Mean Fasting Blood Glucose Research Articles

The effect of preoperative different dexamethasone regimens on postoperative glycemic control in patients with type 2 diabetes mellitus undergoing total joint arthroplasty: a retrospective cohort study

BackgroundConcerns have been raised regarding the impact of preoperative intravenous dexamethasone on postoperative glycemic control in diabetic patients undergoing total joint arthroplasty (TJA). This study aimed to determine relationships between preoperative different dexamethasone regimens and postoperative fasting blood glucose (FBG), as well as to identify risk factors for postoperative FBG ≥ 200 mg/dl in diabetic patients undergoing TJA.MethodsThis retrospective study included 1216 diabetic patients undergoing TJA and categorized into group A (dexamethasone = 0 mg), group B (dexamethasone = 5 mg), and group C (dexamethasone = 10 mg). All dexamethasone was administered before skin incision. FBG levels were monitored until postoperative day (POD) 3. Analyses were conducted for periprosthetic joint infection (PJI) and wound complications during 90 days postoperatively. And the risk factors for postoperative FBG ≥ 200 mg/dl were identified.ResultsPreoperative dexamethasone administration resulted in a transiently higher FBG on POD 0 and POD 1 (all P < 0.001). However, no differences were observed on POD 2 (P = 0.583) and POD 3 (P = 0.131) among three groups. While preoperative dexamethasone led to an increase in postoperative mean FBG and postoperative maximum FBG (all P < 0.001), no differences were found in wound complications (P = 0.548) and PJI (P = 1.000). Increased HbA1c and preoperative high FBG, but not preoperative dexamethasone, were identified as risk factors for postoperative FBG ≥ 200 mg/dl. Preoperative HbA1c level of ≥ 7.15% was associated with an elevated risk of postoperative FBG ≥ 200 mg/dl.ConclusionsAlthough preoperative intravenous administration of 5 mg or 10 mg dexamethasone in diabetic patients showed transient effects on postoperative FBG after TJA, no differences were found in the rates of PJI and wound complications during 90 days postoperatively. Notably, patients with a preoperative HbA1c level of ≥ 7.15% and elevated preoperative FBG may encountered postoperative FBG ≥ 200 mg/dl.

Impacts of Tocolytics on Maternal and Neonatal Glucose Levels in Women With Gestational Diabetes Mellitus.

We investigated the impacts of tocolytic agents on maternal and neonatal blood glucose levels in women with gestational diabetes mellitus (GDM) who used tocolytics for preterm labor. This multi-center, retrospective cohort study included women with GDM who were admitted for preterm labor from twelve hospitals in South Korea. We excluded women with multiple pregnancies, anomalies, overt DM diagnosed before pregnancy or 23 weeks of gestation, and women who received multiple tocolytics. The patients were divided according to the types of tocolytics; atosiban, ritodrine, and nifedipine group. We collected baseline maternal characteristics, pregnancy outcomes, maternal glucose levels during hospitalization, and neonatal glucose levels. We compared the frequency of maternal hyperglycemia and neonatal hypoglycemia among three groups. A multivariate logistic regression analysis was performed to evaluate the contributing factors to the occurrence of maternal hyperglycemia and neonatal hypoglycemia. A total of 128 women were included: 44 (34.4%), 51 (39.8%), and 33 (25.8%) women received atosiban, ritodrine, and nifedipine, respectively. Mean fasting blood glucose (FBG) (112.3, 109.6, and 89.5 mg/dL, P < 0.001) and 2-hour postprandial glucose (PPG2) levels (145.4, 148.3, and 116.5 mg/dL, P = 0.004) were significantly higher in atosiban and ritodrine group than those in nifedipine group. Even after adjusting for covariates including antenatal steroid use, gestational age at admission, and pre-pregnancy body mass index, there was an increased risk of high maternal mean FBG (≥ 95 mg/dL) and PPG2 (≥ 120 mg/dL) levels in the atosiban and ritodrine group than in nifedipine group. The atosiban and ritodrine groups are also at increased risk of neonatal hypoglycemia (< 47 mg/dL) compared to the nifedipine group with the odds ratio of 4.58 and 4.67, respectively (P < 0.05). There is an increased risk of maternal hyperglycemia and neonatal hypoglycemia in women with GDM using atosiban and ritodrine tocolytics for preterm labor compared to those using nifedipine.

A randomized, double-blind clinical trial of poly-herbal traditional decoction for the management of type 2 diabetes in comparison with standard Western treatments

Abstract Introduction: Type 2 diabetes mellitus (T2DM) known as Mathumegam is a significant health concern in the twenty-first century. Despite great advances in contemporary science, there is a lack of moderately safe and effective drugs for treatment. The purpose of this study was to evaluate the efficacy of a poly herbal traditional decoction containing 10 herbs such as Senna auriculata (root &amp; bark), Cissampelos pareira (root), Ficus racemosa (bark), Terminalia arjuna (bark), Acacia arabica (bark), Syzygium cumini (bark), Curcuma longa (rhizome), Terminalia chebula (fruit pulp), Phyllanthus emblica (dry fruit), and Terminalia bellirica (fruit pulp) in the management of T2DM. Materials and Methods: It was a double-blind, randomized controlled trial involving 100 T2DM patients who were not well managed by diet or exercise. For a period of 12 weeks, 50 patients in group A were administered 5g of the test medication mixed with 100ml (one tumbler) of hot water for 10 to 15 min, as well as standard Western therapy. Group B patients (n=50) received a placebo in addition to normal Western therapy. The main focus of the study was to achieve a 3-month decrease in glycosylated hemoglobin (HbA1c) levels from the starting point, with additional objectives including lowering fasting blood glucose (FBG) levels and observing changes in diabetic symptoms. Results: At the end of the trial, mean fasting blood glucose levels decreased to 119.04 ± 11.52 and 176.90 ± 13.91 mg/dL in the test and control groups, respectively. Group A showed a more significant decrease in mean fasting blood glucose levels compared to group B. This indicates that the daily use of poly herbal traditional decoction along with standard allopathic medical therapy for 3 months led to notable reductions in FBG levels. Similarly, group A showed greater improvement in the measured signs and symptoms of diabetes, such as polydipsia, polyuria, polyphagia, weariness, and burning sensation in the hands and feet compared to group B throughout the trial. At baseline, the mean HbA1c (%) in group A and group B was 7.47 ± 0.70 and 7.39 ± 0.66, respectively. After 12 weeks of investigation, the levels of glycated hemoglobin were lowered to 5.03 ± 0.53 and 6.79 ± 0.51 respectively. There were no adverse events reported during the trial period. Conclusion: This study found that the experimental medication was beneficial in T2DM, radically lowering FBG and HbA1c levels in diabetic individuals after 12 weeks of treatment.

Relationship between glycated hemoglobin and blood glucose levels in fasting and two hours after 75 g oral glucose in gestational diabetes mellitus

Background: Oral glucose tolerance test (OGTT) performed at 24-28 weeks gestation is the current recommended method to the diagnosis of gestational diabetes mellitus (GDM). Many recent studies investigating glycated hemoglobin (HbA1c) in detecting GDM yield different results. There are no published data on HbA1c in the diagnosis of GDM in India. Methods: A cross-sectional study was carried out at T.N.M.C. Mumbai during the period from January to June 2021 to assess the reliability of HbA1c in the diagnosis of GDM. Results: We included 397 pregnant females. The age range of the patients was 18 to 35 years, with a mean of 24.57±11.10 years. The mean fasting blood glucose level was 129.73 mg/dl and the mean 2 hours after 75 g oral glucose level was 188.21 mg/dl. The difference between the two was statistically significant. The Spearman's correlation coefficient (r) between fasting blood glucose and HbA1c was 0.610 (p&lt;0.05) and between postprandial blood glucose and HbA1c was 0.683 (p&lt;0.05). Scatter plots of FBG and 2 hours after 75 g oral glucose with HbA1C shows a positive correlation. Conclusions: This study showed that 2 hours after 75 g oral glucose had a better correlation with HbA1c than fasting blood glucose level. In the absence of HbA1c facility or unreliable HbA1c report, postprandial blood glucose can be a surrogate marker of HbA1c for management and monitoring of gestational diabetes mellitus, but a larger study is needed to confirm this finding.

Gut microbiota alterations are associated with functional outcomes in patients of acute ischemic stroke with non-alcoholic fatty liver disease.

Patients with acute ischemic stroke (AIS) with non-alcoholic fatty liver disease (NAFLD) frequently have poor prognosis. Many evidences suggested that the changes in gut microbiota may play an important role in the occurrence and development of AIS patients with NAFLD. The purpose of this study was to explore microbial characteristics in patients of AIS with NAFLD, and the correlation between gut microbiota and functional outcomes. The patients of AIS were recruited and divided into NAFLD group and non-NAFLD group. The stool samples and clinical information were collected. 16 s rRNA sequencing was used to analyze the characteristics of gut microbiota. The patients of AIS with NAFLD were followed-up to evaluate the functional outcomes of disease. The adverse outcomes were determined by modified Rankin scale (mRS) scores at 3 months after stroke. The diagnostic performance of microbial marker in predicting adverse outcomes was assessed by recipient operating characteristic (ROC) curves. Our results showed that the composition of gut microbiota between non-NAFLD group and NAFLD group were different. The characteristic bacteria in the patients of AIS with NAFLD was that the relative abundance of Dorea, Dialister, Intestinibacter and Flavonifractor were decreased, while the relative abundance of Enorma was increased. Moreover, the characteristic microbiota was correlated with many clinical parameters, such as mRS scores, mean arterial pressure and fasting blood glucose level. In addition, ROC models based on the characteristic microbiota or the combination of characteristic microbiota with independent risk factors could distinguish functional dependence patients and functional independence patients in AIS with NAFLD (area under curve is 0.765 and 0.882 respectively). These findings revealed the microbial characteristics in patients of AIS with NAFLD, and further demonstrated the predictive capability of characteristic microbiota for adverse outcomes in patients of AIS with NAFLD.

Association of cumulative blood glucose load with cardiovascular risk and all-cause mortality

BackgroundIncorporation both the magnitude and duration of exposure to elevated fasting blood glucose (FBG) into a single risk parameter (cumulative FBG load) for future diseases is intuitively appealing, although a data-based demonstration of the utility of this metric is not available. This study aimed to investigate the associations with cumulative FBG load with the risk of cardiovascular diseases (CVD) and all-cause mortality in the general population. MethodsThis prospective cohort study included 41,728 participants who were free of CVD and underwent four health examinations from 2006 to 2012. Cumulative FBG load during 2006–2012 was calculated as the area under curve for FBG values ≥ 5.6 mmol/L divided by the total area curve. We also compared the predicting value cumulative FBG load with other FBG metrics. ResultsDuring a median follow-up of 6.75 years, we identified 2323 cases of CVD and 1724 cases of all-cause mortality. Per 1-standard deviation increase in cumulative FBG load was associated with a 16 % higher risk of CVD (hazard ratio [HR]: 1.16; 95 % confidence interval [CI], 1.13–1.20) and 20 % higher risk of all-cause mortality (HR, 1.20; 95 % CI, 1.16–1.25). For the prediction of cardiovascular outcomes and all-cause mortality, cumulative FBG load outperformed FBG time-in-target, visit-to-visit FBG variability, and mean FBG in terms of C-statistics and reclassification indexes. ConclusionsCumulative FBG load may provide a better prediction of cardiovascular outcomes compared with other FBG metrics in the general population. These findings emphasized the important role of cumulative FBG load in assessing cardiovascular and mortality risk.

SAT678 Metabolic Disorders In Thalidomide Embryopathy

Abstract Disclosure: A. Tanabe: None. Thalidomide embryopathy (TE) is a disease that develops in neonates born from women who have taken thalidomide during early pregnancy. Most cases of TE are characterized by developmental abnormalities of the limbs and/or auditory organs. In Japan, thalidomide was marketed as an agent for sleep-induce and digestive ulcers from 1958 to 1962. Up to now, 309 patients have been certified and are supported by the government as drug-induced disease. Currently, many of the victims are in their late 50s, and in addition to congenital disabilities, various health issues such as lifestyle-related diseases can be developed. We investigated their metabolic condition using data of medical health checkup between 2017 and 2019. Sixty-five Japanese cases of TE (33 men and 32 women) were included in this study. The mean age was 56.3±1.5 years in men and 56.1±1.2 years in women. The prevalence of upper limb deformities was 70% in men and 72% in women. The mean body mass index (BMI) was 22.7±2.1 in men and 22.5±4.0 in women. Twelve percent of men and 9% of women had a BMI between 25-30, while 9% of women and no men had a BMI of 30 or greater. Liver dysfunction was seen in 67% of men and 19% of women. The mean low-density lipoprotein cholesterol level was 61±19 mg/dL in men and 69±22 mg/dL in women. The mean high-density lipoprotein (LDL) cholesterol level was 116±29 mg/dL in men and 142±35 mg/dL in women, with 21% of men and 56% of women had LDL level of 140 mg/dL or greater. The mean triglyceride (TG) level was 137±82 mg/dL in men and 121±70 mg/dL in women, with 39% of men and 22% of women had a level of 150 mg/dL or greater. The mean fasting blood glucose level was 114±31 mg/dL in men and 102±17 mg/dL in women. The mean HbA1c level was 5.9±0.9% in men and 5.9±0.4% in women. The prevalence of impaired glucose tolerance was 19% in men and 9% in women. Fatty liver evaluated by ultrasonography or CT scan was 56% in men and 41% in women. The patients with fatty liver showed significantly high BMI, body fat percentage and TGs in men, high alanine aminotransferase and TGs in women, respectively, compared to the patients without fatty liver. There was no significant difference in with or without the upper limb abnormalities in both groups. This is the second report of metabolic disorders in TE, following one from our research group in 2015. Although without obvious overweight, thirty percent of the patients had dyslipidemia and 50% of the patients had the fatty liver. Because there was no association between limb abnormalities and metabolic disorders, other factors could be involved in the development of metabolic disorders. The results of this study provide valuable information for future health management in thalidomide embryopathy. (This study was conducted by a research grant from the National Center for Global Health and Medicine, Japan: 21A1015 and a Grant-in-Aid from the Ministry of Health, Labour, and Welfare, Japan: 20KC2005, 23KC2017). Presentation: Saturday, June 17, 2023

Aloe Vera: Potential to Reduce Fasting Blood Sugar Levels in Prediabetes

Prediabetes is a continuous spectrum of developmental stages before a person is diagnosed with diabetes mellitus. Considering the long-term effects of pharmacological treatment, other natural-based methods are needed. The purpose of this study was to analyze the effect of Aloe Vera Juice on the reduction of fasting blood glucose levels in patients with prediabetes in Pontianak City. A pre and post-test design study was conducted between March and July 2021 at Alianyang Public Health Center. A total of 12 subjects were identified as prediabetic at the beginning of the study through screening involved in this study. The included subjects were asked to consume 175 ml of Aloe Vera Juice for 15 consecutive days and measured their fasting blood glucose (FBG) levels on the 16th day. A paired t-test was performed to determine the difference in FBG levels before and after the treatment. Present findings revealed that the mean FBG level before intervention was 107.4 mg / dL and 92.1 mg/dL after the intervention. A statistically different FBG reduction significance was found between groups (p&lt;0.001). Consuming Aloe vera juice regularly for 15 days has proven to lower FBG levels among prediabetics. Future studies with better adherence monitor and larger sample sizes might have resulted in better determination of the intervention's effect.

AST and ALT APRI Scores and Dysglycemia in Saudi Arabia: A Retrospective Population Study.

Hyperglycemia is a common symptom of numerous conditions, most notably diabetes mellitus and Cushing's syndrome, and the liver plays a pivotal role in the regulation of glucose metabolism. The AST-platelet ratio index (AST APRI score) and ALT-platelet ratio index (ALT APRI score) are novel parameters whose association with circulating glucose levels remains poorly studied. Laboratory data of 14,177 subjects were retrospectively analyzed for the association between AST and ALT APRI scores and fasting blood glucose (FBG) using the Mann-Whitney U and Kruskal-Wallis tests, Spearman's rank correlation coefficient, prevalence and odds ratio (OR) and ROC curve analysis. AST and ALT APRI scores showed progressive increases with FBG, and the mean FBG was significantly higher in subjects with high AST (104.9 ± 0.33 to 120.8 ± 3.27, p < 0.0001) and ALT (104.7 ± 0.34 to 111.6 ± 1.30, p < 0.0001) APRI scores. However, the AST APRI score but not the ALT APRI score was affected by age and gender. Notably, both elevated AST and ALT APRI scores were more prevalent in hyperglycemic subjects irrespective of gender and were associated with FBG, albeit through mediator variables. Increased AST (OR = 2.55, 95% CI: 1.46-2.06, p < 0.0001) and ALT (OR = 1.73, 95% CI: 1.46-2.06, p < 0.0001) APRI scores carried a significantly higher risk for hyperglycemia. Importantly, the ALT APRI score was superior to that of the AST APRI score in distinguishing hyperglycemic subjects. The AST and ALT APRI scores are inexpensive, novel markers of FBG and may serve as supportive evidence in the diagnosis and management of hyperglycemic conditions.

Levels of leptin, irisin, oxytocin and insulin in obese and normal weight Iraqi young men

Introduction and Aim: Obesity is a serious, life-threatening health condition that is prevalent in Iraq and the world as a whole. Since Leptin, irisin, oxytocin and insulin are proposed to play main roles in energy expenditure, glucose homeostasis, regulating body weight, reducing obesity and improving life expectancy so the aim of this study was to evaluate the concentrations of these anti-obesity hormones plus insulin resistance Materials and Methods: The study was conducted on 100 obese young men with a mean age of 29.95 years and fifty normal weight young men with a mean age of 28.44. Results: In obese men, the mean leptin concentration was 24.08±9.91 ng/ml which was significantly higher than in normal weight men 5.48 ng/ml. Serum irisin levels in obese men and normal weight were 8.9 ng/ml, 2.4 ng/ml respectively, and it was significantly higher in obese group in comparison to the normal weight group. The mean serum oxytocin concentration was significantly lower in obese group 6.41pg/ml in comparison to normal weight 29.55 pg/ml. Serum insulin levels in obese and normal weight were 19.55±5.56 and 3.64 micro lU/ml respectively and it was significantly higher in obese men. The mean fasting blood glucose concentration in obese men was 98.67mg/dl and it was significantly higher than in normal weight 84±9.85 mg/ml. Insulin resistance (HOMA IR) was significantly higher in obese men 6.6 than in normal weight 0.68. Conclusion: Serum levels of leptin, irisin, insulin, and insulin resistance are higher in obese young men, while oxytocin levels were noticeably low. Our study also shows that obesity increases the likelihood of insulin resistance.

Sleeve Gastrectomy Decrease Body Weight, Fasting Blood Glucose, and Gene Expression of TNF-α and IL-1 in The Abdominal Aorta of Rats with Obesity and Diabetes Mellitus

BACKGROUND: Sleeve gastrectomy (SG) is one option to significantly reduce body weight while also protect the cardiovascular system by controlling hyperglycemia and inflammatory markers. Secretion of tumor necrosis factor (TNF)-α and interleukin (IL)-1 could induce obesity- and diabetes mellitus (DM)-related inflammation, however its association with SG procedure has not been elucidated well. Therefore, TNF-α and IL-1 gene expression on the abdominal aorta of obese and DM rats that went through SG procedure were evaluated.METHODS: Fifteen rats were divided into 3 groups: lean-non-DM rats model (C1 group), obese-DM rats model (C2 group), and obese-DM rats model underwent SG (T group). Before and 10 days after the SG procedure, rats’ body weight and fasting blood glucose (FBG) were measured. Ten days after the procedure, TNF-α and IL-1 gene expression were also evaluated by PCR.RESULTS: In the end of study, mean body weight and FBG levels in C1 group (231.80±4.32 gram; 68.60±2.07 mg/dL) and T group (232.00±5.33 gram; 114.40±3.20 mg/dL) were significantly lower than in C2 group (264.60± 3.28 gram; 271.00±6.89 mg/dL). TNF-α and IL-1 gene expressions were also found to be significantly lower in the C1 group (1.01±0.01 rfu; 1.01±0.01 rfu) and T group (1.97±0.57 rfu; 1.21±0.78 rfu) compared to the C2 group (224.12±47.59 rfu; 1.85±0.73 rfu).CONCLUSION: SG could decrease body weight and FBG, as well as TNF-α and IL-1 gene expression in the abdominal aorta of rats with obesity and DM, hence SG could be a useful method in reducing body weight and controlling hyperglycemia and inflammatory markers.KEYWORDS: sleeve gastrectomy, TNF-α, interleukin-1, obesity, diabetes mellitus

Role of Circulating Endocan as a Biomarker in Non-Alcoholic Fatty Liver Disease

Abstract Background Nonalcoholic fatty liver disease (NAFLD) has a prevalence of 25% worldwide and is described as the leading cause of chronic liver disease. Liver disease was found to be the third leading cause of death among persons with NAFLD. Its prevalence is increasing in conjunction with metabolic syndrome due to engaged risk factors, which include high body mass index and abdominal obesity, type 2 diabetes, dyslipidemia (high triglycerides and/or low high-densitylipoproteins), age, male sex, and alcohol consumption. Aim of the Work The aim of this study is to study serum level of Endocan in patients with nonalcoholic Fatty Liver disease (NAFLD) to detect its relation to the incidence and severity of nonalcoholic Fatty Liver Disease (NAFLD). Patients and Methods This study was conducted at Ain Shams University hospitals to evaluate the role of serum endocan as a diagnostic biomarker for NAFLD. We included a total of 100 subjects who were divided into two equal groups; Group 1 included 50 patients with NAFLD, and Group 2 included 50 healthy controls. Results Both BMI and waist circumference showed a significant increase in cases compared to controls. The prevalence of DM in the NAFLD group was 36% which was statistically significantly higher as compared with the control group. The mean SBP was statistically significantly higher in the NAFLD group, while DBP showed comparable findings. The mean liver size as detected by US was statistically significantly higher in the NAFLD group as compared with the control group, while spleen size didn’t reveal a statistically significant difference between the two groups. The mean fasting blood glucose, mean HbA1C, mean post-prandial glucose, mean cholesterol level, mean TGs, mean LDL, mean ALT and mean AST, mean ALP, mean GGT and mean ferritin level were statistically significantly higher in the NAFLD group as compared with the control group. The mean HDL level was statistically significantly lower in the NAFLD group as compared with the control group. Other laboratory variables were comparable between the two groups. The mean serum endocan level was statistically significantly higher in the NAFLD group as compared with the control group (54.58 ± 18.61 and 30.69 ± 6.49 respectively). Each of APRI, FIB-4 and NAFLD scores showed significant difference between the two groups. Conclusion Based on the previous findings, one can conclude that: Serum endocan may act as a surrogate marker for the diagnosis of NAFLD as it was significantly elevated in cases compared to controls. As well as detection of disease severity as it has a positive correlation with APRI, FIB-4 score yet still further studies on larger scales are required. This confirms the state of endothelial dysfunction associated with this disease NAFLD is associated with impaired lipid profile, impaired liver functions, and higher incidence of diabetes compared to controls.

Correlation between blood glucose level and poor wound healing after posterior lumbar interbody fusion in patients with type 2 diabetes.

To investigate the correlation of blood glucose level with poor wound healing (PWH) after posterior lumbar interbody fusion (PLIF) in patients with type 2 diabetes (T2D). From January 2016 to January 2023, a case-control study was conducted to analyse the clinical data of 400 patients with T2D who were treated by PLIF and internal fixation at our hospital. The following data were recorded: gender; age; body mass index (BMI); surgical stage; average perioperative blood glucose level; perioperative blood glucose variance; perioperative blood glucose coefficient of variation; glycated haemoglobin level; preoperative levels of total protein, albumin and haemoglobin; postoperative levels of total protein, albumin and haemoglobin; surgical time; intraoperative bleeding volume; operator; postoperative drainage volume; and postoperative drainage tube removal time of each group. The indicators for monitoring blood glucose variability (GV) included the SD of blood glucose level (SDBG), coefficient of variation (CV) and maximum amplitude of variation (LAGE) before and after surgery. According to the diagnostic criteria for PWH, patients with postoperative PWH were determined and assigned to two groups: Group A (good wound healing group; n = 330 patients) and Group B (poor wound healing group; n = 70 patients). The preoperative and postoperative blood GV indicators, namely SDBG, CV and LAGE, were compared between these two groups. We also determined the relationship between perioperative blood GV parameters and PWH after PLIF surgery and its predictive value through correlation analysis and receiver-operating characteristic curve. Of the 400 enrolled patients, 70 patients had PWH. Univariate analysis revealed significant differences between the two groups in the course of diabetes, mean fasting blood glucose (MFBG), SDBG, CV, LAGE, preoperative hypoglycaemic program, surgical segment, postoperative drainage time, incision length and other factors (p < 0.05). However, no significant differences were noted in factors such as gender, age, body mass index, hypertension, coronary heart disease, admission fasting blood glucose, preoperative haemoglobin A1c, surgical time, intraoperative bleeding volume, intraoperative blood transfusion volume and postoperative drainage volume (p > 0.05). The area under the curve (AUC) values of preoperative SDBG, CV and LAGE were 0.6657, 0.6432 and 0.6584, respectively. The cut-off values were 1.13 mmol/L, 6.97% and 0.75 mmol/L, respectively. The AUC values for postoperative SDBG, CV and LAGE were 0.5885, 0.6255 and 0.6261, respectively. The cut-off values were 1.94 mmol/L, 24.32% and 2.75 mmol/L, respectively. The multivariate ridge regression analysis showed that preoperative MFBG, SDBG, CV and LAGE; postoperative SDBG, CV and LAGE; postoperative long drainage time; and multiple surgical segments were independent risk factors for T2D patients to develop surgical site infection after PLIF (p < 0.05). The perioperative blood GV in patients with T2D is closely related to the occurrence of PWH after PLIF. Reducing blood GV may help to reduce the occurrence of PWH after PLIF.

Gender Disparity in the Management of Diabetes among Residents of Sabon Gari Local Government Area of Kaduna State, Nigeria

Gender has been shown to play a major role in the level of management of diabetes mellitus (DM) especially in this part of the world. This study therefore looked into the possibility and level of difference in the management of the condition among patients resident in Sabon Gari Local Government Area (LGA) of Kaduna State, Nigeria. The number of diabetic patients recruited for the study was 250 (aged 35 and above), comprising of 135 and 115 female and male patients respectively. A total of 5mL of blood was taken from the subjects after 10 hour fasting, out of which 3mL was centrifuged and the separated serum analysed for glucose. The remaining 2mL was analysed immediately for glycated haemoglobin (HbA1C). Samples were collected over a period of eight months after which comparison of parameters between both genders was done in order to determine extent of diabetes management. There was a significant difference between the parameters of the female diabetic patients (Mean Fasting Blood Glucose, FBG = 189±82.30mg/dL; Mean HbA1C = 8.5±3.18%) and those of the male diabetic patients (FBG = 223±89.00mg/dL; Mean HbA1C = 9.8±3.39%). The glycaemic markers were significantly lower (though still within the diabetic range) among the female patients as compared with the male patients. Conclusively, the female patients had their diabetes better managed and controlled than their male counterparts.

Poor glycemic control and associated factors among patients with type 2 diabetes mellitus: a cross-sectional study

Glycemic control is of paramount importance in care and management for patients with type 2 diabetes mellitus (T2DM). Poor glycemic control is a major health problem that greatly contributes to the development of diabetes related complications. This study aims to assess the prevalence of poor glycemic control and associated factors among outpatients with T2DM attending diabetes clinic at Amana Regional Referral Hospital in Dar-es-salaam, Tanzania from December 2021 to September 2022. A face to face interviewer semi-structured questionnaire was administered during data collection. Binary logistic regression under multivariable analysis was used to determine the independent predictors of poor glycemic control. A total of 248 patients with T2DM were included in the analysis with mean age of 59.8 ± 12.1 years. The mean fasting blood glucose was 166.9 ± 60.8 mg/dL. The prevalence of poor glycemic control was 66.1% (fasting blood glucose > 130 mg/dL or < 70 mg/dL). Failure to adhere to regular follow-up (AOR = 7.53, 95% CI = 2.34–19.73, p < 0.001) and alcoholism (AOR = 4.71, 95% CI = 1.08–20.59, p = 0.040) were the independent predictors of poor glycemic control. The prevalence of poor glycemic control observed in this study was significantly high. Emphasis should be placed on ensuring that patients have regular follow-up for their diabetes clinics and they should also continue modifying some of lifestyle behaviors including refraining from alcoholism, this can help them to have good glycemic control.

The effect of weight loss on serum ceruloplasmin levels in obese patients

Introduction and aim. Serum ceruloplasmin level may be a biomarker associated with obesity and cardiovascular risk. We aimed to evaluate the effect of body weight lost by diet and exercise program on metabolic parameters and serum ceruloplasmin levels in obese patients. Material and methods. A total of 120 obese patients with BMI ≥30 kg/m 2 were enrolled in a 16-week balanced diet program with the goal of losing 10% or more of body weight while maintaining a daily energy deficit of 500-1000 kcal/day. Results. Mean weights of the patients decreased from 93.2±15.1 kg to 83.2±13.1 kg (p&lt;0.001) and mean BMI decreased from 35.8±5.6 kg/m 2 to 31.9±4.9 kg/m 2 (p&lt;0.001). Mean ceruloplasmin decreased from 25.2±4.7 mg/dL to 23.6±4.9 mg/dL (p&lt;0.001), mean total cholesterol from 191.8±37.1 mg/dL to 153.8±28.7 mg/dL (p&lt;0.001), mean LDL from 120.3±31.4 mg/dL to 91.1±27.7 mg/dL (p&lt;0.001) and mean fasting blood glucose from 108.2±35 mg/dL to 103.3±81.1 mg/dL (p&lt;0.001). There was a statistically significant and weak correlation between the change in ceruloplasmin and the change in BMI (p=0.016, R=0.233). There was a statistically significant and weak correlation between ceruloplasmin change and weight change (p=0.010, R=0.251). Conclusion. Obese patients’ serum ceruloplasmin levels were found to decrease with weight loss.

CARDIOVASCULAR EVENTS IN TYPE 2 DIABETIC PATIENTS

Objective: Cardiovascular diseases represent the first cause of death of patients with type 2 diabetes. The aim of our work is to identify the prevalence of cardiovascular disease in type 2 diabetes. Design and method: This is a retrospective descriptive study conducted over a period of three years (January 2013- January 2016) including type 2 diabetic patients followed up at the nephrology consultation of Mongi slim hospital. Clearance was calculated according to the MDRD formula. The stage of chronic kidney disease (CKD) was defined according to the KDIGO 2012 classification. Results: Our study included 42 patients with diabetic kidney disease followed at our nephrology consultation. The mean age was 63.3 [31-80] with a sex ratio M/F = 1.47. Eighty-eight percent of our patients had hypertension. At the first consultation our patients already had macrovascular disease: 4 patients were suffering from peripheral artery disease, 4 patients had heart failure, a history of ischemic stroke was found in 4 patients and acute coronary syndrome in 11 patients. Regarding cardiovascular risk factors, obesity was found in 13 patients, 6 patients were smokers and 25 patients (59.5%) had dyslipidemia with a mean cholesterol level of 4.48 +/- 1.09 mmol/l. The mean fasting blood glucose level was 10.5 +/-5.23 mmol/l and a mean glycated hemoglobin was 8.24 +/-2.22%. The renal impact was as follows: chronic kidney disease stage 3A in 12 patients (28.6%), stage 3B in 14 patients (33.3%), stage 4 in 6 patients (14.3%) and stage 5 in 2 patients. During the course of the study, 7 patients had an acute coronary syndrome and 1 patient had an ischemic stroke. Conclusions: Diabetes is a cardiovascular risk factor in itself. Although nothing can be done about the non-modifiable risk factors (heredity, age, gender), it is possible to act early and effectively on the other modifiable factors.

Effect of nutritional promotion intervention on dietary adherence among type II diabetes patients in North Shoa Zone Amhara Region: quasi-experimental study

BackgroundDiabetes is a major global public health problem that requires self-management behavior. However, this is difficult to implement in practice and requires new approaches. The purpose of this study was to evaluate nutritional promotion interventions for dietary adherence and lessons learned to improve self-management.MethodsA quasi-experimental study was conducted from January 2020 to February 2021 in North Shoa Zone public hospital. The study enrolled 216 type II diabetic patients from four public hospitals. Study participants were randomly assigned to intervention and control groups at an individual level. Data were measured twice (baseline and end line survey after six months using interviewer-administered questionnaires). Data were entered into Epi Data V.3.1 and analyzed using SPSS version 22. Data were presented as means of standard deviations for continuous variables and percentages for categorical variables. Intervention and control groups were compared before and after intervention using independent t tests. A p-value less than 0.05 was considered significant for all statistical tests.ResultsA total of 216 type II diabetics participated in this study. Nutritional promotion intervention programs increased adherence to the mean number of days adhering to a healthy diet (p < 0.0001). Specifically, the nutrition promotion program improved daily intake of fruits and vegetables, low glycemic index foods, high fiber foods, healthy fish oils, low sugar foods, and healthy eating plans (p ≤ 0.050). Mean fasting blood glucose levels were significantly decreased after the educational intervention (p ≤ 0.05).ConclusionThis study demonstrates that a nutrition-promoting intervention can significantly change patients' adherence to healthy eating behaviors and effectively improve their glycemic control. Health care providers should integrate programs that promote nutrition education into existing health systems service. Primary care platforms such as health posts and health centers can play a key role in integrating health promotion programs to improve self-management behaviors.

Effects of Moringa oleifera leaves on the blood glucose, blood pressure, and lipid profile of type 2 diabetic subjects: A parallel group randomized clinical trial of efficacy.

There is a paucity of information on the antidiabetic potential of graded amounts of Moringa leaves on diabetes human subjects. To ascertain the effeccts of Moringa leaves on type 2 diabetic subjects' blood glucose, blood pressure, and lipid profile levels in a rural Nigerian community. This study adopted a parallel group randomized control design. Participants included 40 adult male and female diabetic subjects who met the inclusion criteria and consented to participate in the study. The participants were randomly assigned to four groups. The control group was fed diets without Moringa oleifera leaves while the experimental groups received 20, 40, and 60 g of Moringa leaves respectively daily for 14 days in addition to the diets. The subjects' baseline data and post-intervention data were collected before and after the intervention, respectively. Data were analyzed using paired-sample t-test and analysis of covariance. Significance was accepted at p < 0.05. The mean fasting blood glucose levels in all the groups did not differ significantly from one another. Group 3 had significantly (p = 0.01) lower mean systolic pressure (from 136.40 ± 7.66 to 123.90 ± 13.82) after the intervention. Group 3 subjects had a significant (p = 0.04) increase in their triglyceride values (from 123.80 ± 53.69 before intervention to 151.20 ± 41.47) after intervention. After adjusting for the pre-intervention values, there was no significant (p > 0.05) difference in all the parameters at the end of the intervention. There were marginal improvements in the parameters assessed which were not dose-dependent.

Glycemic Abnormalities in Pancreatic Cystic Lesions—A Single-Center Retrospective Analysis

Background and Objectives: Glucose metabolism alterations are very common in solid pancreatic lesions, particularly in pancreatic cancer. Similarly, diabetes and especially new-onset diabetes (NOD) have been associated with the malignant transformation of pancreatic cysts. We aimed to assess the prevalence and relevant associations of glycemic abnormalities in pancreatic cystic lesions (PCLs) in a retrospective analysis. Materials and Methods: We retrospectively recruited all patients who underwent endoscopic ultrasound for a PCL over a period of 36 months (January 2018 to December 2021). Final diagnosis was set by means of tissue acquisition, surgery, follow-up, or board decision. Demographic and clinical data, laboratory workup, and imaging features were extracted from the patients’ charts according to a predefined protocol. We considered fasting blood glucose (FBG) and HbA1c values and stratified the patients as nondiabetic (FBG ≤ 99 mg/dL, HbA1c ≤ 5.6%, no history of glycemic abnormalities), prediabetic (FBG 100–125 mg/dL, HbA1c 5.7–6.4%), or diabetic (long-lasting diabetes or NOD). Results: Altogether, 81 patients were included, with a median age of 66 years, and 54.3% of them were male. The overall prevalence of fasting hyperglycemia was 54.3%, comprising 34.6% prediabetes and 22.2% diabetes, of which 16.7% had NOD. The mean FBG and HbA1c levels were higher in malignant and premalignant PCLs (intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), cystadenocarcinoma, and cystic neuroendocrine tumor) compared to the benign lesions (pseudocysts, walled-off necrosis, and serous cystadenoma): 117.0 mg/dL vs. 108.3 mg/dL and 6.1% vs. 5.5%, respectively. Conclusions: Hyperglycemia and diabetes are common in PCLs, with a high prevalence in premalignant and malignant cysts. Screening and follow-up for glycemic abnormalities should be routinely conducted for PCLs, as they can contribute to a tailored risk assessment of cysts.