Measuring Blood Glucose Levels Research Articles

Bauhinia forficata Link, Antioxidant, Genoprotective, and Hypoglycemic Activity in a Murine Model.

Bauhinia forficata L. is a tree used in alternative medicine as an anti-diabetic agent, with little scientific information about its pharmacological properties. The hypoglycemic, antioxidant, and genoprotective activities of a methanolic extract of B. forficata leaves and stems combined were investigated in mice treated with streptozotocin (STZ). Secondary metabolites were determined by qualitative phytochemistry. In vitro antioxidant activity was determined by the DPPH method at four concentrations of the extract. The genoprotective activity was evaluated in 3 groups of mice: control, anthracene (10 mg/kg), and anthracene + B. forficata (500 mg/kg) and the presence of micronuclei in peripheral blood was measured for 2 weeks. To determine the hypoglycemic activity, the crude extract was prepared in a suspension and administered (500 mg/kg, i.g.) in previously diabetic mice with STZ (120 mg/kg, i.p.), measuring blood glucose levels every week as well as the animals' body weight for six weeks. The extract showed good antioxidant activity and caused a decrease in the number of micronuclei. The diabetic mice + B. forficata presented hypoglycemic effects in the third week of treatment, perhaps due to its secondary metabolites. Therefore, B. forficata is a candidate for continued use at the ethnomedical level as an adjuvant to allopathic therapy.

Lactase persistence phenotype and genotype in Iranian Mazani-Shahmirzadi and Afghan Hazara ethnicities

Lactase persistence is an autosomal dominant trait characterized by sustained expression of lactase gene throughout adulthood. This trait is mostly prevalent in populations with pastoral or agro-pastoral ancestry and allows lactase persistent individuals to benefit from milk nutrients. Several genetic variants have been identified to be responsible for lactase persistence in different populations and other genetic variants associated with lactase persistence are expected to be found. In this study, we aimed to investigate the lactase persistence phenotype and genotype in two isolated populations, the Iranian Mazani-Shahmirzadi and Afghan Hazaras living in Iran. For this purpose, we genotyped five single nucleotide polymorphisms −13.907C/G, −13.910C/T, −13.913T/C, −13.915T/G and −22.018A/G in 45 Mazanis from Shahmirzad and 50 Hazaras living in the suburb of Tehran. We also investigated lactase persistence by inquiring about digestive symptoms and measuring blood glucose levels after 50g lactose consumption. Our results show that 24.2% of Mazani-Shahmirzadis and 14% of Hazaras are lactase persistent based on blood glucose levels. Genotype investigation shows that only two SNPs, 13.910 C/T and 22.018 A/G display variation in the studied populations. The −13.910*T allele has a frequency of 7.7% in Mazani-Shahmirzadis and 12.7% in Hazaras. The frequency of −22.018*A was 16.6% in Mazani-Shahmirzadis and 17% in Hazaras. Importantly, we found a new genetic variant at −13.913 single nucleotide polymorphism which has not been previously reported. Given that the −13.913 single nucleotide polymorphism is within the enhancer Oct-1 binding site, the presence of this variant could affect lactase gene expression in adults. Further studies are required to elucidate the impact of this variant on LCT gene enhancer function.

Glucose variability: A physiological correlate of eating disorder behaviors among individuals with binge-spectrum eating disorders.

Elevated glucose variability may be one mechanism that increases risk for significant psychological and physiological health conditions among individuals with binge-spectrum eating disorders (B-EDs), given the impact of eating disorder (ED) behaviors on blood glucose levels. This study aimed to characterize glucose variability among individuals with B-EDs compared with age-matched, sex-matched, and body mass index-matched controls, and investigate the association between frequency of ED behaviors and glucose variability. Participants were 52 individuals with B-EDs and 22 controls who wore continuous glucose monitors to measure blood glucose levels and completed ecological momentary assessment surveys to measure ED behaviors for 1 week. Independent samples t-tests compared individuals with B-EDs and controls and multiple linear regression models examined the association between ED behaviors and glucose variability. Individuals with B-EDs demonstrated numerically higher glucose variability than controls (t=1.42, p=.08, d=0.43), although this difference was not statistically significant. When controlling for covariates, frequency of ED behaviors was significantly, positively associated with glucose variability (t=3.17, p=.003) with medium effect size (f2 =0.25). Post hoc analyses indicated that binge eating frequency was significantly associated with glucose variability, while episodes of 5+ hours without eating were not. Glucose variability among individuals with B-EDs appears to be positively associated with engagement in ED behaviors, particularly binge eating. Glucose variability may be an important mechanism by which adverse health outcomes occur at elevated rates in B-EDs and warrants future study. This study suggests that some individuals with binge ED and bulimia nervosa may experience elevated glucose variability, a physiological symptom that is linked to a number of adverse health consequences. The degree of elevation in glucose variability is positive associated with frequency of eating disorder behaviors, especially binge eating.

Is Raman the best strategy towards the development of non-invasive continuous glucose monitoring devices for diabetes management?

Diabetes has no well-established cure; thus, its management is critical for avoiding severe health complications involving multiple organs. This requires frequent glycaemia monitoring, and the gold standards for this are fingerstick tests. During the last decades, several blood-withdrawal-free platforms have been being studied to replace this test and to improve significantly the quality of life of people with diabetes (PWD). Devices estimating glycaemia level targeting blood or biofluids such as tears, saliva, breath and sweat, are gaining attention; however, most are not reliable, user-friendly and/or cheap. Given the complexity of the topic and the rise of diabetes, a careful analysis is essential to track scientific and industrial progresses in developing diabetes management systems. Here, we summarize the emerging blood glucose level (BGL) measurement methods and report some examples of devices which have been under development in the last decades, discussing the reasons for them not reaching the market or not being really non-invasive and continuous. After discussing more in depth the history of Raman spectroscopy-based researches and devices for BGL measurements, we will examine if this technique could have the potential for the development of a user-friendly, miniaturized, non-invasive and continuous blood glucose-monitoring device, which can operate reliably, without inter-patient variability, over sustained periods.

Designing A Non-Invasive Testing Device for Infant Diabetes using Saliva

Neonatal diabetes is estimated to affect 1 in every 95,000 to 1 in every 400,000 live births. Male and female infants are equally affected by the disease, which has been recorded in all ethnic groups. Neonatal diabetes mellitus is a type of diabetes that develops within the first six months of life. Insulin is a hormone that aids in the production of energy in our cells. This condition causes infants to produce insufficient insulin, resulting in elevated blood glucose levels. Therefore, it is very important to design a testing device that can monitor premature babies indicating symptoms of diabetes. Recognizing the signs of diabetes in an infant might be difficult because diabetes in babies is not common. Frequent wet diapers, a high appetite, dehydration, and weight loss are all signs of neonatal diabetes. Once you have diabetes, you're used to having to take tests to monitor your condition. Conventionally invasive methods are used to check neonatal diabetes which is a painful procedure for infants as it requires prinking to draw blood several times per day. Therefore, this paper aims to design a non-invasive testing design for neonatal diabetes that is not painful to babies. There are several non-invasive ways to test blood glucose levels; urine, sweat, and saliva. Urine tests can be used to detect glucose levels in urine and check for the presence of ketones. The presence of ketone above the threshold indicates a high blood glucose level of over 300ml/dL. Sweat is also used to test diabetes. Hyperhidrosis (excessive sweating) is caused by high blood sugar levels, and it indicates that blood sugar control has to be tightened. Saliva is a new medium to measure blood glucose levels and research is going on its use to measure diabetes. Previous research has found a strong relationship between blood glucose levels and saliva glucose levels. In this paper, saliva is used as a non-invasive method to measure neonatal diabetes. Saliva containing glucose is collected and treated with glucose oxidase. H2O2 produced during this reaction is further treated and an optical sensor along with a microcontroller is used to measure the concentration of blood glucose. The expected results based on the study indicate the amount of glucose in the saliva increases in proportion to the amount of glucose in the blood and confirms the relationship between glucose concentrations in the blood and saliva, implying that the proposed design can take the place of the existing devices. However, more tests should be carried out to improve the efficacy of the proposed design for detecting glucose in saliva.

Nitazoxanide, Ivermectin, and Artemether effects against cryptosporidiosis in diabetic mice: parasitological, histopathological, and chemical studies.

Human cryptosporidiosis is one of the most significant causes of water borne epidemics of diarrhea worldwide. It is extremely important in immunocompromised hosts and malnourished children as it could cause severe life-threatening diarrhea. Despite the global burden of the disease, there are only few available therapies against cryptosporidiosis. Diabetes mellitus is a common metabolic disorder that impair both the innate and adaptive immune responses of the patient. This study aimed to test the effect of Nitazoxanide, Ivermectin, and Artemether against cryptosporidiosis in diabetic mice. Sixty white albino mice were categorized into 6 groups; 10 mice each: GI: normal non-infected non-treated (healthy- control), GII-GVI (diabetic groups), GII: non-infected non treated (diabetic control), GIII: infected non treated (infected control), GIV: infected and treated with Nitazoxanide (NTZ), GV: infected and treated with Ivermectin (IVC), GVI: infected and treated with Artemether (ART). Parasitological, histopathological, and chemical examinations were done to evaluate the effect of NTZ, IVC, and ART against cryptosporidiosis in diabetic mice. Parasitological examination revealed maximum reduction of oocyst shedding in GVI, while histopathological examination showed the least pathologic changes in GV with mild vascular wall fibrosis and moderate lymphocytic infiltration of islets of Langerhans. Measurement of blood glucose level showed the best results with GIV. Nitazoxanide is effective against cryptosporidiosis in diabetic patients with minimal hyperglycemia, Artemether is especially effective in reducing the oocyst shedding in stool, whereas Ivermectin is associated with the least pathological changes in pancreatic islets of Langerhans.Graphical abstract

Antidiabetic and antioxidant potential of total extract and supernatant fraction of the roots of Anogeissus leiocarpus in HFD-fed and Streptozocin -induced diabetic rats

The aim of this study was to evaluate the antidiabetic properties of hydro alcoholic extract and supernatant fraction of the roots of Anogeissus leiocarpus, a plant used by traditional healers to treat Diabetes mellitus. Diabetes mellitus was induced by a single intraperitoneal administration of Streptozocin to Sprague Dawley rats under a fructose-enriched fat diet. Diabetic rats were treated with 500 mg/kg of total extract and 100 mg/kg of supernatant. The antidiabetic activity was assessed by measuring blood glucose level, lipid profile, insulin and biochemical parameters together with the antioxidant potential.The administration of total extract and supernatant exhibited significant decrease (p < 0.01) of the blood glucose level in the diabetic rats after 7 days of treatment compared to the diabetic rats. A significant reduction in the serum concentrations of cholesterol (19.7 %) and triglycerides (56.7 %) was observed in the treated diabetic rats. The levels of insulin did not differ across all the groups. However, compared to diabetic rats, HOMA-IR (Homeostasis Model Assessment for Insulin-resistance) and HOMA-β (Homeostasis Model Assessment for β cell function) showed a statistical decrease in insulin resistance and an increase in pancreatic β cell function in the treated diabetic rats. Moreover, total extract and supernatant significantly increased GSH level and decreased lipid peroxidation because of their antioxidant properties. In comparison, the supernatant fraction exerted stronger antidiabetic and antioxidant effects than the total extract.Hence, the roots of Anogeissus leiocarpus are a potent antidiabetic agent that can be developed as an alternative medicine for diabetes and its complications.

Molecular Hydrogen Mediates Neurorestorative Effects After Stroke in Diabetic Rats: the TLR4/NF-κB Inflammatory Pathway

Diabetes is an independent risk factor for stroke and amplifies inflammation. Diabetic stroke is associated with a higher risk of death and worse neural function. The identification of effective anti-inflammatory molecules with translational advantages is particularly important to promote perioperative neurorestorative effects. Applying molecular hydrogen, we measured blood glucose levels before and after middle cerebral artery occlusion (MCAO), 48-h cerebral oedema and infarct volumes, as well as 28-day weight, survival and neurological function. We also measured the levels of TLR4, NF-κB p65, phosphorylated NF-κB p65, catecholamines, acetylcholine and inflammatory factors. All measurements comprehensively showed the positive effect and translational advantage of molecular hydrogen on diabetic stroke. Molecular hydrogen improved the weight, survival and long-term neurological function of rats with diabetic stroke and alleviated changes in blood glucose levels before and after middle cerebral artery occlusion (MCAO), but no difference in circadian rhythm was observed. Molecular hydrogen inhibited the phosphorylation of NF-κB and significantly reduced inflammation. Molecular hydrogen mediates neurorestorative effects after stroke in diabetic rats. The effect is independent of circadian rhythms, indicating translational advantages. The molecular mechanism is related to the TLR4/NF-κB pathway and inflammation.Graphical abstractMolecular hydrogen (H2) affects outcomes of ischemic stroke with diabetes mellitus (DM).

Design and Development of an Internet of things Based Glucometer with Wireless Transmission

Diabetes is one of the top non-communicable illnesses of public health importance. 6.4% of world population is reported to have diabetes mellitus with the figure, feared to double by 2040. Nigeria has estimated 1.6 million cases in 2015, which ranked her the third diabetes endemic country in Africa. Diabetes complication is a known leading cause of the disease high mortality rates and healthcare burden on developing economies. Daily monitoring of blood sugar levels, however, is an effective way to prevent diabetes complications. Glucometer is a simple device used for blood glucose monitoring. The aim of this study was to design and use locally sourced materials to fabricate a cheap digital glucometer that will be able to measure blood glucose levels and sends a distress signal to medics and caregivers via wireless transmission.The method employed includes programming, calibration, assembling, component testing, and the overall device test. The device is equipped with an Atmega32 microcontroller, One-Touch Ultra glucose sensor, a GSM module, emergency button, and internet of things (IoT). Our device and a conventional device (Accuchek) were used to measure the blood sugar level of 200 individuals in groups of 5, the data were analyzed using SPSS2.0 and Microsoft Excel 2010.The p-value was (&gt;0.05) indicating no significant difference between the data generated by our device and the conventional glucometer, while the coefficient of determination (R2) was 0.9838. From the results above, we conclude that our fabricatrd device is effective and reliable.

ANALYSIS OF BLOOD GLUCOSE LEVELS IN PEOPLE WITH TYPE II DIABETES MELLITUS (DM) AGED 50-60 YEARS WITH GLUCOMETER METHOD AT ISLAMIC MALAHAYATI MEDAN HOSPITAL YEAR 2022

Diabetes Mellitus (DM) type II is a metabolic disorder disease characterized by an increase in blood glucose due to a decrease in insulin secretion by pancreatic beta cells or impaired insulin function (insulin resistance). Blood glucose is a carbohydrate that circulates in the body in the metabolic process. Monitoring blood sugar levels is needed in establishing a diagnosis, especially for Diabetes Mellitus (DM). Blood glucose levels can be checked when the patient is in a fasting condition or it can also be when the patient comes to check, with the results of the examination of blood glucose levels when &gt;200 mg / dl, while for the results of glucose levels during fasting &gt;126 mg / dl.. This type of research is descriptive. A tool to measure blood glucose levels using the Glucometer Method. The time of the study was carried out from January to March at the Islamic Malahayati Medan Hospital’s Laboratory by taking 10 samples. Data collection is carried out by direct examination of blood glucose levels in patients with Diabetes Mellitus at Malahayati Medan Islamic Hospital in March-April 2022. From the results of examination of blood glucose levels in 10 samples of type II diabetes mellitus (DM) aged 50-60 years with glucometer method at Malahayati Islam hospital Medan 2022 obtained the results that all samples showed an average blood glucose level value above 220 mg / dl and increased from its normal value.&#x0D; Keywords: Diabetes Mellitus; Blood Glucose Level

Enzyme-Free Glucose Monitoring Patch

Monitoring of glucose levels in non-invasive biofluids, such as saliva and sweat, can advance personal health tracking. However, the approach remains challenging due to the low glucose concentration in saliva and sweat, about 100 times lower than in the blood. Commercial glucose sensors rely on glucose oxidase to measure blood glucose levels with enzyme reactions. The enzyme activity varies with pH, oxygen level, and temperature (more than 40ºC). Also, the method often suffers from cross-reactivity with other sugar molecules, such as maltose and xylose [1]. Thus, it is crucial to develop highly sensitive and stable non-enzymatic sensors for detecting glucose in non-invasive biological fluids.In this work, we present an enzyme-free, reagent-free electrochemical glucose monitoring patch based on a glucose imprinted polymer nanocomposite. The nanocomposite comprises redox-active chitosan-ferrocene (Cs-Fc) wrapped multi-walled carbon nanotubes (MWCNTs). The Cs-Fc is a polymer with covalently secured redox-active ferrocene, effectively preventing the out leakage of redox substances [2]. The incorporation of MWCNTs increases the surface area, conductivity, and electron transfer rate. The glucose imprinted layer was grown on the surface of the nanocomposite by electropolymerization of functional monomers o-phenylenediamine (o-PD) and 3-aminophenylboronic acid (APBA) in the presence of glucose templates. The successful removal of template molecules created glucose specific recognition sites in the polymer matrices. The sensor directly detected the presence of glucose upon their binding into these cavities. The electrochemical property of the modified sensor was characterized by cyclic voltammetry (CV) in a potential range of 0-0.5 V at a scan rate of 100 mVs-1 in 1x PBS (pH 7.4) solution. For glucose sensing, the sensor was immersed in a sample solution containing different glucose concentrations for 30 min. We have optimized the composition ratio and assay conditions for sensitive glucose detection. Preliminary results indicated a change in redox peak current of ~2.7 times relative to the control upon adding 1 mM glucose, as shown in Figure 1. The proposed glucose patch is label-free, reagentless, cost-effective, easy fabrication, and expected to be utilized for sensitive and selective glucose detection from sweat.

Performance Evaluation of the i-SmartCare 10 Analyzer and Method Comparison of Six Point-of-Care Blood Gas Analyzers.

Blood gas, electrolyte, glucose, and lactate level measurement have an immediate and critical impact on patient care. We evaluated the performance of i-SmartCare 10 (i-SENS Inc., Seoul, Korea) and conducted a method comparison study of five point-of-care (POC) analyzers with i-SmartCare 10 as the comparator, according to the CLSI guidelines. Ten analytes (pH, pCO2, pO2, Na+, K+, Cl-, iCa2+, glucose, lactate, and Hct) were tested on six analyzers: i-SmartCare 10, ABL90 FLEX PLUS (Radiometer Medical ApS, Copenhagen, Denmark), i-Stat (Abbott Point of Care Inc., Princeton, NJ, USA), RapidLab 1265 (Siemens Healthcare Diagnostics Inc., Tarrytown, NY, USA), Stat Profile pHOx Ultra (Nova Biomedical, Waltham, MA, USA), and Gem Premier 5000 (Instrumentation Laboratory, Bedford, MA, USA). The total imprecision and linearity (r2>0.99) were excellent, except for a few analytes that narrowly escaped the preset criteria. Interference was noted for Na+ in the presence of a high K+ level and for iCa2+ in the presence of high K+ and Mg2+ levels. Forty of 48 items demonstrated either a proportional or systematic difference in regression analysis; the relative mean difference (%) of 14/48 items escaped the allowable total error in the difference plot analysis. i-SmartCare 10 shows acceptable performance, and using a single POC blood gas analyzer is recommended for monitoring.

Uji Efektivitas Antidiabetik Kombinasi Ekstrak Daun Senggani (Melastomapolyanthum .Bl) dan Glibenklamid dalam Menurunkan Kadar Glukosa Darah pada Mencit (Mus Musculus)

This study aims to determine the antidiabetic effectiveness of the combination of Senggani leaf extract (Malestoma polyanthum Bl.) And Glibenclamide against alloxan-induced mice. This study used 15 male mice divided into 5 groups and each group consisted of 3 male mice, group I was given Na.CMC 1% w / v, groups III, IV, V were each given a combination of senggani leaf extract 90 mg / kg, 180 mg / kg, 360 mg / kg and 5 mg of glibeclamide as the treatment group, and for group II were given glibenclamide suspension 5 mg for comparison. Alloxan 150 mg / KgBW was used as an inducer of diabetes. Measurement of blood glucose levels was carried out three times, namely initial glucose measurement, post-induction glucose measurement and post-treatment glucose measurement. The results showed that giving senggani leaf extract with a concentration of 90 mg / kg BW, 180 mg / kg BW, 360 mg / kg BW had an antidiabetic effect in male mice. Senggani leaf extract 360 mg / kg BW showed the most effective antidiabetic effect, but still more smaller than the 5 mg glibenclamide suspension.

Antidiabetic Properties of Aqueous Leaf and Stem Extracts of Andrographis paniculata on Alloxan Induced Diabetes in Wistar Rats

Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. The aim of the study was to assess the effectiveness of Andrographis paniculata leaf and stem bark extracts in management of Alloxan induced diabetes Wistar rats. Fifty (50) Wistar rats were divided into eight groups, namely; group A (normal control), B, C, D, E, F, G and H (treatment groups). The study was conducted for four (4) weeks by measuring blood glucose levels in first four weeks. The result showed that the diabetic rats administered with 500mg/kg of aqueous leaf extract and 250mg/kg of stem bark extract were significantly lower than those of untreated control groups. However, the combined dose of 250mg/kg aqueous leaf and 250mg/kg stem extracts were not significantly different from untreated control group. Findings of the study have demonstrated that leaves and stem extract of A. paniculata exhibited significant blood sugar lowering property in Alloxan induced diabetic Wistar rats.

Noninvasive Blood Glucose Monitoring Systems Using Near-Infrared Technology-A Review.

The past few decades have seen ongoing development of continuous glucose monitoring (CGM) systems that are noninvasive and accurately measure blood glucose levels. The conventional finger-prick method, though accurate, is not feasible for use multiple times a day, as it is painful and test strips are expensive. Although minimally invasive and noninvasive CGM systems have been introduced into the market, they are expensive and require finger-prick calibrations. As the diabetes trend is high in low- and middle-income countries, a cost-effective and easy-to-use noninvasive glucose monitoring device is the need of the hour. This review paper briefly discusses the noninvasive glucose measuring technologies and their related research work. The technologies discussed are optical, transdermal, and enzymatic. The paper focuses on Near Infrared (NIR) technology and NIR Photoplethysmography (PPG) for blood glucose prediction. Feature extraction from PPG signals and glucose prediction with machine learning methods are discussed. The review concludes with key points and insights for future development of PPG NIR-based blood glucose monitoring systems.

High-Precision Nonenzymatic Electrochemical Glucose Sensing Based on CNTs/CuO Nanocomposite

The measurement of blood glucose levels is essential for diagnosing and managing diabetes. Enzymatic and nonenzymatic approaches using electrochemical biosensors are used to measure serum or plasma glucose accurately. Current research aims to develop and improve noninvasive methods of detecting glucose in sweat that are accurate, sensitive, and stable. The carbon nanotube (CNT)-copper oxide (CuO) nanocomposite (NC) improved direct electron transport to the electrode surface in this study. The complex precipitation method was used to make this NC. X-ray diffraction (XRD) and scanning electron microscopy were used to investigate the crystal structure and morphology of the prepared catalyst. Using cyclic voltammetry and amperometry, the electrocatalytic activity of the as-prepared catalyst was evaluated. The electrocatalytic activity in artificial sweat solution was examined at various scan rates and at various glucose concentrations. The detection limit of the CNT-CuO NC catalyst was 3.90 µM, with a sensitivity of 15.3 mA cm−2 µM−1 in a linear range of 5–100 µM. Furthermore, this NC demonstrated a high degree of selectivity for various bio-compounds found in sweat, with no interfering cross-reactions from these species. The CNT-CuO NC, as produced, has good sensitivity, rapid reaction time (2 s), and stability, indicating its potential for glucose sensing.Graphical

Investigational Outcomes of Normal and Diabetic Human Volunteers using Microwave based Non-invasive Blood Glucometer

—Noninvasive estimation of blood glucose using microwave based sensor is one of the most challenging research fields in recent days. These methods are more adaptable to avoid soreness and skin estrangement that occur in traditional invasive blood glucose measurement techniques. This paper suggests the investigational outcomes of a microwave based noninvasive blood glucose meter to check performance of the microwave antenna sensor. Narrowband micro strip antenna with resonating microwave frequency of 1.3 GHz is utilized to measure Blood Glucose Level (BGL) noninvasively. Validity of sensor is assessed by performing medical tests on non diabetic and diabetic human volunteers. Mean Absolute Relative Difference (MARD) and Surveillance Error Grid (SEG) analyses were performed during experimentation to find deviation of estimated BGL from reference BGL which is measured using available invasive technique. Direct assessment of estimated data with reference data provides excellent reliability and repeatability of proposed microwave technique. Keywords- glucometer, Blood Glucose Level (BGL), medical tests, Mean Absolute Relative Difference (MARD), Surveillance Error Grid (SEG)

Soy flour snack bars lower glycaemic response in type 2 diabetes mellitus subjects: A randomised cross-over design

Introduction: Low glycaemic snacks may help to improve blood glucose control. However, data on the effect of soybean snack bars on postprandial glucose levels of the diabetic population is scarce. Therefore, the current study aimed to examine the effect of consuming soy flour snack bars on glycaemic response (GR) over a 180-minute period in individuals with diabetes by estimating postprandial glucose levels variation and total area under the curve (AUC). Methods: Nine subjects (age: 54.6±4.0 years; BMI: 25.0±2.5 kg/m2) with type 2 diabetes mellitus (T2DM) diagnoses without complication enrolled in this randomised, open-label, cross-over trial. On three separate sessions, they consumed glucose standard solution, soy flour snack bar (SF), and wheat flour snack bar (WF) containing 25 g of available carbohydrate, respectively. Finger prick capillary method was executed to measure blood glucose levels at 30, 60, 90, 120, 150, 180 minutes after test product ingestion. Results: Overall, significantly lower postprandial glucose levels were observed at 30, 60, 90, and 120 minutes (122.3±17.6, 136.3±24.9, 125.7±25.3, and 107.2±24.1 mg/dL; p&lt;0.001) in those who consumed SF snack bars than WF snack bars (147.9±41.3, 168.0±43.6, 152.6±30.0, and 140.6±33.4 mg/dL). The AUC level after the ingestion of SF snack bar was 2044.8±503.1 mg.min/dL, &gt;20% lower compared to ingestion of WF snack bar (4735.0±666.8 mg.min/dL), p&lt;0.001. These glycaemic control benefits can be explained due to the high fibre and protein content linked to the physicochemical properties of SF. Conclusion: With high nutritional properties, SF snack bar has a low GR and might help control blood glucose in T2DM subjects.

The Impact of Pharmacist Intervention on Clinical Outcome, Adherence, and Quality of Life of Patients with Type 2 Diabetes Mellitus

Diabetes Mellitus (DM) is a chronic disease that occurs when the body cannot produce enough insulin or cannot use insulin (insulin resistance) and diagnosed by measuring blood glucose level (BGL). BGLs of DM patients should always be controlled to prevent complications. The purpose of this analytical cohort study was to analyze the effect of pharmacy intervention (PI) on BGL, adherence, and quality of life (QOL) of DM Type 2 (T2DM) patients (n=48) admitted to Dr. Tengku Mansyur hospital in Tanjung Balai period December 2020 to May 2021. The BGL, adherence, and QOL of the patients were compared before and after PIs. The patients’ BGLs were recruited from their medical records, their adherence to medication was analyzed using MMAS-8 questionnaire, and the patients QOLs were analyzed using the EQ-5D-3L questionnaire and the scores were categorized into 3 categories (&lt; 0.60 = bad, 0.6 - &lt;0.80 = moderate, ≥0.80 = good). The obtained data were analyzed using descriptive and Wilcoxon Signed-Rank tests in the SPSS Program.&#x0D; Mean age of the patients was 59.20 ± 8.20 (years). Most (58.3%) of them were females. The mean BGLs (mg/dL) of the patients: before PI 1, 262.02±5.91; before PI 2, 259.39±5.53; after PI, 202.35±4.80; and follow up after PI, 168.60±3.07. The mean adherence scores: before PI 1, 4.833 ± 0.08; before PI 2 4.70±0.07; after PI 6.833±0.09; follow up after PI 7.793±0.05. The mean QOLs of the patients: before PI 1, 0.719±0.005; before PI 2, 0.719±0.001; after PI, 0.801±0.009; follow up after PI 0.977 ± 0.009. There were significant differences among BGLs, patients’ adherence, and their QOLs before and after PI. p=0.000&#x0D; The present study proved that PI improved medication adherence, BGLs, and QOLs of outpatients with T2DM.

Differences in perceptions between healthcare professionals and caregivers when accepting patients on insulin therapy to elderly care facilities

To clarify the problems with accepting patients on insulin therapy at elderly care facilities. We conducted a questionnaire on staff awareness of diabetes before accepting the first diabetic patient on insulin therapy at our elderly care facility. Once the patient was admitted, we held diabetes classes for staff based on their needs. Six months later, we conducted a questionnaire again to confirm the staff's awareness concerning patients on insulin therapy. In the initial questionnaire, nurses were negative about acceptance while caregivers were positive. Once the patient was admitted, staff struggled to deal with his frequent symptoms. A diabetes specialist held diabetes classes for staff to ensure the patient could enjoy a stable life. Gradually, the staff developed a better collaborative system and performed appropriate care. In the second questionnaire conducted six months later, there was a decrease in excessive optimistic opinions among caregivers. However, nurses still tended to be reluctant about acceptance while caregivers were positive, a trend similar to the initial evaluation. In this study, we noted differences in the perceptions of nurses and caregivers regarding the acceptance of patients on insulin therapy. Mitigating this difference is necessary to ensure the safety of patients. It is essential to institutionalize diabetes education in long-term care facilities, allow educated caregivers to measure blood glucose levels, select patients with treatment policies suitable for a given facility, ensure that doctors deliver accurate instructions, and maintain close communication to build a better medical care cooperation system.