Normal Blood Glucose Levels Research Articles

Insulin Resistance in Systemic Lupus Erythematosus

The objective: to analyze the frequency of insulin resistance (IR) in patients with systemic lupus erythematosus (SLE), study of traditional and rheumatic disease-related risk factors for the development of IR, assessment of the possibility of using of Finnish Type 2 Diabetes Risk Assessment Form (FINDRISC) to detect IR. Materials and methods. 58 patients with SLE (53 women and 5 men) without diabetes mellitus (DM) and hyperglycemia were included in the one-time study. The patients have received the inpatient treatment at the regional medical and diagnostic center of the communal enterprise “Poltava Regional Clinical Hospital named after M. V. Sklifosofsky PRC” in 2020-2023. The average age of patients was 38 [28; 43] years, the average duration of the disease is 4.0 [0.6; 6.0] years. 49 (85%) patients received glucocorticoids (GC), 20 (34%) – hydroxychloroquine, 26 (45%) – immunosuppressants, 2 (3%) persons received biological drugs. In all patients fasting glucose and insulin levels were determined, and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was calculated. The value of the HOMA-IR index ≥2.77 corresponded to the presence of IR. Traditional risk factors for type 2 DM and the risk of its development in the next 10 years in patients with SLE were assessed using the FINDRISC questionnaire. Results. IR was determined in 14 (24%) of 58 patients with SLE. The average value of the HOMA-IR index was 1.8 [1.3; 2,6]. The data of patients with and without IR were similar in terms of sex, age, duration and activity of SLE, therapy performed at the time of examination, frequency of traditional risk factors for type 2 DM. Body mass index (BMI), waist circumference (WC), and insulin concentration were higher in patients with IR. The HOMA-IR index was correlated with BMI (r=0.7; p<0.001), WC (r=0.6; p<0.001), risk categories for the development of type 2 diabetes according to FINDRISС (r=0.4; p=0.04), the SLEDAI-2K index (r=–0.3; p<0.02), the serum concentration of C3 complement (r=0.4; p=0.035) and the duration of GC therapy (r=0.4; p=0.02). Conclusions. IR was diagnosed in 24% of patients with SLE without a history of DM and with a normal fasting venous blood glucose level. The HOMA-IR index increased as SLE activity decreased and the duration of GC treatment increased. However, the development of IR was statistically significantly associated only with an increase in BMI and WC. The use of the FINDRISC questionnaire, which allows to assess the risk of developing type 2 DM in the general population, did not help to detect IR in patients with SLE.

A Case Report of Integrative Treatment in a Type 2 Diabetes Patient with Multiple Symptoms and Evaluation Using Continuous Glucose Monitoring

Introduction: We describe the effects of Sosiho-tang decoction and insulin combination therapy, as well as the effect of integrated traditional Korean medicine therapy, using continuous glucose monitoring (CGM) in a diabetic patient complaining of a range of diabetic symptoms.Case report: A 24-year-old female presented with symptoms of diabetes, including weight loss, thirst, and polyuria, and was diagnosed with type 2 diabetes through blood tests, endocrine tests, and autoantibody tests. During hospitalization, the patient received insulin therapy and Sosiho-tang decoction concurrently, achieving normal blood glucose levels. After discharge, adhering to the Sosiho-tang decoction and CGM enabled the insulin dosage to be gradually reduced while maintaining normal blood glucose levels.Conclusion: Combination therapy with insulin and Sosiho-tang rapidly reduced hyperglycemia in the short term. CGM post-discharge allowed for observation of the patient’s blood glucose levels. Ultimately, Sosiho-tang medication lowered blood glucose levels, reduced insulin requirements, and facilitated a reduction in the insulin dosage.

Regulation of carbohydrate metabolism and insulin secretion in diabetic rats following treatment with Hypericum perforatum L. hairy root aqueous methanol extract

Hairy root (HR) cultures of Hypericum perforatum L. have shown promise in controlling hyperglycemia, regulating blood lipid and enzyme profiles, and improving metabolic function in vivo. These benefits are mainly attributed to the phenolic acids, flavonoids, and xanthones present in HR extracts. However, the specific mechanism underlying these effects remains unclear. This study was performed to elucidate the biochemical and molecular mechanisms driving HR the antihyperglycemic and antidiabetic effects of HR extracts. HR extract (200 mg/kg body weight) was administered daily for 14 days to healthy rats and rats with streptozotocin-induced diabetes, with glibenclamide serving as a positive control. The phenolic composition of the HR extracts was confirmed through high-performance liquid chromatography/diode array detection/electrospray ionization mass spectrometry (HPLC/DAD/ESI-MSn ) analysis. The results showed that HR extract treatment increased the plasma insulin level and pancreatic poly (adenosine diphosphate-ribose) polymerase (PARP) activity in diabetic rats, thus normalizing blood glucose levels. Additionally, it reduced the activity of gluconeogenic enzymes, increased the activity of glycolytic enzymes, and normalized the glycogen content in the liver. HR extract-treated rats also exhibited increased hepatic adenosine monophosphate-activated protein kinase (AMPK) mRNA expression and a decreased protein kinase Cε (PKCε) concentration. In conclusion, HR extract demonstrated insulinotropic effects and effectively regulated hepatic carbohydrate metabolism in diabetic rats by modulating AMPK expression and the PKCε concentration. These findings suggest the potential use of HR extract as an herbal medicine for diabetes treatment and a source of antidiabetic drug development.

Diabetic acidosis with severe fetal hypoxia in pregnancy: Narrative review and case study.

Diabetic ketoacidosis (DKA) in pregnancy could be a disastrous event with increased maternal and perinatal morbidity and mortality. DKA can occur with a normal blood glucose level, known as euglycemic DKA. It particularly affects pregnant women with type I diabetes. Here, we report the case of a 28 year-old primigravid patient, with a diagnosis of type 1 diabetes for 8 years. This patient consulted our department at 29 weeks of gestation with a previous history of headaches, vomiting and diarrhea for 9 h. Blood glucose level was 8.8 mmol/L with a ketone test positive (>15 mg/dL). Blood test showed high anion gap (17.9 mmol/L) with low serum bicarbonate rate (21 mmol/L). Systemic examination and fetal heart rate (FHR) was reassuring. The patient was subsequently discharged. She returned to the clinic 19 h later with further symptoms of nausea, polyuria-polydipsia, asthenia and a weight loss of 4 kg since the day before. Blood sugar was 14.3 mmol/L and a ketone test was strongly positive. Cardiotocography showed fetal tachycardia and repeated late decelerations. A diagnosis of DKA was made and emergency cesarean was performed for fetal distress. At delivery, pH was acidosis (pH: 7.02, lactates: 6.2). The patient was successfully treated with intravenous hydration and insulin. Neonatal evolution was favorable. Pregnant women with type I diabetes can develop euglycemic DKA. Early recognition and prompt treatment could help prevent severe maternal and fetal adverse outcomes. DKA in pregnant women can induce fetal acidosis with abnormal FHR. In this situation, a cesarean can be performed to improve neonatal outcome even inducing a premature delivery. Prolonged pregnancy can lead to irreversible neonatal brain abnormalities.

The effect of incretin-based drugs on the riks of acute pancreatitis: a review.

In recent years, new hypoglycaemic drugs that affect the incretin system have become increasingly popular in the treatment of type 2 diabetes mellitus (T2DM): glucagon-like receptor 1 agonists (GLP1RAs), dipeptidyl peptidase 4 inhibitors (DPP4is) and the recently developed dual glucagon-like receptor 1 agonist and glucose-dependent insulinotropic polypeptide (tirzepatide). Their main role of these drugs is to normalise blood glucose levels. In addition, GLP1RAs are approved for the treatment of excessive body weight. The efficacy of drugs affecting the incretin system is well described in the literature, however, there are still only few reports about their safety. This review aims to summarize the results of current research and meta-analyses on risk of acute pancreatitis (AP) during incretin-affecting drugs treatment. A narrative review was performed using present literature in an attempt to identify the relationship between AP and incretin-affecting drugs. The following keywords were used: acute pancreatitis, glucagon-like receptor 1 agonists, dipeptidyl peptidase 4 inhibitors and tirzepatide. It was demonstrated that the use of DPP4is is safe for the majority of patients with T2DM, whereas a risk of AP should be noted in case of GLP1RAs therapy. To date, most studies found no significant association between tirzepatide therapy and the increased risk of AP. The majority of studies have shown that DPP4is, GLP1RAs and tirzepatide are effective and safe in most T2DM patients. However, the follow-up time for patients treated with tirzepatide is short, therefore more studies are required to confirm the safety of this drug.

Effects of water-based Thai dance on balance, muscle strength, quality of life, and blood glucose levels in elderly women

This study investigated the impact of a water-based Thai dance routine on balance, muscle strength and endurance, quality of life, and blood glucose levels among elderly individuals. Participants were 128 women aged 60 to 70 from the Chaiyaphum Elderly Club, divided equally into an experimental group and a control group. Assessments were conducted at three intervals: before training, after six weeks, and after twelve weeks. Both one-way and two-way ANOVAs with repeated measures were employed, and Bonferroni's method was used for mean difference comparisons. Results showed that the experimental group, who engaged in the water-based Thai dance routines, exhibited significant improvements in static and dynamic balances, enhanced muscle strength and endurance, better quality of life, and maintained normal blood glucose levels compared to the control group (p < .01). Notably, improvements were more significant after twelve weeks of training than after six weeks. Conversely, the control group showed a slight decline in static balance after twelve weeks, although there were no significant changes in dynamic balance, muscle strength and endurance, quality of life, or blood glucose levels at any stage of the study.

Correlation Between Blood Glucose Levels And Risk Of Non-Hemorrhagic Stroke: Analysis Of A Prospective Cohort Study In An Elderly Population

Stroke is one of the main cardiovascular diseases that causes death and disability throughout the world. One of the important risk factors for stroke is hyperglycemia or high blood sugar levels. This study aims to analyze the correlation between blood glucose levels and the risk of non-hemorrhagic stroke in the elderly population. This research utilizes a qualitative approach. The data source used is the scientific literature. The data that has been collected is then analyzed through the process of data reduction, data presentation, and conclusion drawing. The research findings show that there was a significant positive correlation between blood glucose levels and the risk of non-hemorrhagic stroke in the elderly population. Elderly people with high blood glucose levels have a higher risk of non-hemorrhagic stroke compared to elderly people with normal blood glucose levels. Good control of blood glucose levels can be an important strategy to reduce the risk of non-hemorrhagic stroke in the elderly.

Blood glucose fluctuation and in-hospital mortality among patients with acute myocardial infarction: eICU collaborative research database.

To assess the relationship between glycemic variability, glucose fluctuation trajectory and the risk of in-hospital mortality in patients with acute myocardial infarction (AMI). This retrospective cohort study included AMI patients from eICU Collaborative Research Database. In-hospital mortality of AMI patients was primary endpoint. Blood glucose levels at admission, glycemic variability, and glucose fluctuation trajectory were three main study variables. Blood glucose levels at admission were stratified into: normal, intermediate, and high. Glycemic variability was evaluated using the coefficient of variation (CV), divided into four groups based on quartiles: quartile 1: CV≤10; quartile 2: 10<CV≤20; quartile 3: 20<CV≤30; quartile 4: CV>30. Univariate and multivariate Cox regression models to assess the relationship between blood glucose levels at admission, glycemic variability, glucose fluctuation trajectory, and in-hospital mortality in patients with AMI. 2590 participants were eventually included in this study. There was a positive relationship between high blood glucose level at admission and in-hospital mortality [hazard ratio (HR) = 1.42, 95%confidence interval (CI): 1.06-1.89]. The fourth quartile (CV>30) of CV was associated with increased in-hospital mortality (HR = 2.06, 95% CI: 1.25-3.40). The findings indicated that only AMI individuals in the fourth quartile of glycemic variability, exhibited an elevated in-hospital mortality among those with normal blood glucose levels at admission (HR = 2.33, 95% CI: 1.11-4.87). Additionally, elevated blood glucose level was a risk factor for in-hospital mortality in AMI patients. Glycemic variability was correlated with in-hospital mortality, particularly among AMI patients who had normal blood glucose levels at admission. Our study findings also suggest early intervention should be implemented to normalize high blood glucose levels at admission of AMI.

Hyperglycemia as a prognostic factor for increased mortality in patients admitted in Pediatric ICU.

Objective: To study the prevalence and frequency of hyperglycemia in critically ill children. To juxtapose mortality rate in critically ill patients with hyperglycemia against those having normal blood glucose levels. Study Design: Descriptive Case Series. Setting: Pediatric Intensive Care Unit (PICU) of HITEC, IMS Taxila, Al-Ihsan Hospital Rawalpindi &amp; Hameed Latif Teaching Hospital, Lahore. Period: March 2023 to October 2023. Methods: One hundred critically ill children admitted to PICU were included. Patients who had blood glucose levels more than 150mg/dl within 48 hours of admission were included in the hyperglycemic group (Group A).Patients with normal blood sugars were included in Group B. The normoglycemic and hyperglycemic groups were followed till 10 days to determine the mortality associated with hyperglycemia. Results: Mean age of the children was 6.7± 6.29 months. There were 72% male children and 28% female children. Mean blood glucose levels at baseline, after 24h hours, after 36 hours and after 48 hours were 194.91± 135.66mg/dl, 156.91±74.89mg/dl, 156.21 ±83.05mg/dl and 150.13±70.68mg/dl. Frequency of hyperglycemia was observed in 55% (n= 55). Mortality rate was 43% (n= 43/100). Furthermore, mortality rate was crucially inflated 63.6% (n= 35) in hyperglycemic victims than normoglycemic patients (p=&lt;0.001). Conclusion: Frequency of high blood sugar along with mortality within 10 days of hospitalization in children with hyperglyceemia was found higher in patients admitted to Pediatric ICU.

The Effect of Hospital-Based Liquid Diet and Commercial Formulas on Laboratory Parameters and Postoperative Complications in Patients with Head and Neck Cancer.

Background: Patients with head and neck cancer (HNC) are at high risk of malnutrition. The aim of this study was to compare the effect of polymeric formulas available commercially and a high-protein liquid diet prepared in the hospital on laboratory parameters and postoperative complications in patients undergoing surgery for HNC. Methods: This single-center retrospective study included 149 patients who underwent surgery for HNC between 2008 and 2017. The following data were collected: patient and tumor characteristics, postoperative complications, and laboratory parameters measured at baseline and after surgery, including creatinine, alanine transaminase (ALT), aspartate transaminase (AST), and blood glucose levels. Correlations between the duration of enteral nutrition and blood parameters were assessed. Results: After surgery, patients receiving commercial formulas had lower creatinine and blood glucose levels and higher ALT and ASP levels than those on the hospital-based diet. The longer duration of feeding with commercial formulas before surgery was associated with enhanced preoperative levels of ALT and ASP and with lower postoperative blood glucose. Patients on the hospital-based diet had a higher rate of postoperative complications than those receiving commercial formulas (16.1% vs. 3.3%). Conclusions: There were no clinically important differences in blood parameters among patients with HNC depending on the type of preparations used for enteral feeding. However, increased levels of liver enzymes in patients fed with commercial formulas were notable. The early initiation of enteral nutrition before surgery helped achieve normal blood glucose levels after surgery. The use of commercial preparations contributed to reducing the number and incidence of postoperative complications.

Relative importance of triglyceride glucose index combined with body mass index in predicting recovery from prediabetic state to normal fasting glucose: a cohort analysis based on a Chinese physical examination population

BackgroundPrediabetes is a high-risk state for diabetes, and numerous studies have shown that the body mass index (BMI) and triglyceride-glucose (TyG) index play significant roles in risk prediction for blood glucose metabolism. This study aims to evaluate the relative importance of BMI combination with TyG index (TyG-BMI) in predicting the recovery from prediabetic status to normal blood glucose levels.MethodsA total of 25,397 prediabetic subjects recruited from 32 regions across China. Normal fasting glucose (NFG), prediabetes, and diabetes were defined referring to the American Diabetes Association (ADA) criteria. After normalizing the independent variables, the impact of TyG-BMI on the recovery or progression of prediabetes was analyzed through the Cox regression models. Receiver Operating Characteristic (ROC) curve analysis was utilized to visualize and compare the predictive value of TyG-BMI and its constituent components in prediabetes recovery/progression.ResultsDuring the average observation period of 2.96 years, 10,305 individuals (40.58%) remained in the prediabetic state, 11,278 individuals (44.41%) recovered to NFG, and 3,814 individuals (15.02%) progressed to diabetes. The results of multivariate Cox regression analysis demonstrated that TyG-BMI was negatively associated with recovery from prediabetes to NFG and positively associated with progression from prediabetes to diabetes. Further ROC analysis revealed that TyG-BMI had higher impact and predictive value in predicting prediabetes recovering to NFG or progressing to diabetes in comparison to the TyG index and BMI. Specifically, the TyG-BMI threshold for predicting prediabetes recovery was 214.68, while the threshold for predicting prediabetes progression was 220.27. Additionally, there were significant differences in the relationship of TyG-BMI with prediabetes recovering to NFG or progressing to diabetes within age subgroups. In summary, TyG-BMI is more suitable for assessing prediabetes recovery or progression in younger populations (< 45 years old).ConclusionsThis study, for the first time, has revealed the significant impact and predictive value of the TyG index in combination with BMI on the recovery from prediabetic status to normal blood glucose levels. From the perspective of prediabetes intervention, maintaining TyG-BMI within the threshold of 214.68 holds crucial significance.

Functional maturation and longitudinal imaging of intraportal neonatal porcine islet grafts in genetically diabetic pigs

Allogeneic intraportal islet transplantation (ITx) has become an established treatment for patients with poorly controlled type 1 diabetes. However, the loss of viable beta-cell mass after transplantation remains a major challenge. Therefore, noninvasive imaging methods for long-term monitoring of the transplant fate are required. In this study, [68Ga]Ga-DOTA-exendin-4 positron emission tomography/computed tomography (PET/CT) was used for repeated monitoring of allogeneic neonatal porcine islets (NPI) after intraportal transplantation into immunosuppressed genetically diabetic pigs. NPI transplantation (3320-15,000 islet equivalents per kg body weight) led to a reduced need for exogenous insulin therapy and finally normalization of blood glucose levels in 3 out of 4 animals after 5 to 10 weeks. Longitudinal PET/CT measurements revealed a significant increase in standard uptake values in graft-bearing livers. Histologic analysis confirmed the presence of well-engrafted, mature islet clusters in the transplanted livers. Our study presents a novel large animal model for allogeneic intraportal ITx. A relatively small dose of NPIs was sufficient to normalize blood glucose levels in a clinically relevant diabetic pig model. [68Ga]Ga-DOTA-exendin-4 PET/CT proved to be efficacious for longitudinal monitoring of islet transplants. Thus, it could play a crucial role in optimizing ITx as a curative therapy for type 1 diabetes.

FDG imaging with long-axial field-of-view PET/CT in patients with high blood glucose—a matched pair analysis

PurposeHigh blood glucose (hBG) in patients undergoing [18F]FDG PET/CT scans often results in rescheduling the examination, which may lead to clinical delay for the patient and decrease productivity for the department. The aim of this study was to evaluate whether long-axial field-of-view (LAFOV) PET/CT can minimize the effect of altered bio-distribution in hBG patients and is able to provide diagnostic image quality in hBG situations.Materials and methodsOncologic patients with elevated blood glucose (≥ 8.0 mmol/l) and normal blood glucose (< 8.0 mmol/l, nBG) levels were matched for tumor entity, gender, age, and BMI. hBG patients were further subdivided into two groups (BG 8–11 mmol/l and BG > 11 mmol/l). Tracer uptake in the liver, muscle, and tumor was evaluated. Furthermore, image quality was compared between long acquisitions (ultra-high sensitivity mode, 360 s) on a LAFOV PET/CT and routine acquisitions equivalent to a short-axial field-of-view scanner (simulated (sSAFOV), obtained with high sensitivity mode, 120 s). Tumor-to-background ratio (TBR) and contrast-to-noise ratio (CNR) were used as the main image quality criteria.ResultsThirty-one hBG patients met the inclusion criteria and were matched with 31 nBG patients. Overall, liver uptake was significantly higher in hBG patients (SUVmean, 3.07 ± 0.41 vs. 2.37 ± 0.33; p = 0.03), and brain uptake was significantly lower (SUVmax, 7.58 ± 0.74 vs. 13.38 ± 3.94; p < 0.001), whereas muscle (shoulder/gluteal) uptake showed no statistically significant difference. Tumor uptake was lower in hBG patients, resulting in a significantly lower TBR in the hBG cohort (3.48 ± 0.74 vs. 5.29 ± 1.48, p < 0.001). CNR was higher in nBG compared to hBG patients (12.17 ± 4.86 vs. 23.31 ± 12.22, p < 0.001). However, subgroup analysis of nBG 8–11 mmol/l on sSAFOV PET/CT compared to hBG (> 11 mmol/l) patients examined with LAFOV PET/CT showed no statistical significant difference in CNR (19.84 ± 8.40 vs. 17.79 ± 9.3, p = 0.08).ConclusionWhile elevated blood glucose (> 11 mmol) negatively affected TBR and CNR in our cohort, the images from a LAFOV PET-scanner had comparable CNR to PET-images acquired from nBG patients using sSAFOV PET/CT. Therefore, we argue that oncologic patients with increased blood sugar levels might be imaged safely with LAFOV PET/CT when rescheduling is not feasible.

The glutaminase inhibitor CB-839 targets metabolic dependencies of JAK2-mutant hematopoiesis in MPN

AbstractHyperproliferation of myeloid and erythroid cells in myeloproliferative neoplasms (MPN) driven by the JAK2-V617F mutation is associated with altered metabolism. Given the central role of glutamine in anabolic and catabolic pathways, we examined the effects of pharmacologically inhibiting glutaminolysis, that is, the conversion of glutamine (Gln) to glutamate (Glu), using CB-839, a small molecular inhibitor of the enzyme glutaminase (GLS). We show that CB-839 strongly reduced the mitochondrial respiration rate of bone marrow cells from JAK2-V617F mutant (VF) mice, demonstrating a marked dependence of these cells on Gln-derived ATP production. Consistently, in vivo treatment with CB-839 normalized blood glucose levels, reduced splenomegaly and decreased erythrocytosis in VF mice. These effects were more pronounced when CB-839 was combined with the JAK1/2 inhibitor ruxolitinib or the glycolysis inhibitor 3PO, indicating possible synergies when cotargeting different metabolic and oncogenic pathways. Furthermore, we show that the inhibition of glutaminolysis with CB-839 preferentially lowered the proportion of JAK2-mutant hematopoietic stem cells (HSCs). The total number of HSCs was decreased by CB-839, primarily by reducing HSCs in the G1 phase of the cell cycle. CB-839 in combination with ruxolitinib also strongly reduced myelofibrosis at later stages of MPN. In line with the effects shown in mice, proliferation of CD34+ hematopoietic stem and progenitor cells from polycythemia vera patients was inhibited by CB-839 at nanomolar concentrations. These data suggest that inhibiting GLS alone or in combination with inhibitors of glycolysis or JAK2 inhibitors represents an attractive new therapeutic approach to MPN.

Multifunctional applications of natural colorants: Preservative, functional ingredient, and sports supplements

In the food, pharmaceutical, and cosmetic industries, artificial colorant is one of the most vital and frequently used additives due to its easy availability, low cost, and higher stability. However, the main adverse effect of using artificial colorants is its health hazard. For this reason, the food industry is seeking some healthy alternatives. The recent trend of using natural colorants is growing day by day. One of the most prominent components of the plant kingdom currently used in a variety of industries, including the food preservation industry, the cosmetics industry, and the sports sector is called natural colorant. The main objective of this review study is to explore the numerous applications of natural colorants with their proper classification. The usage of natural colorants for the intensification of functional properties of food, for food preservation, and the generation of innovative sports supplements were discussed in the entire manuscript. After the collection of relevant research regarding the topic, it was seen that betalain, anthocyanin, curcumin, and carotenoids are the most frequently discussed natural colorants, mainly used as a preservative and contains enormous health benefits (e.g. anthocyanin is responsible for the maintenance of healthy vision, normal blood glucose level, relaxation of vascular endothelial cells and also contains antioxidant properties). It is used in the food industry to enrich the color as well as nutritional quality of the food product. The uses of natural colors for the development of sports supplements are still limited and need further research in this particular area.

An extract of Hibiscus sabdariffa improves short-term memory in rats with experimental diabetic hyperglycemia

ABSTRACT Background Calyxes of Hibiscus sabdariffa (Hs) contain anthocyanins, that normalize blood glucose levels (BGL) in diabetic patients. Diabetes also causes memory alterations, which could hypothetically decrease with the consumption of Hs. Objectives To investigate the effect of dietary supplementation with a Hs extract on working memory and BGL in rats. Methods Diabetic hyperglycemia (DHG) was induced with streptozotocin (STZ, 55 mg/kg i.p.) in Wistar rats. After 72 h DHG was confirmed, and the consumption of Hs extract began (50 mg/Kg/day). BGL and body weight (BW) were measured at 10, 20 and 30 days after DHG induction in controls and treated animals. Learning and short-term memory were evaluated after 30 days with Novel Object Recognition Test (NOR) and Barnes Maze (BM). The gross hippocampal structure was histologically analyzed. Results STZ-treated animals presented low BW and persistent DHG (BGL <300 mg/dL). Diabetic animals consuming the Hs extract had a dual response: some showed BGL comparable to controls, while others had levels comparable to diabetic animals not consuming extract. Diabetic animals that consumed the Hs extract had a better performance in NOR and BM than the diabetic animals not consuming the extract. At the histological level, hippocampal morphological differences were observed between diabetic animals that consumed the extract and those that did not. Discussion The Hs extract used here could be a good co-adjuvant in the treatment of DHG, aimed at mitigating memory deficits and high BGL. These beneficial effects could be attributed to the anthocyanin content in the extract.

Nonlinear relationship between untraditional lipid parameters and the risk of prediabetes: a large retrospective study based on Chinese adults

BackgroundAbnormal lipid metabolism poses a risk for prediabetes. However, research on lipid parameters used to predict the risk of prediabetes is scarce, and the significance of traditional and untraditional lipid parameters remains unexplored in prediabetes. This study aimed to comprehensively evaluate the association between 12 lipid parameters and prediabetes and their diagnostic value.MethodsThis cross-sectional study included data from 100,309 Chinese adults with normal baseline blood glucose levels. New onset of prediabetes was the outcome of concern. Untraditional lipid parameters were derived from traditional lipid parameters. Multivariate logistic regression and smooth curve fitting were used to examine the nonlinear relationship between lipid parameters and prediabetes. A two-piecewise linear regression model was used to identify the critical points of lipid parameters influencing the risk of prediabetes. The areas under the receiver operating characteristic curve estimated the predictive value of the lipid parameters.ResultsA total of 12,352 participants (12.31%) were newly diagnosed with prediabetes. Following adjustments for confounding covariables, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol were negatively correlated with prediabetes risk. Conversely, total cholesterol, triglyceride (TG), lipoprotein combine index (LCI), atherogenic index of plasma (AIP), non-HDL-C, atherogenic coefficient, Castelli’s index-I, remnant cholesterol (RC), and RC/HDL-C ratio displayed positive correlations. In younger adults, females, individuals with a family history of diabetes, and non-obese individuals, LCI, TG, and AIP exhibited higher predictive values for the onset of prediabetes compared to other lipid profiles.ConclusionNonlinear associations were observed between untraditional lipid parameters and the risk of prediabetes. The predictive value of untraditional lipid parameters for prediabetes surpassed that of traditional lipid parameters, with LCI emerging as the most effective predictor for prediabetes.

Evaluation of the role of atherogenic index of plasma in the reversion from Prediabetes to normoglycemia or progression to Diabetes: a multi-center retrospective cohort study

BackgroundAtherosclerosis is closely linked with glucose metabolism. We aimed to investigate the role of the atherogenic index of plasma (AIP) in the reversal of prediabetes to normal blood glucose levels or its progression to diabetes.MethodsThis multi-center retrospective cohort study included 15,421 prediabetic participants from 32 regions across 11 cities in China, under the aegis of the Rich Healthcare Group’s affiliated medical examination institutions. Throughout the follow-up period, we monitored changes in the glycemic status of these participants, including reversal to normal fasting glucose (NFG), persistence in the prediabetic state, or progression to diabetes. Segmented regression, stratified analysis, and restricted cubic spline (RCS) were performed based on the multivariable Cox regression model to evaluate the association between AIP and the reversal of prediabetes to NFG or progression to diabetes.ResultsDuring a median follow-up period of 2.9 years, we recorded 6,481 individuals (42.03%) reverting from prediabetes to NFG, and 2,424 individuals (15.72%) progressing to diabetes. After adjusting for confounders, AIP showed a positive correlation with the progression from prediabetes to diabetes [(Hazard ratio (HR) 1.42, 95% confidence interval (CI):1.24–1.64)] and a negative correlation with the reversion from prediabetes to NFG (HR 0.89, 95%CI:0.81–0.98); further RCS demonstrated a nonlinear relationship between AIP and the reversion from prediabetes to NFG/progression to diabetes, identifying a turning point of 0.04 for reversion to NFG and 0.17 for progression to diabetes. In addition, we observed significant differences in the association between AIP and reversion from prediabetes to NFG/progression to diabetes across age subgroups, specifically indicating that the risk associated with AIP for progression from prediabetes to diabetes was relatively higher in younger populations; likewise, a younger age within the adult group favored the reversion from prediabetes to NFG in relation to AIP.ConclusionOur study, for the first time, reveals a negative correlation between AIP and the reversion from prediabetes to normoglycemia and validates the crucial role of AIP in the risk assessment of prediabetes progression. Based on threshold analysis, therapeutically, keeping the AIP below 0.04 was of paramount importance for individuals with prediabetes aiming for reversion to NFG; preventatively, maintaining AIP below 0.17 was vital to reduce the risk of diabetes onset for those with prediabetes.

Combination of purple sweet potato (Ipomoea batatas L.) leaf extract with metformin on blood glucose and total cholesterol levels of albino rats induced by high-fat diet and streptozotocin

Background: Diabetes mellitus is a metabolic disease characterized by hyperglycemia due to impaired insulin secretion, often accompanied by hypercholesterolemia. Metformin is a first-line antihyperglycemic drug that is often combined with other antihyperglycemic drugs. Purple sweet potato leaves have been widely studied to reduce glucose and cholesterol levels. Methods: This study was an experimental study using rats induced with a high-fat diet and streptozotocin, which were divided into 8 treatment groups, namely groups given CMC Na 0.5%, Metformin 45 mg/kg BW, Purple Sweet Potato Leaf Extract (SPLE) 200 mg/kg BW, SPLE 400 mg/kg BW, SPLE 800 mg/kg BW, SPLE 200 mg/kg BW with metformin 45 mg/kg BW, SPLE 400 mg/kg BW with metformin 45 mg/kg BW, and SPLE 800 mg/kg BW with metformin 45 mg/kg BW. Results: After treatment for 28 days with SPLE doses of 200 mg, 400 mg, and 800 mg/kg BW, both single doses and combinations with metformin showed a decrease in fasting blood glucose levels and total cholesterol, which were statistically significantly different (p&lt;0.05) between treatment groups using the one-way ANOVA. The combination of SPLE 800 mg/kg BW with metformin normalized blood glucose levels of 93.50±4.93 mg/dl. Conclusion: The combination of purple sweet potato leaf extract with metformin is more effective in reducing blood glucose and total cholesterol levels compared to the single administration of metformin and SPLE.

An Epidemiological Study on Diabetes and Pre-Diabetes in an Urban Area with Reference to Lifestyle Modification

Diabetes mellitus (DM) is one of the most common non-communicable diseases (NCDs) globally. It is the fourth or fifth leading cause of death in most high-income countries and there is substantial evidence that it is an epidemic in newly industrialized and many economically developing countries. Diabetes mellitus is a chronic illness requiring continuous medical care with multifactorial risk reduction strategies beyond glycemic control. Ongoing patient self-management education and support are critical to preventing acute complications and reducing the risk of long-term complications. Genetic factors are responsible for at least some of this. However, as evidenced by the increased incidence of diabetes mellitus in urban populations, the fast epidemiological shift linked to food pattern alterations and decreased physical activity is the main cause of the diabetes mellitus epidemic. Due to population aging, growth, urbanization, a lack of physical exercise, and a high incidence of obesity, there are more persons with DM. Lifestyle factors include eating patterns, exercise routines, alcohol consumption, and smoking. An improvement in these parameters would lead to better adherence to hypoglycemic medications. An epidemiological study on diabetes and pre-diabetes in an urban area with reference to lifestyle modification. A community-based intervention study. It was conducted in an urban area. Personal interviews using a semi-structured, pretested questionnaire were the main technique of data gathering. Detailed information has been taken on the demographic and socio-economic characteristics at both the individual and household levels. All responders provided their willingly given consent. Every second household was visited by systematic random sampling procedure to select 400 respondents. Due to non-response, inaccuracy and/or unreliability of information 50 Cases were not included in the analysis. Four more instances of diabetes were also removed from the research. Finally, analysis was carried out on 346 respondents. All respondents were questioned using a pretested, semi-structured questionnaire after giving their informed consent. Significant difference was observed with positive family history of diabetes, obesity, physical activities in male, high calorie intake, stress, chewable tobacco and blood pressure level with pre-diabetes and diabetes. Compared to responders with normal blood glucose levels, pre-diabetics and diabetics showed more positive family histories. Compared to responders with normal blood glucose levels, pre-diabetics and diabetics were more likely to be overweight. With regard to personal habits of the respondents, smoking was associated with more than 1-fold increase risk of obtaining serum glucose level &gt;110 mg/dl as compared to nonsmokers. The current research was an attempt to examine the effect of intervention with reference to life style modification. From the study, it is evident that overall awareness about diabetes has been found low and no awareness has been found about pre-diabetes. The present study also demonstrated that education is the fundamental tool to make the population aware of their health issues. Awareness about pre-diabetes and diabetes, which can make them beneficial for community and nation and so, they can play an innovative role for prevention of diabetes.