspects of oral semaglutide such as, its chemical structure, route of administration, challenges associated with the oral form of semaglutide, dosage, mechanism of oral bioavailability, robust indications, its placement in the line of defence, drug- drug interaction, various clinical trials (Phase trials and PIONEER studies) including their results. It also summarizes the benefits of oral semaglutide beyond glycaemic control and some future scope of research in the field.

Robust two-degree-of-freedom control: A simulation-based approach for adults population with T1D

Diabetes Mellitus (DM) is emerging as a global concern, affecting people from early ages to adulthood and positioning itself as one of the leading causes of mortality worldwide. The post-COVID-19 era has been characterized by notable progress in the domains of medicine, science, and engineering, creating a favorable atmosphere for the investigation of innovative solutions. The present manuscript aims to investigate the problem of glucose regulation in adults diagnosed with Type 1 Diabetes mellitus (T1D) using a two-degree-of-freedom robust controller technique. A physiological mathematical model involving individuals with T1D serves as the foundation for the proposed closed-loop technique. The control algorithm approach successfully maintains safe glycemic levels in a virtual population of 10 adults using a sophisticated, well-known physiological T1D simulator. We evaluated this with continuous 24-hour simulations. Simulation results support the practicality of the presented approach, and we further validate it using a statistical analysis that incorporates a probability density function and control variability grid analysis (CVGA). Despite being a theoretical and simulation-based methodology, the results of this study demonstrate promise, offering promising opportunities for developments in the field of artificial pancreas technology using Mexican technology.

Neonatal dysglycemia: a review of dysglycemia in relation to brain health and neurodevelopmental outcomes.

Neonatal dysglycemia has been a longstanding interest of research in neonatology. Adverse outcomes from hypoglycemia were recognized early but are still being characterized. Premature infants additionally introduced and led the reflection on the importance of neonatal hyperglycemia. Cohorts of infants following neonatal encephalopathy provided further information about the impacts of hypoglycemia and, more recently, highlighted hyperglycemia as a central concern for this population. Innovative studies exposed the challenges of management of neonatal glycemic levels with a "u-shape" relationship between dysglycemia and adverse neurological outcomes. Lately, glycemic lability has been recognized as a key factor in adverse neurodevelopmental outcomes. Research and new technologies, such as MRI and continuous glucose monitoring, offered novel insight into neonatal dysglycemia. Combining clinical, physiological, and epidemiological data allowed the foundation of safe operational definitions, including initiation of treatment, to delineate neonatal hypoglycemia as ≤47 mg/dL, and >150-180 mg/dL for neonatal hyperglycemia. However, questions remain about the appropriate management of neonatal dysglycemia to optimize neurodevelopmental outcomes. Research collaborations and clinical trials with long-term follow-up and advanced use of evolving technologies will be necessary to continue to progress the fascinating world of neonatal dysglycemia and neurodevelopment outcomes. IMPACT STATEMENT: Safe operational definitions guide the initiation of treatment of neonatal hypoglycemia and hyperglycemia. Innovative studies exposed the challenges of neonatal glycemia management with a "u-shaped" relationship between dysglycemia and adverse neurological outcomes. The importance of glycemic lability is also being recognized. However, questions remain about the optimal management of neonatal dysglycemia to optimize neurodevelopmental outcomes. Research collaborations and clinical trials with long-term follow-up and advanced use of evolving technologies will be necessary to progress the fascinating world of neonatal dysglycemia and neurodevelopment outcomes.

Diabetes current and future translatable therapies.

Diabetes is one of the major diseases and concerns of public health systems that affects over 200 million patients worldwide. It is estimated that 90% of these patients suffer from diabetes type 2, while 10% present diabetes type 1. This type of diabetes and certain types of diabetes type 2, are characterized by dysregulation of blood glycemic levels due to the total or partial depletion of insulin-secreting pancreatic β-cells. Different approaches have been proposed for long-term treatment of insulin-dependent patients; amongst them, cell-based approaches have been the subject of basic and clinical research since they allow blood glucose level sensing and in situ insulin secretion. The current gold standard for insulin-dependent patients is on-demand exogenous insulin application; cell-based therapies aim to remove this burden from the patient and caregivers. In recent years, protocols to isolate and implant pancreatic islets from diseased donors have been developed and tested in clinical trials. Nevertheless, the shortage of donors, along with the need of immunosuppressive companion therapies, have pushed researchers to focus their attention and efforts to overcome these disadvantages and develop alternative strategies. This review discusses current tested clinical approaches and future potential alternatives for diabetes type 1, and some diabetes type 2, insulin-dependent patients. Additionally, advantages and disadvantages of these discussed methods.

Effects of preduodenal ileal surgical transposition on enteroendocrine intestinal cells in wistar rats: Histomorphological and serum changes.

In our study, we focused on the role of the distal ileum as a main endocrine actor in relation to the pancreas. We investigated the effects of intestinally released hormones on the pancreas in terms of type 2 diabetes mellitus (T2DM) improvement, as a main effect of bariatric surgeries. To specifically study the importance of the ileum, we used an experimental surgical model performed in healthy Wistar rats. After preduodenal transposition of the ileum, we analyzed the histology and enterohormonal cells of the intestine. We measured the plasma level of several hormones and effectors in this enteropancreatic axis. We used a surgical control (Sham) group and a surgical group, where ileum preduodenal transposition (PDIT) was performed. We measured basal glycemia and serum levels of several incretins, including GLP-1, PYY, and GIP, and we performed a glucose overdose test. After two test periods, the basal glycemia and glucose overdose results were not different between groups, however, the PDIT group had significantly increased expression of GLP-1, with increased cellular release in the ileum and duodenum compared with the Sham group. Both plasma GIP levels and GIP tissue expression were decreased in the PDIT group compared with the sham group. There were no differences in PPY hormone levels. The ileum crypts and villi of the PDIT group showed improvement in histological parameters. We concluded that model animals had an altered transposed ileum related to the enterohormonal adaptation of the ileum. Our results indicated that the ileum is important in the hormonal control of the enteropancreatic axis.

Assessment of myocardial microvascular dysfunction in patients with different stages of diabetes mellitus: An adenosine stress perfusion cardiac magnetic resonance study

PurposeTo examine myocardial perfusion and T1 mapping indicesin individuals with type 2 diabetes mellitus (T2DM) at various stages of glycemic control and whether uncontrolled glycemic levels would worsen myocardial microvascular function. MethodCardiac magnetic resonance examinations were performed on 114 T2DM patients without obstructive coronary artery disease and 55 matched controls. Participants were further divided into four subgroups: Q1 (control); Q2 (prediabetes); Q3 (controlled T2DM) and Q4 (uncontrolled T2DM). The correlation between glycosylated hemoglobin (HbA1c) levels and myocardial perfusion parameters was evaluated. ResultsGlobal myocardial perfusion reserve index (MPRI) was significantly reduced in the Q3 and Q4 subgroups compared to the Q1 or Q2 subgroup (all P<0.001). Compared with the Q1 subgroup, global stress T1 reactivity (stress ΔT1) was significantly reduced in the Q3 and Q4 subgroups (P=0.004 and < 0.001, respectively), but elevated in the Q2 subgroup (P=0.018). Global extracellular volume (ECV) was considerably higher in the Q2 subgroup and gradually rose in the Q3 and Q4 subgroups compared to the Q1 subgroup (P=0.011, 0.001, and 0.007, respectively). HbA1c levels correlated negatively with global MPRI and stress ΔT1, but positively with global ECV (β = -1.993, P<0.001; β = -0.180, P<0.001; and β = 0.127, P<0.001, respectively). ConclusionsGlobal stress ΔT1 reduced in T2DM patients but rose in prediabetes patients. Compared to MPRI, the ECV parameter can indicate diabetes-induced coronary microvascular dysfunction earlier and persists throughout the disorder. Myocardial perfusion and T1 mapping at stress can be used to detect early signs of microvascular dysfunction and subclinical risk factors in patients with T2DM.

Physical exercise as a key element in the behavioral treatment of type 2 diabetes - the extent to which patients follow recommendations

Introduction and purpose Diabetes is a set of metabolic disorders whose common, characteristic feature is the occurrence of hyperglycemia. Elevated glycemia levels result from impaired insulin secretion and/or defects in its action. In type 2 diabetes, we have modified risk factors such as improper diet, reduced physical activity, and obesity. In the context of these reversible factors, intervention in patients' lifestyle, with particular emphasis on physical activity, seems advisable. To investigate the implementation of recommendations for the treatment of type 2 diabetes, relating to physical activity as a component of behavioral treatment of diabetes. Materials and methods. Author's survey covering patients' knowledge about their disease, needs and expectations regarding education. The questionnaire examines the physical activity of patients newly diagnosed and already treated for type 2 diabetes. Results. The most frequently undertaken exercise was of medium intensity in the form of walking or "Nordic walking". This was also more likely to be intensified. Patients choosing this type of activity practiced it much more often and more regularly than other types of activity. Running and cycling were other activities undertaken by the patients, although in the younger group of patients. Patients who enjoyed physical exercise were more likely and willing to do it and it was more regular. Conclusions. Patients were reluctant to undertake physical exercise and usually did not treat it as an integral part of treatment. Usually, it was not a very intense effort. They also rarely intensified it when the diagnosis was made. Most of the respondents did not understand the role of exercise in the treatment process and its impact on sugar levels.

The added value of an AI-based body composition analysis in a lung cancer screening population: preliminary results

Background and aimsBody composition has been linked with clinical and prognostic outcomes in patients with cancer and cardiovascular diseases. Body composition analysis in lung cancer screening (LCS) is very limited. This study aimed at assessing the association of subcutaneous fat volume (SFV) and subcutaneous fat density (SFD), measured on chest ultra-low dose computed tomography (ultra-LDCT) images by a fully automated artificial intelligence (AI)-based software, with clinical and anthropometric characteristics in a LCS population. Methods and resultsDemographic, clinical, and dietary data were obtained from the written questionnaire completed by each participant at the first visit, when anthropometric measurements, blood sample collection and chest ultra-LDCT were performed. Images were analyzed for automated 3D segmentation of subcutaneous fat and muscle.The analysis included 938 volunteers (372 females); men with a smoking history of ≥40 pack-years had higher SFV (p = 0.0009), while former smokers had lower SFD (p = 0.0019). In female participants, SFV and SFD differed significantly according to age. SFV increased with rising BMI, waist circumference, waist-hip ratio, and CRP levels ≥2 mg/L (p < 0.0001), whereas SFD decreased with rising BMI, waist circumference, waist-hip ratio, and CRP levels ≥2 mg/L (p < 0.001) in both sexes. SFV was associated with glycemia and triglycerides levels (p = 0.0067 and p=<0.0001 in males, p = 0.0074 and p < 0.0001 in females, respectively), while SFD with triglycerides levels (p < 0.0001). ConclusionWe observed different associations of SFV and SFD with age and smoking history between men and women, whereas the association with anthropometric data, CRP, glycemia and triglycerides levels was similar in the two sexes.

Unlocking Optimal Glycemic Interpretation: Redefining HbA1c Analysis in Female Patients With Diabetes and Iron-Deficiency Anemia Using Machine Learning Algorithms.

In response to the nuanced glycemic challenges faced by women with iron deficiency anemia (IDA) associated with diabetes, this study uses advanced machine learning algorithms to redefine hemoglobin (Hb)A1c measurement values. We aimed to improve the accuracy of glycemic interpretation by recognizing the critical interaction between erythrocytes, iron, and glycemic levels in this specific demographic group. This retrospective observational study included 17,526 adult women with HbA1c levels recorded from 2017 to 2022. Samples were classified as diabetic, prediabetic, or non-diabetic based on HbA1c and fasting blood glucose (FBG) levels for distribution analysis without impacting model training. Support Vector Machines, Linear Regression, Random Forest, and K-Nearest Neighbor algorithms as machine learning (ML) methods were used to predict HbA1c levels. Following the training of the model, HbA1c values were predicted for the IDA samples using the trained model. According to our results, there has been a 0.1 unit change in HbA1c values, which has resulted in a clinical decision change in some patients. Using ML to analyze HbA1c results in women with IDA may unveil distinctions among patients whose HbA1c values hover near critical medical decision thresholds. This intersection of technology and laboratory science holds promise for enhancing precision in medical decision-making processes.

Association of Lipoprotein and Apolipoprotein Ratios With Glycemic Levels in Individuals With Prediabetes: A Case-Control Study.

Prediabetes is defined as a hyperglycemic state between normal glucose metabolism and diabetes mellitus. It is also recognized as a predisposing factor for cardiovascular disease. Apolipoprotein is a constituent of lipoproteins, and its ratio levels (ApoB/ApoA1 ratio) are considered an independent risk factor for cardiovascular diseases. This study aimed to evaluate the apolipoprotein ratio (ApoB/ApoA1 ratio) and lipoprotein ratio (low-density lipoprotein cholesterol/high-density lipoproteincholesterol (LDL-C/HDL-C) ratio) in prediabetes in relation to glycemic levels and establish the association between apolipoprotein and lipoprotein ratios in prediabetic individuals and their glycemic levels. A case-control study was conducted among 150 participants, 75 with prediabetes and 75 apparently healthy individuals (with no prediabetes or diabetes), from January 1, 2023 to December 30, 2023. The parameters involved are fasting serumglucose, insulin, blood HbA1c%, HDL-C, LDL-C, apolipoprotein A, apolipoprotein B, and lipoprotein(a) (Lp(a)), measured using different principles. Prediabetes was more predominant in males (58.7%), particularly those aged over 40 years (74.7%). The mean Lp(a) (46.18±11.66 mg/dl), LDL-C/HDL-C ratio (1.74±0.96), and ApoB/ApoA ratio (1.10±0.62) were significantly higher among prediabetic individuals. Moreover, these ratios were insignificantly higher in prediabetic individuals with HbA1c level (5.8-6.4%) and fasting glucose level (100-125 mg/dl) than those with lower levels. Prediabetic individuals exhibited a notably elevated average level of Lp(a), as well as increased mean ApoB/ApoA1 ratio and mean LDL-C/HDL-C ratio compared to individuals who were apparently healthy.

Glycemic Control Impacts the Quality of Bowel Preparation in Patients Undergoing Elective Colonoscopy: A Multicenter Retrospective Cohort Study

Introduction: Diabetes Mellitus has been linked to poor quality of bowel preparation (BP) but the impact of various glycemic control levels remains unclear. The primary objective of this study was to investigate the relationship between the quality of BP and the glycemic control in patients with diabetes. Methods: Data was collected retrospectively to identify adults who underwent elective colonoscopy from March 2020-December 2022. The patient population was subdivided into two groups based on the quality of BP. Univariate and multivariate analyses were used to assess associations between glycemic control, medications, sociodemographic factors, and BP quality. Results: A total of 1458 patients who met the inclusion criteria were included in the final analysis. Of these, 6.3% of patients had suboptimal BP. Non-diabetics, prediabetics, and well-controlled diabetics had lower odds (0.28, 0.20, and 0.32;p&lt;0.001) of having suboptimal BP as compared to poorly controlled diabetics. Insulin users had higher odds (5.39;p&lt;0.01), non-smokers and former smokers had lower odds (0.54, 0.40;p&lt;0.04), and medicare and commercial insurance holders had lower odds (0.49, 0.28;p&lt;0.001) of suboptimal BP. Gender, body mass index, and the use of glucagon-like peptide-1 (GLP-1) agonists were not shown to impact the quality of BP. Conclusions: This study shows that poorly controlled and insulin-dependent diabetics have higher rates of suboptimal QBP, leading to missed lesions and increased colon cancer risk. Limited access to healthcare due to low socioeconomic status indirectly contributes to poorly controlled DM and higher rates of suboptimal QBP. Identifying poor preparation risks allows targeted interventions to enhance QBP in high-risk patients. By prioritizing bowel preparation optimization, we can enhance the overall quality of colonoscopy screening, leading to earlier detection of colorectal malignancies, improved patient outcomes, and a reduction in the burden of colorectal cancer.

The Power of Nutrition

Both the metabolic foundation of diabetes and the complications of the disease can result in significant losses of essential micronutrients. This review is a summary of the research that investigates the impact that type 2 diabetes has on the body's capacity to digest trace minerals, vitamins, and other nutrients. This review covers the micronutrient status, metabolic needs, and likely requirements for micronutrients in type 2 diabetics. Since vitamin D and type 2 diabetes have been the subject of extensive coverage elsewhere, we will not go into further detail about them here. Some of the less well-known micronutrients that were investigated include zinc, magnesium, chromium, copper, manganese, iron, selenium, and vanadium, as well as certain antioxidants and vitamins from the B group. Although there is still a great deal more research to be done in this field, it has been demonstrated that supplementing with micronutrients can have a positive impact on the control of glycemic levels. More research is needed to develop improved biomarkers of the status and requirements of micronutrients in type 2 diabetes. It can be challenging to determine how much micronutrient supplementation a person with type 2 diabetes should take in order to attain glucose homeostasis.

Biological Age as a New Risk Factor for Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus

For the prevention of diabetic retinopathy, it is important to study risk factors, among which, along with the duration of type 2 diabetes mellitus, the level of glycemia, obesity, chronological age is indicated, but biological age is not considered as a potential risk factor, although biological age more objectively than chronological characterizes pathological changes at the cellular level and processes apoptosis. Purpose: to study biological age as a new risk factor for diabetic retinopathy in patients with type 2 diabetes mellitus. 580 patients aged 45–59 years with diabetic retinopathy and type 2 diabetes mellitus, whose biological age was calculated according to the Voitenko V.P. et al. methodology, took part in the study on the basis of the S.N. Fedorov National medical research center “MNTK Eye Microsurgery”. The correspondence of biological and chronological age was established in 124 patients, the excess (acceleration) of the chronological biological age in 357 patients and the excess of the biological chronological age in 99 patients. In the subsequent analysis, the first two groups were considered. Among 45–59­year­old patients with type 2 diabetes mellitus, the incidence of diabetic retinopathy was 19.82 ± 1,32 cases per 100 examined, which is statistically significantly higher (p &lt; 0.001) compared to patients of the same age with type 2 diabetes mellitus with a chronological biological age — 10.24 ± 1.51 cases per 100 examined. Significant differences in the compared groups were also revealed in the values of the chronological age of diagnosis of diabetic retinopathy in this endocrine disease — 47.69 ± 1.24 years in patients with accelerated biological age and 50.23 ± 0.92 years in patients with matching biological and chronological age (p &lt; 0.01). The biological age of diagnosis of diabetic retinopathy, respectively, was 56.13 ± 0.83 years and 49.61 ± 1.11 years (p &lt; 0.001). The difference in the development of diabetic retinopathy in patients 45–59 years old with type 2 diabetes mellitus by biological age was 6,52 ± 1,24 years among patients with accelerated biological age and 0.62 ± 0.09 years among patients with matching biological and chronological age (p &lt; 0.001). Consequently, the acceleration of biological age is a significant and new risk factor for diabetic retinopathy in patients aged 45–59 years with type 2 diabetes mellitus.