Postprandial Blood Sugar Research Articles

Identification and molecular docking study of sugarcane leaf-derived compounds as potent dipeptidyl peptidase IV, α-glucosidase, and α-amylase inhibitors.

Dipeptidyl peptidase-IV (DPP-IV), α-glucosidase, and α-amylase play a prominent role in regulating postprandial blood sugar levels, which are regarded as key targets for the treatment of type 2 diabetes mellitus (T2DM). The present study aimed to characterize bioactive compounds as potent crucial sugar metabolism enzyme inhibitors from sugarcane leaves by virtual screening. In total, 41 sugarcane leaf-derived compounds were used for the screening of multiple targets. Subsequently, the molecular mechanism and activity validation in vitro of the interaction between enzymes and compound were carried out. Flavonoid compound schaftoside was identified by molecular simulation and showed significant DPP-IV (0.1050 ± 1.22 mmol L-1 ), α-glucosidase (0.078 ± 0.06 mmol L-1 ), and α-amylase (0.3067 ± 0.35 mmol L-1 ) inhibitory effects. The residues ARG125 and TYR662 of DPP-IV may play crucial roles in inhibiting the activity of DPP-IV. Multiple hydrogen bonds and electrostatic interactions were exhibited between schaftoside and α-glucosidase. Molecular modeling revealed that schaftoside displays strong binding with the catalytic triad (ASP197, ASP300, and GLU233) of α-amylase. Our findings demonstrate that schaftoside from sugarcane leaves might be an edible for T2DM treatment." © 2023 Society of Chemical Industry.

Predictability of the Development of Insulin Resistance Based on the Risk Factors Among Female Medical Students at a Private College in Saudi Arabia.

Insulin resistance (IR) is currently an underlying phenomenon in the etiology of mostnon-communicable diseases. IR has been proposed as the key linking factor for the metabolic syndrome disease cluster of glucose intolerance. This study's target was to assess the predictability of risk factors for IR among female medical students Methods: A cross-sectional study involving female medical students was carried out. The sample size was 272, and a suitable non-probability sampling method was employed. A correlation test was done, and a P value less than 0.05 is considered statistically significant.Each participant underwent assessment of anthropometric measurements and biochemical testing. For assessing lifestyle, validated questionnaires on physical activity, sleep pattern, dietary pattern, and stress were adopted. The anthropometric data such as height, weight, and waist circumference were collected. Biochemical testing involved estimation of the postprandial capillary blood glucose level on campus. Additionally, systolicblood pressure and diastolic blood pressurewere measured. The association of lifestyle risk factors with waist circumference as an indicator of IR was done wherethe majority of those with high waist circumference were physically inactive and more prone to stress which was statistically significant when compared to those with normal waist circumference. However, poor sleep and unhealthy diet were high among those with high waist circumference, but they were not statistically significant. The correlation of waist circumference as an indicator of IR was highly significant with body mass index, postprandial blood sugar, systolic blood pressure, and diastolic blood pressure. A series of unhealthy lifestyle habits was contributable to developing obesity and therefore IR among medical students in Saudi Arabia.

Pancreatic Dysfunction and Reduction in Quality of Life Is Common After Pancreaticoduodenectomy.

Improvements in survival after pancreaticoduodenectomy has increased the number of patients potentially at risk of pancreatic insufficiency. We studied long-term (> 1year) pancreatic functions (endocrine and exocrine) after pancreaticoduodenectomy and aimed to recognize the impact of various clinicopathological factors and postoperative complications on pancreatic functions. All patients who underwent pancreaticoduodenectomy at least 1year prior were recruited from July 2020 to December 2021. Endocrine function was assessed using HbA1c, fasting blood sugar and postprandial blood sugar levels. Pancreatic exocrine function was assessed clinically with history of steatorrhea and objectively with quantitative estimation of fecal elastase-1 levels in stool samples. Volume of remnant pancreas, parenchymal thickness and duct diameter were assessed by computed tomography. Quality of life assessment was done using SF-36 questionnaire. Of the 106 patients assessed, 64 patients met the inclusion criteria. Endocrine insufficiency was noted in 51.6%, and 34.3% had new onset diabetes mellitus. The incidence of pancreatic exocrine insufficiency was 87.5% and severe insufficiency was found in 62.5% of patients. Twenty-nine (45.3%) patients had both exocrine and endocrine insufficiency. Patients with CRPOPF had higher risk of severe exocrine insufficiency (5 vs. 2, OR 1.57(0.28-8.81) p = 0.6). The SF-36 scores were lower than general population especially in role limitation due to physical health, role limitation due to emotional problems, energy/fatigue, general health perception and health change domains. Post-pancreaticoduodenectomy patients have a high frequency of pancreatic insufficiency and should be screened for same. The post-operative pancreatic fistula increases the risk of pancreatic exocrine insufficiency.

Study of Lipid Profile in Type 2 Diabetes Mellitus Patients in South Chennai Population.

Diabetes Mellitus is caused by the decreased utilization of glucose by tissues and is attributed either to hypoinsulinemia or hyperinsulinemia induced by the overstimulation of insulin-secreting beta cells. Patients with diabetes mellitus, obesity and dyslipidemia are prone to Metabolic syndrome. The study aims to estimate and compare the lipid profile in type 2 diabetes mellitus patients and healthy individuals. This case-control study was undertaken in type II Diabetic patients, where 48 were male, and 45 were female. The diabetic subjects were compared with 33 male and 55 Healthy female subjects who volunteered as controls. Venous blood samples from healthy and diabetic subjects were collected and used to measure routine parameters such as fasting blood sugar (FBS), post-prandial blood sugar(PPBS), Total cholesterol, HDL, and TGL. The Fasting Plasma Glucose and post-prandial glucose were significantly increased among diabetic subjects than the healthy controls. The triglyceride levels in cases had elevated levels in comparison to controls. HDL showed a marginal decrease in the diabetic group than the control group. Mean LDL levels in people with diabetes increase compared to the healthy controls. Besides, the VLDL levels also significantly increased among people with diabetes. There was a substantial increase in FBS and PPBS levels among the diabetic subjects compared to the healthy controls. The lipid profile constituting Total cholesterol, Triglycerides, HDL, LDL and VLDL levels showed the following changes: There was a significant increase in Total cholesterol, TGL, VLDL, and LDL levels, whereas the HDL levels were decreased among the diabetic subjects. Patients with type 2 diabetes mellitus must keep their blood sugar levels under control through follow-ups because uncontrolled diabetes mellitus leads to lipid dysfunction, which ultimately increases the risk of coronary artery disease. Keywords: , , Triglyceride (TGL), Low-Density Lipoprotein (LDL).

Role of HLA-DPrs3077 and HLA-DQrs3920 Polymorphisms as Risk Factors for Type 1 Diabetes Mellitus.

Type 1 diabetes mellitus (T1DM) is a chronic disease caused by the destruction of insulin-producing pancreatic β-cells. During disease progression, inflammatory insulitis increases the presentation of islet antigens on human leukocyte antigen (HLA) molecules to T lymphocytes. This complex system plays a pivotal role in cellular immunity. Thus, genetic variability in HLA can affect the susceptibility to and clinical outcomes of DM. This case-control study aimed to assess the role of HLA-DP-rs3077 (A/G) and HLA-DQrs3920 (A/G) polymorphism in T1DM. This study enrolled 400 individuals: 200 patients with T1DM and 200 ageand sex-matched healthy controls. Hemoglobin A1C and random, fasting, and postprandial blood sugar levels were determined for all subjects. Genotypic and allelic distributions of HLA-DPrs3077 (A/G) and HLA-DQrs3920 (A/G) SNPs were determined using real-time polymerase chain reaction (PCR). Frequency of the HLA-DPrs3077A allele was high among the diabetic group (91.3%); however, the difference was non-significant [OR (95% C.I) = 1.422(0.89-2.252), P=0.098]. The frequency of the HLA-DQrs3920 GG genotype was higher in control than the diabetic group (52.5% vs.12%), whereas that of the AA genotype was higher in the person with diabetes than in the control group (34% vs.4%). Individuals carrying the HLA-DQrs3920A allele were 4.5 times more likely to have T1DM than those carrying the G allele [OR (95% C.I) = 4.510 (3.338- 6.094), P<0.001*]. The presence of HLA-DPrs3077A and HLA-DQ rs3920A in the same person increases T1DM risk by 3.6 times that of G allele [OR (95%C.I) = 3.608(2.173-5.991), P<0.001*]. HLA-DPrs3077 and HLA-DQrs3920 SNPs have a role in T1DM as the coexistence of HLA-DPrs3077A and HLA-DQrs3920A alleles increases the risk.

Incidence of Fetal Myocardial Hypertrophy in Mother with Diabetes Mellitus by Using Cardio-Spatiotemporal Image Correlation (STIC) M-Mode.

The aim was to demonstrate the prevalence of fetal myocardial hypertrophy (FMH) in diabetes mellitus (DM) pregnant women using spatio-temporal image correlation (STIC) M-mode. This prospective descriptive study was conducted at Bhumibol Adulyadej Hospital (BAH) Royal Thai Air Force between April and December 2022. Participants were singleton DM pregnant women with gestational age (GA) between 18 and 40 weeks who had antenatal care and delivery at BAH. DM screening was randomized blood sugar obtained from all participants. All participants underwent fetal heart exams by four-dimension ultrasound with STIC M-mode. One hundred and forty-five participants were recruited and classified as pregestational (PDM) and gestational DM (GDM) at 31 and 114 cases, respectively. The mean age of participants was 31.7 years old. Fasting blood sugar (FBS) of PDM was significantly higher than GDM (105.1 vs 87.0 mg%). GDMA2 had more elevated FBS than GDMA1 (p < 0.001). PDM had significantly greater FBS and two-hour postprandial blood sugar (2hr-PP) than GDM (105.1/87.0 and 151.5/117.9 mg%, respectively). FBS and 2hr-PP of GDMA2 were more than GDMA1 with statistical significance. Good glycemic control of GDM was significantly better than PDM. GDMA1 had better glycemic control than GDMA2 with statistical significance. Four-fifth (115/145) of participants had FMH. FMH and estimated fetal weight among PDM and GDM were comparable. Both good and poor glycemic control had similar FMH. Neonatal outcomes of FMH or non-FMH infants were similar. The prevalence of FMH in diabetic pregnant women was 79.3%. Glycemic control had no correlation to FMH.

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.

Studies on nutritional intervention of ginkgo starch-lauric acid complex in obese rats induced by a high-fat diet

Ginkgo starch was frequently used in food, but consuming too much of it could increase postprandial blood sugar and potentially cause obesity. Through molecular docking, we discovered that lauric acid enters the spiral cavity formed by amylose molecules to form a stable compound. The compound exhibited a V-type structure, enhanced relative crystallinity, short-range order, and long-range order, while also experiencing a 20% reduction in in vitro digestibility. The complex may also lessen body weight, serum triglyceride (TG) and total cholesterol (TC) levels in rats, as well as improve hepatic fat accumulation and intestinal flora composition. It's interesting to note that the complex greatly boosted the number of good bacteria in rats, and that these bacteria positively connected with the production of short-chain fatty acids (SCFAS), superoxide dismutase (SOD), TC, and TG. In conclusion, the high-fat diet-induced obesity is significantly improved by the ginkgo starch-lauric acid combination (GSL).

Incidence of impaired glucose tolerance and diabetes mellitus in transfusion dependent thalassemia patients of rural Bengal - An institutional study

: Thalassemia is the world’s commonest monogenic disorder. Molecular biology and genetics have revealed more than 200 mutations of thalassemia syndrome. These children become symptomatic from progressive haemolytic anaemia. They have to take lifelong treatments with regular packed red blood cell transfusion. Our body has no effective means of iron excretion and this leads to progressive iron accumulation in various organs after prolonged blood transfusion. This results in dysfunction of liver, heart and endocrine system and increased mortality. Iron toxicity to pancreatic beta cell leads to impairment in glucose metabolism. : Our study aims to find out the incidence of impaired glucose tolerance (IGT) and diabetes mellitus (DM) in transfusion dependent thalassemia major patients. This is an observational descriptive study carried out from January 2017 to June 2018. The study included 48 samples. There post-prandial blood sugar level and glycated haemoglobin (HbA1c) was analysed. Any proved case of juvenile diabetes mellitus was excluded from the study. We found that the incidence of IGT and DM were 12.5% and 4.16% respectively in our study population. The blood sugar level was significantly high in study group (p=&amp;#60;0.0001) as compared to the control group. The present study showed strong correlation between units of blood transfusion and blood sugar level as well as HbA1C percentage (in both cases p= &amp;#60;0.00001.)Thalassemia patients receiving regular blood transfusion are at increased risk of developing IGT and DM. Early initiation of chelation and judicious use of blood transfusion must be considered for these patients to prevent such complications.

Effects of dapagliflozin on type 2 diabetes and other metabolic disorders: Results from a prospective, observational DIATOM study

Abstract Objectives: To evaluate the effects of dapagliflozin, sodium-glucose cotransporter-2 inhibitor, in the treatment of type 2 diabetes mellitus (T2DM) and other metabolic disorders. Materials and Methods: The DIATOM (effect of Dapagliflozin In treAtment of Type 2 diabetes and Other Metabolic disorders) was a prospective, observational study conducted at S.V.P. Hospital, Ahmedabad, between April 2018 and October 2022. Patients with T2DM who were on dapagliflozin were included. The study outcomes included changes in glycemic parameters, body weight, body mass index (BMI), lipid profile, blood pressure, and renal and liver functions. Results: A total of 55 patients with T2DM who received dapagliflozin-based antidiabetic therapy were analyzed. The mean age of patients was 50.47 years, and the majority were males (69.1%). The majority of patients (49.1%) had diabetes duration of more than 10 years and a family history of T2DM or other metabolic disorders (81.8%). Hypertension was the most common comorbidity (60%). Metformin (98.2%) was the most common concomitant antidiabetic medication. Dapagliflozin-based antidiabetic therapy demonstrated a significant reduction from baseline to 6 months in the mean fasting blood sugar, postprandial blood sugar, glycated hemoglobin, body weight, and BMI. Also, reductions in serum creatinine and cholesterol levels were reported, though they were not significant. Conclusions: Dapagliflozin-based antidiabetic therapy showed improvements in the glycemic parameters and body weight as well as other metabolic parameters in Indian patients with T2DM.

Platelet indices as a predictor of microvascular complications of type 2 diabetes mellitus

Abstract Background: The burden of diabetes is increasing day by day, and diabetic individuals are predisposed to develop micro- and macrovascular complications leading to increased mortality and morbidity. Platelet indexes can alert us regarding endothelial dysfunction in diabetes and in turn regarding microvascular complications. Materials and Methods: A case–control study was conducted on 100 diabetic patients with age and sex matched and 100 nondiabetic controls. All diabetic patients were evaluated for microvascular complications such as diabetic neuropathy, retinopathy, and nephropathy. Clinical history of all patients was taken regarding associated comorbidities and association. Fasting and postprandial blood sugar, HbA1c, platelet count, and platelet indices were measured. Statistical analysis was performed by using student unpaired t test and χ2 test. Results: Platelet indices mean platelet volume, plateletcrit, platelet distribution width (PDW), and platelet large cell ratio (P-LCR) were significantly higher in diabetic patients compared with controls. It was also observed that changes in mean platelet volume, PDW, and P-LCR were more significant in diabetic patients with microvascular complications than diabetic patients without microvascular complications. Conclusion: Values of platelet indices were statistically associated with diabetes and its microvascular complications.

Real-world Data of Glycemic Control in a Suburban Population in Northern India during the COVID-19 Pandemic

Abstract Background: This study compared the 2-year glycemic outcomes with oral antidiabetic drugs (OADs) versus combination of OADs with insulin among the real-world patients at a single suburban center in India during the COVID-19 pandemic. Methods: Patients aged &gt;18 years on the treatment for type 2 diabetes mellitus were included and followed up for 2 years. The patients were divided into four groups according to their antidiabetic medication as follows: (1) sodium-glucose cotransporter-2 inhibitors (SGLT2i) + insulin + OADs; (2) SGLT2i + OADs; (3) insulin + OADs (excluding SGLT2i); and (4) OADs excluding SGLT2i. Patients who were reluctant to initiate insulin as add-on therapy or those already taking insulin but wanting to switch to OADs were prescribed SGLT2i as add-on therapy. The parameters measured at every follow-up were blood pressure, weight, fasting blood sugar (FBS), postprandial blood sugar, and HbA1c. Results: In all, 1204 patients were included in the study. The mean age of patients was 59.07 ± 13.08 years, and 729 (60.54%) were males. Out of 1204 patients, the HbA1c data were available for only 472 patients. All glycemic parameters were maintained in the SGLT2i + Insulin + OADs group over the period of 3 years with no significant change in their values. The number of patients in the SGLT2i + OADs group more than doubled over the 2 years of follow-up. There was a significant improvement in weight and FBS at year 2 in this group. A significant improvement in HbA1c and FBS was seen in patients with baseline HbA1c ≥10 at baseline. No statistically significant change was observed in any of the clinical parameters in patients in the Insulin + OADs (excluding SGLT2i) group. Only about 50% of those who were on insulin at baseline, continued insulin at the first and second follow-up. In the OADs (excluding SGLT2i) group, weight and post lunch blood sugar showed a significant decrease at the second follow-up. Among patients who remained on OADs throughout the study, there was a significant improvement in HbA1c from baseline at year 2, although other parameters did not show any significant improvement. Conclusion: Patients on various OAD regimens showed better glycemic control compared to those on combined insulin and OADs in this study in a suburban population in India.

Short-term effect of laparoscopic sleeve gastrectomy on hyperlipidemic obese patients

Introduction Obesity has become a global epidemic and a major health problem in the twenty-first century. Studies have demonstrated that weight loss lowers increased serum total cholesterol and low-density lipoprotein (LDL) cholesterol and raises high-density lipoprotein (HDL) cholesterol. One of the most recent procedures for managing weight loss in obese people with other options is laparoscopic sleeve gastrectomy (LSG). Objectives The aim of this study was to evaluate the short-term effect of laparoscopic sleeve gastrectomy on lipid profile in hyperlipidemic obese patients during the nine months of postoperative care. Methods From July 2020 to October 2021, 50 hyperlipidemic obese patients who were eligible for bariatric surgery underwent this prospective study at Main University Hospital in Alexandria, Egypt. Before and one, three, six, and nine months after the surgical intervention, measurements of body weight, body mass index (BMI), waist circumference, fasting and postprandial blood sugar, serum cholesterol, triglyceride, HDL, and LDL levels were taken. Results The patients’ average age was 33.72±7.95 years. BMI, weight, blood sugar, and other measurements all significantly decreased. The mean body mass index (BMI) of the patients was 48.59±5.78 kg/m2 before surgery, however, it was reduced to 32.58±3.91 kg/m2 nine months afterwards. Studies revealed a statistically significant rise in HDL levels in the serum and a statistically significant fall in triglycerides, total cholesterol, and LDL levels. Results also revealed a favorable association between preoperative differences in age, BMI, and diabetes state and postoperative lipid profile alterations. Conclusion Laparoscopic sleeve gastrectomy (LSG) decreases body mass index, improves glucose and lipid metabolism, and alters the lipid profile by significantly lowering total cholesterol, triglycerides, and LDL cholesterol while significantly raising HDL cholesterol.

Efficacy of Vijayasaradi capsule as add-on management in insulin-dependent type 2 diabetes – A randomized standard controlled clinical trial

BACKGROUND: In patients with hyperglycemia, the resistance to oral antihyperglycemic drugs may lead to insulin therapy. Insulin therapy has some limitations, such as the cost of medicine, dose monitoring, and the risk of hypoglycemia. The classical text of Ayurveda has described several formulations for treating diabetes. The role of Ayurveda antidiabetic formulations needs to be studied for controlling hyperglycemia and reducing the dose and frequency of insulin administration. Vijayasaradi capsule is an antidiabetic herbal formulation mainly utilized to treat hyperglycemia. Objective: This study aimed to evaluate the clinical efficacy of Vijayasaradi capsule as add-on management in the cases of insulin-dependent type 2 diabetes. MATERIALS AND METHODS: Seventy-nine patients of either sex with insulin-dependent diabetes mellitus (T2-IDDM) between 18 and 70 years were studied. The intervention for the control group (n = 38) was hypoglycemic drugs with insulin injections. The trial group (n = 41) was treated with the Vijayasaradi capsule, two capsules (500 mg each) thrice daily before food, hypoglycemic medicine, and insulin injection. The duration of the study was 3 months, and follow-ups were done weekly. Percentage changes of reduction in the units of insulin therapy, fasting and postprandial blood sugar levels, and hemoglobin A1c before and after the treatment and the associated subjective symptoms of type 2 diabetes were the primary outcome measures. RESULTS: The trial drug significantly decreased fasting blood sugar (P = 0.02) and postprandial blood sugar (P = 0.0001). The average insulin dose was also reduced from 33.27 ± 19 to 28.8 ± 80 units. A significant reduction (P = 0.001) in hemoglobin A1c was observed after the treatment. After the treatment, reduction in the maximum average insulin dose was also observed. CONCLUSION: Vijaysaradi capsule can be used as an add-on therapy to manage hyperglycemia and reduce insulin doses in patients with T2-IDDM.

Relationship between serum high-sensitivity C-reactive protein (hs-CRP) and glycated hemoglobin (HbA1c) in South Indian population

Introduction and Aim: Cardiovascular disease are a leading cause of death in the world. Atherosclerosis plays the most important role in its pathophysiology. It is a slowly progressing chronic inflammatory process resulting in increased levels of inflammatory markers in serum. hs-CRP is a novel biomarker of coronary heart disease risk prediction. Type 2 diabetes mellitus individuals are at an increased risk of developing cardiovascular diseases. In this study, we aim to find the association of HbA1c with hs-CRP in the South Indian population. Materials and Methods: This was a retrospective study. The study participants were categorised into 3 groups based on their serum hs-CRP levels: Group 1 with hs-CRP &lt; 1.0 mg/L; group 2 with hs-CRP 1.0 – 3.0 mg/L and group 3 with hs-CRP &gt; 3.0 mg/L. The sample size was estimated to be 40 for each group. Age, fasting blood glucose, postprandial blood glucose, HbA1c, hs-CRP, total count, and ESR were collected. Statistical analyses were performed with SPSS version 16.0. Results: Age showed no significant difference among the groups. FBS, PPBS, HbA1c, TLC, and ESR showed a significant difference among the 3 groups. TLC, FBS, PPBS, and HbA1c had a significant positive correlation with hs-CRP. Conclusion: hs-CRP has a statistically significant positive correlation with HbA1c, fasting blood sugar, and postprandial blood sugar Additionally, we also observed that total leukocyte count had a significant positive correlation with hs-CRP and HbA1c. Hence, our results show that impaired glycemic control is associated with an increased risk of developing cardiovascular diseases.

Clinical Effects of Insulin Glargine and Acarbose Tablets in the Treatment of Diabetes Mellitus in the Elderly and Analysis of Glycosylated Hemoglobin

Objective: To analyze the clinical effects of insulin glargine and acarbose tablets in the treatment of diabetes mellitus in the elderly and the analysis of glycosylated hemoglobin. Methods: Patients (80 cases) from Taizhou City Hospital of Traditional Chinese and Western Medicine (January 2021–December 2022) were randomly divided into two groups (40 cases/group). Patients in the control group were treated with acarbose tablets, whereas those in the observation group were treated with insulin glargine and acarbose tablets. The clinical effects were compared. Results: The difference in blood glucose level and quality of life score between the two groups before treatment was insignificant (P &gt; 0.05). The total effective rate (97.5%) of the observation group was significantly higher than that of the control group (85.0%); the blood sugar indices of the observation group were significantly lower than those of the control group; and the observation group scored higher in the quality-of-life scale than the control group (P &lt; 0.05). Conclusion: Diabetes in elderly is characterized by repeated attacks. The elderly often suffers from chronic diseases, such as cardiovascular disease and respiratory system disease, making it is challenging to achieve the desired effect in treatment. Therefore, it is necessary to explore new treatment methods for the management of diabetes in the elderly. Insulin glargine is a new type of insulin analog, which can last for 24 hours, effectively controlling patients’ blood sugar level. According to research, insulin glargine can effectively regulate the blood sugar level of diabetic patients for an extended period of time, significantly lower the fasting blood sugar, and reduce the complications caused by hypoglycemia. Acarbose tablet, on the other hand, is an alpha-glucosidase inhibitor, which prevents the breakdown of starch into sugar, thereby reducing postprandial blood sugar levels. For diabetic patients, especially those whose staple food is starch, acarbose is a suitable drug.

Prevalence of Karapada daha-suptata in Madhumeha with reference to diabetic peripheral neuropathy in type 2 diabetes mellitus patients.

Background: Diabetes mellitus is a major health issue in today's world. Main threat is not the disease itself but its complications like nephropathy, retinopathy and neuropathy etc. Diabetic peripheral neurropathy is the leading cause of foot ulcers, their complications like limb amputation and cost associated with it. Madhumeha which has been described as 'Maharogas' i.e. difficult to treat disease has many similarities with Diabetes mellitus can be understood and studied as same disease. Ayurveda has mentioned the causes, pathophysiology and symptoms of Diabetic Peripheral Neuropathy as 'karapada daha -suptata' in purvarupa lakshanas and upadrava lakshanas but inscattered form. It needs depth study to understand the concept of Karapada daha- suptata (DPN).&#x0D; Objective: To study prevalence of Karapada daha-suptata (Diabetic peripheral neuropathy) and the relation of Karapada daha- suptata (DPN) with age, gender, duration of disease Madhumeha, blood sugar level, alcohol and smoking habit etc in Madhumeha patients.&#x0D; Method :A cross sectional study was carried out in Tribhuvan University Ayurveda Teaching Hospital,. Madhumeha patients (Type 2 diabetes mellitus) patients were recruited for the study. MNSI (Michigan Neuropathy Screening Instrument) was used to diagnose Karapada daha- suptata (Diabetic peripheral neuropathy).&#x0D; Result: Among 100 patients 31% patient had Karapada daha- suptata (DPN). Our study showed that the prevalence of Karapada daha-suptata(DPN) increased with increasing age of the study population. Similarly prevalence of Karapada daha -suptata in patients with disease duration of Madhumeha (DM2) for more than 5 years was 61.29% where as patients having Diabetes for less than 5 year was 38.71%. Prevalence of Karapada daha-suptata (DPN) was very high (43.13%) among uncontrolled fasting blood sugar level (&gt;126mg/dl) and (47.5%) among uncontrolled post prandial blood sugar level (&gt;200mg/dl). In this study mean Fasting blood sugar level was 177.0323 mg/dl in the patients with Karapada daha-suptata(DPN) and mean post prandial blood sugar level in patients with diabetic peripheral neuropathy was 239.1613mg/dl.&#x0D; Conclusion: Our study showed Karapada daha-suptata/DPN is highly prevalent and increasing as the duration of disease Madhumeha increses but its not uncommon in newly disagnosed disease too. This study showed significant relation of Karapada daha suptata with disease duration of Madhumeha, level of blood sugar, and increasing age of the patients.Study showed no significant differences in the prevalence of Kara pada daha- suptata in male and female patients and with the smoking habit of the patients.

Determinants of coronary heart disease among adults: a case-control study

BackgroundAccording to recent World Health Organization data, coronary heart disease (CHD) remains the leading cause of death worldwide. Although the risk factors of this disease are well known, the strength of these factors varies in different populations. The aim of the study was to assess the determinants of CHD in Indonesian adults aged 25 years and over. MethodsA case–control study was carried out involving 592 subjects aged 25 years and over (444 controls and 148 cases). Participants were interviewed using validated questionnaires. Physical examinations and supporting examinations were conducted. The Chi square test, Fisher’s exact test, and independent t test were used to analyze the data. To determine independent predictors of CHD, the odds ratio (OR) was determined via the multiple logistic regressions test. ResultsThe CHD subjects (case group) showed higher blood sugar and systolic pressure than non-CHD subjects (controls), with mean fasting blood sugar of 92.53±27.05 mg/dL vs 88.29 ±23.43 mg/dL (p=0.038), 2-hour postprandial blood sugar of 133.15±65.09 mg/dL vs 120.87±44.60 mg/dL (p=0.000), and systolic blood pressure of 89±27.62 mmHg vs 129.98±10.58 mmHg (p=0.002). The logistic regression analysis in the case group showed that higher education (college) had a 2.32-fold greater effect (95% CI. 1.01-5.35) on CHD incidence compared to the control group. ConclusionsThis study has demonstrated that the most frequent risk factor for CVD in adults aged 25 years and over is higher education. Control and prevention of CHD need to be done with regular control of blood sugar levels and blood pressure to stabilize them within normal limits.

A Prospective Observational Study of Comparison, Safety, and Efficacy of Dipeptidyl Peptidase-4 Inhibitors for the Treatment of Type 2 Diabetes Mellitus in A Tertiary Care Hospital

Aims: The purpose of the study was to determine the safety and efficacy of Dipeptidyl Peptidase 4-Inhibitor as mono-therapy and in combination therapy. The impact of age, disease duration and gender on the efficacy of DPP-4 inhibitors were also studied. Materials and Methods: A prospective observational study was conducted among patients with type 2 diabetes mellitus. The study consisted of 6 groups: Metformin+Glimepiride, Metformin+Teneligliptin, Glimepiride+Teneligliptin, Metformin only, Teneligliptin only and Glimepiride only. Fasting and Post Prandial Blood Sugar and HbA1c were monitored before and after 6 months of therapy. Results: In combination therapy, the adverse effects were higher in Glimepiride and Teneligliptin group followed by Metformin and Glimepiride and Metformin and Teneligliptin. The mean FBS reduction was 21.57 mg/dl, 28.32 mg/dl, and 20.08mg/dl in Metformin+Glimepiride, Metformin+Teneligliptin and Glimepiride+Teneligliptin, respectively. The mean Post-Prandial Blood Sugar reduction was 27.63mg/dl, 42.78mg/dl, 34.13mg/dl in Metformin+Glimepiride, Metformin+Teneligliptin and Glimepiride+Teneligliptin, respectively. The mean HbA1c reduction was 1.30%, 1.41%, and 0.80% in Metformin+Glimepiride, Metformin+Teneligliptin and Glimepiride+Teneligliptin, respectively. Conclusion: Metformin and Teneligliptin combination therapy and Teneligliptin monotherapy were safe and efficacious compared to all other oral hypoglycemic drugs under study. There was no significant impact of gender, BMI class and disease duration on the drug’s efficacy.

Screening of Potential α-Glucosidase Inhibitors from the Roots and Rhizomes of Panax Ginseng by Affinity Ultrafiltration Screening Coupled with UPLC-ESI-Orbitrap-MS Method.

Panax ginseng was a traditional Chinese medicine with various pharmacological activities and one of its important activities was hypoglycemic activity; therefore, panax ginseng has been used in China as an adjuvant in the treatment of diabetes mellitus. In vivo and in vitro tests have revealed that ginsenosides, which are derived from the roots and rhizomes of panax ginseng have anti-diabetic effects and produce different hypoglycemic mechanisms by acting on some specific molecular targets, such as SGLT1, GLP-1, GLUTs, AMPK, and FOXO1. α-Glucosidase is another important hypoglycemic molecular target, and its inhibitors can inhibit the activity of α-Glucosidase so as to delay the absorption of dietary carbohydrates and finally reduce postprandial blood sugar. However, whether ginsenosides have the hypoglycemic mechanism of inhibiting α-Glucosidase activity, and which ginsenosides exactly attribute to the inhibitory effect as well as the inhibition degree are not clear, which needs to be addressed and systematically studied. To solve this problem, affinity ultrafiltration screening coupled with UPLC-ESI-Orbitrap-MS technology was used to systematically select α-Glucosidase inhibitors from panax ginseng. The ligands were selected through our established effective data process workflow based on systematically analyzing all compounds in the sample and control specimens. As a result, a total of 24 α-Glucosidase inhibitors were selected from panax ginseng, and it was the first time that ginsenosides were systematically studied for the inhibition of α-Glucosidase. Meanwhile, our study revealed that inhibiting α-Glucosidase activity probably was another important mechanism for ginsenosides treating diabetes mellitus. In addition, our established data process workflow can be used to select the active ligands from other natural products using affinity ultrafiltration screening.