Poor Glucose Research Articles

Intake of Sugar Substitute Gummy Candies Benefits the Glycemic Response in Healthy Adults: A Prospective Crossover Clinical Trial.

Sugar reduction in food has attracted great health concerns worldwide. Gummies have been one of the most popular and highly favored candies due to their chewable properties, simplicity to swallow, and delicious taste. The general perception is that gummies raise blood sugar levels, but the truth is that gummies with the right formula can control glycemic response. The purpose of this study is to investigate the effects of the gummy dosage form and sugar types on the glycemic response control. Maltitol and erythritol as sweetener alternatives were applied in gummy candies (total and partial sugar substitutes gummy, T-SG and P-SG), with sucrose-based gummies used as comparisons (CG). A prospective crossover study was then conducted on 17 healthy adults. The effects of different types of gummies on glycemic response in healthy adults were evaluated on the basis of the participants’ glycemic index (GI) and glycemic load (GL) values. Every three-day interval, participants took CG, P-SG, T-SG, and glucose solution, respectively, and the theoretical glucose conversion content was kept the same in all groups for each trial. Each participant performed four tests with each sample and recorded the changes in blood glucose after food consumption. It was found that all three types of gummies slowed down subjects’ glycemic response when not taken in excess, and the improvement effect was in the trend of T-SG > P-SG > CG. Both P-SG and T-SG were low-GI candies (54.1 and 49.9). CG that was not consumed in excess of 17.2 g had a high GI (81.9) but a low GL (<10). Texture analysis and in vitro digestion were used to explore the effect of gummy matrix on glucose release. T-SG and P-SG retained a higher hardness and were less hydrolyzed to release glucose during digestion compared with CG. Additionally, experiments have revealed that gummies can reverse the poor glucose tolerance in women. In conclusion, gummies are a good carrier for dietary supplements due to their sustained-release characteristic of available carbohydrates and provide healthier options for people in control of glucose homeostasis.

Glycation-Driven Inflammation: COVID-19 Severity in Pregnant Women and Perinatal Outcomes.

The link between being pregnant and overweight or obese and the infectivity and virulence of the SARS CoV-2 virus is likely to be caused by SARS-CoV-2 spike protein glycosylation, which may work as a glycan shield. Methylglyoxal (MGO), an important advanced glycation end-product (AGE), and glycated albumin (GA) are the results of poor subclinical glucose metabolism and are indices of oxidative stress. Forty-one consecutive cases of SARS-CoV-2-positive pregnant patients comprising 25% pre-pregnancy overweight women and 25% obese women were recruited. The aim of our study was to compare the blood levels of MGO and GA in pregnant women with asymptomatic and symptomatic SARS-CoV-2 infection with pregnant women without SARS-CoV-2 infection with low risk and uneventful pregnancies and to evaluate the relative perinatal outcomes. The MGO and GA values of the SARS-CoV-2 cases were statistically significantly higher than those of the negative control subjects. In addition, the SARS-CoV-2-positive pregnant patients who suffered of moderate to severe COVID-19 syndrome had higher values of GA than those infected and presenting with mild symptoms or those with asymptomatic infection. Premature delivery and infants of a small size for their gestational age were overrepresented in this cohort, even in mild-asymptomatic patients for whom delivery was not indicated by the COVID-19 syndrome. Moreover, ethnic minorities were overrepresented among the severe cases. The AGE–RAGE oxidative stress axis on the placenta and multiple organs caused by MGO and GA levels, associated with the biological mechanisms of the glycation of the SARS-CoV-2 spike protein, could help to explain the infectivity and virulence of this virus in pregnant patients affected by being overweight or obese or having gestational diabetes, and the increased risk of premature delivery and/or low newborn weight.

The relationship between poor glycaemic control at different time points of gestational diabetes mellitus and pregnancy outcomes

We aimed to identify the complications of gestational diabetes mellitus (GDM) associated with poor control of fasting plasma glucose (FPG) and postload plasma glucose (PPG) on the 75-g oral glucose tolerance test (OGTT). This retrospective study included 997 singleton pregnancy GDM patients who were assigned to poor or good glycaemic control groups. Multivariate analysis indicated that poor FPG control and poor PPG control were both independent predictors of hypertensive disorder complicating pregnancy (HDCP) (odd ratio (OR) of 2.551 (95% CI [1.146–5.682], p = .022) and OR of 2.084 (95% [1.115–3.894], p = .021) compared with good glycaemic control groups, respectively). Poor PPG control promoted the rate of caesarean delivery (1.534 (95% CI [1.063–2.214]), p = .022), whereas good PPG control increased the risk of premature rupture of membranes (PROM) (0.373 (95% CI [0.228–0.611]), p < .001). Conclusively, poor control FPG and PPG dissimilarly affect pregnancy complications in GDM; these findings may help clinicians in the effective implementation of measures to prevent pregnancy complications in GDM. IMPACT STATEMENT What is already known on this subject? Previous studies displayed that GDM patients with 2-h PPG elevated at 24–28 week of gestation had a 2.254-fold increased risk of postpartum dysglycaemia. Abnormal plasma glucose in GDM mother increased the probability of childhood obesity in the offspring. With the implementation of China’s second-child policy, the incidence of GDM is rising. What do the results of this study add? Our results indicated that the older patients with GDM, the greater the risk of abnormal plasma glucose control. In addition, maternal age and prenatal BMI were notably correlated with poor plasma glucose control of FPG and PPG, respectively. We also found that both poor FPG and PPG control notably increased the incidence of HDCP in pregnant women. The incidence of PROM was higher in the good PPG control group compared with the poor PPG control group. What are the implications of these findings for clinical practice and/or further research? This study displayed that the effects of poor FPG and PPG control on pregnancy complications and newborn outcomes were heterogeneous, which might be related to the specificity of plasma glucose metabolism at different time points. Good glycaemic control, especially PPG control, was of great significance for improving pregnancy complications and perinatal conditions.

204 Awardee Talk: Poor Maternal Nutrition Impacts Metabolic Factors and Glucose Tolerance in Sheep Offspring

Abstract To evaluate the hypothesis that offspring born to restricted- and over-fed ewes would exhibit decreased glucose tolerance, total cholesterol (TC), and triglyceride (TG), and increased leptin, multiparous Dorset ewes (n = 46) pregnant with twins were fed 100%, 60% or 140% of National Research Council (NRC) requirements from d30±0.02 of gestation until parturition. Offspring are referred to as CON (n=10 ewes; 12 rams), RES (n=13 ewes; 21 rams), and OVER (n =16 ewes; 15 rams), respectively. Blood samples were collected from offspring at d0, 7, 14, 58, 210, and 252 of age and plasma TC, plasma TG, and serum leptin were analyzed with commercial kits. Concentrations of TG were greater in rams than ewes (P=0.029). Leptin was greater (P&amp;lt; 0.0001) in ewes than rams at d30 and 36, and greater in CON than RES and OVER at d252 (P=0.058). At d133±0.25 an intravenous glucose tolerance test was performed, and blood samples collected at -30, -15, 0, 2, 5, 10, 15, 30, 60, and 120 min relative to glucose infusion (0.25 g/kg body weight of a 50% dextrose solution). Glucose and insulin concentrations were determined using commercial kits. Glucose concentrations were greater at 5 and 15 min in ewes than rams (P≤0.04) and at 2 min, OVER were greater than CON and RES (P=0.03). Insulin concentrations were greater in rams than ewes between 5 and 15 min (P=0.0251). Insulin in RES rams tended to be greater than OVER and RES ewes between 5 and 10 min (P=0.06) and continued to be greater than RES ewes at 15 min (P=0.05). First-phase response of insulin tended to be greater in RES compared with CON and OVER (P=0.092). There were no differences detected in insulin:glucose (P=0.312). In conclusion, poor maternal nutrition negatively impacts key metabolic hormones in offspring thereby contributing to altered growth and metabolism.

Low Aerobic Capacity Accelerates Lipid Accumulation and Metabolic Abnormalities Caused by High-Fat Diet-Induced Obesity in Postpartum Mice.

Women during pregnancy and postpartum show high rates of obesity and metabolic diseases, especially women with excessive caloric intake. In the past, it was proved that individuals with high intrinsic aerobic exercise capacities showed higher lipid metabolism and lower fat production than those with low intrinsic aerobic exercise capacities. The purpose of this study was to determine whether mice with the low-fitness phenotype (LAEC) were more likely to develop metabolic abnormalities and obesity under dietary induction after delivery, and if mice with a high-fitness phenotype (HAEC) had a protective mechanism. After parturition and weaning, postpartum Institute of Cancer Research (ICR) mice received dietary induction for 12 weeks and were divided into four groups (n = 8 per group): high-exercise capacity postpartum mice with a normal chow diet (HAEC-ND); high-exercise capacity postpartum mice with a high-fat diet (HAEC-HFD); low-exercise capacity postpartum mice with a normal chow diet (LAEC-ND); and low-exercise capacity postpartum mice with a high-fat diet (LAEC-HFD). Obesity caused by a high-fat diet led to decreased exercise performance (p < 0.05). Although there were significant differences in body posture under congenital conditions, the LAEC mice gained more weight and body fat after high-fat-diet intake (p < 0.05). Compared with HAEC-HFD, LAEC-HFD significantly increased blood lipids, such as total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein (LDL) and other parameters (p < 0.05), and the content of TG in the liver, as well as inducing poor glucose tolerance (p < 0.05). In addition, after HFD intake, excessive energy significantly increased glycogen storage (p < 0.05), but the LAEC mice showed significantly lower muscle glycogen storage (p < 0.05). In conclusion, although we observed significant differences in intrinsic exercise capacity, and body posture and metabolic ability were also different, high-fat-diet intake caused weight gain and a risk of metabolic disorders, especially in postpartum low-fitness mice. However, HAEC mice still showed better lipid metabolism and protection mechanisms. Conversely, LAEC mice might accumulate more fat and develop metabolic diseases compared with their normal rodent chow diet (ND) control counterparts.

Exosomes as Crucial Player in Insulin Resistance and Obesity: Potential Therapeutic Approach

Increasing obesity has become a serious health problem worldwide in recent years, both in adults and children. Obesity can lead to numerous diseases such as osteoarthritis, diabetes, cardiovascular and respiratory diseases, and other metabolic disorders. In addition, obesity is considered one of the most common causes of insulin resistance in the body. Moreover, obesity disrupts normal insulin physiology, resulting in impaired insulin signaling and other intrinsic abnormalities such as poor glucose movement, phosphorylation, and decreased glucose oxidation and glycogenesis. Therefore, it is necessary to find an effective treatment for such conditions. Recently, exosomal therapy has been proposed as one of the alternative approaches to treat metabolic diseases. Exosomes are endosome-derived extracellular vesicles that circulate in body fluids such as mucus, blood plasma, urea, etc., transfer molecules and signals from one cell to another, and thus are involved in various normal and pathological processes in the human body. It has been discovered that exosomes play a role in processes related to obesity, such as adipocyte differentiation, angiogenesis, inflammation, etc. The current study reviewed exosomes’ role in the development of insulin resistance associated with obesity and possible targets.

Antidiabetic effect of Melicope glabra (Blume) T.G. Hartley (Rutaceae) in high-fat diet/streptozotocin-induced diabetic rats and its bioactive components

Melicope glabra­ (Blume) T. G. Hartley is a plant of Rutaceae family. The present study aimed to evaluate the in vivo hypoglycemic effect of M. glabra leaves extract on diabetic rats and identify its bioactive components. The induction of diabetes in Sprague-Dawley rats was done by a combination of high-fat diet and low-dose streptozotocin injection. The M. glabra extracts and standard sitagliptin were orally administered once daily to the diabetic rats for 28 days. The diabetic rats showed drastic weight loss, hyperglycemia, poor glucose tolerance, hyperlipidemia, and disturbances in the liver and kidney functions. However, oral administration of M. glabra extracts to the diabetic rats significantly lowered the DPP-4 level and increased glucagon-like peptide-1 (GLP-1) level. Scopoletin, pachypodol, and stigmasterol were revealed as the active DPP-4 and α-amylase inhibitors. This study revealed novel findings which suggest the

CORRELATION BETWEEN PHYSICAL ACTIVITY AND FASTING BLOOD GLUCOSE IN PATIENT WITH TYPE 2 DIABETES MELLITUS

Introduction: Diabetes Mellitus is a disease caused by an increase in blood glucose levels, which is an increase in levels at an abnormal level, or called hyperglycemia. Diabetes is a metabolic disease related to various factors such as physical activity, lifestyle, habits, diet, etc. Diabetes mellitus is classified as type 1 diabetes mellitus, type 2 diabetes mellitus, and gestational diabetes. Type 2 Diabetes Mellitus (T2DM) is caused by the body's inability to use insulin effectively (insulin resistance). This study aims to determine the relationship between physical activity and fasting blood glucose levels of T2DM patients to provide social change by increasing physical activity to control fasting blood glucose in patients with T2DM. Methods: This study is quantitative research of analytic observation with a cross-sectional design. The sample in this study was the outpatient T2DM at Endocrine Unit RSUD Dr Soetomo Surabaya from June until September 2018 consecutive sampling. The independent variable was physical activity, and the dependent variable was fasting blood glucose (FBG). Methods of collecting primary data by interview using IPAQ (International Physical Activity Questionnaire) and secondary data by looking at the results of FBG from the patient's medical records of laboratory tests. Collected data were entered into Microsoft excel and then statistically analyzed using IBM SPSS 22. Spearman’s Rho Correlation Test analyzed the data. Results: Sixty three respondents became in inclusion criteria. Most patients have a moderate physical activity of 28 people, or around 44.4%. Thirty-two people had poor fasting blood glucose levels of about 50.8%. The analysis result was there is a significant correlation between physical activity and fasting blood glucose levels of T2DM patients and a low correlation coefficient in the opposite direction (not in the same order). Conclusion: Physical activity impacts fasting blood glucose levels and has a negatively correlated direction. The increase in physical activity showed by the value of the IPAQ score, followed by a decrease in fasting blood glucose level.

ASSOCIATION BETWEEN RISK FACTORS AND COGNITIVE IMPAIRMENT AMONG TYPE 2 DIABETES MELLITUS PATIENTS

Background: Diabetes mellitus type 2 is considered as one of the leading causes of illness and mortality through over the globe. Diabetic retinopathy, neuropathy, and nephropathy are all effectively screened on a regular basis. Recent research have shown that cognitive deterioration can occur in patients with diabetes and that it can go unnoticed for a long time, implying that routine screening is necessary. &#x0D; Methodology: An observational cross sectional study was conducted among 158 patients with complaint of T2DM aged between 60-79 years of age were found with cognitive impairment on the basis of MMSE score in a tertiary care centre. Detailed history along with laboratory and biochemical data were taken from patients after taking written informed consent and approval of Institutional Ethical committee through the pre-structured questionnaire. &#x0D; Results: Mild cognitive impairment was noted in 88 (55.69%) type 2 diabetes mellitus patients and Normal cognitive function in 70 (44.30%). Those with MCI had higher HbA1c (6.57 ± 1.27 vs. 6.13 ± 1.22), higher FBS (148.34 ± 18.61 vs. 145.25 ± 16.31), PPBS (173.91 ± 42.64 vs. 167.47 ± 38.15) and TNF-α (79.32 ± 8.74 vs. 72.98 ± 6.76), which were statistically significant. The cognitive domains of executive function, naming, attention, language, and memory showed a statistically significant difference between those with Mild cognitive impairment and Normal cognitive function. There were no differences in the mean age, duration of disease, and education level between the groups. &#x0D; Conclusion: The significant prevalence of Mild cognitive impairment in type 2 diabetes patients emphasizes the value of routine screening of cognitive functions. Further research into the link between cognitive impairment and poor blood glucose control is needed to see if improving blood glucose control can assist in enhancing cognitive functions.

Subclinical Neuropathy in Children With Type I Diabetes Mellitus: Tertiary Care Centre Experience.

Introduction: Diabetic peripheral neuropathy is a common complication of diabetes mellitus (DM) type 1. However, it can occur without evidence of symptoms or clinical signs of neuropathy labeled as subclinical neuropathy, which neurophysiological studies can best detect.Purpose: To evaluate the prevalence of subclinical neuropathy among children with DM type 1, determine the association with blood sugar control, and evaluate the pattern of nerve involvement in neurophysiological studies.Methods: This cross-sectional study evaluated 100 children with DM type 1, aged five to 15 years, at least one year after the diagnosis. Subclinical neuropathy was evaluated using nerve conduction study. Glycemic control was assessed using hemoglobin A1c (HbA1c).Results: The mean age of subjects was 11.5 ± 0.25 years. The average age at the onset of the disease was 5.95 ± 0.25 years. There were 64 patients who had electrophysiological evidence of peripheral neuropathy. The most observed electrophysiological changes were distal latency abnormalities in the left and right peroneal nerves in 39 and 33 patients, respectively. Sensory nerve amplitude, peak latency, and conduction velocity were normal in all patients (100%). HbA1c level did not show a statistically significant association with the incidence of subclinical neuropathy.Conclusion: Subclinical neuropathy was prevalent in children with DM type 1. Poor glucose control was only associated with an increased odds ratio of subclinical neuropathy.

Effect of the Early Application of Evolocumab on Blood Lipid Profile and Cardiovascular Prognosis in Patients with Extremely High-Risk Acute Coronary Syndrome.

Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors significantly reduce low-density lipoprotein cholesterol (LDL-C) and improve the prognosis of patients with acute coronary syndrome (ACS). However, the feasibility and safety of early application of PCSK9 inhibitors on the basis of statins combined with ezetimibe to strengthen lipid lowering in extremely high-risk coronary heart disease populations are still unknown.This study was a prospective, randomized controlled study. A total of 136 patients with extremely high-risk ACS with LDL-C ≥ 3.0 mmol/L after percutaneous coronary intervention (PCI) treatment were randomly assigned 1:1 to the control group (atorvastatin 40 mg/day and ezetimibe 10 mg/day) or the evolocumab group (evolocumab 140 mg every 2 weeks combined with atorvastatin 40 mg/day and ezetimibe 10 mg/day). We compared the blood lipid profiles, major adverse cardiovascular events (MACEs), and adverse reactions. MACEs included cardiogenic death, nonfatal myocardial infarction, nonfatal stroke, and readmission due to angina. Adverse reactions included allergies, myalgia, poor blood glucose control, and liver damage.Within 1 month, the average level of LDL-C in the evolocumab group decreased from 3.54 to 0.57 mmol/L and that in the control group decreased from 3.52 to 1.26 mmol/L. The LDL-C compliance (< 1.0 mmol/L) rate was significantly increased in the evolocumab group compared with the control group (82.35% versus 22.06%, P < 0.01). The average level of lipoprotein (a) (Lp (a) ) in the control group increased by 9.94 ± 51.93% from baseline after treatment, but evolocumab reduced the Lp (a) level (-38.84 ± 32.40%). Additionally, evolocumab further reduced the levels of apolipoprotein B/A1 (-70.56 ± 22.38% versus -51.29 ± 18.14%), cholesterol (-54.76 ± 18.10% versus -41.16 ± 18.14%), and apolipoprotein B (-66.47 ± 26.89% versus -46.78 ± 24.12%) compared with those in the control group, all P < 0.01. The blood lipid levels of both control and evolocumab groups stabilized after 1 month. During the 3-month follow-up, the incidence of MACEs after PCI was lower in the evolocumab group than in the control group (8.82% versus 24.59%, P = 0.015), and evolocumab combined with statins and ezetimibe did not increase the occurrence of adverse reactions (13.24% versus 11.48%, P = 0.762).In patients with extremely high-risk ACS with high levels of LDL-C, adding evolocumab to their treatment regimen as early as possible may enhance lipid lowering, increase the patient's LDL-C compliance rate in the short term, and improve cardiovascular prognosis but will not increase adverse reactions.

Incidence, progression and regression of diabetic retinopathy in a northeastern Chinese population

AimTo determine the incidence, progression and regression of diabetic retinopathy (DR), with corresponding risk factors, in a northeastern Chinese population of patients with type 2 diabetes.MethodsAmong 2006 patients who completed...

Design Strategies and Prospects in Developing Wearable Glucose Monitoring System Using Printable Organic Transistor and Microneedle: A Review

Diabetes mellitus is a worldwide leading disease that brings about fatal complications due to poor body glucose management which requires regular screening. With progressive evolution of healthcare monitoring system, high demand for wearable biosensors has efficiently bridged the gap between organic semiconductor devices and biological systems due to their flexibility and biocompatibility as enzyme-based transducing mechanism. In this work, significant features of existing glucose monitoring systems and integration components are evaluated to extend the fully integrated sensing platform with exciting potentials of organic thin-film transistor (OTFT) as electrochemical glucose sensor at low manufacturing process <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$&lt; 200 ^{\circ }\text{C}$ </tex-math></inline-formula> . This review highlights the design strategies and challenges in developing printable OTFT devices with low voltage and high on/off-current ratio <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$&gt; 10^{6}$ </tex-math></inline-formula> by considering material configuration including nanomaterials, advanced printing techniques and functionalization for highly sensitive performance based on amperometric or potentiometric measurements. For sample extraction, the role of microneedle is critically discussed with their prospects to provide real-time diagnosis of interstitial fluid through correlation with blood glucose for long wear period. It can be concluded that this paper accentuates the potentials of printable OTFT biosensors and ISF sampling system based on microneedle by adapting the key design requirements and characteristics presented here for novel breakthrough of cost-effective, minimally invasive and self-monitoring flexible integrated glucose sensor system that conform to skin.

The effects of nutrition counseling on dietary compliance and blood sugar levels of type 2 diabetes mellitus patients

One of the efforts to increase individuals’ or families’ knowledge and ability of nutrition is nutrition counseling. Patients are entitled to qualified nutrition counseling because it is an integral part to accelerate their healing process. Type II DM patients’ compliance with diet therapy is a difficult problem to control. Some studies showed that 75% of patients did not comply with the recommended diet, and 53% had poor blood glucose control. This study employed an experimental study with a quasi-experimental design as well as a pretest and posttest without a control. The sample of this study was 30 people. This study was conducted in Meuraxa Regional General Hospital, Banda Aceh from June to July 2017. The primary and secondary data were analyzed using the statistical test of T-test dependent and chi-square test with a level of confidence (0:05). Th Moreover, before the counseling, the average of their blood sugar levels was 318.13, but after the counseling, their blood sugar levels decreased by 273.20 mg/dl; thus, the margin of decline was 42.167 mg/dl. The chi-square test discovered that the nutrition counseling significantly influenced adherence and obtained a p-value of &lt;0.05. Meanwhile, the dependent t-test showed that the blood sugar levels of the type II diabetes patients were p&lt;0.05. It is expected that the nutrition officers provide continuous or sustainable nutrition counseling to increase the patients’ knowledge and dietary compliance and help them achieve normal blood sugar levels.

Efficacy of Internal Heat Acupuncture Combined with High-Voltage Long-Duration Pulsed Radiofrequency on Subacute Postherpetic Neuralgia: A Retrospective Study.

Objectives This study aims at investigating the internal heat acupuncture (IHA) combined with the high-voltage long-duration pulsed radiofrequency (PRF) therapeutic effect on subacute postherpetic neuralgia (PHN). Methods This retrospective study comprised 81 cases with PHN. They were divided into three groups: IHA combined with the high-voltage long-duration PRF group (IHA-PRF), intradermal injection combined with the high-voltage long-duration PRF group (II-PRF), and the high-voltage long-duration PRF group. The pain numerical rating score (NRS), IL-6, Gal-3, and blood glucose levels were recorded before and after treatment. Results Compared with before treatment, NRS scores of the three groups were all decreased at each time point. NRS scores of the IHA-PRF group patients decreased significantly in comparison to the PRF group at 1, 4, 8, and 12 weeks following treatment, while group II-PRF only decreased significantly at one week following treatment. Compared with groups II-PRF and PRF, respectively, IL-6 and Gal-3 levels in plasma of patients in group IHA-PRF were significantly decreased at 4 and 12 weeks after treatment. The effective rate of group IHA-PRF was 88.9%, which was considerably more than the other groups, II-PRF (63.0%) and PRF (63.0%). Compared with group II-PRF, patients' blood glucose levels in IHA-PRF and PRF groups significantly decreased three days and one week after treatment. Conclusion Internal heat acupuncture combined with high-voltage long-duration pulsed radiofrequency has a satisfactory therapeutic effect on subacute PHN and has no obvious adverse reactions, which is especially suitable for patients with poor blood glucose control.

Flash glucose monitoring system in special situations.

The management of diabetes mellitus (DM) requires maintaining glycemic control, and patients must keep their blood glucose levels close to the normal range to reduce the risk of microvascular complications and cardiovascular events. While glycated hemoglobin (A1C) is currently the primary measure for glucose management and a key marker for long-term complications, it does not provide information on acute glycemic excursions and overall glycemic variability. These limitations may even be higher in some special situations, thereby compromising A1C accuracy, especially when wider glycemic variability is expected and/or when the glycemic goal is more stringent. To attain adequate glycemic control, continuous glucose monitoring (CGM) is more useful than self-monitoring of blood glucose (SMBG), as it is more convenient and provides a greater amount of data. Flash Glucose Monitoring (isCGM /FGM) is a widely accepted option of CGM for measuring interstitial glucose levels in individuals with DM. However, its application under special conditions, such as pregnancy, patients on hemodialysis, patients with cirrhosis, during hospitalization in the intensive care unit and during physical exercise has not yet been fully validated. This review addresses some of these specific situations in which hypoglycemia should be avoided, or in pregnancy, where strict glycemic control is essential, and the application of isCGM/FGM could alleviate the shortcomings associated with poor glucose control or high glycemic variability, thereby contributing to high-quality care.

1505-PUB: Impact of Diabetes on Radiotherapy-Related Infection

Background and Purpose: Poor perioperative glucose control in diabetes patients is associated with infectious adverse effects (AEs) . Radical radiotherapy (RT) for head and neck (H&amp;N) cancer extensively destroys skin and the mucosa barrier function, and can be as invasive as surgery. In this study, the risk of radiation-induced acute infectious AEs was investigated in a cohort of diabetic patients given RT for H&amp;N cancer. Materials and Methods: Acute AEs associated with RT in diabetic patients treated between January 2017 and July 2021 at three institutions were retrospectively analyzed. Patients were included if they met the following criteria: confirmed diagnosis of type 1 or 2 diabetes mellitus, age &amp;gt; years, stable on glucose-lowering therapy before starting RT, and had undergone RT for pathologically proven malignancies. The endpoint was the rate of acute infectious AEs graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0. Results: A total of 216 patients were eligible for the present study (median follow-up, 15.6 months; range, 1.3-33.3 months; median age, 72 years; range, 33-90 years) . The median glycated hemoglobin (A1c) value at the start of RT was 7.4% (range, 4.1%-12.7%) . Grade ≥ 3 acute infectious AEs that occurred in 31 (14.4%) patients included mucosal infection, pneumonia, and sepsis. Five patients died due to infectious AEs that developed during or after RT. Concurrent chemoradiotherapy (CCRT) (OR, 2.0; 95%CI, 0.9-4.6; P = 0.08) tended to be a predictor of severe infectious AEs. The frequency of glucose control by diabetologists during CCRT was significantly lower than during RT alone (P = 0.001) . Conclusions: The incidence of severe infectious AEs was high in the present cohort of irradiated diabetic patients with H&amp;N cancer compared with historical data. Patients with CCRT had a higher risk of AEs, which should be considered before irradiation. Therapeutic intervention for glucose control by diabetologists during CCRT may lead to fewer severe infectious AEs. Disclosure K. Ito: None.

Risk Factors for Nonalcoholic Fatty Liver Disease in Postmenopausal Women with Type 2 Diabetes Mellitus and the Correlation with Bone Mineral Density at Different Locations

ObjectiveTo explore the risk factors for nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with type 2 diabetes mellitus (T2DM) and the correlation with bone mineral density (BMD) in different areas of the body.MethodsA total of 434 postmenopausal women with T2DM were enrolled and categorized as 198 patients in the NAFLD group and 236 patients in the non-NAFLD group based on color Doppler ultrasound of the liver. The BMD of the lumbar spine, femoral neck, and total hip were measured by dual-energy X-ray absorptiometry.ResultsIn postmenopausal women with T2DM, the prevalence of NAFLD was 45.6%. The body mass index (BMI), systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), triacylglycerol (TG), uric acid (UA), and homeostatic model assessment for insulin resistance (HOMA-IR) C-peptide (CP) were significantly higher in the NAFLD group than in the non-NFALD group, and the duration of diabetes, and high-density lipoprotein cholesterol (HDL-C) were lower than in the non-NAFLD group (P < 0.05). Logistic regression analysis revealed that BMI (odds ratio [OR] = 1.303, 95% confidence interval [CI]: 1.152–1.346), HbA1c (OR = 1.263, 95% CI: 1.095–1.392), TG (OR = 1.263, 95% CI: 1.031–1.601), and SUA (OR = 1.005, 95% CI: 1.001–1.007) were correlated with NAFLD (P < 0.05). The BMD of the total hip and femoral neck in the NAFLD group was higher than in the non-NAFLD group (P < 0.05).ConclusionComplicated NAFLD in postmenopausal women with T2DM is associated with weight gain, poor blood glucose control, abnormal lipid metabolism, and elevated UA levels. In addition, the NAFLD group had higher femoral neck and total hip BMD than the non-NAFLD group, suggesting NAFLD in postmenopausal women with T2DM may reduce the risk of osteoporosis.

178-LB: Prevalence of Vitamin D Deficiency among Patients with Type 2 Diabetes in Qingdao, China

The aim of the current study is to investigate the prevalence of vitamin D deficiency among patients with type 2 diabetes (T2DM) in a Chinese cohort. We enrolled 3025 patients with T2DM (aged 30-91 yrs) who were hospitalized in Qingdao Endocrine and Diabetes Hospital from Jan 2018 to Jan 2019. The exclusion criteria were as follows: (1) with other types of diabetes; (2) pregnant or lactating females; (3) with acute complications of diabetes or other stress states, such as surgery and trauma; (4) with rheumatologic, serious hepatic, cardiac, renal failure, malignancy, and endocrine diseases that affect the metabolism of vitamin D. Serum level of 25-OH-vitamin D ≥ 30 ng/mL was defined as normal, 20 ng/mL ≤ 25-OH-vitamin D &amp;lt; 30 ng/mL as vitamin D insufficiency (VDI) , and serum 25-OH-vitamin D &amp;lt; 20 ng/mL as vitamin D deficiency (VDD) . The chi-square test was used for group comparison of VDD or VDI prevalence. In all subjects, the prevalence of VDI was 35%. Male patients had higher prevalence of VDI than female patients (40.0% vs. 28.9%, P&amp;lt;0.05) . The prevalence of VDD was 48.8% in total while female had higher prevalence than male patients (57.2% vs. 41.8%, P&amp;lt;0.001) . We found a clear trend toward decreasing serum vitamin D concentration with rising HbA1c levels (P&amp;lt;0.001 in male and P&amp;lt;0.003 in female) . Dividing the HbA1c into deciles showed a linear association. In conclusion, VDI and VDD is prevalent in patients with type 2 diabetes. Poor glucose control is related to lower serum level of vitamin D. Future studies are required to verify if vitamin D supplementation could be beneficial in patients with diabetes. Disclosure L. Zhang: n/a. J. Wang: None. Y. Yang: None. Y. Dong: None.

1491-PUB: Demographic and Psychosocial Predictors of Diabetes Risk and Glycemic Control in Hispanic/Latino Adults

In the U.S., Hispanic/Latino adults face a disproportionate burden of type 2 diabetes (T2D) , in part due to biological factors, including poor glucose control, and diagnosis delays. Beyond biology, social and environmental factors account for majority of risk for T2D progression. In this study, demographic and psychosocial predictors of T2D diagnosis and glycemic control were evaluated among Hispanic/Latino adults with T2D (Morales et al., in BMC Endocrine Disorders, 2020) . T2D was reported by 83% of participants (N=187; 90% Mexican-origin) . Of those with T2D, 69% were female (vs. 47% without T2D) , average age was 58.8±10.2 years (vs. 52.7±12.1 years without T2D) , and 60% had HbA1c &amp;gt; 7%. Females with T2D had a weight of 165.4±31.9; males 172.3±26.3 lbs. (vs. 164.3±36.4 for females and 180.5±30.5 lbs. for males without T2D) . A categorical classification algorithm (Rokach &amp; Maimon, Data Mining and Knowledge Discovery Handbook, 2010) identified T2D diagnosis as most strongly predicted by older age, lower weight, and greater perceived stress (Figure 1A) . Poor glycemic control was most strongly predicted by faith/spirituality, trust in physician, and depression symptomatology (Figure 1B) . T2D interventions for Hispanic/Latino adults should consider how demographic and psychosocial determinants differentially impact and perhaps even predict T2D risk, diagnosis, and glycemic control outcomes. Disclosure S.A. Fields: None. N.M. Glantz: Research Support; Abbott. D. Kerr: Advisory Panel; Abbott Diabetes, Novo Nordisk A/S, Sanofi. Consultant; Evidation Health. Research Support; Novo Nordisk A/S. Stock/Shareholder; Glooko, Inc., Hi.Health.