Oral Glucose Overload Research Articles

Neonatal undernutrition induced by litter size expansion alters testicular parameters in adult Wistar rats.

Several models of maternal undernutrition reveal impairment of testicular development and compromise spermatogenesis in male offspring. The expansion of the litter size model, valuable for studying the impact of undernutrition on early development, has not yet been used to evaluate the consequences of early undernutrition in the adult male reproductive system. For this purpose, pups were raised in either normal litter (ten pups/dam) or large litter (LL; sixteen pups/dam). On postnatal day 90, sexual behaviour was evaluated or blood, adipose and reproductive tissues were collected for biochemical, histological and morphological analysis. Adult LL animals were lighter and thinner than controls. They showed increased food intake, but decrease of retroperitoneal white adipose tissue weight, glycaemia after oral glucose overload and plasma concentration of cholesterol. Reproductive organ weights were not altered by undernutrition, but histopathological analysis revealed an increased number of abnormal seminiferous tubules and number of immature spermatids in the tubular lumen of LL animals. These animals also showed reduction in total spermatic reserve and daily sperm production in the testes. Undernutrition decreased the number of Sertoli cells, and testosterone production was increased in the LL group. Mitochondrial activity of spermatozoa remained unchanged between experimental groups, suggesting no significant impact on the energy-related processes associated with sperm function. All animals from both experimental groups were considered sexually competent, with no significant difference in the parameters of sexual behaviour. We conclude that neonatal undernutrition induces histological and physiological testicular changes, without altering sperm quality and sexual behaviour of animals.

Antidiabetic Effect of Passiflora ligularis Leaves in High Fat-Diet/Streptozotocin-Induced Diabetic Mice.

Type 2 diabetes mellitus (T2DM) is a major global public health concern, prompting the ongoing search for new treatment options. Medicinal plants have emerged as one such alternative. Our objective was to evaluate the antidiabetic effect of an extract from the leaves of Passiflora ligularis (P. ligularis). For this purpose, T2DM was first induced in mice using a high-fat diet and low doses of streptozotocin. Subsequently, an aqueous extract or an ethanolic extract of P. ligularis leaves was administered for 21 days. The following relevant results were found: fasting blood glucose levels were reduced by up to 41%, and by 29% after an oral glucose overload. The homeostasis model assessment of insulin resistance (HOMA-IR) was reduced by 59%. Histopathologically, better preservation of pancreatic tissue was observed. Regarding oxidative stress parameters, there was an increase of up to 48% in superoxide dismutase (SOD), an increase in catalase (CAT) activity by 35% to 80%, and a decrease in lipid peroxidation (MDA) by 35% to 80% in the liver, kidney, or pancreas. Lastly, regarding the lipid profile, triglycerides (TG) were reduced by up to 30%, total cholesterol (TC) by 35%, and low-density lipoproteins (LDL) by up to 32%, while treatments increased high-density lipoproteins (HDL) by up to 35%. With all the above, we can conclude that P. ligularis leaves showed antihyperglycemic, hypolipidemic, and antioxidant effects, making this species promising for the treatment of T2DM.

Lower glycemia levels in subjects with excessive erythrocytosis during the oral glucose tolerance test living in conditions of severe hypoxia.

Previous studies showed that residents of higher elevations have lower glucose levels. Our objective in this study is to determine the basal and postprandial glucose levels in apparently healthy permanent residents of the miner population center of La Rinconada located 5100 meters (m) above sea level. Forty male permanent residents of the Rinconada miner population center were studied. The oral glucose tolerance test was used to evaluate basal and postprandial glycemia levels at 1, 2, and 3h. The individuals had a mean age of 43.95 ± 8.54years. Basal glycemia in subjects without excessive erythrocytosis (EE) was 73.3 ± 7.9mg/dL, while levels in patients with EE were 57.98 ± 7.38mg/dL. In the postprandial period, at 1h after oral glucose overload, a mean value of 76.35 ± 13.53mg/dL was observed in subjects with EE compared to 94.68 ± 9.98mg/dL in subjects without EE. After 2h, subjects with EE had a glycemia level of 72.91 ± 9.17mg/dL EE compared to 90.73 ± 13.86mg/dL without EE. At 3h, the average glycemia level in subjects with EE was 70.77 ± 8.73mg/dL compared to 87.79 ± 14.16mg/dL in those without EE. These findings suggest that under hypoxic conditions, glycemia levels are lower in both subjects with and without EE, having obtained lower levels in subjects with EE in relation to those with normal values of Hb and Hct. The results of this study indicate that in the conditions of severe hypoxia, blood glucose levels are below the values considered normal for sea level.

In Search of the Hyperglycemic Threshold Required to Induce Growth Hormone (GH) Suppression.

Introduction According to the 2014 Endocrine Society Clinical Practice Guideline on acromegaly, the confirmation of acromegaly diagnosis is established by finding a lack of suppression of growth hormone (GH) to < 1 ug/L following documented hyperglycemia during an oral glucose tolerance test. However, in this setting, the concept of hyperglycemia has never been clearly defined. Objective This study aimed to define the hyperglycemic threshold required to induce GH suppression. Methods We retrieved the glycemia profile of 44 individuals after a standard 2-h 75g oral glucose tolerance test prescribed to assess GH suppression and performed a comprehensive analysis of two subgroups of individuals (28 reaching GH suppression and 16 in whom GH suppression was not observed). All of the data were analyzed with the program Graph Pad Prism. Differences between means were assessed by Student's unpaired t-test or Mann-Whitney U test as deemed appropriate. Fisher's exact test was used for categorical variables. Results Individuals in G1 and G2 were different only for the median basal GH and median IGF-1. No significant differences in terms of the prevalence of diabetes and prediabetes were found. The glucose peak was achieved earlier in the group that reached GH suppression. The median of the highest glucose values of both subgroups was not different. A correlation between peak and baseline glucose value was found only among those in whom GH suppression was reached. Among these, the median glucose peak (P50) was 177 mg/dl, whereas the 75th percentile (P75) and 25th percentile (P25) were 199 mg/dl and 120 mg/dl, respectively. Conclusion Considering that 75% of those in whom GH suppression was observed after an oral glucose overload test reached blood glucose values above 120 mg/dl, we propose to use this value as the blood glucose threshold for inducing GH suppression. In light of our results, whenever GH suppression is not observed; and the highest glycemic value is below 120 mg/dl, it might be useful to repeat the test prior to any conclusion.

Effect of Prosopis ruscifolia on incretin and insulin secretion in alloxan-induced hyperglycemic rats

Background: Diabetes mellitus treatment is based on oral hypoglycemic agents or insulin. Medicinal plants constitute an option, and the leaves of Prosopis ruscifolia (Pr) were shown to be effective in reducing glycemia in hyperglycemic animals. Objective: In this paper, we report the effect of P. rusciofolia (Pr) on insulin and incretin secretion in alloxan-induced hyperglycemic rats. Methodology: The effective dose was selected, and four groups (n=10) of Wistar rats were used. Two groups with normal glycemia received water or Pr (75 mg/Kg, per os, p.o.), and two groups with hyperglycemia induced by alloxan (intraperitoneal, ip), received water or Pr (75 mg/Kg, p.o.) for 2 weeks. Oral glucose tolerance test, and incretin and insulin levels were measured at the end of the experimental period. Results: The results showed that extract promotes better tolerance to oral glucose overload, in addition to a statistically significant (p&lt;0.001) increase in blood levels of incretin and insulin, compared to the hyperglycemic rats. Conclusion: It is concluded that the ethanolic extract of P. ruscifolia leaves has a hypoglycemic effect in hyperglycemic animals by a mechanism that involves the incretin-insulin system.

EFFECT OF THE AQUEOUS EXTRACT OF CLERODENDRUM THOMSONIAE LINN (VERBENACEAE) LEAVES ON TYPE 2 DIABETIC WISTAR RATS INDUCED BY THE MACAPOS1 TYPE DIET AND DEXAMETHASONE

Aim and objective: Clerodendrum thomsoniae leaves are used in Cameroon to manage diabetes and its related disorders. The study aimed at investigating the antidiabetic effect of the aqueous extract on diet and dexamethasone induced diabetic rats. Methods: Young mature leaves of C thomsoniae were dried, finely powdered and submitted to aqueous extraction. The dehydrated extract was tested in rats at 3 doses 312.5, 625 and 1250 mg/kg based on the local use of the plant. The effect of the extract on the fasting blood glucose in normoglycemic rats and MACAPOS 1 type diet induced diabetic rats, using respectively glibenclamide and metformin as positive control groups, were investigated. Results: AECT significantly reduced blood glucose levels in normoglycemic rats (p&lt;0.05) two hours after administration, from 83±2 mg/dL to 57.39±1.7 mg/dL with the dose of 1250 mg/kg. given the highest reduction rate of 30.86%. In normoglycemic rats 30 minutes after oral glucose overload, the maximum reduction rate was observed with glibenclamide 5 mg / kg and calculated at 49.90% followed by 36.39%, for the extract at 1250 mg / kg. After 30 days of repeated oral administration, AECT produced a reduction on blood glucose levels (p&lt;0.05) in type 2 diabetic rats. This reduction in blood sugar was much more expressed with the dose of 1250mg/kg (73.52±0.71 mg/dL) followed by metformin 38mg/kg (70.21±0.89 mg/dL) as the normal control with no significant difference (P &lt; 0.05). Conclusion: These results show that the antidiabetic activity of AECT can be explained by insulin stimulating effect, also give support to the traditional use of this plant. Peer Review History: Received 11 May 2021; Revised 17 June; Accepted 27 June, Available online 15 July 2021 Academic Editor: Dr. Asia Selman Abdullah, Al-Razi university, Department of Pharmacy, Yemen, asia_abdullah65@yahoo.com UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Terhemen Festus Swem, Department of Veterinary Physiology and Biochemistry, College of Veterinary Medicine, Federal University of Agriculture, Makurdi, Benue State, Nigeria, swemfestus422@gmail.com Taha A.I. El Bassossy, Medicinal and Aromatic Plants Department, Desert Research Center, Cairo, Egypt, tahachemist2008@gmail.com Prof. Dr. Ali Gamal Ahmed Al-kaf, Sana'a university, Yemen, alialkaf21@gmail.com Similar Articles: ANTIDIABETIC AND ANTIHYPERLIPIDEMIC ACTIVITY OF DRACAENA CINNABARI BALF. RESIN ETHANOLIC EXTRACT OF SOQATRA ISLAND IN EXPERIMENTAL ANIMALS THE SCOPING REVIEW OF CHINESE AND WESTERN MEDICINE TREATMENT OF DIABETIC FOOT IN ASIA ANTIHYPERGLYCEMIC AND ANTI-OXIDANT POTENTIAL OF ETHANOL EXTRACT OF VITEX THYRSIFLORA LEAVES ON DIABETIC RATS EFFECTS OF EMODIN ON BLOOD GLUCOSE AND BODY WEIGHT IN TYPE 1 DIABETIC RATS

Adiponectin agonist treatment in diabetic pregnant rats.

Gestational diabetes mellitus (GDM) reduces maternal adiponectin and docosahexaenoic acid (DHA) materno-fetal transfer, which may have negative consequences for the offspring. Our aim was to evaluate the effects of the administration of a novel adiponectin agonist (AdipoRon) to GDM rats on the long-term consequences in glycaemia and fatty acids (FA) profile in the offspring. Pregnant rats were randomized to three groups: GDM rats (GDM, n = 8), GDM rats treated with AdipoRon (GDM + ADI, n = 9), and control rats (n = 10). Diabetes was induced with streptozotocin (50 mg/kg) on day 12 of gestation. GDM+ADI received 50 mg/kg/day AdipoRon from day 14 until delivery. Glycaemia and FA profile were determined in mothers and adult offspring (12 weeks old). AdipoRon tended to reduce fasting glucose in diabetic mothers. Diabetic rats presented the foetus with intrauterine growth restriction and higher adiposity, which tried to be counteracted by AdipoRon. In the adult offspring, both GDM + ADI and control animals showed better glucose recovery after oral glucose overload with respect to GDM. DHA in offspring plasma was significantly reduced in both GDM and GDM + ADI compared to controls (P = 0.043). Nevertheless, n-6/n-3 polyunsaturated FA (PUFA) ratio improved in plasma of GDM + ADI adult offspring (GDM: 14.83 ± 0.85a%; GDM + ADI: 11.49 ± 0.58b%; control: 10.03 ± 1.22b%, P = 0.034). Inflammatory markers and oxidative stress were reduced in the adult offspring of AdipoRon-treated mothers. In conclusion, AdipoRon administration to pregnant diabetic rats improved glycaemia in the mothers and long-term glucose tolerance in the offspring. In addition, it tended to reduce excessive foetal fat accumulation and improved n-6/n-3 PUFA ratio significantly in offspring at the adult state.

Improved gestational diabetes screening protocol.

This work aimed to assess the diagnostic validity of two approaches for the screening of gestational diabetes mellitus (GDM) with less discomfort for pregnant women. A prospective diagnostic validation study was conducted with 2007 pregnant women. According to risk factors for GDM, women were classified into high-risk and low-risk groups. The current diagnostic procedure, based on oral glucose overload, was followed; simultaneously HbA1c was tested and an algorithm combining both biomarkers was applied. In the low-risk group, the Glucose challenge test (GCT) showed a higher area under the curve (AUC 0.953; 95% CI 0.915-0.992) than the HbA1c test (0.688; 95% CI0.541-0.834). The best GCT cut-off, 153.5mg/dL (8.52mmol/L), showed higher diagnostic validity than that for HbA1c, 28mmol/mol (4.75%), and that the algorithm using both tests. In the high-risk group, the GCT showed better diagnostic performance than the HbA1c and the algorithm; the optimal GCT cut-offs were higher than those recommended in current protocols. 13th week: GCT AUC 0.882 (95% CI 0.843-0.921), HbA1c AUC 0.624 (95% CI 0.562-0.686), GCT cut-off 140.5mg/dL (7.8mmol/L), HbA1c cut-off 33mmol/mol (5.15%). 24th week: GCT AUC 0.944(95% CI 0.925-0.962), HbA1c AUC 0.642 (95% CI 0.575-0.709), GCT cut-off, 145.5mg/dL (8.08mmol/L), HbA1c cut-off 29mmol/mol (4.85%). The GDM diagnostic approach using as the first step the GCT with higher cut-offs showed the best diagnostic validity. Applying these thresholds, 55.6 and 13.7% of 100g. Oral glucose overloads would have been avoided in low-risk and high-risk pregnant women.

Sedentary Behaviors and Physical Activity Habits Independently Affect Fat Oxidation in Fasting Conditions and Capillary Glucose Levels After Standardized Glucose-Rich Meal in Healthy Females.

PurposeSedentary behaviors and muscle inactivity are being growingly recognized as important risk factors for health, adjunctively and independently from a scarce physical activity (PA), although the metabolic mechanism underneath is barely clear. To explore the relation between sedentary behaviors (SBs) and metabolism, we measured the metabolic profile in fasting condition and after oral glucose overload in a group of women, along with objective monitoring of their PA/sedentary lifestyle habits.Subjects and MethodsThirteen women (age: 32.5 ± 16.1 years; BMI: 24.0 ± 3.3 kg/m2), recruited among university students and research staff, underwent indirect calorimetry to assess fat and carbohydrate contribution to energy metabolism, in fasting conditions and after a glucose-rich standard meal (about 45 g of glucose). Glucose concentration in capillary blood was determined in fasting state and 15 and 30 min after meal. Habitual PA and SBs in the previous week were continuously monitored with Actigraph accelerometers.ResultsAfter adjustment for age, the contribution of fat oxidation to metabolic energy sources, normalized for fat-free mass, in fasting conditions was significantly correlated with time spent in sitting/lying position during wake hours (p < 0.001), independent from PA habits, whereas capillary blood peak and change of glucose concentration after the meal were significantly and inversely correlated with average daily moderate to vigorous PA (p = 0.025 and p = 0.019, respectively), independent from average daily sitting/lying time.ConclusionsHere, we report for the first time a direct effect of muscle inactivity on increased fat oxidation in fasting conditions, which can be hypothesized as a preliminary condition for the development of insulin resistance. We also report the direct independent effect of PA on the capacity to respond to a glycemic load, so that SBs and reduced PA appear to concur, although independently, to the increased health risk, as elsewhere observed on an epidemiological ground.

Phenotype of haptoglobin and presence of subclinical vascular disease: Population study

Introduction and objectivesHaptoglobin is a protein involved in the protection against oxidative damage caused by iron in haemoglobin. This protein is polymorphic, with 3 isomorphs prevalent in the population. The carriers of the Hp2-2 isoform have a lower antioxidant capacity and, in the population with diabetes, an increased risk of subclinical vascular disease and cardiovascular complications. The objective of this study was to evaluate whether this isomorphy is associated with an increased risk of carotid arteriosclerosis in subjects with and without diabetes, and free of cardiovascular disease. Patients and methodsA study was conducted in a population between 45 and 74 years of age, randomly selected from the northwest area of Madrid. The participants were characterised in terms of their glycaemic status by oral glucose overload and the determination of the concentration of Hb1Ac. The haptoglobin phenotypes in all of them were determined by means of an immunoenzymatic assay, and the presence of carotid arteriosclerosis by ultrasound. ResultsOf the 1256 participants included in the present analysis (mean age 61.6 ± 6 years, 41.8% males), the distribution of the isoforms of haptoglobin was as follows: Hp1-1: 13.3%, Hp1-2: 48.5%, and Hp2-2: 38.2%. In comparison with subjects Hp1-1 and Hp1-2, those with the Hp2-2 phenotype had a higher prevalence of dyslipidaemia (53.3% vs 43%; p < .0001) and arterial hypertension (39.2% vs. 32.2%, p = .012), and they more frequently received treatment with statins (31.5% vs 21.6%, p < .0001), and with antihypertensive agents (38.4% vs 30.8%, p = .006). The carriers of the Hp2-2 isoform had a higher prevalence of carotid plaques (OR: 1.35, 95% CI: 1.07–1.69, p = .011), with no differences in that prevalence as regards the glycaemic status. There were no differences in the intima-media thickness between the different phenotypes. The relationship of the Hp2-2 phenotype with the presence of plaques in the carotid was independent of age, gender, presence of risk factors (dyslipidaemia, hypertension and diabetes), the concentration of LDL-cholesterol, C-reactive protein and uric acid, blood pressure, and treatment with statins, and hypertensive drugs (OR: 1.31, 95% CI 1.01–1.70, p = .044). ConclusionSubjects with the Hp2-2 phenotype of haptoglobin have a higher prevalence of carotid arteriosclerosis, which is independent of the presence of other cardiovascular risk factors and their glycaemic status.

Fenotipo de la haptoglobina y presencia de enfermedad vascular subclínica: estudio poblacional

Introduction and objectivesHaptoglobin is a protein involved in the protection against oxidative damage caused by iron in haemoglobin. This protein is polymorphic, with 3 isomorphs prevalent in the population. The carriers of the Hp2-2 isoform have a lower antioxidant capacity and, in the population with diabetes, an increased risk of subclinical vascular disease and cardiovascular complications. The objective of this study was to evaluate whether this isomorphy is associated with an increased risk of carotid arteriosclerosis in subjects with and without diabetes, and free of cardiovascular disease. Patients and methodsA study was conducted in a population between 45 and 74years of age, randomly selected from the northwest area of Madrid. The participants were characterised in terms of their glycaemic status by oral glucose overload and the determination of the concentration of Hb1Ac. The haptoglobin phenotypes in all of them were determined by means of an immunoenzymatic assay, and the presence of carotid arteriosclerosis by ultrasound. ResultsOf the 1,256 participants included in the present analysis (mean age 61.6±6years, 41.8% males), the distribution of the isoforms of haptoglobin was as follows: Hp1-1: 13.3%, Hp1-2: 48.5%, and Hp2-2: 38.2%. In comparison with subjects Hp1-1 and Hp1-2, those with the Hp2-2 phenotype had a higher prevalence of dyslipidaemia (53.3% vs 43%; P<.0001) and arterial hypertension (39.2% vs. 32.2%, P=.012), and they more frequently received treatment with statins (31.5% vs 21.6%, P<.0001), and with antihypertensive agents (38.4% vs 30.8%, P=.006). The carriers of the Hp2-2 isoform had a higher prevalence of carotid plaques (OR: 1.35, 95%CI: 1.07-1.69, P=.011), with no differences in that prevalence as regards the glycaemic status. There were no differences in the intima-media thickness between the different phenotypes. The relationship of the Hp2-2 phenotype with the presence of plaques in the carotid was independent of age, gender, presence of risk factors (dyslipidaemia, hypertension and diabetes), the concentration of LDL-cholesterol, C-reactive protein and uric acid, blood pressure, and treatment with statins, and hypertensive drugs (OR: 1.31, 95%CI 1.01-1.70, P=.044). ConclusionSubjects with the Hp2-2 phenotype of haptoglobin have a higher prevalence of carotid arteriosclerosis, which is independent of the presence of other cardiovascular risk factors and their glycaemic status.

El sobrecrecimiento bacteriano de intestino delgado es una entidad frecuente tras gastrectomía, pero con escasa relevancia en el estado nutricional

BackgroundAvailable evidence assessing the impact of small intestinal bacterial overgrowth (SIBO) following gastrectomy is limited. ObjectivesTo evaluate the prevalence of SIBO after gastrectomy and its association with malnutrition. To describe the antibiotic treatment required to correct it and if nutritional status improves. Material and methodsA prospective cohort study was performed at the Agencia Sanitaria Costa del Sol (Costa del Sol Health Agency) from 2012 to 2015. A hydrogen-methane breath test with oral glucose overload was performed. Demographic variables and nutritional parameters were collected at baseline and one month after effective treatment of SIBO. The antibiotic regimens and the number of treatment lines used were assessed. ResultsSixty gastrectomy patients were analysed, 58.3% of which were male. A sub-analysis of the curve was performed at 45min to minimise possible false positives, and SIBO was identified in 61.6% of cases. SIBO patients tended to have a lower BMI, although this trend was not statistically significant. After treatment with rifaximin, 94.6% of patients were still positive for SIBO, which fell to 85.7% after metronidazole. The rate of total antibiotic treatment failure was 67.6%. No statistically significant changes were found in nutritional parameters after treatment. ConclusionsSIBO was identified in 61.6% of patients after gastrectomy. No correlation was found with any malnutrition parameter. Rifaximin and metronidazole were found to be largely ineffective in eradicating SIBO. When treatment was effective, the impact on malnutrition was negligible and may have been associated with other factors.

Potential application of&lt;i&gt; Conyza canadensis&lt;/i&gt; (L) Cronquist in the management of diabetes:&lt;i&gt; In vitro&lt;/i&gt; and &lt;i&gt;in vivo&lt;/i&gt; evaluation

Purpose : To investigate the antihyperglycemic activity of Conyza canadensis via α-glucosidase inhibition in alloxan-induced diabetic mice. Methods : In vitro antidiabetic activity was investigated using α-glucosidase inhibition assay with acarbose (62.5, 125, 500 and 1000 μg/ml) as the standard drug. Conyza canadensis crude extract (Cc.Cr) in doses of 10, 30, 100 and 300 mg/kg were administered daily as a single dose to alloxaninduced (200 mg/kg) diabetic mice (Balb/c), and its effect on fasting blood glucose levels and body weight were evaluated for 15 consecutive days; oral glucose tolerance test was conducted. Metformin (500 mg/kg) was used as a standard antidiabetic drug for comparison. Acute toxicity of Cc.Cr was also evaluated at doses of 3 and 5 g/kg. Results : Conyza canadensis crude extract (Cc.Cr) exhibited strong enzyme inhibition at concentrations (μg/ml) of 1000 (74.78 ± 0.92), 500 (65.11 ± 0.07), 250 (57.55 ± 0.41), 125 (51.55 ± 0.67) and 62.5 ( 44.00 ± 0.57), with a median inhibitory concentration (IC 50 ) of 107 μg/ml. Cc.Cr at all test doses (10 - 300 mg / kg) reduced fasting blood glucose levels in alloxan (200 mg/kg) - induced diabetic mice on days 5, 10 and 15 compared to the diabetic control group (p < 0. 001). These effects were similar to those caused by the standard antidiabetic drug, metformin. Cc.Cr at all test doses also increased body weight of treated animals. The extract (300 mg/kg) significantly improved tolerance of oral glucose overload in mice, like metformin. The extract did not cause any mortality up to the maximum dose of 5 g/kg. Conclusion : The results reveal that Conyza canadensis possesses potent secondary metabolites which can cause inhibition of α-glucosidase. Moreover, the plant extract has the ability to reduce blood glucose level in diabetic animals and significantly improves oral glucose overload tolerance. Keywords : Conyza canadensis , α-Glucosidase, Blood glucose, Alloxan, Diabetes, Glucose tolerance

Utilization of a healthcare failure mode and effects analysis to identify error sources in the preanalytical phase in two tertiary hospital laboratories.

IntroductionThe presence of errors in the preanalytical phase is a thoroughly studied problem. A strategy to increase their source detection might be the use of the Healthcare Failure Mode and Effects Analysis (HFMEA). The aim of this study is improving the capacity of identifying sources of error during the preanalytical period in samples provided by primary care clinics (PCC) with the use of the HFMEA as a tool in the laboratories of two tertiary hospitals.Materials and methodsA HFMEA was carried out in each laboratory, by means of the creation of groups of experts with similar characteristics (doctors and nurses from PCC and laboratory, support staff, and laboratory technicians). The Risk Priority Number (RPN) was calculated.ResultsItems with elevated RPN were presented in both centers. The highest RPN were in LAB1: “two request notes for a patient” and “the segregation of oncology urgent samples” (both with 384), while in LAB2 was “the lack of information in patients with oral glucose overload test” (RPN 576). Considering the different steps in the preanalytical phase, LAB1 paid attention in sampling, samples reception and the programming in the Laboratory Information System, while LAB2 paid attention in the request form, the appointment system, sampling procedures, transport and reception.ConclusionThe laboratories prioritized the problems differently. However, both centers offer solutions to these possible sources of error. We proposed improvement actions that can be resolved easily, with a low cost for the system, mainly to schedule a specific formative programme and a deep revision of the existing protocols.

Antioxidant, antihyperglycemic, and antidiabetic activity of Apis mellifera bee tea.

Diabetes has emerged as one of the largest global epidemics; it is estimated that by 2035, there will be 592 million diabetic people in the world. Brazilian biodiversity and the knowledge of traditional peoples have contributed to the treatment of several diseases, including diabetes. Apis mellifera bee tea is used by indigenous Brazilians to treat diabetes, and this traditional knowledge needs to be recorded and studied.The objective of this study was to record the use and to evaluate the antioxidant, antihyperglycemic, and antidiabetic activity of Apis mellifera bee tea, which is used by the Guarani and Kaiowá indigenous people for the treatment of diabetes. Semi-structured interviews were performed with Guarani and Kaiowá ethnic indigenous people from the State of Mato Grosso do Sul, Brazil, seeking to identify the animal species used for medicinal purposes. For the experimental procedures, tea prepared with macerated Apis mellifera bees was used. In vitro assays were performed to evaluate antioxidant activity; direct free radical scavenging, protection against oxidative hemolysis, lipid peroxidation were evaluated in human erythrocytes and potential in inhibiting the formation of advanced glycation end products (AGEs). In vivo, normoglycemic Swiss male mice treated with Apis mellifera tea (AmT) were subjected to the oral glucose tolerance test and compared with control and metformin-treated groups. Diet-induced diabetic mice were treated for 21 days with AmT and evaluated for glycemia and malondialdehyde levels in the blood, liver, nervous system, and eyes. During interviews, the indigenous people described the use of Apis mellifera bee tea for the treatment of diabetes. In in vitro assays, AmT showed direct antioxidant activity and reduced oxidative hemolysis and malondialdehyde generation in human erythrocytes. The AmT inhibited the formation of AGEs by albumin-fructose pathways and methylglyoxal products. In vivo, after oral glucose overload, normoglycemic mice treated with AmT had reduced hyperglycemia at all times evaluated up to 180 min. AmT also reduced hyperglycemia and malondialdehyde levels in the blood, liver, nervous system, and eyes of diabetic mice to similar levels as those in metformin-treated mice and normoglycemic controls. In summary, Apis mellifera bee tea showed antioxidant, antihyperglycemic, and antidiabetic activity, which provides support for the therapeutic application of Guarani and Kaiowá indigenous knowledge.

Computational and Pharmacological Evaluation of Ferrocene-Based Acyl Ureas and Homoleptic Cadmium Carboxylate Derivatives for Anti-diabetic Potential.

We investigated possible anti-diabetic effect of ferrocene-based acyl ureas: 4-ferrocenyl aniline (PFA), 1-(4-chlorobenzoyl)-3-(4-ferrocenylphenyl) urea (DPC1), 1-(3-chlorobenzoyl)-3-(4-ferrocenylphenyl) urea (DMC1), 1-(2-chlorobenzoyl)-3-(4-ferrocenylphenyl) urea (DOC1) and homoleptic cadmium carboxylates: bis (diphenylacetato) cadmium (II) (DPAA), bis (4-chlorophenylacetato) cadmium (II) (CPAA), using in silico and in vivo techniques. PFA, DPC1, DMC1, DOC1, DPAA and CPAA exhibited high binding affinities (ACE ≥ −350 Kcal/mol) against targets: aldose reductase, peroxisome proliferator-activated receptor γ, 11β-hydroxysteroid dehydrogenase-1, C-alpha glucosidase and glucokinase, while showed moderate affinities (ACE ≥ −250 Kcal/mol) against N-alpha glucosidase, dipeptidyl peptidase-IV, phosphorylated-Akt, glycogen synthase kinase-3β, fructose-1,6-bisphosphatase and phosphoenolpyruvate carboxykinase, whereas revealed lower affinities (ACE < −250 Kcal/mol) vs. alpha amylase, protein tyrosine phosphatases 1B, glycogen phosphorylase and phosphatidylinositol 3 kinase. In alloxan (300 mg/Kg)-induced diabetic mice, DPAA and DPC1 (1–10 mg/Kg) at day 1, 5, 10, 15, and 20th decreased blood glucose levels, compared to diabetic control group and improved the treated animals body weight. DPAA (10 mg/Kg) and DPC1 (5 mg/Kg) in time-dependent manner (30–120 min.) enhanced tolerance of oral glucose overload in mice. DPAA and DPCI dose-dependently at 1, 5, and 10 mg/Kg decreased glycosylated hemoglobin levels in diabetic animals, as caused by metformin. These results indicate that aforementioned derivatives of ferrocene and cadmium possess anti-diabetic potential.

Fasting Glycemia as Screening Tool to Rule-Out Gestational Diabetes in Low-Risk Population.

The use of a glucose challenge test as the universal screening for gestational diabetes is common in many countries. This test represents significant costs for laboratories and inconveniences for the patients, who have to wait for one hour and, very often, feel discomfort and nausea. In this work we propose the use of fasting glycemia, in a population with low prevalence of gestational diabetes as a pre-screening test that would avoid the oral glucose overload in those pregnant women with low risk of gestational diabetes. The study was done with the fasting glucose levels of 6,573 pregnant women who underwent a two steps strategy to screen for gestational diabetes, a first step consisting of a 50 g glucose challenge test, followed when glycemia ≥ 140 mg/dL by a 100 g Oral Glucose Tolerance Test, based on recommendations made by National Diabetes Data Group. The ROC curve for fasting glucose was calculated, and we obtained an AUC = 0.633 (0.569 - 0.696). The sensitivity, specificity, and predictive values were established for different thresholds. We proposed that women with fasting glycemia ≤ 62 mg/dL, (S = 91.3%, NPV = 98.79% and LR- = 0.87) are in low risk of suffering gestational diabetes, which means that 10% of our population would not undergo the glucose challenge test.

Effectiveness of a low-fructose and/or low-sucrose diet in decreasing insulin resistance (DISFRUTE study): study protocol for a randomized controlled trial

BackgroundResearch published to date on the relationship between insulin resistance (IR) and fructose consumption is scarce, has used different methods, and has yielded sometimes contradictory results. This study aims to determine whether a low-fructose and/or low-sucrose diet supervised by a physician or nurse decreases IR compared to a standard diet.Methods/designThis field trial is located at primary care centers. The participants are adults aged 29 to 66 years, with a Body mass Index (BMI) between 29 and 40.99 kg/m2 and without diabetes. To date, 245 participants have been assigned randomly to the low-fructose diet intervention group (LFDI) at health centers in the western health service zone of Tenerife island, and 245 to the standard-diet control group (SDC) at health centers in the eastern health service zone. Recruitment is opportunistic and is carried out by physicians and nurses at participating health centers. Initially (baseline), and after 24 weeks of intervention, dietary records, physical activity, waist circumference, BMI, blood pressure, fasting blood glucose and insulin concentrations (HOMA2-IR) and lipid profile are recorded; blood glucose and insulin and lipid profile are also recorded 2 h after a 75-g glucose overload. After 48 weeks (24 weeks after the intervention), fasting blood samples are again obtained and a physical examination is performed. All tests and measures are repeated and recorded except dietary records, physical activity and oral glucose overload. Low-fructose diets are designed by calculating free and total (free + fructose associated with sucrose) fructose contents in standard diets, and removing foods with a fructose content in the highest quartile for the amounts in the standard diet.Participants in both groups are prescribed a diet that contains 30 to 40% less than the participant’s energy requirements. The primary endpoint is change in HOMA2-IR between baseline and week 24, and other outcomes are change in HDL-cholesterol, LDL-cholesterol, triglycerides , waist circumference to height ratio and BMI. The secondary endpoint is change in HOMA2-IR between week 24 and week 48 together with the outcomes noted above. Comparisons between groups for variables used to indicate IR levels are done with a Student’s t test for unpaired variables or the Mann-Whitney U test if the distribution is not normal. Multivariate regression models will be used to control for confounding factors not accounted for in the study design, and for independent prognostic factors.DiscussionIf the dietary intervention being tested, i.e., a diet low in fructose/sucrose, is able to reduce IR, the results – if translated into regular clinical practice – could provide a hitherto unavailable tool to prevent type-2 diabetes mellitus.Trial registrationISRCTN, ID: ISRCTN41579277. Registered retrospectively on 15 November 2016.

Cardiovascular and Renal Effects of Birdseed Associated with Aerobic Exercise in Rats.

Phalaris canariensis L. (Pc), known as birdseed, is rich in tryptophan. The aqueous extract of Pc (AEPc) treatment reduced systolic blood pressure (SBP) in spontaneously hypertensive rats (SHR) via mechanisms mediated by the tryptophan metabolizing enzyme indoleamine 2,3-dioxygenase (IDO). Hypertension is a risk factor to cardiovascular and renal diseases. Considering that physical exercise improves hypertension and cardiovascular function, the aim of this study was to evaluate whether the benefits of exercise (Ex) would be enhanced by concomitant AEPc treatment (400 mg·kg·d p.o.). Vascular reactivity was assessed in aorta rings from SHR treated with AEPc for 4 wk. Training intensity was based on maximal lactate steady state obtained during the 2-wk adaptation period in a treadmill running. Then exercised (60 min running, five times per week during 8 wk) or sedentary SHR were untreated or treated with AEPc during 8 wk. SBP was estimated by plethysmograph. Heart mass and body mass were used to obtain the index of cardiac hypertrophy. Glucose tolerance test was evaluated by oral glucose overload, and the mRNA expressions of indoleamine 2,3-dioxygenase, interleukin 1β (IL-1β), and IL-10 in the kidney were obtained by real time polymerase chain reaction. AEPc induced endothelial-mediated vascular relaxation. AEPc or Ex alone reduced SBP, the index of cardiac hypertrophy and ventricular fibrosis, improved glucose metabolism, and attenuated proteinuria and the renal expression of the proinflammatory IL-1β with an overexpression in the anti-inflammatory IL-10. AEPc potentiated the benefits of the Ex on the cardiovascular system, metabolic parameters, and renal inflammation. Birdseed reduced cardiovascular risk related to hypertension and had positive effects when associated to physical exercise.

Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) in the Diagnosis of Insulin Resistance and Prediabetes

Type 2 diabetes mellitus consists of metabolic disturbances characterised mainly characterized by hyperglycemia which usually result from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. In clinical practice its very difficult to establish how much part of this metabolic disturbances is due to lack of insulin and how much it is due to peripheral resistance to insulin. In many of the cases of type 2 diabetes mellitus metabolic syndrome is present for many years before development of full blown type 2 diabetes mellitus. Metabolic syndrome is a cluster of biochemical and physiological abnormalities associated with the development of cardiovascular disease and type 2 diabetes. Insulin resistance is one of the important determinants of development of metabolic syndrome and then type 2 diabetes mellitus. Insulin resistance is increasing in many parts of the world due to sedentary lifestyle, substance abuse, obesity and harmful food habits. Several methods including estimation of blood glucose and insulin levels during fasting or after oral or intravenous glucose overload, have been used. But due to the simplicity of its determination and calculation, insulin resistance assessment by the homeostatic assay (HOMA-IR) is becoming more popular technique in clinical practice as well as in various epidemiological studies. Unlike type 1 diabetes, type 2 diabetes mellitus is gradual in onset and its diagnosis is usually delayed for many years. Early treatment of hyperglycaemia, hyperlipidemia and other metabolic irregularities reduces the cardiovascular risk in these patients. But these benefits are usually denied to patients mainly due to delay in diagnosis. In fact many of the patients admitted with myocardial infarction are diagnosed with type 2 diabetes while in intensive care units for myocardial infarction. Unlike in type I diabetes mellitus where insulin is deficient consequent to immune mediated destruction of B cells in type 2 diabetes there is Insulin resistance. Insulin resistance in pre diabetic stages can be diagnosed by using various methods. Some simple methods, from which indices can be derived, have been validated. These indices are used depending upon whether they are to be used for epidemiological or clinical purposes. For clinical purposes Quantitative insulin sensitivity check index (QUICKI) and homeostasis model assessment- insulin resistance (HOMA-IR) are most commonly used while for epidemiological purposes indices like Belfiore, Cederholm and Stumvoll index are suitable. This review explains the utility of homeostasis model assessment- insulin resistance (HOMA-IR) for the diagnosis of insulin resistance which is hallmark of pre diabetic state. The purpose of this paper was to review the current information