Prandial Blood Glucose Research Articles

Relationship between Serum Zinc Level and Retinopathy in Type 2 Diabetic Patients

Abstract Background Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia caused by insulin resistance (IR) or impaired insulin production. Diabetic retinopathy (DR) is a common microvascular disorder which occurs in type 2 diabetes mellitus (T2DM) patients due to chronic hyperglycemia. Previous studies reported that serum zinc (Zn) was associated with certain diabetic microvascular complications. Objective To evaluate relation between serum zinc level and diabetic retinopathy in patients with type 2 diabetes mellitus. Subjects and Methods The current study included 60 subjects with their ages ranging from 18- 60, selected from diabetes and ophthalmology outpatient clinics of Ain Shams University Hospitals for 7 months in a period from July 2022 to January 2023 with matched age and sex . fasting and post prandial blood glucose, hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP),serum creatnine, LDL, HDL, TG,TC and serum zinc levels were measured among groups. Results The study shows statistically significant difference between DM type II subgroups regarding duration of disease (yrs) being higher in DM II with retinopathy 12.5 (10.5 – 16.5) than DM II without retinopathy 9 (6 – 12) with p < 0.001. serum Zn levels were significantly lower in the DR group than the controls and diabetic without retinopathy.in whole DM type II group, there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, LDL, TC, FBS, 2PP and serum creatinine level, while in DM II without retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, LDL, TC and FBS and also in DM type II retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, FBS, 2PP and serum cretainine level .There is no statistically significant difference found between control group and DM type II group regarding weight, height and BMI of the studied patients with p-value = 0.108, 0.198 and 0.343; respectively. There is no statistically significant difference found between control group and DM type II group regarding systolic and diastolic blood pressure of the studied patients with p- value = 0.554 and 0.405; respectively. Conclusion Our study suggested that lower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications. Patients with lower serum zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function. Older age, higher HbA1c level, and the prevalence of DN were risk factors related to the lower serum zinc level.

Effects of Ellagic Acid on Glucose and Lipid Metabolism: A Systematic Review and Meta‐Analysis

Background. Abnormal glucose and lipid metabolism (GALM) serve as both a cause and an inducer for the development of the disease. Improvement and treatment of GALM are an important stage to prevent the occurrence and development of the disease. However, current clinical treatment for GALM is limited. Ellagic acid (EA), a common polyphenol present in foods, has been shown to improve abnormalities in GALM observed in patients suffering from metabolic diseases. Objective. This study used a meta‐analysis method to systematically assess the effects of EA on GALM. Method. As of November 8, 2023, a comprehensive search was conducted across 5 databases, namely, PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar to identify randomized controlled trials (RCTs) in which EA served as the primary intervention for diseases related to GALM. The risk of bias within the included studies was assessed according to the Cochrane Handbook. All statistical analyzes were performed using RevMan 5.4 software. Results. In this study, a total of 482 articles were retrieved, resulting in the inclusion of 10 RCTs in the meta‐analysis. The results showed that EA could reduce fasting blood glucose (FBG) (p = 0.008), increase insulin secretion (p = 0.01), improve insulin resistance index (HOMA‐IR) (p = 0.003), decrease triglyceride (TG) (p = 0.004), and reduce cholesterol (Chol) (p = 0.04) and low‐density lipoprotein (LDL‐c) (p = 0.0004). EA had no significant effect on waist circumference (WC), body weight (BW), body mass index (BMI), 2 hours after prandial blood glucose (2 h‐PG), total cholesterol (TC), and high‐density lipoprotein (HDL‐c). Conclusions. The effect of improvement in glucose and lipids of EA was closely related to the dose and the intervention time. EA can improve GALM caused by diseases. To corroborate the findings of this study and improve the reliability of the results, EA is imperative to refine the research methodology and increase the sample size in future investigations.

Calisthenics versus Pilates training on glycemic control and body fat in overweight individuals with type 2 diabetes mellitus

BACKGROUND: Physical activity plays an important role in management and preventing complications of type 2 diabetes mellitus (DM). Effectiveness of Pilates on DM showed that there was improvement in glucose control. Presently, resistance training forms are becoming very popular for weight loss and DM. Calisthenics is a relatively new form of resistance exercise training that has been less studied in obese and diabetic individuals. STUDY PURPOSE: To evaluate and compare the effect of Calisthenics and Pilates training approaches on percentage body fat and glycemic control (HbA1C, Post Prandial Blood Glucose (PPBG)) in overweight individuals with type 2 Diabetes mellitus (DM). METHODS: Thirty (n = 30) over weight individuals with type 2 DM with HbA1C levels >6.5% were recruited for the study. The participants were randomly allocated to calisthenics (CG) and Pilates (PG) study groups who received respective exercise interventions for 12 weeks. The outcome measures were HbA1C, PPBG and percentage body fat assessed at pre and post intervention. RESULTS: Both CG and PG study groups showed statistically significant difference for glycemic control (HbA1C, PPBG) post 12 week intervention. However, significant improvement was noted in CG than PG in terms of HbA1c (p = 0.03), PPBG (P = 0.01) and body fat percentage (p < 0.0001). CONCLUSION: Calisthenics exercise training was more effective than the Pilates training in achieving long term (HbA1c) and post meal (PPBS) glycemic control with significant reduction in body fat percentage in overweight individuals with type 2 DM.

Correlation of Fasting and Postprandial Blood Glucose with Hba1c in monitoring Glycemic Control of Diabetic Patients in FCT Abuja, Nigeria

Achieving glycemic control or reduction of hyperglycemia would significantly decrease most of the complications associated with hyperglycemia in diabetes mellitus. It has been stated that measurement of glycosylated hemoglobin (HbA1C) remains the gold standard for the assessment of glycemic control; there is no consensus whether the Fasting or Postprandial is a better predictor of glycemic control in poor resource setting where HbA1C is not easily accessed or available. The aim of this research is to determine fasting and postprandial plasma glucose and their correlation with HbA1C in glycemic control. A cross sectional case control study was carried out from January, 2023 to July, 2023; a total of 203 participants were recruited into the study. Fasting blood glucose (FBG), 2 hours post prandial blood glucose (2HPBG) were determined in all the subjects using the enzymatic glucose oxidase method for glucose estimation according to the instruction of the manufacturer, while HbA1C was determined using Boroaffinity Chromatographic method according to the instruction of the manufacturer. Statistical data analysis was carried out using SPSS software (Version 25.0, IBM Corp., Armonk, New York USA), and p<0.001 were defined as statistically significant; the correlation between the parameters was carried out using Pearson’s correlation. Both the FBG and the 2HPBG showed positive correlation with HbA1C in the diabetic and control subjects; however, the level of correlation varies. The correlation of FBG and 2HPBG with HbA1C is directly proportional to the concentration of blood glucose level. The FBG for the control and the subjects are 7.40±1.59 and 143.67±5.01, with HbA1C of 4.45±0.05; 6.26±1.47 respectively. The 2HPBG for the control and the subjects are 120.70±1.75 and 192.92±7.05, with HbA1C of 5.56±0.07; 7.82±0.22 respectively. The FBG correlation to HbA1C is r= 0.875, p<0.001; while 2HPBG is r= 0.908, NEWPORT INTERNATIONAL JOURNAL OF PUBLIC HEALTH AND PHARMACY (NIJPP) Volume 4 Issue 2 2023 OPEN ACCESS ©NIJPP ONLINE ISSN: 2992-5479 Publications 2023 PRINT ISSN: 2992-605X Page | 10 p<0.001. The study showed positive correlation of FBG and 2HPBG with HbA1C, since HbA1C is the value of the percentage concentration of glucose at a given period of time; FBG, 2HPBG and HbA1C can be used to evaluate the degree of glycemic control in diabetic patients’ management, in order to minimize or avoid diabetic complications. Keywords: FBG, PBG, Diabetes, HbA1C, Correlation, Complications

Effect of cooking and storage temperature on resistant starch in commonly consumed Indian wheat products and its effect upon blood glucose level

Background/objectivesThe health benefits provided by resistant starch have been well documented; however, few studies are available on the resistant starch content of wheat products in India. Moreover, few studies have examined the in vivo efficacy of resistant starch in wheat products in improving glucose levels. This study was conducted to evaluate the effect of cooking and storage temperature on the formation of resistant starch in Indian wheat products and its effect on blood glucose levels in humans and rats.MethodsWheat products were prepared by common cooking methods including roasting (Chapati), boiling (Dalia), Shallow frying (Paratha), and Deep frying (Poori). They were then stored at different temperatures including freshly prepared within 1 h (T1), stored for 24 h at room temperature (20-22°C) (T2), kept at 4°C for 24 h (T3) and reheated after storing at 4°C for 24 h (T4). The products were then analyzed for proximate composition (moisture, crude protein, crude fat, ash crude fibre, and carbohydrates). The effect of different cooking methods and storage temperatures on Resistant, non-resistant and total starch, total dietary fibre (soluble and insoluble), in vitro starch digestion rate (rapidly and slowly digestible starch), amylose and amylopectin content were analysed using standard operating procedures. The effect of products found to have higher resistant starch was studied on the post prandial blood glucose response of 10 healthy individuals using change in by analysing their glycemic index and glycemic load of wheat products. Further, the effect of resistant starch rich chapati on the blood glucose level of rats was also studied. Tukey’s test in factorial CRD was used to assess the effect of cooking and temperature on various parameters.ResultsThe amount of resistant starch was found to be high in dalia (boiling, 7.74%), followed by parantha (shallow frying, 4.94%), chapati (roasting, 2.77%) and poori (deep frying 2.47%). Under different storage temperatures, it was found high in products stored at 4°C (T3), followed by products stored at room temperature (T2), reheated products (T4) and lesser in freshly prepared products (T1). The glycemic index and glycemic load were found low in chapati (43, 32.3) and dalia (41.1, 28.6) stored at 4°C (T3) compared to others. The resistant starch content found in chapati stored at T3 was found to be more effective at reducing blood glucose levels in rats from 291.0 mg/100 mL to 225.2 mg/100 mL in 28 days of study compared to freshly prepared chapati (T1) and stored at room temperature (T2).ConclusionCooking methods including boiling, roasting and shallow frying increased the amount of resistant starch in foods, but cooking methods such as deep frying decreased the amount of resistant starch in food. Products stored at 4°C and at room temperature for 24 h increased the amount of resistant starch whereas the products that were freshly cooked and reheated decreased the amount of resistant starch in foods. At 4°C the stored products have a high amount of insoluble dietary fibre, slowly digestible starch, high amylose and low glycemic index. They take time to digest, meaning that they slowly increase blood glucose levels. The effect of insoluble dietary fibre and resistant starch in the inhibition of glucose diffusion in the small intestine is suggested to be due to the absorption or inclusion of the smaller sugar molecules. In vivo research showed that fibre and resistant starch in the digestive system of rats acts as the main factors in slowing glucose absorption and reducing a rise in blood glucose levels by promoting glycogen synthesis and inhibition of gluconeogenesis.

Effect of Amla Powder and Turmeric Powder Consumption on Geriatric Subjects Suffering from Non-Insulin Dependent Diabetes Mellitus

Diabetes mellitus is the most challenging public health problem of 21st century. International Diabetes Federation, (2015) reported 69.1 million cases of diabetes in India. Worldwide 2011 estimation of prevalence of diabetes in the elderly population (60 years & above) is between 15% to 20% (IDF Diabetes Atlas, 2012). The present study titled “Effect of amla powder and turmeric powder consumption on geriatric subjects (60 years & above) suffering from non-insulin dependent diabetes mellitus” involved multistage random sampling technique. The study was conducted on 18 geriatric subjects residing in Kala Mahal & Pipal Mandi area of Agra city, randomly divided into 2 groups- experimental group (N1=8) and control group (N2=9). 2.5g each of amla powder and turmeric powder was consumed by experimental geriatric non-insulin dependent subjects for 45 continuous days and its effect on fasting and post prandial blood glucose level was recorded and compared with the control group. Demographic, anthropometric and dietary patterns of both groups was also recorded. Statistical tests were applied and it was found that consumption of amla powder and turmeric powder was significantly effective on geriatric subjects (60 years & above) and there was a significant drop in the fasting & post prandial blood glucose level of experimental group on 45th day of feeding trial. In the 24-hour diet recall average consumption of thiamine (mg) was significant at 95% confidence interval (p<0.05)nwhen t-test was applied while energy (kcal), protein (g), carbohydrates(g), fat(g), phosphorus (mg), iron (mg), vitamin A (mcg), riboflavin (mg), niacin (mg) and vitamin C (mg) intake were not significant (p>0.05).

The Prevalence of Diabetic Retinopathy in Type 1 Diabetic Subjects Attending Ain Shams Diabetes Outpatient Clinic

Abstract Background Diabetic retinopathy is a chronic progressive, potentially sight threatening disease of the retinal microvasculature associated with the prolonged hyperglycaemia and other conditions linked to diabetes mellitus such as hypertension Aim detect the prevalence of diabetic retinopathy in type 1 diabetic subjects in relation to duration of diabetes, control of blood glucose level and other micro-vascular complications. Patients and Methods This was a cross sectional study conducted on 120 patients attending diabetes outpatient clinic at ain shams university hospital during period from april 2020 to October 2020 to detect the prevalence of diabetic retinopathy in type 1 diabetic subjects in relation to duration of diabetes, control of blood glucose level and other micro-vascular complications Patients were subjected to full history taking and clinical examination. DN4 questionnaire for neuropathy assessment, Laboratory investigations included; fasting blood sugar, 2 hour post prandial blood glucose, (glycated haemoglobin HBAIC), serum creatinine and albumin/creatinine ratio, also all patients subjected to detailed fundus examnation using ophthalmoscope. Results Our study show that total patients of study is 120 patient, fundus examination results revealed that 66 of them normal fundus (55%), 17 mderate NPDR (14.17%), 8 sever NPDR (6.67%), 29 PDR (24.17%). Also show that there is statistically significant relation between fundus examination results and (age of the patient, duration of diabetes mellitus and smoking) also clinical data (SBP, DBP, pulse and BMI) also laboratory data (FBS, 2h PPBG, HBA1C and albumin /creatinine ratio). Also show that there is statistically significant relation between fundus examination results and total insulin dose and DN4 questionnaire. The study also show that there is no significant relation between fundus examination results and (gender, s. creatinine level, family history of diabetes or type of basal insulin). Conclusion DR. is a progressive blinding disease that affects 4.2 million people worldwide, making it a leading cause of blindness in adults and this number is expected to continue to increase. DR. affected by age of the patient, duration of diabetes mellitus and smoking also clinical data (SBP, DBP, pulse and BMI) also laboratory data (FBS, 2h PPBG, HBA1C and albumin /creatinine ratio) and total insulin dose.

Comparative Study between Metformin and Insulin in Controlling uncomplicated Gestational Diabetes Mellitus

Gestational diabetes always accompanies an increased maternal and neonatal risk. Insulin is the standard therapy but causes multiple complications. Metformin has less complications. This study aims to assess the efficacy of metformin in controlling maternal blood glucose level compared to insulin in women with gestational diabetes .A randomized controlled trial conducted in the obstetric department in Salah Al-Deen general Hospital during the period from 1st February - 31st July 2022. Total sample of 100 pregnant women suffered from gestational diabetes at (24-28week) gestational age were recruited randomly. The patients were divided into two groups: 1-Metformin group (50 patients). 2-Insulin Group (50 patients). Fasting and post prandial blood glucose levels 2 h after breakfast were done at each visit and HbAlc each trimester. Follow up was continued till delivery to evaluate the pregnancy outcome The mean HbAlc was significantly higher among Insulin group (5.8± 0.5) than in Metformin group (5.4 ± 0.8). Preeclampsia was lower among Metformin group (14%) than Insulin group (19.6%). hypoglycemia episode was significantly lower among Metformin group (14%) than Insulin group (41.3%), Caesarean delivery was higher among Insulin group (58.7%) than Metformin group (37.2%). The mean birth weight was significantly higher among Insulin group (3761.4±470) than Metformin group (3540.9±338). Prematurity was found among (8.7%) of the Insulin group in comparison to (4.7%) of the Metformin group. Prematurity was non significantly higher among Insulin group (8.7%) than Metformin group (4.7%) .Metformin is effective and safe in the glycemic control of gestational diabetes, with better maternal and neonatal outcomes.

Efficacy and Quality of Life Assessment of ‘Kapiva Dia Free Juice’ Treatment as an Adjuvant for Type 2 Diabetes

Background: Diabetes mellitus (DM) is characterized by chronic hyperglycemia, defects in insulin secretion, action, or both, and is fuelled by the obesity epidemic. Conventional medication offers side effects and insufficient glycaemic management in chronic use. Safe and effective adjuvants from the natural source need to be studied clinically. Methods: 30 patients of diabetes mellitus were enrolled in the study for 3 months. The interventional product kapiva dia free juice was administered twice daily along with the conventional antidiabetics. Fasting and post prandial blood glucose were measured every month while HbA1c, serum C-peptide level, BMI, biochemical and hematological investigations on baseline and day 90. Data was analysed using SPSS (version 19). Result: HbA1c was reduced significantly by 11.11% after 90 days of treatment. The percentage of significant reduction in fasting and post prandial blood glucose was 30.05% and 33.11% respectively. BMI was significantly reduced by 2.92% with average weight reduction of 2.17 kg. Insulin resistance was also reduced significantly which was evident by lowered C-Peptide by 28.81%. All the biochemical and hematological parameters were found within normal range and no adverse events were reported related to the investigational product. Conclusion: Kapiva dia free juice is an effective adjuvant treatment in diabetes mellitus which can improve glycemic control, reduce BMI and insulin resistance. This reduces cardiac risk and improves antidiabetic medication effectiveness. All hematological parameters were well within limits in the study which indicates the safety of the product.

Role of yoga in type 2 diabetes mellitus

Type 2 Diabetes Mellitus (T2DM) has become most common problem worldwide. Yoga provides best means of self-improvement and gaining full potential of one’s body, mind & soul. It has been proved that pranayama and certain Asana’s help in lowering blood glucose, balancing blood pressure and calms nervous system. The asanas improve the sensitivity of β-cells to glucose, improves insulin secretion, and improves glucose uptake. Hence, Yogic asanas are important for preventing and curing many ailments. The effect of yogic practices in diabetics has to be investigated well. To assess the effect of yoga on blood glucose levels and anthropometric parameters before and after doing yoga in T2DMpatients. A total of 100 T2DM diabetic patients in age group 30-60 years were taken. Effect of Yoga on fasting Blood glucose (FBG), Post prandial blood glucose (PPBG), HbA1c levels and serum insulin were assessed. Anthropometric parameters like BMI and waist hip ratio were also assessed. There was significant decrease in FBG, PPBG and HbA1c levels with p value<0.001 after doing yoga. There was also significant improvement in serum insulin levels and decrease in BMI & waist hip ratio. A significant improvement in the blood glucose levels occurred in subjects who practiced Yoga. There was also lowering of the drug requirement.

ASSESSMENT OF STATUS OF DIABETES MELLITUS IN FIRST DEGREE RELATIVES OF DIABETES MELLITUS TYPE II PATIENTS

Type 2 diabetes mellitus is an important public health problem worldwide, and its prevalence is increasing in both developed and developing nations. Diabetes mellitus presents multiple challenges to public health, this disease contributes to signicant morbidity, including cardiovascular, cerebrovascular, and renal disease, premature mortality, may progress undetected for years and is often not diagnosed until onset of clinical symptoms or complications. This hospital based cross sectional study was conducted on a consecutive sample of 255 individuals who were rst degree relatives (FDR) of patients with type 2 diabetes mellitus attending the Medicine department out patients (OPD) & Inpatient (IPD) of R.D.B.P Jaipuria Hospital, Jaipur attached with RUHS CMS Jaipur. The participants were divided in three groups as non-diabetic, pre-diabetic and diabetic on the basis of, fasting, post prandial blood glucose and HBA1C levels performed at the time of enrollment. First degree relatives who were already diagnosed with type-2 diabetes mellitus prior to the time of enrolment were not included. Out of total 255 participants, Non-Diabetics were 141(55.29%), Pre-Diabetics were 94(36.86%) and Diabetics were 20 (7.84%). Family history is an important information that should always be included in screening procedure. By identifying patients with pre-diabetes and diabetes and initiating early interventions in lifestyle and/or pharmacological treatments, the progression can be delayed, or in some cases even prevented. Earlier the diagnosis, easier it is to reverse the condition and curb the development of grave complications

Real-world Clinical Effectiveness on Glycaemic Parameters, Safety and Additional Benefits of Glargine U300 (Toujeo®) Initiation after Oral Antidiabetic Drug Failure in Insulin-naïve Patients with type 2 Diabetes Mellitus.

Several studies have proved the advantages of second-generation insulin analogs in lowering intra-individual variability in plasma insulin levels, flexibility in dosing, a sustained glucose-lowering effect, and decreasing the risk of hypoglycemia. Glargine 300 is one of the newer second-generation basal insulin analogs to have been approved for both type 1 and 2 diabetes. The present study aims to assess the real-world clinical effectiveness and safety of Glargine U300 (Toujeo®) initiation after oral antidiabetic drug failure in insulin-naïve patients with T2DM. A prospective, observational study was conducted where participants were interviewed regarding their basic demographics, body weight, and treatment details. Glycemic parameters (HbA1C%, Fasting Plasma Glucose, and Post Prandial Blood Glucose) were observed in the initial 6 months, and changes were noted and compared. Any hypoglycemic events or other complications were also noted. Data collected were statistically analyzed. The study included a total of 188 patients. Treatment with glargine 300 significantly reduced the mean HbA1C level from 9.78% at baseline to 7.90% at the end of 6 months of treatment (p < 0.001). 10.60% of patients achieved the glycemic target of ≤7.0% by the end of 6 months, while only 6.90% were within the target range at baseline. Similarly, significant reduction in FPG was observed at the end of 6 months treatment period with Glargine U300. A significant increase in dose requirement was observed throughout the study phase (p < 0.001). Incidence of hypoglycemia was noted in 2.12% of subjects. The lower incidence statistics of hypoglycemia coupled with sustained positive glycemic effects, stands out to be a prominent advantage of Glargine U300 over its other congeners.

Ocimum Sanctum Linn Extract As An Adjuvant Therapy For Effective Glycaemic Control In Type II Diabetes Mellitus

Ocimum sanctum Linn extract as an adjuvant therapy for effective glycaemic control in type II diabetes mellitus, a case control study was conducted at selected hospitals of Sangli, Miraj, Kupwad corporation area. The objectives of the study were to assess the blood glucose levels in diabetic patients before and after treatment with Ocimum sanctum Linn extract combined with oral hypoglycaemic agent and to compare these blood glucose levels in experimental and control groups. The hypothesis H0 was that there would be no significant difference between after the administration of Ocimum sanctum Linn leaves extract on blood sugar level of experimental and control group and H1 there is significant difference between pre-test and post-test blood sugar level of experimental and control group. The study used the quantitative research approach. The conceptual framework was used in this study was ERNESTINE WIEDENBACHS PRESCRIPTIVE THEORY. Total 60 samples were selected for the study by non-probability convenient sampling technique (30 for experimental 30 for control group). Experimental group had given Ocimum sanctum Linn extract with OHA for 20 days,whereas control group continued OHA treatment only. Demographic variables and blood glucose level data was collected. The data was analysed using the descriptive and inferential statistics such as mean, standard deviation, frequency and percentage were utilised as well as inferential analysis such as chi square test, paired t and unpaired t test. The study results suggested that the mean value of pre and post-test fasting blood glucose levels in the experimental group were 166.00 and 132.37 mg% respectively. The mean pre-test and post-test fasting blood glucose levels in control group were 169.63 and 163.50 mg% respectively. The mean value of pre and post-test post prandial blood glucose levels in the experimental group were 170.27 and 141.31 mg% respectively. The mean pre-test and post-test post prandial blood glucose levels in control group were 166.47 and 159.87 mg% respectively. The result of comparison of post prandial blood glucose levels in experimental and control groups had calculatedt value of 50.18 and pvalueof0.000 which suggests that there is a significant difference in the post prandialblood sugar levels of the experimental and the control groups. The study concluded that Ocimum sanctum Linn can be recommended for the treatment of moderate diabetes mellitus in combination with oral hypoglycaemic agents to get the synergistic effect of both the medicines for effective control of hyperglycemia.

Role of glycated hemoglobin in microvascular complications in type 2 diabetes mellitus: cross sectional study

Background. Diabetes mellitus (DM) is a complex disorder which defects mainly vascular complications. Complications increase the morbidity and mortality associated with the disease, reducing life expectancy by 10–15 years. Diabetic neuropathy (DN) is a frequent complication of DM and is defined as the presence of peripheral nerve dysfunction after exclusion of other causes. Poor glycaemic control and chronic hyperglycaemia are the major risk factors for DN. Most important treatment of DN remains good glucose control generally noted as HbA1c ≤ 7.5 %. The purpose of this cross-sectional study is to investigate the role of glycated hemoglobin in microvascular complications in type 2 diabetes mellitus. Materials and methods. This cross-sectional study was carried out in Teerthanker Mahaveer Medical College and Research Center, Moradabad from Jan 2016 to December 2016 in which 100 type 2 diabetic mellitus (T2DM) patients in the age group of 35–69 years were included. Patients were divided into 2 groups of 50 each. Group 1 constituted of T2DM patients without any microvascular complication and group 2 includes T2DM patients with microvascular complications. Examination of patients included recording of medical history, pulse rate and blood pressure. Neuropathy was assessed by clinical examination based on modified NDS procedure, which included examination of vibration, pin prick sensation, temperature sensation on dorsum of foot and Achilles tendon reflex. Blood samples were collected by venepuncture and accordingly biochemistry analysis was carried out (Fasting Blood Glucose, post prandial blood glucose and HbA1c were recorded). HbA1c estimation was done by using COBAS fully automated analyser. Results. Among recruited patients, Mean fasting, PPBS level, HbA1c among test group was significantly more than control group. In control group significant correlation of HbA1c is found with age, weight and BMI and in test group significant correlation of HbA1c is observed with age and duration of DM. Significant correlation of HbA1c with FBS and PPBS seen in both control group and in test group. Among test group, 19 patients were found to have DN and significant correlation of HbA1c is observed with NDS score. Conclusions. Increased HbA1c is closely associated with DN in T2DM patients and could be considered as a potent indicator for DN in these patients.

Side Effects Evaluation of the Use of Metformin and Glimepiride Combination In Type 2 Diabetes Mellitus Outpatients

The combination of metformin and glimepiride can significantly reduce fasting blood glucose, post prandial blood glucose, and HbA1c levels. Side effects that often occur in the use of metformin are gastrointestinal disturbances. This study aims to determine the side effects of using a combination of metformin and glimepiride in outpatient type 2 diabetes mellitus at a hospital in Gianyar. This research is an observational research and data collection is done with a cross sectional approach and analyzed using descriptive methods. Data was taken by looking at the patient's medical record, including name, medical record number, gender, age, drugs given, patient diagnosis, and patient complaints during therapy. Sampling used purposive sampling technique with a total of 70 patients who entered the inclusion criteria. The results show that the number of women (62.86%). The most age range suffering from type 2 diabetes mellitus is 56-65 years (52.86%). The highest percentage of people with type 2 diabetes mellitus had a basic education level (40.00%). The side effects obtained from the combination of metformin and glimepiride in patients with type 2 diabetes mellitus at the hospital were nausea and vomiting (31.43%), flatulence (25.71%), fatigue (17.14%), headache (15.72%), and hypoglycemia (10.00%).

Hypomagnesaemia among patients with type 2 diabetes mellitus and impaired glucose tolerance and its correlation with glycemic control: a cross-sectional study in a tertiary care hospital of Bangladesh

Background: Hypomagnesaemia is linked to insulin resistance in type 2 diabetes mellitus (T2DM) and chronic diabetic complications. Prevalence of hypomagnesaemia is high in patients with T2DM and multiple studies have shown evidence of effect of serum magnesium (Mg) level on glycaemic control in these patients. The aims of this study were to evaluate the frequency of hypomagnesaemia in hospitalized patients with T2DM and impaired glucose tolerance (IGT) and to evaluate its correlation with glycaemic control.&#x0D; Methods: This was a cross-sectional study conducted from November, 2016 to March, 2017 in BIRDEM General Hospital. Hypomagnesaemia was defined as serum Mg concentration &lt;0.7 mmol/L. Patients who had acute diarrhea or vomiting in previous 7 days, patients who had chronic diarrhea or malabsorpsion syndrome or who had recent history of taking diuretics were excluded from the study. Patients’ clinical information were collected using a structured questionnaire and laboratory information were collected from the hospital records.&#x0D; Results: Total patients were 100, including T2DM (92) and IGT (8). Thirty nine (42.4%) patients with T2DM and five (62.5%) patients with IGT had hypomagnesaemia. The median (IQR) serum Mg level in patients with T2DM was 0.77 (0.6-0.8) mmol/L and IGT was 0.6 (0.52-0.77) mmol/L. HbA1c was higher among patients with hypomagnesaemia than normal Mg level [median (IQR) 9.4 (7.8-12.7) % vs 8.85 (7.2-9.95) %] though it was not significant (p&gt;0.05). The mean fasting blood glucose (FBG) was 9.82 mmol/l in patients with hypomagnesaemia and 9.63 mmol/l in patients with normal serum Mg. Median 2-hour post prandial blood glucose level was 12 (10.4-16.15) mmol/L in hypomagnesaemia group and 11.7 (10.3-14.7) mmol/L in normal Mg group, though the difference was not statistically significant. There was negative correlation between serum Mg and HbA1c, FBG and post prandial blood glucose level (r, -0.075, -0.003. -0.006 respectively). Among the patients with hypomagnesaemia, the percentage of ischemic heart disease (IHD), diabetic retinopathy, diabetic nephropathy and diabetic neuropathy was 31.8%, 36.4%, 43.2% and 34.1% compared to 23.2%, 30.4%, 32.1% and 25% respectively in patients with normal Mg level.&#x0D; Conclusion: Around half of the patients with T2DM and IGT had hypomagnesaemia and patients with hypomagnesaemia were found to have relatively poor glycemic control and had increased rate of diabetic complications. Although relationship between serum magnesium level and glycemic control was not significant, it indicated the need of further research in this aspect.&#x0D; BIRDEM Med J 2022; 12(3): 207-211

Revealing Anti-diabetic potential of Siddha formulation Gandhaka Sarkkarai using alpha amylase and alpha glucosidase enzyme inhibition assay

Background: Diabetes mellitus (DM) is a complex metabolic disorder which involves multiple pathology manifested with increased blood glucose, neural degeneration, chronic inflammation, organ dysfunction etc. Hyperactive metabolic enzymes like alpha amylase and alpha glucosidase that are involved in digestion of starch and sucrose further upswings the postprandial hyperglycaemia by rushing excess glucose moieties into the bloodstream. Drugs that effectively inhibit the action of these digestive enzymes may be expected to better regulate the post prandial blood glucose in the diabetic patients. Conventional anti-diabetic agents offer potential side effects upon long-term usage which includes vomiting, diarrhoea, pigmentation, GI disturbance, dark urination etc.The Siddha system of medicine has excelled in the art of treating human ailments for several centuries. Aim: Present investigation designed to investigate the anti-diabetic potential of siddha formulation Gandhaka sarkkarai (GS) using in-vitro alpha amylase and alpha glucosidase enzyme inhibition assay model. Results: It was evidenced from the outcome of the in-vitro data’s that the siddha formulation GS shown significant inhibition against alpha glucosidase enzyme with the maximum inhibition of about 50.44 % and the corresponding IC50 is 471.1 μg/ml, similar pattern of activity were observed against alpha amylase enzyme with the inhibition of 60.84 % (IC50 400.9 μg/ml). Conclusion: Our data concludes that siddha formulation GS possess significant anti-diabetic activity via inhibiting two major carbohydrate-digesting enzymes, further studies needs to extrapolated at pre-clinical level in order to ascertain the efficacy of the formulation.&#x0D; Key words: Diabetes mellitus, Alpha amylase, Alpha glucosidase, Siddha, Gandhaka sarkkarai, Enzyme inhibition assay, In-vitro, Anti-diabetic activity.

Effect of artificial light at night on sleep and metabolism in weaver birds.

Artificial light at night is constantly minimizing the span of dark nights from the natural light-dark cycle of earth. Over the past century, the "lightscape" of earth has completely changed owing to technological advancements which subsequently changed the lifestyle of human as well as the nearby animal species. This motivated the present study, wherein we investigated the impact of light at night (LAN) on behavior and physiology of a diurnal passerine finch, baya weaver (Ploceus philippinus). A group of bird (N=10) exposed to 12L:12D photoperiod was initially subjected to dark nights (0 lux) for a period of 1.5 weeks followed by 5 lux, night light for a span of 4 weeks. The first week in LAN served as acute treatment with respect to the fourth week (chronic). The results reveal significant increase in nighttime activity and sleep loss with respect to acute LAN, while significant inclusion of drowsiness behavior during the day in response to chronic LAN. Besides these behavioral alterations, changes in physiological parameters such as reduction in body mass, loss of gradient between pre- and post- prandial blood glucose levels, and elevation in plasma corticosterone levels were more prominent during acute exposure of LAN. Plasma metabolites such as triglycerides, total protein, serum glutamic-oxaloacetic transaminase (SGOT), and creatinine concentrations also hiked in response to acute LAN treatment. Thus, acute exposure of LAN seems to serve as a novel environment for the bird leading to more pronounced impacts on behavioral and physiological observations during the experiment. In chronic exposure, the birds sort of adapted themselves to the prevailing circumstances as evident by decreased nighttime activity, rebound of sleep and corticosterone levels, etc. Thus, the study clearly demonstrates the differential impact of acute and chronic exposure of LAN on behavior and physiology of birds.

A structural equation modeling examining the influence of body mass index on the lipid profile of type II diabetes patients.

Background: High Body Mass Index (BMI) has a two times greater risk of developing type II diabetes compared to low BMI. The results showed that general obesity had a risk of 2.24 times while abdominal obesity had a risk of 2.44 times for the occurrence of diabetes. Aim: Based on the background described, the researcher was interested in examining the influence of BMI on the lipid profile of type II diabetes patients. Methods: A considerably large sample of 500 type II diabetes patients who attended the outpatient department of Endocrinology wing of NIMS Medicity (NICER-Noorul Islam Centre for Endocrinology Research), Kerala, India were selected to the macrosample pool following purposive random sampling method. Height and weight of the patients were taken following standard methods and BMI of the patients was computed. Biochemical investigations such as their lipid profile along with Fasting, Post Prandial Blood Glucose values and HbA1C were obtained from patients' medical records. Finally, the hypothesized model was developed and tested by Structural Equation Modeling (SEM) technique using SPSS AMOS 22.0. Results: The results show that height and weight highly influenced the BMI, among which weight, as shown by Standardized Regression Weights (SRW) Estimate- 1.102, Statistically Significant) influenced more than height (SRW Estimate:-0.683, Statistically Significant), weight had a positive influence, whereas height had a negative influence in selected Type II Diabetes patients. The model could not establish any relationship between BMI and lipid profile (SRW Estimate:-0.037, Statistically not Significant). Conclusion: The findings suggest that in diabetes patients increase in BMI alone does not lead to any alterations in their lipid profile.

COMPARATIVE EFFICACY OF METFORMIN AND INSULIN IN THE TREATMENT OF GESTATIONAL DIABETES - A RANDOMISED CONTROL STUDY.

AIMS AND OBJECTIVES: To compare the efcacy of insulin over metformin in the management of gestational diabetes mellitus and to compare maternal and foetal outcome in patients treated with Metformin and Insulin. : This was a hospital based randomised control study conductedMATERIALS AND METHODOLOGY over a period of 12 months from April 2020 to March 2021 amongst 104 pregnant women attending antenatal OPD of Department of Obstetrics and Gynaecology ,Guwahati medical college and hospital, Assam. Open label RCT Randomization process was used to randomize participants into Insulin and Metformin group. Maternal and foetal variables were followed up among both the groups and the results were compared. Metformin when compared with Insulin was showing similarRESULTS: efcacy and safety in terms of variables like Fasting and Post Prandial blood glucose control.Metformin signicantly reduces the incidence of polyhydramnios, fasting hypoglycaemia, post prandial hyperglycaemia and excessive weight gain during pregnancy. In the foetus, Metformin use was found to have reduced incidence of large for gestational age babies and indirectly preventing its related complications like need for LSCS, occurrence of shoulder dystocia at labour and neonatal hypoglycaemia. Insulin use in Gestational diabetes showed better neonatal outcome in terms of APGAR score and neonatal hypoglycaemia. But comparative efcacy of Insulin to Metformin in terms of post prandial blood glucose control was better, thus reducing the incidence of complications of poor glycaemic control in Gestational diabetes. ComparedCONCLUSION: with Insulin, Metformin also can be used as an effective treatment of Gestational Diabetes but efcacy of Insulin is more than Metformin in terms of maternal and foetal outcomes. Further larger trials are needed to conrm.