Oral Glucose Tolerance Test Test Research Articles

Development and validation of a Non-INvaSive Pregnancy RIsk ScoRE (INSPIRE) for the screening of high-risk pregnant women for gestational diabetes mellitus in Pakistan

IntroductionThe prevalence of gestational diabetes mellitus (GDM) is on the rise in low-income and middle-income countries, such as Pakistan. Therefore, the development of a risk score that is simple, affordable...

HbA1c as an early diagnostic marker in gestational diabetes mellitus.

Objective: To assess the effectiveness of HbA1c as an indicator of Gestational Diabetes mellitus(GDM). Study Design: Prospective Cases Control study. Setting: Fauji Foundation Hospital Rawalpindi. Period: March 2022 to Oct 2022. Methods: All pregnant females older than 18 years of age having pregnancy confirmed by gynecologist in 1st trimester were included. A 5ml blood sample was obtained from each case to evelaute the HbA1c level. Oral glucose tolerance test (OGTT) was performed on both groups at conception to 12 weeks (1st trimester) as well as at 12 to 24 weeks of gestation (2nd trimester) to evaluate correlation between OGTT and HbA1c test. All the females suffering from GDM were taken in cases group and comparatively in equal number non GDM pregnant women were taken in control group. All the relevant information was collected via study proforma and SPSS version 26 was used for analysis. Results: The number of females suffering from GDM was 45 in number and we took 45 pregnant females as control group. Average level of HbA1c in women with GDM (test group) was higher than in women with Non-GDM (control group). Patients having age groups 35-39 showing greater prevalence of gestational diabetes with 73.2% sensitivity and 66.7% specificity at a cut-off value of 5.6% (31 mmol/mol) for GDM diagnosis. Conclusion: The findings reveal significantly elevated HbA1c levels during both the first and second trimesters in individuals diagnosed with GDM, with a test specificity of 95%. This underscores its ability to accurately pinpoint individuals who truly have GDM. However, HbA1c is observed as a valuable diagnostic tool for the early detection of GDM.

The effects of non-bitter <i>Cucumis metuliferus</i> fruit extract on blood sugar of high-fat/fructose diet and streptozotocin-induced type II diabetic Wistar Albino rats

Globally, diabetes mellitus (DM) remains one of the leading debilitating non-communicable diseases, with its prevalence projected to increase from 8.8% in 2015 to 10.0% in 2030. The management of diabetes mellitus remains a major challenge, and the number of diabetes-related deaths is projected to rise from 3.1 million in 2015 to 4.2 million in 2030. This continues to be a public health concern, particularly in developing countries where the majority of people are poor and predominantly live in rural areas, facing challenges in accessing healthcare services. However, the non-bitter Cucumis metuliferus fruit is being used for managing type 2 diabetes mellitus by some communities in Kenya, although its therapeutic benefits have not been adequately studied and proven. The study aimed to determine the effects of non-bitter Cucumis metuliferus fruit extract on blood sugar in high-fat/fructose diet and streptozotocin-induced type II diabetic Wistar albino rats. This study adopted an experimental laboratory-based design. A sample size of 64 male Wistar albino rats, aged 5 weeks and weighing between 90 and 130 grams, was randomly assigned to two major study groups: the control group and the experimental group. The experimental group received a high-fat/fructose diet plus streptozotocin (STZ) injection to induce diabetes mellitus, whereas the control group received a standard rodent pellet diet plus 0.9% normal saline injection. The experimental group was further divided into a positive control group treated with pioglitazone (the standard drug) at a dose of 20 mg/kg body weight, a low-dose CMFE group at 200 mg/kg body weight, and a high-dose CMFE group at 400 mg/kg body weight. Fasting blood sugar (FBS), oral glucose tolerance test (OGTT), and haemoglobin A1c (Hb A1c) tests were used as indicators, and the results were compared between the groups. The study findings revealed a significant statistical rise (P <0.001) of FBS in the treatment group after induction of type II DM, followed by a decline to pre-induction levels after treatment. Similarly, there was a statistically significant increase (P <0.001) of the OGTT after induction of type II DM, with the OGTT declining to pre-induction levels following treatment (P =0.106). The findings on both the FBS and OGTT tests indicate that treatment with CMFE controlled the blood sugar. Consequently, there was no significant difference (P =0.712) in Hb A1c test results between the control group and the treatment group at the end of the experiment, indicating that treatment with CMFE had a long-term control effect on blood sugar. This study concludes that the non-bitter CMFE possesses both short-term and long-term hypoglycemic properties in type II diabetes mellitus.

The Value of ER∝ in the Prognosis of GH- and PRL-Secreting PitNETs: Clinicopathological Correlations.

Pituitary neuroendocrine tumors (PitNETs) are divided into multiple histological subtypes, which determine their clinical and biological variable behavior. Despite their benign evolution, in some cases, prolactin (PRL) and growth hormone (GH)-secreting PitNETs may have aggressive behavior. In this study, we investigated the potential predictive role of ER∝, alongside the clinicopathological classification of PitNETs (tumor diameter, tumor type, and tumor grade). A retrospective study was conducted with 32 consecutive cases of PRL- and mixed GH- and PRL-secreting PitNETs (5 patients with prolactinomas and 27 with acromegaly, among them, 7 patients with GH- and PRL- co-secretion) who underwent transsphenoidal intervention. Tumor specimens were histologically and immunohistochemical examined: anterior pituitary hormones, ki-67 labeling index, CAM 5.2, and ER∝; ER∝ expression was correlated with basal PRL levels at diagnosis (rho = 0.60, p < 0.01) and postoperative PRL levels (rho = 0.58, p < 0.001). In our study, the ER∝ intensity score was lower in female patients. Postoperative maximal tumor diameter correlated with Knosp grade (p = 0.02); CAM 5.2 pattern (densely/sparsely granulated/mixed densely and sparsely granulated) was correlated with postoperative PRL level (p = 0.002), and with ki-67 (p < 0.001). The IGF1 level at diagnosis was correlated with the postoperative GH nadir value in the oral glucose tolerance test (OGTT) (rho = 0.52, p < 0.05). Also, basal PRL level at diagnosis was correlated with postoperative tumor diameter (p = 0.63, p < 0.001). At univariate logistic regression, GH nadir in OGTT test at diagnostic, IGF1, gender, and invasion were independent predictors of remission for mixed GH- and PRL-secreting Pit-NETs; ER∝ can be used as a prognostic marker and loss of ER∝ expression should be considered a sign of lower differentiation and a likely indicator of poor prognosis. A sex-related difference can be considered in the evolution and prognosis of these tumors, but further studies are needed to confirm this hypothesis.

Characterization, In Vitro Biological Activity and In Vivo Cardioprotective Properties of Trametes versicolor (L.:Fr.) Quél. Heteropolysaccharides in a Rat Model of Metabolic Syndrome.

The present study aimed to examine the biological activity and cardioprotective potential of Trametes versicolor heteropolysaccharides (TVH) in a rat model of metabolic syndrome (MetS). This study included 40 Wistar rats divided into 5 groups: CTRL-healthy non-treated rats; MetS-non-treated rats; and H-TV, M-TV and L-TV-rats with MetS treated with either 300, 200 or 100 mg/kg TVH per os for 4 weeks. After finishing the treatment, we conducted an oral glucose tolerance test (OGTT), hemodynamic measurements and the animals were sacrificed, hearts isolated and subjected to the Langendorff technique. Blood samples were used for the determination of oxidative stress parameters, lipid status and insulin levels. We showed that α-amylase inhibition was not the mode of TVH antidiabetic action, while TVH showed a moderate inhibition of pathogenic microorganisms' growth (MIC 8.00 mg·mL-1; MBC/MFC 16.00 mg·mL-1). H-TV and M-TV significantly reduced the level of prooxidants (O2-, H2O2, TBARS; p < 0.05), increased antioxidants activity (SOD, CAT, GSH; p < 0.05), reduced blood pressure (p < 0.05), improved glucose homeostasis in the OGTT test (p < 0.05), and ejection fraction (p < 0.05) and cardiac contractility (p < 0.05) compared to MetS (p < 0.05). Moreover, TVH treatment normalized the lipid status and decreased insulin levels compared to MetS rats (p < 0.05). The obtained results demonstrated that the TVH may be considered a useful agent for cardioprotection in MetS conditions.

Effects of herbal tea (Platostoma palustre) on blood glucose regulation in vivo

Platostoma palustre jelly is a traditional food. Platostoma palustre has been used as folk medicine and is effective against heat-shock, hypertension and diabetes. Therefore, the aim of in vivo study was to determine the effects of herbal tea (Platostoma palustre) on blood glucose regulation. The commercial herbal tea (Platostoma palustre) was kindly provided by Yueta Agricultural Biotechnology Inc. Adult male 18 Institute of Cancer Research (ICR) mice [8 weeks old; body weight (BW) between 31-33 g] with specific pathogen-free conditions were used for this study. All ICR mice were divided respectively the normal control group (n = 6), the negative control group (n = 6), and the herbal tea group (n = 6). The ICR mice (the negative control group and the herbal tea group) were intraperitoneally injected with streptozotocin (65 mg/kg BW) and nicotinamide (230 mg/kg BW) for inducing the symptoms of hyperglycemia. In the herbal tea group, the herbal tea (10 mL/kg BW) was administrated to ICR mice by gavage. To monitor the blood glucose levels in ICR mice, blood was obtained from the tail of ICR mice, and blood glucose levels were determined using the external glucometer. Blood glucose measurements were conducted once in ICR mice before the experiment and were detected once per month after the experiment. Additionally, the change of ICR mice’ BW, the blood glucose of ICR mice, and the observation of ICR mice’ behavior were monitored and detected during the experiment. The results of this experiment showed · Weight change: the weight gain of the negative control group and the herbal tea group were significantly lower than those of the normal control group and there was no significant difference between the negative control group and the herbal tea group. · Fasting blood glucose and postprandial blood glucose: the fasting blood glucose of the negative control group was significantly higher than that of the normal control group, while the herbal tea group had a tendency to lower the fasting blood glucose, but there was no significant difference compared with the negative control group. The postprandial blood glucose level results showed that the negative control group was significantly higher than the normal control group. The postprandial blood glucose level of the herbal tea group was between the normal control group and the negative control group at the 4th week administration with the herbal tea. At the 8th week administration with the herbal tea, there was a significant difference compared with the negative control group. · Oral glucose tolerance test (OGTT): 4 to 12 weeks after hyperglycemia was induced, the blood glucose levels of the negative control group at each OGTT test point were significantly higher than those of the normal control group. The blood glucose level at the test point tended to decrease, but there was no significant difference from the negative control group. By calculating the area under the OGTT curve, it was found that the area under the curve of the negative control group was significantly higher than that of the normal control group, while the results of the herbal tea group at the 8th and 12th weeks were significantly lower than those of the negative control group. Taken all results together, the hyperglycemia was successfully induced in the experimental ICR mice. After administrating with the herbal tea, the fasting blood glucose level of the ICR mice tended to improve. In addition, a significant improvement was seen in the results of postprandial blood sugar and oral glucose tolerance test effectiveness. Therefore, based on the results of this experiment, it is speculated that drinking the herbal tea for 3 months has considerable potential for blood glucose regulation, which can be used as the basis for the development of related products of the herbal tea in the future.

Evaluation of the hemoglobin a1c test in detecting pediatric prediabetes

Aim: It was aimed to evaluate the diagnostic performance of the hemoglobin A1c (HbA1c) test in pediatric prediabetes, and to determine the cut-off value for the adolescent. &#x0D; &#x0D; Material and Method: This study was carried out by retrospectively evaluating the data of 379 adolescents aged between 10 and 18 years. Prediabetes was diagnosed based on glucose criteria, either the fasting glucose value or the 2-hour (2h) glucose value during a 75 g oral glucose tolerance test (OGTT), or HbA1c criteria. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for fasting, OGTT 2h glucose, and HbA1c. The area under the curve (AUC) was calculated for each test by receiver-operating characteristic analysis. &#x0D; &#x0D; Results: 2.1% of individuals were assigned to the diabetes mellitus group, 21.9% to the prediabetes group, and 76.0% to the normoglycemia group. When 5.7 was used as the threshold value for HbA1c in prediabetes, the sensitivity was 53.0%. The AUC was 0.83 for the HbA1c test. An HbA1c threshold of 5.55% was determined as the optimal cut-off for diagnosing prediabetes, with 62.7% sensitivity and 93.0% specificity. &#x0D; &#x0D; Conclusion: Although the use of adults’ HbA1c criteria for the diagnosis of prediabetes in the pediatric ages is controversial due to the differences between the results of glucose and HbA1c-based tests, prediabetes screening is still important. HbA1c≥5.55 will be useful to follow up on adolescents with prediabetes in terms of risk and to screen them with blood glucose.

Investigation of the Effectiveness of the ADA Prediabetes Risk Test in Identifying Prediabetic Turkish Patients and Determination of the Frequency of Retinopathy in Prediabetic Patients

Aim: In this study, the Turkish version of the American Diabetes Association (ADA) prediabetes risk test and the 75-g oral glucose tolerance test (OGTT) were administered to patients to determine the rate of prediabetic patients in our geographical region and investigate its consistency with the ADA risk test. In addition, the presence of retinopathy in prediabetic patients was examined.&#x0D; Material and Method: &#x0D; The study included a total of 342 patients with a fasting plasma glucose value of 100-125 mg/dl. The 75-g OGTT test was performed on the patients. The ADA prediabetes risk test was also administered, and the scores were noted. The OGTT and risk test results were compared. According to the ADA prediabetes risk test, the patients were classified into those at risk for type 2 diabetes mellitus (DM) and those diagnosed with prediabetes. In the evaluation of retinopathy, visual acuity, intraocular pressure measurement, and anterior segment and fundus examinations were performed in each patient. The data of the patients were compared with statistical analysis methods.&#x0D; Results: When the OGTT results of the patients with negative ADA prediabetes risk test scores were compared, the sensitivity was determined as 54% and the specificity as 63% (p0.05). There was no retinopathy finding in the eye examination of 262 of the 342 patients included in the study (p&gt;0.05).&#x0D; Conclusion: In this study, we found that a positive ADA prediabetes risk score was effective in predicting prediabetes, but it was not sufficient. However, prediabetes diagnosed according to OGTT was found to be higher in the patients with negative test scores. Therefore, the prediabetes risk test was not effective in predicting prediabetes among the patients with negative scores.

Rapid and non-invasive diagnosis of type 2 diabetes through sniffing urinary acetone by a proton transfer reaction mass spectrometry

Urinary acetone in urine is produced from fat metabolism in human body, which can be accelerated in diabetic patients because of insufficient utilization and storage of glucose. In this study, we tried to develop a novel diagnosis method of type 2 diabetes (T2D) through sniffing urinary acetone by a proton transfer reaction mass spectrometry (PTR-MS). A total of 180 T2D patients and 180 healthy volunteers were recruited from three hospitals for multicenter study. Urine samples were collected in the morning when donators were fasting and stored in glass bottles. Acetone in the headspace of these bottles was qualitatively and quantitatively detected by the PTR-MS in 8 h. Using a threshold of 690.1 ppbv, a diagnostic model was established using urinary acetone with an accuracy of 81.3% (sensitivity: 73.3%, specificity: 89.3%) in hospital Ⅰ. In the verification studies, the accuracies were 92.5% (sensitivity: 88.7%, specificity: 96.2%) in hospital Ⅱ and 83.7% (sensitivity: 76.9%, specificity: 90.4%) in hospital Ⅲ, respectively. The accuracy is comparable to that of clinically used diagnosis methods, fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), and glycosylated hemoglobin A1c (HbA1c) test. The sensitivity for 35 newly diagnosed patients was 85.7%. The newly developed technology is completely non-invasive and much more rapid than clinical FPG, OGTT, and HbA1c tests. It has a promising prospect in clinical use. But the applicability in different human races still need more validations.

GLUCOSE INTOLERANCE PREDICTS CARDIORESPIRATORY FITNESS IN A HEALTHY POPULATION

https://youtu.be/oIXKiLYDh6g BACKGROUND Aerobic capacity or maximum oxygen consumption rate (VO2max) is accepted as the single best indicator of cardiorespiratory fitness. VO2max is also an indicator of metabolic health and known as an all-cause mortality predictor. It is well established that glucose intolerance and insulin resistance in patients with diabetes is associated with decline in cardiorespiratory fitness. However, it is not clear if glucose intolerance is associated with poorer cardiorespiratory fitness in a population without diabetes. Therefore, the purpose of this study was to assess if glucose intolerance measured by oral glucose tolerance test (OGTT) is associated with cardiorespiratory fitness in a population without diabetes. METHODS Fifty one (30 males and 21 females) predominantly Mexican-American adults without diabetes (Age 26.1 ± 5.3 years; BMI 26.7 ± 4.2 kg/m2; fasting blood glucose 92.1 ± 10.0 mg/dL) from the border region of El Paso, TX participated in this study. VO2max was assessed using a standardized graded exercise test protocol on a treadmill with Parvomedics metabolic cart. Glucose tolerance was measured by a 3-hour OGTT preformed after a 12-hour overnight fast. Blood glucose measured at fasting and every 30 minutes after the ingestion of 75g of glucose drink during OGTT and glucose area under the curve was determined to access glucose tolerance. Pearson correlation analysis was performed at 0.05 significance level. RESULTS Glucose intolerance measured by glucose area under the curve was negatively correlated with VO2max (r = −0.40, p = 0.006). Additionally, blood glucose level during OGTT test at 120 min (r = −0.43, p = 0.003), 150 min (r = −0.36, p = 0.014), and 180 min (r = −0.32, p = 0.048) were also negatively associated with VO2max. However, fasting blood glucose was not associated with VO2max (r = −0.09, p = 0.56). CONCLUSION Poorer cardiorespiratory fitness is indicated by greater glucose intolerance and a greater surge of glucose level during an OGTT, but not fasting blood glucose in a population without diabetes.

The preventive effect of mussel oil on gestational diabetes mellitus in pregnant mice fed by a high-fat and high-sucrose diet.

The present study aimed to investigate the preventive effect of mussel oil (MO) on gestational diabetes mellitus (GDM) in mice fed by a high-fat and high-sucrose (HFHS) diet. Pregnant mice were allocated to four groups: normal diet + corn oil (CO), HFHS + CO, HFHS + fish oil (FO), and HFHS + MO. The total n-3 polyunsaturated fatty acids (PUFAs) in MO (51.30%) and FO (48.25%) were comparable (mainly C22:6n-3 and C20:5n-3). HFHS + MO and HHFS + FO had a significantly lower area under the curve (AUC) for the oral glucose tolerance test (OGTT) than the HFHS + CO group. The HFHS + MO group but not HFHS + FO group had a significantly lower AUC for the insulin tolerance test (ITT) than the HFHS + CO group. The HFHS + MO group had significantly lower homeostasis model assessment-insulin resistance (HOMA-IR) and fasting serum insulin than the HHFS + FO and HFHS + CO groups. Liver sphingosine kinase 1 (SphK1) was significantly higher, while SphK2, Akt, and P-Akt were significantly lower in the HFHS + CO group compared with the normal diet + CO group. The HFHS + MO group but not the HFHS + FO group had significantly higher SphK2, Akt, and P-Akt than the HFHS + CO group. SphK2 had a strong negative correlation with the AUC for the OGTT (r = -0.759, p = 0.001) and insulin tolerance test (ITT) (r = -0.637; p = 0.008), fasting serum insulin (r = -0.594, p = 0.015), fasting blood glucose (r = -0.587, p = 0.017) and HOMA-IR (r = -0.629, p = 0.009) and a strong positive correlation with Akt (r = 0.594, p = 0.015) and P-Akt (r = 0.676, p = 0.004). In conclusion, mussel oil improved glucose intolerance and insulin resistance during mice pregnancy, which was superior to the effects of fish oil.

Hypoglycemia after exposure of diclofenac medication.

Diclofenac is commonly used as pain relief. Hypoglycemia has rarely been reported due to aspirin and indomethacin use but not of any other nonsteroidal anti-inflammatory drugs. A 69-years old endocrinologist participated as a control in a glucagon-like peptide-1 (GLP-1) study. He decreased his plasma glucose to 1.8 mmol/L and developed full-blown hypoglycemic symptoms during an oral glucose tolerance test (OGTT). He had taken a 50 mg diclofenac tablet at 10 pm the evening before for a harmless muscle stretch in the lower back. Apart from well-controlled hypothyroidism he was healthy. During medical school he often had reactive hypoglycemia which came after intake of a carbohydrate rich but otherwise poor breakfast followed by bicycling. However, he had never experienced problems later in life after more decent meals containing slower absorbable carbohydrates. A 3-day continuous glucose monitoring (CGM) was performed three weeks after the OGTT test. A glucose value of 3.1 mmol/L was registered on the third CGM day in the afternoon after intake of 500 mg aspirin in the early morning the same day. Otherwise, all values were normal. A second OGGT where no medications apart from levothyroxine had been taken during at least a 2-week period adjacent was normal. Detailed analyses of the OGTTs showed that the GLP-1 levels before the test were higher after diclofenac exposure while the insulin levels increased after the glucose challenge which suggesting uncoupling. With this case report we would like to draw attention to that diclofenac may cause hypoglycemia.

The characteristics of postprandial glycemic response patterns to white rice and glucose in healthy adults: Identifying subgroups by clustering analysis.

Large interpersonal variability in postprandial glycemic response (PGR) to white rice has been reported, and differences in the PGR patterns during the oral glucose tolerance test (OGTT) have been documented. However, there is scant study on the PGR patterns of white rice. We examined the typical PGR patterns of white rice and glucose and the association between them. We analyzed the data of 3-h PGRs to white rice (WR) and glucose (G) of 114 normoglycemic female subjects of similar age, weight status, and same ethnic group. Diverse glycemic parameters, based on the discrete blood glucose values, were calculated over 120 and 180 min. K-means clustering based on glycemic parameters calculated over 180 min was applied to identify subgroups and representative PGR patterns. Principal factor analysis based on the parameters used in the cluster analysis was applied to characterize PGR patterns. Simple correspondence analysis was performed on the clustering categories of WR and G. More distinct differences were found in glycemic parameters calculated over 180 min compared with that calculated over 120 min, especially in the negative area under the curve and Nadir. We identified four distinct PGR patterns to WR (WR1, WR2, WR3, and WR4) and G (G1, G2, G3, and G4), respectively. There were significant differences among the patterns regard to postprandial hyperglycemia, hypoglycemic, and glycemic variability. The WR1 clusters had significantly lower glycemic index (59 ± 19), while no difference was found among the glycemic index based on the other three clusters. Each given G subgroup presented multiple patterns of PGR to WR, especially in the largest G subgroup (G1), and in subgroup with the greatest glycemic variability (G3). Multiple subgroups could be classified based on the PGR patterns to white rice and glucose even in seemingly homogeneous subjects. Extending the monitoring time to 180 min was conducive to more effective discrimination of PGR patterns. It may not be reliable to extrapolate the patterns of PGR to rice from that to glucose, suggesting a need of combining OGTT and meal tolerance test for individualized glycemic management.

Chemical Constituents and Effect of Ethanol Leaf Extract of Hibiscus articulatus Hochst. ex A. Rich. (Malvaceae) on Glucose- and Streptozotocin-Induced Hyperglycaemia using Wistar Rats

Hibiscus articulatus is an herbaceous plant that is consumed over decades as diet, in management stomach pain and diabetes in north central Nigeria. The aim of the study is to determine the chemical constituents and evaluate the effect of ethanol leaf extract of Hibiscus articulatus (ELEHA) on glucose- and streptozotocin-induced hyperglycaemia using Wistar rats. Preliminary phytochemical screening, proximate and gas chromatography-mass spectrophotometric (GC-MS) analyses was conducted on ELEHA. Acute toxicity, blood glucose levels of ELEHA in Wistar rats was evaluated using; glycaemic index (GI) test, oral glucose tolerance test (OGTT) and streptozotocin-induced hyperglycaemia test. Secondary metabolites; alkaloids, tannins, saponins, flavonoids, triterpenes and primary metabolites; carbohydrates, proteins and fats, were present in ELEHA. Ascorbic acid, linoleic acid, coumaran, phytol hexadecanoic acid are some chemical constituents present in ELEHA. The oral median lethal dose was estimated to be &gt; 5000 mg/kg body weight in rats. The glycaemic index and glycaemic load of ELEHA were calculated to be 41.60 % and 17.83 respectively. There was significant (p &lt; 0.05) decrease in the blood glucose level (250 and 500 mg/kg of ELEHA administered) in OGTT and streptozotocin-induced hyperglycaemia test compared with diabetic group. Superoxide dismutase, catalase, malondialdehyde and glutathione reductase were evaluated however, only superoxide dismutase levels (250 and 500 mg/kg) were significantly (p &lt; 0.05) increased. Moreso, the level of low density lipoprotein (125 mg/kg) and HOMA IR values (125 and 250 mg/kg) were significantly (p &lt; 0.05) decreased when compared with diabetic group. In summary, the ethanol leaf extract of Hibiscus articulatus possesses important phytochemicals with anti-hyperglycaemic activity on Wistar rats.

Long-term health after Severe Acute Malnutrition in children and adults- the role of the Pancreas (SAMPA): Protocol.

Background: Prenatal growth retardation may increase the risk of later chronic non-communicable diseases (NCDs), including diabetes; however, long-term effects of wasting malnutrition in childhood or adulthood are less studied. Pancreatic exocrine and endocrine functions, both critical for nutrition and NCD aetiology, may not fully recover following malnutrition. However, the evidence and mechanistic information is piecemeal. We hypothesise that wasting malnutrition at any age has long-term detrimental effects on endocrine and exocrine pancreatic structure and function. Methods: The SAMPA international research programme will assess pancreatic structure and function in 3700 participants from ongoing observational nutrition cohorts, two adolescent and four adult, in Zambia, Tanzania, Philippines, and India. Pancreas size, structure, and calcification will be assessed by ultrasound and computed tomography (CT) scan; exocrine function by faecal elastase and serum lipase; and endocrine function by haemoglobin A1c (HbA1c) and blood glucose, insulin and C-peptide concentrations during an oral glucose tolerance test (OGTT). In-depth hormonal analyses of incretins, glucagon, proinsulin and trypsinogen during OGTT and intravenous glucose tolerance tests will be done in subsets of adult participants. Pancreatic size and function outcomes will be compared between people with and without prior wasting malnutrition. Analyses will investigate effect modification by sex, current age, time since malnutrition, current body mass index and dietary patterns. Mathematical modelling of OGTT data will be used to estimate the relative contribution to glucose dysregulation of decreased insulin production, changes in insulin clearance and increased insulin resistance. Proinsulin/insulin ratio will be analysed in archived samples from the Tanzanian cohort using a nested case-control design to investigate whether abnormal values precede diabetes. Conclusions: SAMPA, a large-scale multi-centre research programme using data from people with or without prior wasting malnutrition to assess several aspects of pancreatic phenotype, will provide coherent evidence for future policies and programmes for malnutrition and diabetes.

Long-term health after Severe Acute Malnutrition in children and adults- the role of the Pancreas (SAMPA): Protocol

Background: Prenatal growth retardation may increase the risk of later chronic non-communicable diseases (NCDs), including diabetes; however, long-term effects of wasting malnutrition in childhood or adulthood are less studied. Pancreatic exocrine and endocrine functions, both critical for nutrition and NCD aetiology, may not fully recover following malnutrition. However, the evidence and mechanistic information is piecemeal. We hypothesise that wasting malnutrition at any age has long-term detrimental effects on endocrine and exocrine pancreatic structure and function. Methods: The SAMPA international research programme will assess pancreatic structure and function in 3700 participants from ongoing observational nutrition cohorts, two adolescent and four adult, in Zambia, Tanzania, Philippines, and India. Pancreas size, structure, and calcification will be assessed by ultrasound and computed tomography (CT) scan; exocrine function by faecal elastase and serum lipase; and endocrine function by haemoglobin A1c (HbA1c) and blood glucose, insulin and C-peptide concentrations during an oral glucose tolerance test (OGTT). In-depth hormonal analyses of incretins, glucagon, proinsulin and trypsinogen during OGTT and intravenous glucose tolerance tests will be done in subsets of adult participants. Pancreatic size and function outcomes will be compared between people with and without prior wasting malnutrition. Analyses will investigate effect modification by sex, current age, time since malnutrition, current body mass index and dietary patterns. Mathematical modelling of OGTT data will be used to estimate the relative contribution to glucose dysregulation of decreased insulin production, changes in insulin clearance and increased insulin resistance. Proinsulin/insulin ratio will be analysed in archived samples from the Tanzanian cohort using a nested case-control design to investigate whether abnormal values precede diabetes. Conclusions: SAMPA, a large-scale multi-centre research programme using data from people with or without prior wasting malnutrition to assess several aspects of pancreatic phenotype, will provide coherent evidence for future policies and programmes for malnutrition and diabetes.

Prevalence of Gestational Diabetes Mellitus among Pregnant Women Undergoing Oral Glucose Tolerance Test (OGTT) at Chitwan Medical College and Teaching Hospital

INTRODUCTION: Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance of variable severity in which spontaneous hyperglycemia develops during pregnancy. GDM is affecting approximately 14% of pregnancies worldwide, representing approximately 18 million births annually. GDM increases the risk of adverse maternal and perinatal outcome and also increases risk of future diabetes to the mother and their child. MATERIALS AND METHODS: The cross-sectional study was carried out over 8 months in 149 pregnant subjects of gestation period between 24 and 28 at Chitwan Medical College Teaching Hospital (CMCTH). All pregnant women were considered for 50gm Glucose Tolerance Test (GCT). Those pregnant subjects with GCT ≥ 140mg% only undergo 100 gm Oral Glucose Tolerance Test (OGTT) &amp; plasma glucose were estimated at the interval of 0,1,2 and 3 hours respectively. The GDM was diagnosed after performing OGTT based on Carpenter-Coustan Criteria. RESULTS: In our study from 149 study population, the frequency of normal &amp; abnormal GCT in pregnant women was 111(74.50%) &amp; 38(25.50%) respectively. Out of 149 subjects only 38 pregnant women have abnormal GCT in which only 23 have done OGTT test. Among 23 subjects the presence of GDM was found in 9 subjects with 39.10% whereas GDM was not found in 14 subjects with 60.9%. The prevalence of GDM among 149 populations was found to be 9 which is 6.04%. CONCLUSIONS: The prevalence of GDM among 149 populations was found to be 6.04%. The real burden, risk factors, and potential preventative interventions of gestational diabetes mellitus must also be measured in large observational studies for finding the correlation to assess the severity of the disease.

Long-term health after Severe Acute Malnutrition in children and adults- the role of the Pancreas (SAMPA): Protocol.

Background: Prenatal growth retardation may increase the risk of later chronic non-communicable diseases (NCDs), including diabetes; however, long-term effects of wasting malnutrition in childhood or adulthood are less studied. Pancreatic exocrine and endocrine functions, both critical for nutrition and NCD aetiology, may not fully recover following malnutrition. However, the evidence and mechanistic information is piecemeal. We hypothesise that wasting malnutrition at any age has long-term detrimental effects on endocrine and exocrine pancreatic structure and function. Methods: The SAMPA international research programme will assess pancreatic structure and function in 3700 participants from ongoing observational nutrition cohorts, two adolescent and four adult, in Zambia, Tanzania, Philippines, and India. Pancreas size, structure, and calcification will be assessed by ultrasound and computed tomography (CT) scan; exocrine function by faecal elastase and serum lipase; and endocrine function by haemoglobin A1c (HbA1c) and blood glucose, insulin and C-peptide concentrations during an oral glucose tolerance test (OGTT). In-depth hormonal analyses of incretins, glucagon, proinsulin and trypsinogen during OGTT and intravenous glucose tolerance tests will be done in subsets of adult participants. Pancreatic size and function outcomes will be compared between people with and without prior wasting malnutrition. Analyses will investigate effect modification by sex, current age, time since malnutrition, current body mass index and dietary patterns. Mathematical modelling of OGTT data will be used to estimate the relative contribution to glucose dysregulation of decreased insulin production, changes in insulin clearance and increased insulin resistance. Proinsulin/insulin ratio will be analysed in archived samples from the Tanzanian cohort using a nested case-control design to investigate whether abnormal values precede diabetes. Conclusions: SAMPA, a large-scale multi-centre research programme using data from people with or without prior wasting malnutrition to assess several aspects of pancreatic phenotype, will provide coherent evidence for future policies and programmes for malnutrition and diabetes.

Monitoring of blood glucose after pediatric kidney transplantation: a longitudinal cohort study

BackgroundGlucose metabolism after kidney transplantation (KT) is highly dynamic with the first post-transplantation year being the most critical period for new-onset diabetes after transplantation (NODAT) occurrence. The present study aimed to analyze dynamics of glucose metabolism and report incidence/risk factors of abnormal glycemic state during the first year after KT in children.MethodsTwenty-one consecutive freshly transplanted pediatric kidney transplant recipients (KTRs) were assessed for fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) weekly for 4 weeks, then every 3 months for 1 year.ResultsInterpretation of OGTT test showed normal glucose tolerance (NGT) in 6 patients (28.6%) while 15 (71.4%) experienced impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) at any time point of monitoring. Seven patients had NODAT, for which three needed insulin therapy. Hyperglycemia onset was 7.8 ± 13.12 weeks (median (range) = 1 (0–24) week) after KT. Percent of patients with abnormal OGTT was significantly more than that of IFG (38.1% vs. 71.4%, p = 0.029). Patients with abnormal glycemic state had significantly elevated trough tacrolimus levels at 6 months (p = 0.03). Glucose readings did not correlate with steroid doses nor rejection episodes while positively correlating with tacrolimus doses at 3 months (p = 0.02, CC = 0.73) and 6 months (p = 0.01, CC = 0.63), and negatively correlating with simultaneous GFR at 9 months (p = 0.04, CC = − 0.57).ConclusionsUp to two thirds of pediatric KTRs (71.4%) experienced abnormal glycemic state at some point with peak incidence within the first week up to 6 months after KT. OGTT was a better tool for monitoring of glucose metabolism than FPG. Abnormal glycemic state was induced by tacrolimus and adversely affected graft function.Graphical abstractA higher resolution version of the Graphicalabstract is available as Supplementary information.

Early Initiation and Long-Term Use of Vaginal Progesterone may Cause Gestational Diabetes Mellitus.

Preterm birth (PTB) is an important cause of neonatal mortality and morbidity. Spontaneous PTB (sPTB) is the most common cause of PTB. In patients with a singleton pregnancy, progesterone treatment appears to reduce the rate of spontaneous preterm birth in those with a previous history of spontaneous preterm labor and/or cervical shortening in the current pregnancy. Progesterone therapies used for the prevention of sPTB may increase the risk of gestational diabetes mellitus (GDM) towards the end of pregnancy owing to their effects on carbohydrate metabolism. We aimed to show the effects of vaginal progesterone use, starting time, and duration of treatment on GDM. A retrospective cohort study was carried out in pregnant women 18 to 39 years old who came to our hospital between January 1, 2021, and August 31, 2021, and who had a 2-hour 75-g oral glucose tolerance test (OGTT) at 24 to 28 weeks of gestation. In a total of 540 patients, 68 were diagnosed with GDM based on at least one abnormal plasma glucose value at screening. The remaining 472 patients with normal plasma glucose levels were considered as the control group. The groups were compared in terms of age, parity, pre-pregnancy body mass index (BMI), smoking, gestational age, and vaginal progesterone use. Patients using vaginal progesterone with and without GDM were then compared again in terms of indications for vaginal progesterone use, initiation time of progesterone therapy, duration of progesterone use, and cervical length. The incidence of GDM in our study group was 12.5%. Despite the use of vaginal progesterone at a higher rate in the GDM group than in the control group (23.5 vs. 13.9%; p=0.07), it was not statistically significant. When we examined patients using progesterone as a subgroup analysis, the mean time to start vaginal progesterone treatment was 19.8±2.6 (14-24), and it was significantly earlier in the GDM group (18.1±2.0 vs. 20.2±2.6; p=0.007). Initiation of vaginal progesterone before 20 weeks of gestation was statistically significantly more frequent in the GDM group than the control group (68.8 vs. 39.4%; p=0.050 OR :3.3, 95%CI: 1.0-10.8). The mean duration of vaginal progesterone use was 50.0±15.6 days (28-90) and it was longer in the GDM group (57.8±13.4 vs. 48.1±15.6; p=0.027). Since the duration of vaginal progesterone use will be prolonged, there may be a risk of GDM, especially in patients who started vaginal progesterone before the 20th week of pregnancy. Even if the OGTT test performed between 24-28 weeks is normal, it should be kept in mind that these patients may have GDM in the later weeks of pregnancy, and repeating the OGTT test should be considered if necessary.