Blood Glucose Measurements Research Articles

Community service: stroke risk detection and primary prevention of stroke education

Stroke is a neurovascular disease that is the second cause of death and the third cause of disease in the world. The prevalence of stroke in Indonesia has increased. The increasing prevalence of stroke can be caused by low stroke prevention. Factors that influence stroke prevention behavior are knowledge and awareness. Efforts to reduce the incidence of stroke are primary preventions. The first activity was detection of stroke risk using the Stroke Risk Scorecard, examination of blood pressure, body weight, measurement of blood glucose and cholesterol levels. The second was providing education. This activity was carried out at Kendangan, Caturharjo, Sleman, Yogyakarta. The stroke risk detection was attended by 67 people. The results of risk factor detection found that people at high risk of stroke were 4 people (6%), and 63 people at low risk of stroke (94%). People with hypertension 31 (46%), hypercholesterolemia 26 (38%), smoking 7 (10%), never exercising 50 (74%), and overweight 7 (10%). Education of stroke was attended by 36 people. The knowledge has increased after being given education (score 15) with an average pre-test score of 59,41 (min-max 20-100) and a post-test of 74.41 (min-max 30-100). Stroke risk detection and primary prevention education is an effort to prevent stroke in an early and continuous manner

Community service: Stroke risk detection and primary prevention of stroke education

Abstract. Stroke is a neurovascular disease and is the second cause of death and the third cause of disease in the world. The prevalence of stroke in Indonesia has increased. The increasing prevalence of stroke can be caused by low stroke prevention. Factors that influence stroke prevention behavior are knowledge and awareness. Efforts to reduce the incidence of stroke are primary prevention. This community service program made 2 basic efforts in stroke prevention. The first activity was detection of stroke risk using the stroke risk scorecard, examination of blood pressure and body weight, and measurement of blood glucose and cholesterol levels. The second one was providing education. This program was carried out at Kendangan, Caturharjo, Sleman, Yogyakarta. Stroke risk detection was attended by 67 people. The results of risk factor detection found that there were 4 people at high risk of stroke (6%), and 63 people were at low risk of stroke (94%). There were also other health issues found; 31 people with hypertension (46%), 26 people with hypercholesterolemia (38%), 7 people smoking (10%), 50 people never exercise (74%), and 7 people with overweight (10%). Education of stroke was attended by 36 people. The knowledge had increased after given education with an average pretest score of 59.41 (with minimum score of 20 and maximum score of 100) and an average post-test score of 74.41 (with minimum score of 30 and maximum score of 100). Stroke risk detection and primary prevention education are efforts to prevent stroke early, so they need to be done continuously.

Effect of Acute Caffeine Exposure on Blood Glucose and Hepatic Glycogen Content in Normal and Thyroidectomized Male Wistar Rats.

Acute caffeine exposure had been shown to induce hyperglycemia however; the influence of thyroid hormones on the caffeine-induced hyperglycemia is yet to be established. The present study was therefore designed to investigate the effect of caffeine exposure on blood glucose and hepatic glycogen content in thyroidectomized rats. Sixty adult male Wistar rats were randomly divided into 10 groups as I-X (n=6). Rats in groups I, III, V, VII and IX were given normal saline, caffeine, prazosin + caffeine, propranolol +caffeine, combined prazosin+ propranolol+caffeine injections respectively while rats in groups II, IV, VI, VIII and X were thyroidectomized and treated in similar manner as the normal rats respectively. Surgical removal of the thyroid gland was done in the thyroidectomised groups while sham-operation was done in Normal group to serve as control. After healing and following an overnight fast, the rats were anaesthetized and the femoral vein and carotid artery were cannulated for drug administration and blood glucose measurement respectively. After stabilization, following basal measurements, rats from each group were injected normal saline or caffeine (6mg/kg) while another sets were pre-treated prazosin (0.2 mg/kg), propanolol (0.5 mg/kg) or their combination before caffeine administration. Blood glucose was then monitored for 60 minutes post-injection of caffeine at 5 minutes interval. Liver samples were collected at the end of the observation period for glycogen content determination. Caffeine caused significant increased blood glucose levels in both normal and thyroidectomized rats which were up to 210% and 180% respectively at the peak of their responses. Liver glycogen content of the thyroidectomized rats (3.11 ± 0.20 mg/100g tissue weight) was significantly higher than the normal rats (1.91 ± 0.43 mg/100g tissue weight). These glycogen contents were significantly reduced by caffeine in both normal (0.25 ± 0.04 mg/100g tissue weight) and thyroidectomized rats (1.65 ± 0.16 mg/100g tissue weight) when compared with their controls. The caffeine effects on blood glucose and hepatic glycogen content were abolished by pretreatment with propanolol or a combination of prazosin and propanolol in both normal and thyroidectomized rats but pretreatment with prazosin caused only significant reduction in hyperglycemic response to caffeine. The findings of this study suggest that caffeine-induced hyperglycemia in both normal and thyroidectomized rats are mediated through both alpha and beta adrenoceptors.

Assessment of Serum Metalloendopeptidase level in Patients with Double Diabetes

Background: Double diabetes is the term used to describe situations in which a patient exhibits characteristics that are a combination of type 1 and type 2 Diabetes Mellitus. Metalloendopeptidase or Neprilysin is membrane-bound metallopeptidase. It has a wide range of physiological function and a variety of substrates. It has a significant impact on the proteolytic functions of the kidney, cardiovascular health, immunological response, cell proliferation, and fetal development. It also has a preventative effect on the onset of type 2 diabetes, obesity, and cancer. Objective: The study aims to assess the level of MEP in patients with double diabetes and determine its predictive value in the diagnosis of double diabetes. Subjects and Methods: Eighty participants were divided into two groups for this study. 40 patients with double diabetes made up the first group (G1), whereas 40 age- and gender-matched apparently healthy subjects made up the second group (G2), which served as the control group. ELISA was used to measure the serum's metalloendopeptidase level. For the measurement of HbA1c, whole blood was used. The measurement of insulin, blood glucose, and lipid profile were performed using serum. The HOMA test measured insulin resistance. Results: This study revealed a significant elevation in serum metalloendopeptidase levels in patients with DD (p value < 0.05). The ROC curves analysis for serum metalloendopeptidase level showed the area under the curve (AUC) of serum metalloendopeptidase (pg/mL) was 0.992. Conclusions: Serum metalloendopeptidase level could be used as a novel biomarker in patients with double diabetes.

Graphene and coltan

The clean and renewable energy scenario has gone through a transformation process with the discovery of new generation sources and devices for their storage. Sustainable and efficient solutions are sought to satisfy the growing energy demand of today's population. The environmental problems related to fossil fuels are recognized throughout the world, but to abandon them and for renewable energies to cover current demand, they must not only deliver enough energy but must also be accumulated and transported. In this perspective, batteries play an important role in different areas, from energy storage to powering electronic devices, electric vehicles, etc. Electronic devices use relatively little power, so even small improvements in batteries have driven big changes in their performance and daily use. The functionalities of graphene and coltan make them ideal for a variety of applications, which are at the same time development opportunities for Colombia, such as water purification and desalination, catalyzing systems for the production of hydrogen and foams for lighting purposes, and a rapid heating element; graphene used as a photocatalytic coating material in smart buildings can purify the air in cities; It is also a promising material in the fields of printed electronics, sensors, graphene-based field-effect transistor (GFET) biosensors, optical biosensors, and photovoltaic cells. The possibility of incorporating graphene microchips implanted in teeth for bacterial detection and monitoring of oral hygiene is currently being studied, which could facilitate the study and prevention of periodontal diseases in the future; At the University of Manchester, new graphene condoms were obtained thanks to graphene composite polymers, which provide a higher heat transfer rate, improving sensitivity and the ability to disperse active drugs to prevent sexually transmitted diseases uniformly, pregnancy or even increase sexual pleasure. Graphene sheets have also recently been used to measure blood glucose levels through sweat and deliver pharmacological doses through the skin. This research focuses on a case study: the sizing of a Lithium battery with graphite in both electrodes as an alternative solution for greater energy storage. In this process, the participation of graphite in both electrodes is expanded, specifically in the coating of the cathode through layers to reduce losses and thereby improve battery storage. With this proposal, both the anode and the cathode will be made up of intercalator materials (graphite), different from the metallic lithium anode, which is dangerous, and the Li+1 ion can travel reversibly between them. As a result of the work, the structure of the new battery that will be built and tested in the following stages of the research was designed in SolidWorks software.

Hypoglycemia in non-diabetic in-patients at a teaching referral hospital in Iran.

This study aims to investigate comorbidities, clinical features, laboratory values, and diagnoses in non-diabetic patients experiencing hypoglycemic episodes. A retrospective observational study was conducted at Shariati Hospital in Iran from 2016 to 2023. Seventy-four non-diabetic patients admitted with a diagnosis of hypoglycemia were included, while patients with diabetes were excluded. Demographic data, symptoms, and biochemical assessments were obtained from the hospital information system. Hypoglycemic episodes were identified based on low measured blood glucose, recorded medications for hypoglycemia treatment, or recorded codes indicating hypoglycemia. Hypoglycemia was defined as blood glucose below 70mg/dL (3.9 mmol/L) along with two other criteria of the Whipple triad. Statistical analysis was performed using SPSS software (version 26). Among the enrolled patients, 63.5% were female, and 13.5% were elderly (≥ 65 years). The most common comorbidities observed were cardiovascular disease (20.3%), psychological disorders (20.3%), hypothyroidism (14.9%), and hypertension (8.1%). The prevalent symptoms included weakness, loss of consciousness, sweating, palpitations, dizziness, and tremors. Non-diabetic hypoglycemia was caused by factitious disorders, insulinoma, organ failure, and infection, respectively. Due to the diverse range of clinical symptoms, hypoglycemia in non-diabetic patients may be diagnosed late, leading to misdiagnoses such as psychological disorders or seizures. It is crucial to consider the possibility of hypoglycemia in non-diabetic patients and determine its underlying cause. Given the poor prognosis associated with hypoglycemia, timely interventions are essential.

Apelin as a potential marker in Iraqi children with Type 1 Diabetes Mellitus

Objective: This study aims to evaluate apelin levels and their correlation with key metabolic parameters in pre-pubertal and pubertalindividuals with type 1 diabetes in Iraq, providing insights into apelin's role in diabetes pathogenesis and its potential as an early diagnostic marker for cardiovascular disease. Methods: Ninety children, divided into pre-pubertal T1DM, pubertal T1DM, and healthy subjects, underwent measurements of variousbiochemical parameters, including apelin, fasting blood glucose, lipid profile, and thyroid hormones. Results: Positive correlations (P < 0.01) were found between apelin levels and FSB, TG, BMI, HbA1c, TC, TSH, and a negative correlation with HDL-C in pubertal and pre-pubertal groups, revealing potential links between apelin, glucose, and insulin sensitivity. Conclusion: The study suggests apelin's involvement in diabetes pathogenesis, highlighting its rise in adulthood as an indicator of diabetes complications and its potential use as a diagnostic marker for early detection of cardiovascular disease in individuals with T1DM.

Gaps in the type 2 diabetes care cascade: a national perspective using South Africa’s National Health Laboratory Service (NHLS) database

BackgroundResearch out of South Africa estimates the total unmet need for care for those with type 2 diabetes mellitus (diabetes) at 80%. We evaluated the care cascade using South Africa’s National Health Laboratory Service (NHLS) database and assessed if HIV infection impacts progression through its stages.MethodsThe cohort includes patients from government facilities with their first glycated hemoglobin A1c (HbA1c) or plasma glucose (fasting (FPG); random (RPG)) measured between January 2012 to March 2015 in the NHLS. Lab-diagnosed diabetes was defined as HbA1c ≥ 6.5%, FPG ≥ 7.0mmol/l, or RPG ≥ 11.1mmol/l. Cascade stages post diagnosis were retention-in-care and glycaemic control (defined as an HbA1c < 7.0% or FPG < 8.0mmol/l or RPG < 10.0mmol/l) over 24-months. We estimated gaps at each stage nationally and by people living with HIV (PLWH) and without (PLWOH).ResultsOf the 373,889 patients tested for diabetes, 43.2% had an HbA1c or blood glucose measure indicating a diabetes diagnosis. Amongst those with lab-diagnosed diabetes, 30.9% were retained-in-care (based on diabetes labs) and 8.7% reached glycaemic control by 24-months. Prevalence of lab-diagnosed diabetes in PLWH was 28.6% versus 47.3% in PLWOH. Among those with lab-diagnosed diabetes, 34.3% of PLWH were retained-in-care versus 30.3% PLWOH. Among people retained-in-care, 33.8% of PLWH reached glycaemic control over 24-months versus 28.6% of PLWOH.ConclusionsIn our analysis of South Africa's NHLS database, we observed that 70% of patients diagnosed with diabetes did not maintain in consistent diabetes care, with fewer than 10% reaching glycemic control within 24 months. We noted a disparity in diabetes prevalence between PLWH and PLWOH, potentially linked to different screening methods. These differences underscore the intricacies in care but also emphasize how HIV care practices could guide better management of chronic diseases like diabetes. Our results underscore the imperative for specialized strategies to bolster diabetes care in South Africa.

Umbilical artery cord blood glucose predicted hypoglycemia in gestational diabetes mellitus and other at-risk newborns

BackgroundTo explore the value of umbilical artery cord blood glucose (UACBG) in predicting hypoglycemia in gestational diabetes mellitus (GDM) and other at-risk newborns, and to provide a cut-off UACBG value for predicting hypoglycemia occurrence.MethodsIn this prospective study, we enrolled at-risk infants delivered vaginally, including neonates born to mothers with GDM, premature, macrosomic, and low birth weight. We separated the infants into GDM group and other at-risk group. All subjects underwent UACBG measurement during delivery. Neonatal peripheral blood glucose measurement was performed at 0.5 and 2 h after birth. The predictive performance of UACBG for neonatal hypoglycemia was assessed using receiver operating characteristic curve (ROC), area under curve (AUC), sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV).Results916 newborns were included, with 538 in GDM group and 378 in other at-risk group. 85 neonates were diagnosed hypoglycemia within 2 h after birth, including 36 belonging to GDM group and 49 to other at-risk group. For hypoglycemia prediction within 2 h, the best cut-off of UACBG was 4.150 mmol/L, yielding an AUC of 0.688 (95% CI 0.625–0.751) and a NPV of 0.933. In detail, the AUC was 0.680 in GDM group (95% CI 0.589–0.771), with the optimal cut-off of 4.150 mmol/L and a NPV of 0.950. In other at-risk group, the AUC was 0.678(95% CI 0.586–0.771), the best threshold was 3.950 mmol/L and the NPV was 0.908. No significant differences were observed between GDM group and other at-risk group in AUC at 0.5 h, 2 h and within 2 h.ConclusionsUACBG has a high NPV for predicting neonatal hypoglycemia within 2 h after birth. It was implied that individuals with cord blood glucose levels above the threshold were at lower risk for hypoglycemia. UACBG monitoring provides evidence for subsequent classified management of hypoglycemia.

Association between normal-weight obesity and cardiometabolic risk factors among adults in Addis Ababa, Ethiopia

The relationship between normal-weight obesity (NWO)—high percent body fat (%BF) in individuals with normal body mass index (BMI)—and cardiometabolic abnormalities has not been explored in Africa. We determined the prevalence of the NWO and evaluated its association with hypertension, elevated blood sugar and dyslipidaemia among adults in Addis Ababa, Ethiopia. A cross-sectional study was conducted among adults 18–64 years (n = 600). Blood pressure, blood glucose, lipid profile, and anthropometric measurements were completed. As a function of skinfold thickness, body density and %BF were estimated using Durnin & Womersley and Siri Equations, respectively. The relationship between the NWO and the outcomes of interest, assessed using adjusted linear and logit models. The age- and sex-standardised prevalence of NWO was 18.9% (95% confidence interval (CI) 15.8, 22.2%). Comparison between normal-weight lean (normal %BF and BMI) and normal-weight obese individuals suggested no difference in systolic blood pressure (β = 2.55; 95% CI − 0.82, 5.92); however, diastolic blood pressure (β = 3.77: 95% CI 1.37, 6.18) and odds of hypertension (adjusted odds ratio (AOR) = 2.46: 95% CI 1.18, 5.13) were significantly raised in the latter. Similarly, adults with NWO had elevated blood glucose (β = 2.30; 95% CI 1.23, 15.66) and increased odds of high blood sugar level (AOR = 1.68; 95% CI 1.05, 2.67). LDL (β = 8.73: 1.56, 15.90), triglyceride (β = 20.99: 0.78, 41.22), total cholesterol (β = 10.47: 1.44, 19.50), and Cholesterol to HDL ratio (β = 0.65: 0.27, 1.04) were also raised among adults with NWO. NWO is common among adults in Addis Ababa and is associated with cardiometabolic derangements.

Salvianolic acid B ameliorates myocardial fibrosis in diabetic cardiomyopathy by deubiquitinating Smad7

BackgroundSalvianolic acid B (Sal B), a water-soluble phenolic compound derived from Salvia miltiorrhiza Bunge, is commonly used in Traditional Chinese Medicine to treat cardiovascular disease. In our previous study, Sal B protected against myocardial fibrosis induced by diabetic cardiomyopathy (DCM). This study aimed to investigate the ameliorative effects and potential mechanisms of Sal B in mitigating myocardial fibrosis induced by DCM.MethodsVarious methods were used to investigate the effects of Sal B on myocardial fibrosis induced by DCM in vivo and in vitro. These methods included blood glucose measurement, echocardiography, HE staining, Masson’s trichrome staining, Sirius red staining, cell proliferation assessment, determination of hydroxyproline levels, immunohistochemical staining, evaluation of fibrosis-related protein expression (Collagen-I, Collagen-III, TGF-β1, p-Smad3, Smad3, Smad7, and α-smooth muscle actin), analysis of Smad7 gene expression, and analysis of Smad7 ubiquitin modification.ResultsThe animal test results indicated that Sal B significantly improved cardiac function, inhibited collagen deposition and phenotypic transformation, and ameliorated myocardial fibrosis in DCM by upregulating Smad7, thereby inhibiting the TGF-β1 signaling pathway. In addition, cell experiments demonstrated that Sal B significantly inhibited the proliferation, migration, phenotypic transformation, and collagen secretion of cardiac fibroblasts (CFs) induced by high glucose (HG). Sal B significantly decreased the ubiquitination of Smad7 and stabilized the protein expression of Smad7, thereby increasing the protein expression of Smad7 in CFs and inhibiting the TGF-β1 signaling pathway, which may be the potential mechanism by which Sal B mitigates myocardial fibrosis induced by DCM.ConclusionThis study revealed that Sal B can improve myocardial fibrosis in DCM by deubiquitinating Smad7, stabilizing the protein expression of Smad7, and blocking the TGF-β1 signaling pathway.

The Relationship Between On-Site Clinical Practice, Nursing Professional Value, and Nursing Clinical Self-Efficacy During COVID-19: A Cross-Sectional Study.

During COVID-19, nursing students experienced variations in on-site clinical practice, such as a combination of on-site and non-face-to-face clinical practice. Although on-site clinical practice is critical for increasing nurses' clinical self-efficacy and developing professional nursing values, there is a lack of knowledge that reflects the current clinical practice environment. To examine the relationship between on-site clinical practice, nursing professional values, and nursing clinical self-efficacy during the COVID-19 pandemic. This study is a cross-sectional correlational study design. Demographic characteristics, on-site clinical practice, nursing professional values, and nursing clinical self-efficacy were assessed using an online survey from October 3, 2022, to November 6, 2022. Data were analyzed using descriptive statistics, ANOVA, t-test, Pearson's correlation coefficient, and multiple regression. Of the 86 participants, 18 (20.9%) were male and 68 (79.1%) were female. The duration of the participants' average participation in on-site clinical practice was 39.67 days (61.04%). Nursing professional values significantly influenced clinical self-efficacy (β=0.379, p<0.001). However, on-site clinical practice was not significantly related to clinical self-efficacy (β=0.051, p=0.611). In terms of nursing clinical self-efficacy, measuring blood glucose had the highest score. On the other hand, establishing and maintaining intravenous catheters had the lowest scores. Nursing students' professional values were significantly associated with nursing clinical self-efficacy; however, the extent of involvement in on-site clinical practice during the pandemic did not have a significant impact on nursing clinical self-efficacy. Given that this study focused on a single university, it is imperative to replicate this research using diverse samples in the future. In addition, there is a need to establish a range of teaching and learning approaches for clinical practice, including simulation, online learning, and the use of state-of-the-art technology for faculty-student feedback strategies, in anticipation of the need for alternative practices.

Blood glucose level and infestation degree by Zeylanicobdella sp. in cantang grouper before and after closed wet transportation system

The cantang grouper is one of the high-value fisheries commodities. Transportation is an integral activity in aquaculture, notably in transporting cantang grouper. Among the methods is the closed wet transportation system. The disrupted environment in the closed wet transportation system, exhaustion, and deficit of the immune system can cause the cantang grouper to be infested by marine leech or Zeylanicobdella. In this study, Zeylanicobdella sp. infestation levels and cantang grouper blood glucose levels are compared before and after a closed wet transportation system. This research used an experimental method. The 35 individuals’ sample was examined for blood glucose levels and the infestation degree of Zeylanicobdella. Subsequently, they were transported from Situbondo, East Java, to the Faculty of Fisheries and Marine Universitas Airlangga Surabaya and re-examined. The results of measuring blood glucose levels of cantang grouper were in the below-normal category, normal, and above-normal. There was no significant difference in the infestation degree by Zeylanicobdella sp. between before and after transportation. This study concludes that closed wet transportation affected blood glucose levels and did not affect the degree of infestation by Zeylanicobdella sp. in cantang grouper.

Effect of Polygonati Rhizoma in improving pyroptosis injury of diabetic macroangiopathy via NLRP3/caspase-1/GSDMD pathway

This study aims to explore the influence of Polygonati Rhizoma on the pyroptosis in the rat model of diabetic macroangiopathy via the NOD-like receptor thermal protein domain associated protein 3(NLRP3)/cysteinyl aspartate specific proteinase-1(caspase-1)/gasdermin D(GSDMD) pathway. The rat model of diabetes was established by intraperitoneal injection of streptozotocin(STZ) combined with a high-fat, high-sugar diet. The blood glucose meter, fully automated biochemical analyzer, hematoxylin-eosin(HE) staining, enzyme-linked immunosorbent assay, immunofluorescence, immunohistochemistry, and Western blot were employed to measure blood glucose levels, lipid levels, vascular thickness, inflammatory cytokine levels, and expression levels of pyroptosis-related proteins. The mechanism of pharmacological interventions against the injury in the context of diabetes was thus explored. The results demonstrated the successful establishment of the model of diabetes. Compared with the control group, the model group showed elevated levels of fasting blood glucose, total cholesterol(TC), triglycerides(TG) and low-density lipoprotein cholesterol(LDL-c), lowered level of high-density lipoprotein cholesterol(HDL-c), thickened vascular intima, and elevated serum and aorta levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and interleukin-18(IL-18). Moreover, the model group showed increased NLRP3 inflammasomes and up-regulated levels of caspase-1 and GSDMD in aortic vascular cells. Polygonati Rhizoma intervention reduced blood glucose and lipid levels, inhibited vascular thickening, lowered the levels of TNF-α, IL-1β, IL-18 in the serum and aorta, attenuated NLRP3 inflammasome expression, and down-regulated the expression levels of caspase-1 and GSDMD, compared with the model group. In summary, Polygonati Rhizoma can slow down the progression of diabetic macroangiopathy by inhibiting pyroptosis and alleviating local vascular inflammation.

Food & You: A digital cohort on personalized nutrition.

Nutrition is a key contributor to health. Recently, several studies have identified associations between factors such as microbiota composition and health-related responses to dietary intake, raising the potential of personalized nutritional recommendations. To further our understanding of personalized nutrition, detailed individual data must be collected from participants in their day-to-day lives. However, this is challenging in conventional studies that require clinical measurements and site visits. So-called digital or remote cohorts allow in situ data collection on a daily basis through mobile applications, online services, and wearable sensors, but they raise questions about study retention and data quality. "Food & You" is a personalized nutrition study implemented as a digital cohort in which participants track food intake, physical activity, gut microbiota, glycemia, and other data for two to four weeks. Here, we describe the study protocol, report on study completion rates, and describe the collected data, focusing on assessing their quality and reliability. Overall, the study collected data from over 1000 participants, including high-resolution data of nutritional intake of more than 46 million kcal collected from 315,126 dishes over 23,335 participant days, 1,470,030 blood glucose measurements, 49,110 survey responses, and 1,024 stool samples for gut microbiota analysis. Retention was high, with over 60% of the enrolled participants completing the study. Various data quality assessment efforts suggest the captured high-resolution nutritional data accurately reflect individual diet patterns, paving the way for digital cohorts as a typical study design for personalized nutrition.

Change in HbA1c post-transfusion is correlated to pre-transfusion HbA1c result

Abstract Hemoglobin A1c (HbA1c) results are used to diagnose and monitor patients with diabetes mellitus. As such, they have a direct impact on patient care and treatment decisions. While within the laboratory community, there is the assumption that recent red blood cell (RBC) transfusion would interfere with HbA1c measurement, there is limited published evidence regarding whether HbA1c results provide an accurate estimate of long term glycemic control in patients who have received a RBC transfusion. This retrospective laboratory information system record review aims to address this gap in the literature with a retrospective analysis of patient results. Retrospective data was obtained from the laboratory information system. The study population included all patients over 18 years of age, both inpatients and outpatients, who had at least one HbA1c result during the study period (January 2018 – December 2020), and record of a RBC transfusion in the three months prior to the A1c result. Data collected included relevant laboratory results and transfusion information. 1,752 pre- and post-transfusion HbA1c pairs were analyzed. The average age of patients at transfusion was 66.0 years. Men comprised 51.7% of subjects (n=905). Most patients were White (64.0%; n=1,104), with Black (29.7%; n=513) and Multiracial / Multicultural (4.1%; n=71) subjects making up the largest minority. Most patients had diagnoses of anemia (93.0%; n=1,629) and/or diabetes (86.2%; n=1,511), with a minority having a diagnosis of any type of cancer (40.6%; n=712). Rarely, patients had hemoglobin disorders (3.1%; n=54). Most patients were treated with some form of glycemic control medication (91.5%; n=1,603). Average pre-transfusion HbA1c for all subjects was 7.0% ± 1.9 (1 sd). Average post-transfusion HbA1c for all subjects was 6.3% ± 1.3 (1 sd). The average change in HbA1c from pre- to post-transfusion was -0.7% ± 1.5 (1 sd). In contrast, the mean change in the random blood glucose measurement closest to the pre- or post-transfusion HbA1c was only -11.5 mg/dL (CI: -16.7 mg/dL to -6.2 mg/dL; p&amp;lt;0.001). The median time between the pre-transfusion HbA1c and transfusion was 20.0 days; the median time between transfusion and the post-transfusion HbA1c was 38.0 days. There was a larger decrease in pre- to post-transfusion HbA1c in patients with diabetes (p&amp;lt;0.001), patients without anemia (p=0.040), patients without hemoglobin disorders (p=0.045), patients without cancer (p=0.005), and patients on any glycemic control medication (p&amp;lt;0.001). Overall, pre-transfusion HbA1c level was strongly associated with post-transfusion HbA1c level, with the greatest degree of negative change seen in patients with a pre-transfusion value &amp;gt; 9.0%. In contrast, patients with a pre-transfusion value of &amp;lt; 5.7% saw an average increase in HbA1c (p&amp;lt;0.001). This study provides insight into the influence of transfusion on HbA1c results and reinforces the important role that pre-analytical factors play in laboratory testing.

Роль самоконтроля гликемии у подростков с сахарным диабетом 1-го типа: клинический разбор

Type 1 diabetes mellitus (dm) is a disease characterized by chronic hyperglycemia and the development and progression of severe microvascular complications. The results of the AdVAnce, Accord and VAdT large-scale research studies have definitely proved that glycemic control plays a role in prevention of the dm microvascular complications. A number of studies have shown that glycemic variability parameters play a separate role in prediction of diabetic retinopathy, nephropathy and cardiovascular complications. Adolescents with type 1 dm are characterized by the labile disease course and the tendency to develop hypoglycemia and ketoacidosis. modern approach to type 1 dm management, especially in adolescents, includes the need for mandatory self-monitoring of blood glucose (BG). Adolescents with type 1 dm are unable to achieve target glucose levels themselves at home without BG monitoring. Glycemic control in type 1 dm should be accurate, simple and convenient, allowing patients to adjust insulin therapy for dm on their own. Selection of BG monitor is one of the main aspects of self-monitoring of BG. From the doctor's point of view, compliance with accuracy standards is the most important criterion for choosing the glucose meter, while from the patient’s perspective it is convenience and ease of use. With improvements in technology, the accuracy of BG measurement increases, the self-monitoring of BG procedure gets simpler, which results in higher adherence to treatment and treatment efficacy. It is impossible to achieve and maintain target BG levels without active full-fledged participation of patient with type 1 dm, self-monitoring of BG using the advanced, accurate and convenient for patient glucose meter, such as contour Plus one.

Sex-specific associations between skeletal muscle mass and incident diabetes: A population-based cohort study.

To investigate the sex-specific associations between predicted skeletal muscle mass index (pSMI) and incident type 2 diabetes in a retrospective longitudinal cohort of Chinese men and women. We enrolled Chinese adults without diabetes at baseline from WATCH (West chinA adulT health CoHort), a large health check-up-based database. We calculated pSMI to estimate skeletal muscular mass, and measured blood glucose variables and assessed self-reported history to identify new-onset diabetes. The nonlinear association between pSMI and incident type 2 diabetes was modelled using the penalized spline method. The piecewise association was estimated using segmented linear splines in weighted Cox proportional hazards regression models. Of 47 885 adults (53.2% women) with a median age of 40 years, 1836 developed type 2 diabetes after a 5-year median follow-up. In women, higher pSMI was associated with a lower risk of incident type 2 diabetes (Pnonlinearity = 0.09, hazard ratio [HR] per standard deviation increment in pSMI: 0.79 [95% confidence interval {CI} 0.68, 0.91]). A nonlinear association of pSMI with incident type 2 diabetes was detected in men (Pnonlinearity < 0.001). In men with pSMI lower than 8.1, higher pSMI was associated with a lower risk of incident type 2 diabetes (HR 0.58 [95% CI 0.40, 0.84]), whereas pSMI was not significantly associated with incident diabetes in men with pSMI equal to or greater than 8.1 (HR 1.08 [95% CI 0.93, 1.25]). In females, a larger muscular mass is associated with a lower risk of type 2 diabetes. For males, this association is significant onlyamong those with diminished muscle mass.

Factory-Calibrated Continuous Glucose Monitoring Systems in Type 1 Diabetes: Accuracy during In-Clinic Exercise and Home Use.

Continuous glucose monitors (CGMs) are valuable tools for improving glycemic control, yet their accuracy might be influenced by physical activity. This study sought to assess the accuracy of the three latest factory-calibrated CGM systems available in Europe at the time the study was conducted, both during aerobic exercise and in typical daily scenarios. The accuracy evaluation, based on metrics such as the median absolute relative difference (MARD) and point and rate error-grid analyses (PEGA and REGA), involved 13 adults with type 1 diabetes. Participants wore all sensors during a 1 h in-clinic exercise session followed by a subsequent 3-day home period, with blood glucose measurements serving as reference values in both contexts. During exercise, no statistically significant differences in MARD were observed (Dexcom G6: 12.6%, Guardian 4: 10.7%, and Freestyle Libre 2: 17.2%; p = 0.31), and similarly, no significant differences emerged in PEGA-zone-AB (100%, 100%, 96.8%; p = 0.37). Nevertheless, Freestyle Libre 2 showed comparatively diminished accuracy in estimating glucose trends during exercise (REGA-zone-AB: 100%, 93.0%, 73.3%; p = 0.0003). In the home environment, Freestyle Libre 2 exhibited a significantly higher MARD when compared to the other systems (10.2%, 11.9%, 16.7%, p = 0.02). Overall, Dexcom G6 and Guardian 4 demonstrated superior accuracy in both exercise and daily life scenarios compared to Freestyle Libre 2.

Comparison of Two Methods for the Measurement of Blood Plasma and Capillary Blood Glucose in Tropical Highland Grassing Dairy Cows.

(1) Background: There is lack of published studies validating specific cow-side glucometers such as Centrivet GK (CVGK). (2) Methods: The aims were (1) to measure and compare the blood glucose concentrations in 52 tropic highland grassing cows by using CVGK and the traditional enzymatic/photometric assay (EPA) in plasma and serum (reference method) and (2) to establish if glucose concentrations obtained via these methods could be affected by several demographic and zootechnical parameters of the dairy herd evaluated. (3) Results: Glucose concentrations were significantly (p = 0.00) affected by the method used for their measurement. The intra-assay coefficient of variation (CV) for glucose concentrations in plasma EPA and for CVGK was 14% for both methods with serum EPA, whereas the inter-assay CV for plasma EPA and CVGK was 8% and 13.7%, respectively, with serum EPA. Pearson correlation coefficient calculations between the reference method in serum and plasma presented a slightly positive significant (p = <0.000) correlation (r = 0.56), whereas there was not a significant (p = 0.413) correlation between serum EPA and CVGK (r = 0.135). The Passing and Bablok regressions were out of the ideal expected values for the slope (β = 1) and the intercept (α = 0) (11), whereas the Bland-Altman plots showed a bias of 5.29 ± 11.73 (mg/dL) for serum and plasma and 11.01 ± 15.74 (mg/dL) for serum and CVGK. The ROC curve showed no sensitivity in detecting normoglycemic cows (area = 53.7 %, e.d = 12.5 %, p = 0.759) for CVGK when compared to plasma EPA (area = 36.1 %, e.d = 14.2 %, p = 0.256). Plasma EPA exhibited a better but not significant effect in detecting hyperglycemic cows (area = 63.9%, e.d = 14.2%, p = 0.256) when compared to HHD (area = 46.3 %, e.d = 12.5 %, p = 0.759). General glucose concentrations, independently of the method used, were significantly (p = <0.001) greater in young cows when compared to adult and old cows. (4) Conclusions: Glucose concentration measurement in plasma by using EPA or in capillary blood via CVGK were not reliable methods when compared with the reference method.