Plasma Glucose Concentrations Research Articles

Effect of short-term exposure to high-altitude hypoxic climate on feed-intake, blood glucose level and physiological responses of native and non-native goat.

The exposure to high altitude and cold stress poses challenges in maintaining normal physiological standards and body homeostasis in non-native animals. To enhance our understanding of the physiology of native and non-native goats in high-altitude environments, we conducted a comparative study to examine the impact of natural hypoxic and cold stress conditions on their feed intake (FIT) and associated changes in physiological responses, including plasma glucose concentration (PGC). The study took place at an altitude of 3505.2m above mean sea level and involved twenty-two healthy females from two different breeds of goats. This study was conducted over a period of 56days after the arrival of non-native Black Bengal goats (BBN) and compared with native Changthangi (CHAN) goats. Both groups were extensively reared in a natural high-altitude and cold-stress environment in Leh, India, and were subjected to defined housing and management practices. The parameters evaluated included FIT, PGC, respiration rate, heart rate, pulse rate, and rectal temperature. High altitudes had a significant (p < 0.05) impact on FIT, PGC, respiration rate, heart rate, pulse rate, and rectal temperature in BBN, whereas these parameters remained stable in CHAN throughout the study period. Additionally, the detrimental effects of high-altitude stress were more pronounced in non-native goats compared to native goats. These findings suggest that physiological responses in non-native goats tend to stabilize after an initial period of adverse effects in high-altitude environments. Based on the physiological responses and glucose concentration, it is recommended to pay special attention to the nutrition of non-native goats for up to the third week (21days) after their arrival in high-altitude areas.

Efficacy of nutritional selenium nanoparticles on growth performance, immune response, antioxidant capacity, expression of growth and immune-related genes, and post-stress recovery in juvenile Sobaity seabream (Sparidentex hasta)

This study evaluated the impacts of nano-Se on the growth, immunity, antioxidant capacity, physiological parameters, gene expression, and stress resistance of fingerling Sobaity seabream (Sparidentex hasta). The fish with an average weight of 21.5 ± 0.1 g were divided into four treatment groups in triplicates that received one of the test diets supplemented with varying levels of nano-Se: 0 (control), 0.5 (Se-0.5), 1 (Se-1), and 2 (Se-2) mg/Kg for 60 days. The results showed that final weight, weight gain rate, specific growth rate, feed intake, and feed conversion ratio improved with significant linear and quadratic trends (P < 0.05) in response to nano-Se-supplemented diets, and the best values were measured in the Se-2 group. Superoxide dismutase activity level remained unaffected among the four groups (P > 0.05). Catalase activity increased in nano-Se-supplemented groups, with the highest level measured in fish fed the Se-0.5 diet. Glutathione peroxidase activity levels were not significantly different between the control and nano-Se groups, but the lowest malondialdehyde concentration was detected in the Se-2 group. Nano-Se had no marked effect on total plasma Ig levels; however, the highest lysozyme activity and alternative complement activity (ACH50) were observed in the Se-0.5 and Se-2 groups, respectively. No significant differences (P > 0.05) were observed in plasma total protein, albumin, globulin, triglyceride, and thyroid hormone (T3 and T4) contents among the groups. However, the lowest cholesterol and low-density lipoprotein values and the highest high-density lipoprotein concentration were measured in the Se-2 group. The Se-0.5 and Se-1 groups exhibited significantly lower levels of aspartate aminotransferase activity, and the lowest alkaline phosphatase activity level was detected in the Se-1 group. The expression level of insulin-like growth factor I gene in all nano-Se-fed groups was significantly higher than the control. Also, the expression of interleukin-1β and lysozyme genes was significantly upregulated in nano-Se-supplemented groups, with the highest values in the Se-2 group. Following acute crowding stress, plasma cortisol and lactate levels at all post-stress time intervals were not significantly different among the experimental groups. Fish fed the Se-0.5 and Se-2 diets tended to have lower plasma glucose concentrations than other groups. In conclusion, dietary nano-Se at 2 mg/kg is recommended to promote growth performance and enhance antioxidant and immune parameters in Sobaity juveniles.

Effects of war-related stress on the cardiovascular system, metabolism and the rate of ageing in women

Chronic war-related stress (WRS) due to disruption of adaptation mechanisms can affect physiological processes in the body, in particular, metabolism, neuroendocrine regulation, and the state of the cardiovascular and respiratory systems. WRS can also cause changes in the body's rate of ageing. Purpose of the Study: To investigate the effects of WRS on the cardiovascular system, metabolism and the rate of ageing in women. The study included 91 women aged from 30 to 74 years who experienced chronic WRS and 79 women examined before the Russian-Ukrainian war (control group). The biological age (BA) was determined according to the indicators of hemodynamics, heart rate variability and metabolism (cardiometabolic age) using a formula that was obtained by multiple stepwise regression. The indicators were selected, which correlate as much as possible with age and little among themselves. During the war, no statistically significant changes in heart rate, or systolic and diastolic blood pressure were observed, but a significant reduction in overall HRV in the supine position was obtained. Additionally, indices of parasympathetic nervous system activity are significantly lower during the war. In women, examined during the war, there is a statistically significant higher concentration of blood plasma glucose at fasting and 2-hour post-standard oral glucose tolerance test, they also exhibit higher plasma insulin concentration and a higher HOMA-IR index. An increased frequency of prediabetic disorders was observed. So, in the group of women examined before the war, an elevated fasting blood plasma glucose level was found in 6 %, while during the war it was observed in 19 %. Impaired glucose tolerance before the war was present in 10 % of women, and during the war, it increased to 25 %. To assess the effect of WRS on the rate of ageing, the BA of women before and during war was calculated. The formula for calculating BA was obtained on a group of healthy women before the war, and the ageing rate was calculated as the difference between BA and chronological age (CA). The average BA in the group of women before the war was 56.5±1.4 years, and in the group during the war – 64.7 ± 1.1 years. The difference between BA and CA is (0.02 ± 0.79) years in the women before the war and (10.8 ± 1.36) years during the war (p &lt; 0.05). Chronic WRS leads to the disruption of the cardiovascular system's functioning and simultaneously triggers an imbalance in the autonomic nervous control in women. These changes indicate a state of heightened stress. Women exposed to chronic WRS experience unfavourable alterations in carbohydrate and lipid metabolism, increasing the risk of diabetes mellitus development. Chronic WRS accelerates the rate of cardiometabolic ageing in women. _________________________________________________________________________________________ Keywords: cardiovascular system; metabolism; biological age; war-related stress; woman

The burden of hypertension, diabetes, and overweight/obesity by sedentary work pattern in Bangladesh: Analysis of Demographic and Health Survey 2017-18.

Most low- and middle-income countries, including Bangladesh, are currently undergoing epidemiologic and demographic transitions with an increasing burden of hypertension, diabetes, and overweight/obesity. Inadequate physical activity is a risk factor for these conditions and work-related activities contribute to most of the physical activities in Bangladesh. We investigated the association of the sedentary nature of occupation with hypertension, diabetes, and overweight/obesity in Bangladesh. If a person's systolic/diastolic blood pressure, fasting plasma glucose concentration, and body mass index were ≥130/80 mmHg, ≥7 mmol/l, and ≥23 kg/m2, respectively, they were classified as hypertensive, diabetic, and overweight/obese. The nature of occupation/work was classified into three types: non-sedentary workers (NSW), sedentary workers (SW), and non-workers (NW). After describing the sample according to exposure and outcomes, we performed simple and multivariable logistic regression to investigate the association. Among 10900 participants (60.7% females, mean age: 40.0 years), about 43.2%, 13.2%, and 42.8% were NSW, SW, and NW, respectively. NSW, SW, NW, and overall people, respectively, had 6.7%, 14.5%, 11.7%, and 9.9% prevalence rates for diabetes; 18.0%, 32.9%, 28.3%, and 24.4% prevalence rates for overweight/obesity; and 18.0%, 32.9%, 38.3%, and 28.0% prevalence rate for hypertension. SW had higher odds of diabetes (AOR: 1.44, 95% CI: 1.15-1.81), overweight/obesity (AOR: 1.83, 95% CI: 1.52-2.21), and hypertension (AOR: 1.47, 95% CI: 1.21-1.77) than NSW. NW had higher odds of diabetes (AOR: 1.43, 95% CI: 1.19-1.71) or hypertension (AOR: 1.37, 95% CI: 1.22-1.56) but not higher odds of overweight/obesity (AOR: 1.11, 95% CI: 0.98-1.27) than NSW. We found higher prevalence and odds of the studied conditions among SW than NSW. Workplace physical activity programs may improve the physical activity and health of SW.

Triglyceride-glucose index is capable of identifying metabolically obese, normal-weight older individuals

BackgroundThe concept of metabolically obese, normal weight (MONW) has emerged to describe individuals with a normal body mass index (BMI) who are at a relatively high risk of chronic diseases. However, BMI itself is a suboptimal index for the assessment of the health risks associated with visceral fat. The triglyceride-glucose (TyG) index is considered to be a reliable and cost-effective marker of insulin resistance. Therefore, in the present study, we aimed to determine the TyG index cut-off values that could be used to define MONW in older people and to determine the usefulness of these values for the prediction of chronic diseases.MethodsA total of 4,721 participants in the Korea National Health and Nutritional Examination Survey who were ≥ 60 years of age and did not have underweight or obesity were included. MONW was defined using the criteria for metabolic syndrome (MS), and the TyG index was calculated on the basis of the fasting plasma triglyceride and glucose concentrations. Chronic diseases, including T2DM, hypertension, and non-alcoholic fatty liver disease (NAFLD), were diagnosed.ResultsThe prevalence of MS increased from the lowest to the highest TyG index tertile. The cut-off values of the TyG index for MONW were calculated as 8.88 and 8.80 for males and females, respectively. MONW, defined using these cut-off values, was associated with high odds ratios for NAFLD, T2DM, and hypertension in both males and females.ConclusionsThe TyG index cut-off values calculated in the present study can be used to discriminate individuals with MONW from other older individuals without obesity and to predict the risk of chronic diseases. These findings show that the TyG index is an effective and cost-efficient method of assessing the risk of chronic diseases in people with MONW.

Effect of temperature fluctuation on the physiological stress response of hybrid pearl gentian grouper during waterless keeping alive.

Temperature fluctuations are inevitable and have an important impact on the survival of fish during transportation. Therefore, the effect of temperature fluctuation (15 ± 1 °C, 15 ± 2 °C, 15 ± 3 °C) on the muscle quality, physiological, and immune function of hybrid pearl gentian grouper before waterless keeping alive, during keeping alive (0 h, 3 h, 6 h, 9 h, 12 h), and after revival for 12 h was investigated. The plasma glucose concentration of grouper gradually decreased to 0.645 ± 0.007 mg/mL, 0.657 ± 0.006 mg/mL, and 0.677 ± 0.004 mg/mL after keeping alive for 12 h under different temperature fluctuations of 15 ± 1 °C, 15 ± 2 °C, and 15 ± 3 °C, respectively. The cortisol concentration and lysozyme activity of pearl gentian grouper significantly increased (P < 0.05) during the keeping alive period. The results suggested that fish bodies would produce acute stress response, strengthen immune defense ability, and quickly consume a lot of energy to adapt to the low-temperature anhydrous environment. In all treatment groups, the activities of plasma alanine transaminase (ALT) and aspartate aminotransferase (AST) and the content of creatinine gradually increased with the prolongation of the survival time. The hardness and springiness of muscle decreased from 5965.99 ± 20.15 and 0.90 ± 0.00 to 3490.69 ± 27.59 and 0.42 ± 0.01, respectively. In the meanwhile, the change of glycogen and lactic acid content was opposite, indicating that temperature fluctuation harmed the liver, kidney function, and muscle quality. In the later stage of keeping alive, the superoxide dismutase (SOD) and catalase (CAT) activities decreased, especially in the temperature fluctuation group of ±3 °C (125.99 ± 5.48 U/mgprot, 44.21 ± 0.63 U/mgprot), leading to an imbalance of fish immunity. In summary, higher temperature fluctuation would influence the physiological function and immune defense ability and decrease the quality of pearl gentian grouper.

Glucose volume of distribution affects insulin sensitivity measured by intravenous glucose tolerance test.

To determine whether glucose volume of distribution (VdGLUCOSE ) affects the diagnosis of impaired insulin sensitivity (IS) when using an intravenous glucose tolerance test (IVGTT). Individuals with distinct levels of IS underwent IVGTT after an overnight fast. The prediabetic group (Prediab; n = 33) differed from the healthy group (Healthy; n = 14) in their larger glycosylated hemoglobin (HbA1c of 5.9 ± 0.3 vs. 5.4 ± 0.1%; 41 ± 4 vs. 36 ± 1 mmol/mol; p < 0.001), percent body fat (37 ± 6 vs. 24 ± 3%; p < 0.001) and cardiovascular fitness level (VO2MAX 22 ± 5 vs. 44 ± 5 mL of O2 ·kg-1 ·min-1 ; p < 0.001). Ten minutes after intravenous infusion of the glucose bolus (i.e., 35 g in a 30% solution), VdGLUCOSE was assessed from the increases in plasma glucose concentration. IS was calculated during the next 50 min using the slope of glucose disappearance and the insulin time-response curve. VdGLUCOSE was higher in Healthy than in Prediab (230 ± 49 vs. 185 ± 21 mL·kg-1 ; p < 0.001). VdGLUCOSE was a strong predictor of IS (β standardized coefficient 0.362; p = 0.004). VO2MAX was associated with VdGLUCOSE and IS (Pearson r = 0.582 and 0.704, respectively; p < 0.001). However, body fat was inversely associated with VdGLUCOSE and IS (r = -0.548 and -0.555, respectively; p < 0.001). Since fat mass is inversely related to VdGLUCOSE and in turn, VdGLUCOSE affects the calculations of IS, the IV glucose bolus dose should be calculated based on fat-free mass rather than body weight for a more accurate diagnosis of impaired IS.

Effects of Benzo[a]pyrene on Food Metabolism and Reproductive Endocrine and Ovarian Development in Female Scallop Chlamys farreri at Different Reproductive Stages.

Benzo[a]pyrene (B[a]P), a polycyclic aromatic hydrocarbon (PAH) with the most carcinogenic effects of all the PAHs, has multiple toxic effects on marine bivalves. We investigated the interference mechanism of B[a]P on food metabolism (sugars, proteins, and sugars), and on reproductive endocrine and ovarian development in female scallops (Chlamys farreri). Scallops were exposed to different concentrations of B[a]P concentrations of 0, 0.38, 3.8, and 38 μg/L throughout gonadal development. Total cholesterol and triglyceride contents in the digestive glands were increased, and their synthesis genes were upregulated. The plasma glucose contents decreased with the inhibition of glycogen synthesis genes and the induction of glycolysis genes in the digestive gland. The results showed that B[a]P had endocrine-disrupting effects on scallops, that it negatively affected genes related to ovarian cell proliferation, sex differentiation, and egg development, and that it caused damage to ovarian tissue. Our findings supplement the information on B[a]P disruption in gonadal development of marine bivalves. Environ Toxicol Chem 2024;43:748-761. © 2023 SETAC.

A high sucrose detection threshold is associated with increased energy intake and improved post-prandial glucose response independent of the sweetness intensity of isocaloric sucrose solutions

Several studies proposed a role for the sweet taste receptor in energy intake and blood glucose regulation, but little is yet known about the impact of the individual sweet taste perception. Here, we found in a cross-over human intervention study with 29 male participants that modulating the sweetness of an isocaloric sucrose solution did not influence postprandial plasma concentrations of blood glucose and associated hormones over 120 min and 2 h post-load energy intake. Independent of the sweetness of the test solution, tests persons with a higher sucrose detection threshold had an average of 402 ± 78.8 kcal (39 ± 21%) higher energy intake and a higher glucose/insulin ratio, combined with a higher liking for sweet tasting food, than the test persons of the low threshold group. The body composition suggested a higher fat-free mass in the high threshold group that may have influenced energy intake and post-prandial glucose responses.

Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis

ObjectiveTo evaluate the comparative efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on glycaemic control, body weight, and lipid profile in adults with type 2 diabetes.DesignSystematic review and network...

Insulin sensitivity and beta cell function after duodenal mucosal resurfacing: an open-label, mechanistic, pilot study

Background and AimsThe duodenum has been shown to play a key role in glucose homeostasis. Duodenal mucosal resurfacing (DMR) is an endoscopic procedure for patients with type 2 diabetes (T2D) in which the duodenal mucosa is hydrothermally ablated. DMR improves glycemic control, but the underlying mechanisms remain unclear. Here, we report changes in glucoregulatory hormones and indices of insulin sensitivity and beta cell function after DMR. MethodsWe included 28 patients on non-insulin glucose lowering medications who underwent open-label DMR and a mixed meal test (MMT) in Revita-1 or Revita-2. Inclusion criteria were hemoglobin A1c (HbA1c) 7.6-10.4% and BMI 24-40kg/m2. Baseline and 3-months MMT data included plasma glucose, insulin, C-peptide, glucagon-like peptide-1 (GLP-1), and gastric inhibitory polypeptide (GIP) concentrations. Glucoregulatory hormones, insulin sensitivity indices (homeostatic model assessment for insulin resistance [HOMA-IR], Matsuda index [MI] and hepatic insulin resistance [HIR]), and beta cell function (insulinogenic index [IGI], disposition index [DI] and insulin secretion rate [ISR]) were assessed. ResultsFasting insulin, glucagon, and C-peptide decreased significantly. Insulin sensitivity (HOMA-IR, MI, and HIR) and beta cell function (DI and ISR) all improved significantly. Decline in postprandial glucose, mainly driven by a decrease in fasting levels, was observed, as well as a decline in postprandial glucagon whereas GLP-1 and GIP did not change. ConclusionsInsulin sensitivity and insulin secretion improved 3 months after DMR. It is unlikely that incretin changes are responsible for improved glucose control after DMR. These data add to the growing evidence validating the duodenum as a therapeutic target for patients with T2D.

Nutrient intake, productive and metabolic parameters of Nellore bulls feed a forage free diet using cottonseed cake as a fiber source.

We hypothesized that cottonseed cake in confined Nellore young bulls' diet as fiber source, could maintain or improve the nutrient intake, and productive and metabolic parameters. It was evaluated the total replacement of whole plant corn silage (WPCS) by cottonseed cake (CSC) as a source of fiber in the diet. A completely randomized design with two treatments and 12 replications was used. The treatments were two experimental diets containing 300g/kg of WPCS or CSC as roughage. All animals at 0, 15, 30, 60 and 112days were weighed to monitor productive performance and nutrient intake. Dry matter intakes, organic matter, neutral detergent fiber, physically effective neutral detergent fiber, crude protein and non-fiber carbohydrates of the WPCS treatment cattle were higher (p < 0.05), and the ethereal extract intake of cattle fed CSC diet was higher. The BW of cattle fed WPCS was higher in the two initial periods of confinement (p < 0.05). Animals from both treatments showed linear growth during the confinement period. There was a fiber source × period interaction for total weight gain (TWG), average daily gain (ADG) and feed efficiency (FE) (p < 0.05), with the lowest in the first 15days and the highest at 30days, reflecting a compensatory gain in animals fed with CSC. Bulls fed with CSC showed negative TWG and ADG in the first period (p < 0.05), but recovered in the following periods, surpassing that of the SC treatment in the last two periods. There was negative EF of bulls fed with CSC in the first period (P < 0.05), but in the following periods the CSC diet did not differ from the WPCS diet. The animals fed CSC diet showed a higher concentration of cholesterol and glucose in the blood plasma (p < 0.05). The forage-free diet containing cottonseed cake as a source of fiber replacing corn silage promoted better animal performance.

Effects of dietary palmitic acid and oleic acid ratio on milk production, nutrient digestibility, blood metabolites, and milk fatty acid profile of lactating dairy cows

Adequate energy supply is a crucial factor for maintaining the production performance in early lactating cows. Adding fatty acids to diets can improve energy supply, while the effect could be related to the chain length and degree of saturation of fatty acids. This study was conducted to evaluate the effect of different ratios of palmitic acid (C16:0) to oleic acid (cis-9 C18:1) on the production performance, nutrient digestibility, blood metabolites and milk fatty acids profile in early lactating dairy cows. Seventy-two multiparous Holstein cows (63.5 ± 2.61 d in milk) blocked by parity (2.39 ± 0.20), body weight (668.3 ± 20.1 kg), body condition score (3.29 ± 0.06), and milk yield (47.9 ± 1.63 kg) were used in a completely randomized design. Cows were divided into 3 groups with 24 cows in every group. Cows in 3 treatments were provided iso-energy and iso-nitrogen diets, whereas the C16:0 to cis-9 C18:1 ratio was different: (1) 90.9% C16:0 + 9.1% cis-9 C18:1 (90.9:9.1); (2) 79.5% C16:0 + 20.5% cis-9 C18:1 (79.5:20.5); (3) 72.7% C16:0 + 27.3% cis-9 C18:1 (72.7:27.3). Fatty acids were added at 1.3% in dry matter basis. Although the dry matter intake fat-corrected milk yield and energy-corrected milk yield were not affected, the milk yield, milk protein yield and feed efficiency increased linearly with the increasing of cis-9 C18:1 ratio. The milk protein percentage and milk fat yield did not differ among treatments, whereas the milk fat percentage tended to decrease linearly with the increasing of cis-9 C18:1 ratio. The lactose yield increased linearly and lactose percentage tended to increase linearly with increasing cis-9 C18:1 ratio, whereas the percentage of milk total solids and somatic cell count decreased linearly. Though the changes of body condition score were not affected by treatments, the body weight loss decreased linearly with the increasing of cis-9 C18:1 ratio. The effect of treatment on nutrient digestibility was limited, except a linear increase in ether extract and neutral detergent fiber digestibility with the increasing of cis-9 C18:1 ratio. There was a linear increase in the concentrations of plasma glucose, whereas the triglyceride and nonesterified fatty acid concentration decreased linearly with the increasing of cis-9 C18:1 ratio. As the cis-9 C18:1 ratio increased, the concentration of de novo fatty acids decreased quadratically, while the mixed and preformed fatty acids increased linearly. In conclusion, increasing cis-9 C18:1 ratio could increase production performance and decrease body weight loss by increasing nutrient digestibility, and the ratio had the most powerful beneficial effect on early lactating cows suggested by 72.7:27.3.

Incidence of concurrent systemic injuries with traumatic proptosis and its effect on outcome - 100 dogs.

To evaluate the incidence of concurrent systemic injuries in dogs with traumatic ocular proptosis and their effect on survival to discharge. Additionally, to evaluate for associations between the type of trauma, each presenting vital signs, minimum laboratory database findings including packed cell volume, total solids, plasma glucose and lactate concentrations, and the diagnosis of concurrent systemic injury and survival. Retrospective study between the years 2017 and 2022. One university teaching hospital and one large, private practice. One hundred dogs presenting to the hospital with a diagnosis of traumatic ocular proptosis. Medical records were retrospectively reviewed; signalment, breed, sex, age, weight, date of presentation, type of trauma sustained, time from trauma to presentation, vitals on presentation, and minimum laboratory database findings including packed cell volume (PCV), total solids (TS), plasma glucose concentration, and plasma lactate concentration were recorded. A modified animal trauma triage (ATT) score was retrospectively calculated. A total of 17 dogs (17%) had concurrent systemic injury. Compared to dogs without systemic injuries, dogs with systemic injuries had a significantly lower body temperature [median 101.1F (38.3C) vs. 101.6F (38.6C); P = 0.008], significantly higher plasma glucose concentrations (125 mg/dL, 6.9 mmol/L vs. 112 mg/dL, 6.2 mmol/L; P = 0.012) and approaching statistical significance, lower PCV values (median 40 vs. 46%; P = 0.051). Dogs presenting with traumatic ocular proptosis do present with concurrent systemic, non-ocular injuries; however, these concurrent injuries do not seem to be associated with survival to discharge.

Impaired plasma glucose clearance is a key determinant of fasting hyperglycemia in people with obesity.

The objective of this study was to evaluate the relative importance of the basal rate of glucose appearance (Ra) in the circulation and the basal rate of plasma glucose clearance in determining fasting plasma glucose concentration in people with obesity and different fasting glycemic statuses. The authors evaluated basal glucose kinetics in 33 lean people with normal fasting glucose (<100 mg/dL; Lean < 100 group) and 206 people with obesity and normal fasting glucose (Ob < 100 group, n = 118), impaired fasting glucose (100-125 mg/dL; Ob 100-125 group, n = 66), or fasting glucose diagnostic of diabetes (≥126 mg/dL; Ob ≥ 126 group, n = 22). Although there was a large (up to three-fold) range in glucose Ra within each group, the ranges in glucose concentration in the Lean < 100, Ob < 100, and Ob 100-125 groups were small because of a close relationship between glucose Ra and clearance rate. However, the glucose clearance rate at any Ra value was lower in the hyperglycemic than the normoglycemic groups. In the Ob ≥ 126 group, plasma glucose concentration was primarily determined by glucose Ra, because glucose clearance was markedly attenuated. Fasting hyperglycemia in people with obesity represents a disruption of the precisely regulated integration of glucose production and clearance rates.

A Multicenter, Open-Label, Single-Arm Trial of the Efficacy and Safety of Empagliflozin Treatment for Refractory Diabetes Mellitus with Insulin Resistance (EMPIRE-01).

Insulin resistance syndrome and lipoatrophic diabetes are characterized by severe insulin resistance and are often refractory to treatment. Trials assessing the efficacy of antidiabetes drugs for these rare conditions have been limited, however. Sodium-glucose cotransporter2 (SGLT2) inhibitors, which lower glycemia independently of insulin action, have shown efficacy for type2 diabetes with insulin resistance. We here investigated the efficacy and safety of the SGLT2 inhibitor empagliflozin for treatment of insulin resistance syndrome and lipoatrophic diabetes. The trial was conducted at five academic centers in Japan and included seven patients with insulin resistance syndrome and one patient with lipoatrophic diabetes. Participants received 10mg of empagliflozin daily. If the hemoglobinA1c (HbA1c) level was ≥ 7.0% (52mmol/mol) after 12weeks, the dose was adjusted to 25mg. The study duration was 24weeks, and the primary outcome was the change in HbA1c level by the end of the treatment period. Safety evaluations were performed for all participants. By the end of the 24-week treatment period, the mean HbA1c level for all eight patients had decreased by 0.99 percentage points (10.8mmol/mol) (95% confidence interval [CI], 0.59 to 1.38 percentage points, 6.6 to 14.9mmol/mol) and the mean fasting plasma glucose concentration had declined by 63.9mg/dL (3.55mmol/L) (95%CI 25.5 to 102.3mg/dL, 1.42 to 5.68mmol/L). Continuous glucose monitoring revealed a reduction in mean glucose levels from 164.3 ± 76.1 to 137.6 ± 46.6mg/dL (9.13 ± 4.23 to 7.65 ± 2.59mmol/L) as well as an increase in the time in range (70-180mg/dL) from 58.9 ± 36.1% to 70.8 ± 18.3%. Seventeen mild adverse events were recorded in five individuals throughout the study period. No severe events were reported. The mean body mass showed a slight decrease and the mean serum ketone body concentration showed a slight increase during treatment. Our results demonstrate that empagliflozin shows a certain level of efficacy and safety for treatment of insulin resistance syndrome and lipoatrophic diabetes. jRCTs2051190029 and NCT04018365.

P-23 Insulin autoimmune syndrome possibly induced by Alpha-Lipoic acid

Abstract Introduction Insulin autoimmune syndrome (IAS) is a relative rare cause of hypoglycemia due to the presence of extremely high circulating insulin levels and elevated serum concentrations of autoantibodies to human insulin despite no prior exposure to exogenous insulin, insulin analogues or oral hypoglycemic agents. It is characterized by repeated fasting hypoglycemia or episodes of hypoglycemia late after meals in non-diabetic, non-acutely ill patients. Increasing the titer of insulin autoantibodies and immune reactive insulin occurs owing to both genetic influences and environmental triggers such as medication, genetic instability and other factors. It is associated with the use of drugs comprising sulfhydryl groups, such as methimazole, clopidogrel and alpha lipoic acid, mostly. Insulin autoantibodies appear a few weeks after the exposure of sulfhydryl radicals. Here, we summarize the case of IAS caused by drug administration. Clinical Case A 60-year-old female patient who has a history of migraine for 30 years was referred to our hospital for feeling of hunger, dizziness, sweating, tremor, and palpitations for 1 month. These symptoms had commenced episodically, soon after starting 600 mg/day of alpha lipoic acid. She was diagnosed with hypoglycemia based on a plasma glucose concentration of 31 mg/dL. There was no personal or family history of diabetes mellitus, or previous use of oral hypoglycemic drugs such as sulfonylureas or exogenous insulin. No abnormality was detected in the systemic examination. She had no smoking and alcohol abuse. Her regular medication was tricyclic antidepressant (amitriptyline). Laboratory results are presented in Table 1. On our evalution, the serum levels of insulin, C-peptide, and anti-insulin antibody titers were inappropriately elevated in the presence of hypoglycemia, confirming the diagnosis of hyperinsulinemic hypoglycemia. Thyroid function, human growth hormone, insulin growth factor-1 (IGF-1), and cortisol result were within normal limits. Screening for antinuclear factor, serum protein electrophoresis, serology for viral hepatitis, and other autoimmune diseases were negative. Insulinoma was excluded with computed tomography. In light of the above results, a diagnosis of IAS was made with possible alpha lipoic acid. Because, alpha lipoic acid was the only medication being taken associated with a sulfhydryl group. The patient was prescribed oral methylprednisolone (32 mg once daily), alpha lipoic acid was withdrawn. Hypoglycemia did not occur after methylprednisolone treatment of follow-up. Methylprednisolone treatment was tapered to 4 mg once daily within 2 months. The insulin, and anti-insulin antibody titers had decreased. Conclusion We report a rare case of IAS. Sulfhydryl group containing drugs such as alpha lipoic acid might induce or exacerbate hypoglycemia in patients with a history of IAS. For this reason, the use of alpha lipoic acid should be questioned in patients with IAS. Table 1. Laboratory test results

Trace mineral source and chromium propionate supplementation affect performance and carcass characteristics in feedlot steers.

Angus-crossbred steers (n = 400; 369.7 ± 7.6kg) were used to determine the influence of trace mineral (TM) source and chromium propionate (Cr Prop) supplementation on performance, carcass characteristics, and ruminal and plasma variables in finishing steers. Steers were blocked by body weight (BW) and randomly assigned within block to treatments in a 2 × 2 factorial arrangement, with factors being: 1) TM source (STM or HTM) and 2) Cr supplementation (0 or 0.25mg Cr/kg DM, -Cr or + Cr, respectively). Treatments consisted of the addition of: 1) sulfate TM (STM; 90, 40, and 18mg/kg DM of Zn, Mn, and Cu, respectively), 2) STM and 0.25mg Cr/kg DM from Cr Prop, 3) hydroxychloride TM (HTM; 90, 40, and 18mg/kg DM of Zn, Mn, and Cu, respectively), and 4) HTM and 0.25mg Cr/kg DM from Cr Prop. Each treatment consisted of 10 replicate pens with 10 steers per pen. Body weights were obtained on consecutive days at the initiation and termination of the 154-d study. Steers were fed a steam-flaked corn-based finishing diet. Ractopamine hydrochloride was fed for the last 31 d of the study. Ruminal fluid and blood samples were obtained from one steer per pen on days 28 and 84 for ruminal volatile fatty acids (VFA) and plasma TM and glucose analysis. Steers were slaughtered at the end of the study and individual carcass data were collected. No Cr × TM source interactions (P = 0.48)were detected. Steers supplemented with HTM had greater (P = 0.04) hot carcass weight (HCW), dressing percentage (DP), longissimus muscle (LM) area, and USDA yield grade (YG), and tended (P = 0.12) to have greater average daily gain (ADG) than those receiving STM. Average daily gain, gain:feed, dressing percentage, and longissimus muscle area were greater (P = 0.04) for + Cr steers compared to-Cr steers. Hot carcass weight tended (P = 0.06) to be greater for + Cr steers. Ruminal acetate concentrations at 28 d were lesser (P = 0.01) for HTM vs. STM steers, and greater (P = 0.04) for + Cr steers compared to-Cr steers. Plasma concentrations of Zn, Cu, and Mn were not affected by TM source or Cr supplementation. Steers supplemented with Cr had greater (P = 0.05) plasma glucose concentrations than-Cr steers at 28 but not at 84 d. Results of this study indicate replacing STM with HTM improved carcass characteristics in finishing steers, and Cr Prop supplementation improved steer performance and carcass characteristics.

Maternal pre- and postpartum supplementation of a Bacillus-based DFM enhanced cow and calf performance.

This study evaluated the effects of maternal supplementation of a Bacillus-based direct-fed microbial (DFM) on the physiology and growth performance of Bos indicus-influenced cow-calf pairs. On day 0 (~139 d before expected calving date), 72 fall-calving, Brangus crossbred beef heifers (20 to 22 mo of age) pregnant with first offspring were stratified by their initial body weight (BW; 431 ± 31kg) and body condition score (BCS; 6.0 ± 0.36; scale 1 to 9), and randomly allocated into 1 of 12 bahiagrass pastures (1 ha and six heifers per pasture). Treatments were randomly assigned to pastures (six pastures per treatment) and consisted of heifers supplemented with 1kg/d of soybean hulls (dry matter, DM) that was added (BAC) or not (CON) with DFM containing Bacillus subtilis and B. licheniformis (Bovacillus; Chr. Hansen A/S, Hørsholm, Denmark). Treatments were provided from days 0 to 242 (139 ± 4 d prepartum to 104 ± 4 d postpartum). Calves were weaned on day 242 (96 ± 30 d of age) and then allocated into 1 of 16 drylot pens and fed the same concentrate at 3.25% of BW (DM) until day 319. Maternal treatment effects were not detected (P ≥ 0.29) for herbage allowance and forage chemical composition. Heifer BCS on days 39 and 63 tended (P ≤ 0.09) to be greater for BAC vs. CON heifers, whereas heifer BCS on day 91 was greater (P = 0.01) for BAC vs. CON heifers. Heifer BCS did not differ (P ≥ 0.20) between treatments on days 179 and 242. Plasma glucose concentration did not differ from days 0 to 63 (P ≥ 0.14) but were greater (P < 0.01) on day 179 and tended (P = 0.09) to be greater on day 242 for BAC vs. CON heifers. Calf BW at birth, ADG from birth to weaning, and BW at weaning did not differ (P ≥ 0.19) between treatments, but calf BW at drylot exit (day 319) was greater (P = 0.05) for BAC vs. CON calves. Maternal treatment effects were not detected (P ≥ 0.42) for calf serum concentration of IgG at birth and postvaccination plasma concentrations of glucose, cortisol, and haptoglobin. Serum titers against bovine respiratory syncytial virus (BRSV) were greater (P = 0.04) for BAC vs. CON calves on day 287, whereas seroconversion against parainfluenza-3 virus (PI-3) was greater (P < 0.01) for BAC vs. CON calves on day 271. Thus, maternal supplementation of a Bacillus-based DFM increased prepartum BCS gain and postpartum plasma glucose concentration of heifers and led to positive carryover effects on postweaning BW gain and humoral immune response in their offspring.

Influence of vasoactive intestinal polypeptide on growth performance, nutrient digestibility, nitrogen balance, and digestive enzyme activity in lambs.

This study evaluated if vasoactive intestinal polypeptide (VIP) influences growth performance, nutrient digestibility, nitrogen balance, and digestive enzyme activity. Sixteen wether lambs (69.6 ± 1.9kg) were housed in individual pens, adapted to a corn grain-based diet, and randomly assigned to 2 treatment groups. Lambs were injected intraperitoneally every other day for 28 d with saline (0.9% NaCl) containing no VIP (n = 8; control) or containing VIP (n = 8; 1.3 nmol/kg body weight [BW]). All lambs were transferred to individual metabolic crates for the final 7 d of the experiment to measure nitrogen balance and nutrient digestibility. At the end of the treatment period, lambs were slaughtered, and pancreatic tissue, small intestinal tissue, and rumen fluid were collected for protein, digestive enzymes, ruminal pH, and volatile fatty acid (VFA) analyses. Lambs treated with VIP had greater final BW, average daily gain, and gain:feed (P = 0.01, 0.05, 0.03, respectively). No differences between treatment groups were observed (P ≥ 0.25) for nutrient intake, digestibility, nitrogen retention, ruminal pH, and VFA concentrations. Moreover, VIP treatment did not influence (P ≥ 0.19) plasma glucose, urea N, and insulin concentrations. Treatment with VIP increased (P = 0.03) relative cecum weight (g/kg BW) and decreased (P = 0.05) relative brain weight. Pancreatic and intestinal digestive enzyme activities, except for duodenal maltase (P = 0.02), were not influenced (P ≥ 0.09) by VIP treatment. These data suggest that the administration of VIP may have potential to improve average daily gain and gain:feed in lambs fed grain-based diets.