Blood Glucose Management Research Articles

Association of metabolic syndrome and its components with hearing loss in low-income women: A population-based cross-sectional study

BackgroundHearing loss (HL) is globally prevalent among older adults and a common disability cause. Metabolic syndrome (MetS) is a complex disorder characterized by high blood pressure, high blood sugar, excess fat around the waist, and abnormal cholesterol or triglyceride levels. Few studies have examined the association between MetS and HL in women. This study investigated the association between HL and metabolic disease among low-income population women in China. MethodsThis population-based cross-sectional study was conducted between September and November 2013. All participants completed questionnaires, physical examinations, laboratory examinations, and hearing tests. HL was measured using pure-tone audiometry, and audiologists determined the final diagnoses. ResultsA total of 1448 women were enrolled, including 781 (53.9 %) with demonstrated HL and 804 (55.5 %) with MetS. Elevated blood pressure (BP) and fasting blood glucose (FBG) levels were independent risk factors for pure-tone averages (PTAs) in the high pure tone audiometry (high-PTA) group, after adjusting for education level, smoking and drinking status, body mass index group, and low high-density lipopolysaccharide cholesterol levels (all, P < 0.05); PTAs increased by 2.11 dB HL of hearing level in patients with elevated BP compared with normal BP (95 % confidence interval [CI], 0.22–4.01; P = 0.029); PTAs increased by 1.64 dB HL of hearing level (95 % CI, 0.12–3.15; P = 0.034) in patients with elevated FBG levels compared with normal FBG levels. ConclusionThese results indicate that hypertension and hyperglycemia are influencing factors for HL, and strengthening the management of blood glucose and blood pressure in community populations can reduce the burden of HL.

Learning Difference Equations With Structured Grammatical Evolution for Postprandial Glycaemia Prediction.

People with diabetes must carefully monitor their blood glucose levels, especially after eating. Blood glucose management requires a proper combination of food intake and insulin boluses. Glucose prediction is vital to avoid dangerous post-meal complications in treating individuals with diabetes. Although traditional methods, and also artificial neural networks, have shown high accuracy rates, sometimes they are not suitable for developing personalised treatments by physicians due to their lack of interpretability. This study proposes a novel glucose prediction method emphasising interpretability: Interpretable Sparse Identification by Grammatical Evolution. Combined with a previous clustering stage, our approach provides finite difference equations to predict postprandial glucose levels up to two hours after meals. We divide the dataset into four-hour segments and perform clustering based on blood glucose values for the two-hour window before the meal. Prediction models are trained for each cluster for the two-hour windows after meals, allowing predictions in 15-minute steps, yielding up to eight predictions at different time horizons. Prediction safety was evaluated based on Parkes Error Grid regions. Our technique produces safe predictions through explainable expressions, avoiding zones D (0.2% average) and E (0%) and reducing predictions on zone C (6.2%). In addition, our proposal has slightly better accuracy than other techniques, including sparse identification of non-linear dynamics and artificial neural networks. The results demonstrate that our proposal provides interpretable solutions without sacrificing prediction accuracy, offering a promising approach to glucose prediction in diabetes management that balances accuracy, interpretability, and computational efficiency.

Novel Approaches to Control Diabetes.

Diabetes is a chronic, long-term, incurable, but controllable condition. Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia that results from defects in insulin secretion, insulin action, or both. People who have diabetes often experience a variety of symptoms, including blurry vision, excessive thirst, fatigue, frequent urination, hunger, and weight loss. This review article includes a discussion on diabetes types, symptoms, diagnostic tests, and various therapies for treating, controlling, and managing blood glucose levels, with a focus on its most recent innovation of therapies and medications. Diabetes management will also be reviewed, along with clinical pharmacodynamics, bioavailability, advantages, and complications of combined drugs/medications.

Practical considerations for continuous glucose monitoring in elite athletes with type 1 diabetes mellitus: A narrative review.

Type 1 diabetes mellitus (T1DM) refers to a metabolic condition where a lack of insulin impairs the usual homeostatic mechanisms to control blood glucose levels. Historically, participation in competitive sport has posed a challenge for those with T1DM, where the dynamic changes in blood glucose during exercise can result in dangerously high (hyperglycaemia) or low blood glucoses (hypoglycaemia) levels. Over the last decade, research and technological development has enhanced the methods of monitoring and managing blood glucose levels, thus reducing the chances of experiencing hyper- or hypoglycaemia during exercise. The introduction of continuous glucose monitoring (CGM) systems means that glucose can be monitored conveniently, without the need for frequent fingerpick glucose checks. CGM devices include a fine sensor inserted under the skin, measuring levels of glucose in the interstitial fluid. Readings can be synchronized to a reader or mobile phone app as often as every 1-5min. Use of CGM devices is associated with lower HbA1c and a reduction in hypoglycaemic events, promoting overall health and athletic performance. However, there are limitations to CGM, which must be considered when being used by an athlete with T1DM. These limitations can be addressed by individualized education plans, using protective equipment to prevent sensor dislodgement, as well as further research aiming to: (i) account for disparities between CGM and true blood glucose levels during vigorous exercise; (ii) investigate the effects of temperature and altitude on CGM accuracy, and (iii) explore of the sociological impact of CGM use amongst sportspeople without diabetes on those with T1DM.

Exploring Australian Dietitians' knowledge, experience and perspectives of time-restricted eating in private practice: A qualitative study.

Time-restricted eating is a novel nutrition intervention with evidence of beneficial effects on weight loss, blood glucose management, and other metabolic health outcomes. Adherence to time-restricted eating is higher than some traditional nutrition interventions to support individuals living with overweight/obesity and type 2 diabetes mellitus. However, there may be an evidence-practice gap of time-restricted eating in Australian dietetic practice. The present study aimed to explore dietitians' knowledge, experiences, and perspectives of time-restricted eating and timing of eating advice in practice. Semi-structured interviews with 10 private practice dietitians across Australia were conducted. Audio recordings were transcribed and analysed thematically. Six themes were identified: (i) distinction of time-restricted eating to other fasting protocols; (ii) knowledge of health benefits of time-restricted eating; (iii) patient-led advice frequently given: timing of breakfast and dinner; (iv) dietitian-led advice frequently given: eating cut-off time to avoid late night snacking; (v) barriers and facilitators to offering time-restricted eating or timing of eating advice; (vi) timing of eating advice within professional guidelines and resources. These findings suggest the need for development of professional resources and educational development tools for dietitians on time-restricted eating.

IMO-PSO FO-PID controller based insulin infusion system for type 1 diabetes patients during post-operation condition

Blood Glucose level controls of type 1 diabetic patients (T1D) in post operative conditions are extremely important. This work proposes controllers for management and control of insulin injections to T1D in post operative care. Proposed work investigated IMO-PSO FO-PID controller as a novel approach to improve insulin delivery. The controller utilizes optimization algorithms to regulate insulin levels in real time. Particle swarm optimization (PSO) based tuning is already a proven method in insulin regulation and multiobjective PSO is well suited when combined with FO-PID which is tested. Additionally, system aims to achieve lower insulin levels, as high insulin levels have been linked to increase risks of complications for T1D patients. Results showed that IMO-PSO FO-PID controller is effective in improving glucose control, with patients experiencing fewer fluctuations and instances of hypoglycemia or hyperglycemia. Simulation results show that the use of the controller is very useful in managing blood glucose levels over a longer period and corresponding insulin infusion levels are also controlled well, which is much less than the previously reported control methodologies. This paper highlights potential benefits of using this controller in managing T1D and improving glucose control.

Tailored Meal-Type Food Provision for Diabetes Patients Can Improve Routine Blood Glucose Management in Patients with Type 2 Diabetes: A Crossover Study.

This study aimed to determine whether patients with type 2 diabetes can benefit from a meal plan designed based on diabetes management guidelines to improve blood glucose levels. Participants were divided into intervention and control groups. The intervention group consumed a diabetic diet for 2 weeks, while the control group consumed their normal diet. After 2 weeks, the groups switched their dietary regimens. The participants' demographic and clinical characteristics were evaluated, including factors such as blood pressure, blood lipid levels, weight and waist circumference, blood glucose levels (self-monitored and continuously monitored), nutritional status, and blood-based markers of nutrient intake. The dietary intervention group improved waist circumference, body fat percentage, low-density lipoprotein cholesterol, triglyceride levels, and glucose. The energy composition ratio of carbohydrates and proteins changed favorably, and sugar intake decreased. In addition, the proportion of continuous glucose monitoring readings within the range of 180-250 mg/dL was relatively lower in the intervention group than that of the control group. Meals designed based on diabetes management guidelines can improve clinical factors, including stable blood glucose levels in daily life, significantly decrease the carbohydrate energy ratio, and increase the protein energy ratio. This study can help determine the role of dietary interventions in diabetes management and outcomes.

Practise of Self-Monitoring of Blood Glucose Among Pregnant Women with Gestational Diabetes Mellitus Attending a Tertiary Care Hospital in Lucknow, Uttar Pradesh

Background: Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance of varying degree diagnosed first time during the pregnancy. Blood glucose values revert to the normal level soon after the delivery. But the women carry a lifetime risk of getting overt diabetes within 5 years. The management of GDM mainly comprises of medical nutrition therapy, exercise, weight management and Self-Monitoring of Blood Glucose (SMBG). Among all the management components, SMBG is the mostly neglected especially among pregnant women with GDM.Overall, the practise of SMBG in developing nation like India is not up to the mark. Aim: The aim of the present study was to determine the practice of SMBG amongst the pregnant women with GDM. The study was conducted in the antenatal OPD of Queen Mary’s Hospital KGMU, Lucknow, Uttar Pradesh. Methodology: It was a quasi experimentalstudy on 188 pregnant women with GDM managed on life style intervention. Statistical analysis:Descriptive statistics in the form of frequencies and percentages were used to analyse the sociodemographicfactors. ANOVA was applied to compare the mean score between the two groups. Result: The overall adherence to the SMBG practice was found to be very low among the study participants. No significant difference was observed between the two groups. Conclusion: Patient empowerment and imparting proper information regarding SMBG may be helpful in managing the GDM with better maternal and foetal outcomes.

Glu-Ensemble: An ensemble deep learning framework for blood glucose forecasting in type 2 diabetes patients

Diabetes is a chronic metabolic disorder characterized by elevated blood glucose levels, posing significant health risks such as cardiovascular disease, and nerve, kidney, and eye damage. Effective management of blood glucose is essential for individuals with diabetes to mitigate these risks. This study introduces the Glu-Ensemble, a deep learning framework designed for precise blood glucose forecasting in patients with type 2 diabetes. Unlike other predictive models, Glu-Ensemble addresses challenges related to small sample sizes, data quality issues, reliance on strict statistical assumptions, and the complexity of models. It enhances prediction accuracy and model generalizability by utilizing larger datasets and reduces bias inherent in many predictive models. The framework's unified approach, as opposed to patient-specific models, eliminates the need for initial calibration time, facilitating immediate blood glucose predictions for new patients. The obtained results indicate that Glu-Ensemble surpasses traditional methods in accuracy, as measured by root mean square error, mean absolute error, and error grid analysis. The Glu-Ensemble framework emerges as a promising tool for blood glucose level prediction in type 2 diabetes patients, warranting further investigation in clinical settings for its practical application.

Diabetic management and infection risk in total ankle arthroplasty

BackgroundAs total ankle arthroplasty (TAA) increases in popularity nationwide for the management of end-stage arthritis, it is essential to understand ways to mitigate the risk of infection. Diabetes increases the risk of infection due to compromised immunity and impaired wound-healing mechanisms. However, there is limited research on how diabetic management, inclusive of medications and glucose control, may impact infection risks post-TAA. This study aims to demonstrate the impact of diabetic management on the occurrence of periprosthetic joint infection (PJI) following TAA. MethodsThis was a retrospective study of patients who underwent a TAA at a single academic institution from March 2002 to May 2022. Patients with diabetes who developed an intraarticular infection following TAA were propensity score matched (1:3) to diabetic patients who did not. Data collection included demographics, implant types, diabetic medications, and preoperative hemoglobin A1c. PJI was diagnosed based on Musculoskeletal Infection Society (MSIS) criteria. Statistical analyses assessed differences in medication use, glucose control, and infection rates between groups. ResultsOf the 1863 patients who underwent TAA, 177 patients had a diagnosis of diabetes. The infection rate in patients with diabetes (2.8%) was higher than the total cohort rate (0.8%). Five patients with diabetes developed a PJI at an average of 2.2 months postoperatively. This cohort (n = 5) was compared to propensity score-matched controls (n = 15). There was no significant difference in diabetic medication use. Patients who developed PJI had higher rates of uncontrolled diabetes (60.0% vs. 6.7%) and average A1c levels (7.02% vs. 6.29%) compared to controls. ConclusionOur findings suggest that the elevated risk of PJI observed in individuals with diabetes subsequent to TAA may be attributed not solely to the presence of diabetes, but to inadequate glycemic control. Effectively managing blood glucose levels is imperative for achieving favorable outcomes following TAA. Level of evidenceIII

Type 2 Diabetes: Tips for Healthy Living

Patient Education| 2021 Type 2 Diabetes: Tips for Healthy Living Connected Content Translation: Diabetes tipo 2: consejos para una vida saludable: (Type 2 Diabetes: Tips for Healthy Living) Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Type 2 Diabetes: Tips for Healthy Living. Pediatric Patient Education 2021; 10.1542/peo_document576 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Topics: blood glucose, diabetes mellitus, type 2, glucose, insulin, physical activity Read on for information from the American Academy of Pediatrics (AAP) about managing blood glucose and creating plans for healthy living. Glucose is found in the blood and is the body's main source of energy. The food your child eats is broken down by the body into glucose. Glucose is a type of sugar that gives energy to the cells in the body. The cells need the help of insulin to take the glucose from the blood to the cells. Insulin is made by an organ called the pancreas. In children with type 2 diabetes, the pancreas does not make enough insulin and the cells don't use the insulin very well. Glucose will build up in the blood if it cannot be used by the cells. High blood glucose levels can damage many parts of the body, such as the eyes, kidneys, nerves, and... © 2013 American Academy of Pediatrics You do not currently have access to this content.

Combined Microbial Fermentation Converts Bioactive Compounds in Nitraria Tangutorum Bobrov Fruit and Displays its Antidiabetic Potential

Nitraria tangutorum Bobrov is a berry shrub with white flowers and red fruits, which grows in the deserts in the Tibetan Plateau, Mongolia, and western China. Its fruit N. tangutorum Fruit (NTF) contains various bioactive compounds, with anti-fatigue, anti-inflammatory, and neuroprotective functions. However, the high saccharide content of NTF makes it unsuitable for diabetic patients. In this study, we fermented NTF to obtain N. tangutorum Fermented Juice (NTJ), and N. tangutorum Fermented Residue (NTR), which are suitable for diabetics to consume. We characterized the bioactive compounds in NTF, NTR, and NTJ, and found that fermentation increased the diversity of bioactive compounds, and greatly reduced sucrose, glucose, and fructose content while generating trehalose, which has the potential to manage blood glucose levels. Further, NTJ displays anti-diabetic potential due to various compounds anti-diabetic properties. This study provides a basis for further clinical research on NTJ’s anti-diabetic function in humans.

Non-invasive measurements of blood glucose levels by time-gating mid-infrared optoacoustic signals

Non-invasive glucose monitoring (NIGM) represents an attractive alternative to finger pricking for blood glucose assessment and management of diabetes. Nevertheless, current NIGM techniques do not measure glucose concentrations in blood but rely on indirect bulk measurement of glucose in interstitial fluid, where glucose is diluted and glucose dynamics are different from those in the blood, which impairs NIGM accuracy. Here we introduce a new biosensor, termed depth-gated mid-infrared optoacoustic sensor (DIROS), which allows, for the first time, non-invasive glucose detection in blood-rich volumes in the skin. DIROS minimizes interference caused by the stratum corneum and other superficial skin layers by time-gating mid-infrared optoacoustic signals to enable depth-selective localization of glucose readings in skin. In measurements on the ears of (female) mice, DIROS displays improved accuracy over bulk-tissue glucose measurements. Our work demonstrates how signal localization can improve NIGM accuracy and positions DIROS as a holistic approach, with high translational potential, that addresses a key limitation of current NIGM methods.

Society for Ambulatory Anesthesia Updated Consensus Statement on Perioperative Blood Glucose Management in Adult Patients With Diabetes Mellitus Undergoing Ambulatory Surgery.

This consensus statement is a comprehensive update of the 2010 Society for Ambulatory Anesthesia (SAMBA) Consensus Statement on perioperative blood glucose management in patients with diabetes mellitus (DM) undergoing ambulatory surgery. Since the original consensus guidelines in 2010, several novel therapeutic interventions have been introduced to treat DM, including new hypoglycemic agents and increasing prevalence of insulin pumps and continuous glucose monitors. The updated recommendations were developed by an expert task force under the provision of SAMBA and are based on a comprehensive review of the literature from 1980 to 2022. The task force included SAMBA members with expertise on this topic and those contributing to the primary literature regarding the management of DM in the perioperative period. The recommendations encompass preoperative evaluation of patients with DM presenting for ambulatory surgery, management of preoperative oral hypoglycemic agents and home insulins, intraoperative testing and treatment modalities, and blood glucose management in the postanesthesia care unit and transition to home after surgery. High-quality evidence pertaining to perioperative blood glucose management in patients with DM undergoing ambulatory surgery remains sparse. Recommendations are therefore based on recent guidelines and available literature, including general glucose management in patients with DM, data from inpatient surgical populations, drug pharmacology, and emerging treatment data. Areas in need of further research are also identified. Importantly, the benefits and risks of interventions and clinical practice information were considered to ensure that the recommendations maintain patient safety and are clinically valid and useful in the ambulatory setting. What Other Guidelines Are Available on This Topic? Since the publication of the SAMBA Consensus Statement for perioperative blood glucose management in the ambulatory setting in 2010, several recent guidelines have been issued by the American Diabetes Association (ADA), the American Association of Clinical Endocrinologists (AACE), the Endocrine Society, the Centre for Perioperative Care (CPOC), and the Association of Anaesthetists of Great Britain and Ireland (AAGBI) on DM care in hospitalized patients; however, none are specific to ambulatory surgery. How Does This Guideline Differ From the Previous Guidelines? Previously posed clinical questions that were outdated were revised to reflect current clinical practice. Additional questions were developed relating to the perioperative management of patients with DM to include the newer therapeutic interventions.

Review on the Therapeutic Role of Asclepias tuberosa Seeds in Diabetes Management

Diabetes mellitus (DM) presents a significant global health challenge characterized by elevated blood glucose levels, leading to debilitating complications. Despite various therapeutic approaches, effective glucose regulation remains elusive, often accompanied by adverse effects from current medications. Medicinal plants, including Asclepias tuberosa, have shown promise in managing blood glucose levels with fewer side effects. This review highlights the potential of Asclepias tuberosa as herbal antidiabetic agents based on recent literature, suggesting avenues for further research and therapeutic development in DM management. Considering the urgent need for safer and more effective antidiabetic treatments, exploring the therapeutic potential of Asclepias tuberosa presents a promising avenue for addressing this growing public health concern. Future studies should focus on elucidating the mechanisms of action, conducting clinical trials to validate the efficacy and safety of Centaurea-based interventions in DM management, and exploring synergistic effects with existing therapies.&#x0D; Furthermore, within the context of utilizing plant materials for the treatment of Diabetes mellitus, particular attention is directed towards the utilization of Asclepias tuberosa seeds. Asclepias tuberosa, commonly known as butterfly weed or pleurisy root, is a medicinal plant native to North America. Traditionally, various parts of this plant, including the roots, leaves, and seeds, have been used in folk medicine for their purported therapeutic effects&#x0D; Keywords: Diabetes mellitus, Asclepias tuberosa, antidiabetic agents, herbal remedies, blood glucose regulation.

Continuous Glucose Monitoring System After Coronary Artery Bypass Graft Surgery: A Feasibility Study.

Blood glucose level variability has been associated with increased risk of complication in the postoperative setting of cardiovascular surgery. Although interesting for optimization of blood glucose management in this context, continuous blood glucose (CBG) devices can have a limited reliability in this context, in particular because of the use of paracetamol. The aim of this study was to evaluate the reliability of Dexcom G6®, a recently developed continuous glucose monitoring device. We performed a prospective, observational, non-randomized, single-centre study comparing Dexcom G6® CBG level monitoring with the standard methods routinely used in this context. The standard blood glucose values were paired to the time corresponding values measured with Dexcom G6®. Agreement between the two methods and potential correlation in case of paracetamol use were calculated. From May 2020 to August 2021, 36 out of 206 patients operated for isolated coronary artery bypass grafting were enrolled; 673 paired blood glucose level were analyzed. Global agreement (ρc) was 0.85 (95% C.I.: 0.84-0.86), intensive care unit agreement was 0.78 (95%C.I.: 0.74-0.82) and ward agreement was 0.91 (95%C.I.: 0.89-0.93). In the diabetic population, it was 0.87 (95%C.I.: 0.85-0.90). When paracetamol was used, the difference was 0.02 mmol/l (95%C.I.: 0.29-0.33). Dexcom G6® provides good blood glucose level accuracy in the postoperative context of cardiac surgery compared to the standard methods of measurements. The results are particularly reliable in the ward where the need for repeated capillary glucose measurements implies patient discomfort and time-consuming manipulations for the nursing staff.

An effective insulin infusion protocol for severe traumatic brain injury patients: A retrospective observational study

PurposeSevere traumatic brain injury (sTBI) patients often experience stress hyperglycaemia, which can lead to negative outcomes. This study aims to introduce an effective insulin infusion protocol specifically designed for sTBI patients. MethodsData was collected from all sTBI patients during two periods: 1 October 2019 to 30 April 2020, and 1 June 2020 to 31 December 2020. In May 2020, a new insulin infusion protocol was implemented. Blood glucose management, infection, coagulation, and prognosis were compared in these two periods. Result195 patients were included, with 106 using the new protocol. The proportion of hyperglycaemia decreased from 40.04% to 26.91% (P<0.05), and the proportion of on-target blood glucose levels increased from 35.69% to 38.98% (P<0.05). Average blood glucose levels decreased from 9.98±2.79mmol/L to 8.96±2.82mmol/L (P<0.05). There was no substantial increase in hypoglycaemia, which remained controlled below 1%. The new protocol positively influenced glucose concentration and dispersion trends. There were no significant differences in catheter-related infections, antibiotic use, mechanical ventilation (MV) duration, length of stay in ICU, Glasgow Outcome Scale (GOS), or mortality. However, the conventional protocol group had a higher coagulation tendency (R-value of thromboelastography 4.80±1.35min vs. 5.52±1.87min, P<0.05), with no difference in deep vein thrombosis (DVT) incidence. ConclusionOur findings suggest that a customized insulin infusion process for sTBI patients can effectively manage blood glucose. While there is no significant improvement in infection control or prognosis, it may have a positive impact on coagulation without affecting the occurrence of DVT.

Adaptive responses of the ileum of NOD mice to low-dose fluoride: A proteomic exploratory study.

Fluoride (F) has been employed worldwide to control dental caries. More recently, it has been suggested that the consumption of low doses of F in the drinking water may reduce blood glucose levels, introducing a new perspective for the use of F for the management of blood glucose. However, the exact mechanism by which F affects blood glucose levels remains largely unexplored. Given that the small gut plays a pivotal role in glucose homeostasis, the aim of this study was to investigate the proteomic changes induced by low doses of F in the ileum of female nonobese-diabetic (NOD) mice. Forty-two female NOD mice were divided into two groups based on the F concentration in their drinking water for 14 weeks: 0 (control) or 10 mgF/L. At the end of the experimental period, the ileum was collected for proteomic and Western blot analyses. Proteomic analysis indicated an increase in isoforms of actin, gastrotropin, several H2B histones, and enzymes involved in antioxidant processes, as well as a decrease in enzymes essential for energy metabolism. In summary, our data indicates an adaptive response of organism to preserve protein synthesis in the ileum, despite significant alterations in energy metabolism typically induced by F, therefore highlighting the safety of controlled fluoridation in water supplies.

Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV database

Blood glucose management in intensive care units (ICU) remains a controversial topic. We assessed the association between time-weighted average glucose (TWAG) levels and ICU mortality in critically ill patients in a real-world study. This retrospective study included critically ill patients from the Medical Information Mart for Intensive Care IV database. Glycemic distance is the difference between TWAG in the ICU and preadmission usual glycemia assessed with glycated hemoglobin at ICU admission. The TWAG and glycemic distance were divided into 4 groups and 3 groups, and their associations with ICU mortality risk were evaluated using multivariate logistic regression. Restricted cubic splines were used to explore the non-linear relationship. A total of 4737 adult patients were included. After adjusting for covariates, compared with TWAG ≤ 110 mg/dL, the odds ratios (ORs) of the TWAG > 110 mg/dL groups were 1.62 (95% CI 0.97–2.84, p = 0.075), 3.41 (95% CI 1.97–6.15, p < 0.05), and 6.62 (95% CI 3.6–12.6, p < 0.05). Compared with glycemic distance at − 15.1–20.1 mg/dL, the ORs of lower or higher groups were 0.78 (95% CI 0.50–1.21, p = 0.3) and 2.84 (95% CI 2.12–3.82, p < 0.05). The effect of hyperglycemia on ICU mortality was more pronounced in non-diabetic and non-septic patients. TWAG showed a U-shaped relationship with ICU mortality risk, and the mortality risk was minimal at 111 mg/dL. Maintaining glycemic distance ≤ 20.1 mg/dL may be beneficial. In different subgroups, the impact of hyperglycemia varied.

The mediation mechanism of calcium ions on black bean type 3 resistant starch: Metabolomics, structure characteristics and digestibility

The type 3 resistant starch (RS3) is beneficial for blood glucose management. A high quality RS3 was provided and its formation mechanism after calcium ion (Ca2+) treatment was investigated in this study. The metabolomics, structure and digestion properties were evaluated. Metabolomics was performed by untargeted UHPLC-Q-TOF/MS, and a total of 11 significantly different metabolites was found. The NMR, ATR-FTIR, and XRD results showed that the degree of double helix decreased from 5.34 to 1.07, crystallinity decreased from 33.58 % to 19.88 %, and the amorphous region increased from 69.76 % to 78.33 %. Large particle polymers were observed by SEM on the granule surface of starch with Ca2+ treatment. Digestion test showed that Ca2+ increased the RS3 from 9.70 % to 22.26 %. The result indicated that Ca2+ induced the formation of chelates between Ca2+ and –OH, promoted the RS3 content and regulated carbohydrate metabolism. The study provided theoretical basis for producing low-glycemic black bean foods.