Random Blood Glucose Levels Research Articles

Effect of Stress, Depression and Anxiety on Blood Glucose Level in Pregnant Women

Introduction: Pregnancy is a rollercoaster ride for a woman. With joy and excitement, there are also times of stress, anxiety, and depression. This research aims to investigate the effect of anxiety, depression and stress on blood glucose levels in pregnant women. Methodology: In this cross-sectional study, 123 pregnant women were included using random sampling. DASS-21 questionnaire, a validated tool, was used to determine stress, anxiety and depression. Random Blood glucose levels of the study participants were measured. The Chi-square test was used, and p values were determined. Results: Among 123 females, 56.91% (n=70) were stressed, 78.86% (n=97) were depressed, and 84.55% (n=104) were anxious. Blood glucose level was significantly higher in stressed and depressed pregnant females (X2 = 12.77, P-value = 0.0004 and X2 =5.75 0.016, P-value: 0.016 respectively). Conclusion: Stressed and depressed pregnant women were found to have higher blood glucose levels. Anxiety didn’t significantly affect blood glucose levels in pregnant females.

Effect of Stress, Depression and Anxiety on Blood Glucose Level in Pregnant Women

Introduction: Pregnancy is a rollercoaster ride for a woman. With joy and excitement, there are also times of stress, anxiety, and depression. This research aims to investigate the effect of anxiety, depression and stress on blood glucose levels in pregnant women. Methodology: In this cross-sectional study, 123 pregnant women were included using random sampling. DASS-21 questionnaire, a validated tool, was used to determine stress, anxiety and depression. Random Blood glucose levels of the study participants were measured. The Chi-square test was used, and p values were determined. Results: Among 123 females, 56.91% (n=70) were stressed, 78.86% (n=97) were depressed, and 84.55% (n=104) were anxious. Blood glucose level was significantly higher in stressed and depressed pregnant females (X2 = 12.77, P-value = 0.0004 and X2 =5.75 0.016, P-value: 0.016 respectively). Conclusion: Stressed and depressed pregnant women were found to have higher blood glucose levels. Anxiety didn’t significantly affect blood glucose levels in pregnant females.

Prevalence of Erectile Dysfunction Among Men with Type 2 Diabetes Mellitus in Indonesia: An Observational Study

Background: Diabetes mellitus (DM) is a chronic metabolic disorder that can lead to multiple long-term complications in the human body including erectile dysfunction (ED). ED is a condition that commonly affects men and may reduce their quality of life. However, ED amongst men with type 2 DM (T2DM) has rarely been assessed and addressed by nurses who have an essential role in providing holistic patient care.Objective: This study aimed to describe ED among men with T2DM based on their demographic characteristics and health profiles.Methods: This was a descriptive study with a cross-sectional approach of 32 male respondents who were selected through convenience sampling in the outpatient department of PKU Muhammadiyah Hospital Yogyakarta, Indonesia. The data was collected by using the erectile function’s domain of Indonesian version of International Index of Erectile Function (IIEF). Descriptive statistics were used to present this study’s findings.Results: The results showed that 62.5% of the participants had uncontrolled blood glucose levels with an average random blood glucose of 207.75 ± 77.21 mg/dl. Only four respondents (12.5%) had received sexual counselling. Twenty-nine respondents (90,6%) had ED which were categorized into mild (17.2%), mild to moderate (6.9%), moderate (24.1%) and severe (51.7%).Conclusion: ED levels varied across age, duration of T2DM, random blood glucose levels, previous history of smoking, current smoking status, sexual counselling experience, complications, and occupation levels. Severe ED was common amongst men with T2DM in this study. Nurses should assess patient’s sexual function regularly and identify the effects of ED in men with T2DM. Early detection of ED could allow nurses to plan adequate intervention and health education to provide better outcomes for men with T2DM.

299-OR: A Combinatorial Approach with Monoclonal Antibodies to SerpinB13 and CD3 Is Therapeutically Superior to Single Antibody Use in Autoimmune Diabetes

A successful approach to autoimmune diabetes therapy may require simultaneous insulin-producing cell regeneration and T-cell mediated autoimmunity resolution in pancreatic islets. While CD3 antibody has been proved to reduce islet inflammation, the monoclonal antibody (mAb) to serpinB13 protease inhibitor, developed in our laboratory, was shown to cause regenerative changes in beta cells. Whether a combination of both antibodies is superior to single antibody use in the treatment of autoimmune diabetes is unclear. To address this non-obese diabetic (NOD) female mice at late pre-diabetic stage were injected with serpinB13 mAb (clone B29, 10, 40 or 200 micrograms/animal) and CD3 mAb (clone 145-2C11; at a suboptimal dose of 10 micrograms). All experimental injections were controlled with nonspecific hamster IgG and mouse IgG (clone HB-158). After the last antibody injection, random blood glucose levels were assessed for 20 weeks, and mice were declared diabetic after two measurements of glucose exceeding 300 mg/dL. We found that the combination of 40 micrograms of serpinB13 mAb with CD3 mAb offered a significant level of protection from diabetes (p=0.0027, Kaplan-Meyer with log rank test), while the combination with 10 micrograms of serpinB13 mAb had no effect. The higher dose of 200 micrograms of serpinB13 mAb showed a trend in favor of diabetes inhibition. Interestingly, at 6 to 7 weeks after completing the treatment with 40 micrograms of serpinB13 mAb alone, NOD mice showed a strong tendency to remain healthy, and separated from the double-negative control, which continued to progress to diabetes. Our results indicate that a combinatorial approach with mAbs to serpinB13 and CD3 is beneficial in autoimmune diabetes. The observations also suggest that an intermediate dose of serpinB13 mAb, and a sufficient time following administration of this mAb, is critical for its positive impact on diabetes prevention. Disclosure B.Szepietowska: None. S.V.Avdulov: None. Y.Kryvalap: None. J.Czyzyk: None. Funding JDRF (2-SRA-2022-1215-S-B)

Ultrasound-guided intra-sacroiliac joint injection — methylprednisolone versus triamcinolone: a randomized comparative study

BackgroundThe sacroiliac joint (SIJ) has been considered as a pain generator in about 10% to 25% of patients with leg or low back pain. The current study was conducted to compare the effectiveness of ultrasound-guided intra-articular SIJ injection of methylprednisolone versus triamcinolone acetonide according to postinjection pain relief, the random blood glucose (RBG) level in diabetic patients, quality of life (QoL), patient’s satisfaction, and the analgesic requirement.ResultsNRS was better at rest and at motion in MTP groups 3 (2–3) and 4 (3–5) compared to TMC groups 4 (3–5) and 5 (3–6) at 2 weeks after injection with statistically significant difference P equal 0.025 and 0.036, respectively, while there was no statistically significant difference between the studied groups at 1, 2, and 3 months after injection. The RBG level was higher in the MTP group in the 1st, 2nd, and 3rd days after injection 206 (168–308), 245 (200–385), and 215 (179–343) compared to the TMC group 170 (136–271), 168 (119–233), and 166 (110–253) with statistically significant difference P equal 0.066, 0.045, and 0.049, respectively. However, there was no statistically significant difference in the RBG level at baseline, 4th, 5th, 6th, and 7th days after injection between the two studied groups. Moreover, there was a statistically significant elevation in the RBG level within the MTP group in the first 3 days compared to the baseline (P ˂ 0.001). There was no statistically significant difference according to QoL, patient’s satisfaction, and the analgesic requirement between both groups.ConclusionsSIJ injection with methylprednisolone or triamcinolone acetonide showed an improvement in pain score, while the MTP group was better in NRS at 2 weeks. Also, the RBG level in diabetic patients was higher in the MTP group in the 1st, 2nd, and 3rd days after injection. There was upgrading in QoL, similarity in patient’s satisfaction, and reducing the use of analgesia with no statistically significant difference between the studied groups.

The Effect of Butterfly Pea Extract on Blood Glucose Levels in White Rats with Metabolic Syndrome Model

<p class="AbstractNormal"><strong>Introduction:</strong> Metabolic syndrome is an accumulation of several disorders, one of which is hyperglycemia. <em>Clitoria ternatea</em> is a plant that contains lots of flavonoids and is known to reduce blood glucose levels in metabolic syndrome. This study aimed to determine the effect of butterfly pea extract (<em>Clitoria ternatea</em>) on blood glucose levels in white rats with metabolic syndrome models.</p><p class="AbstractNormal"><strong>Methods: </strong>This research is an experimental study using animal models with pre and post-test control group design method. The number of samples was 30 male white rats which were divided into 5 groups: group 1–negative control group; group 2–positive control group; group 3, group 4, and group 5 were the metabolic syndrome group which was given <em>Clitoria ternatea</em> extract with doses of 100, 200, and 400 mg/kgBW, respectively for 28 days. Measurement of blood glucose levels for all groups was carried out on the 36<sup>th</sup> day as the pre-test and the 64<sup>th</sup> day as the post-test. Blood glucose levels were obtained through retroorbital venous blood which was analyzed with the Easy Touch blood glucose stick meter. One-way ANOVA was used to analyze data, followed by post-hoc LSD test, and paired T-test.</p><p class="AbstractNormal"><strong>Results: </strong>The average post-test random blood glucose levels decreased by 135.16 mg/dl, 163.18 mg/dl, and 168.35 mg/dl. There was a significant difference (p<0.05) between the pre-test and post-test blood glucose levels along with the average blood glucose level amongst groups.</p><p class="AbstractNormal"><strong>Conclusion: </strong>Butterfly pea (<em>Clitoria ternatea</em>) could decrease blood glucose levels and cause further decrease with higher doses.</p>

Pulmonary Mycobacterium tuberculosisinfection alters the hepatic immunometabolic landscape and compromises insulin responsiveness early after infection

Abstract Immunity against Mycobacterium tuberculosis(Mtb) is associated with both regional and systemic inflammation as well as with metabolic disruption in tuberculosis (TB) patients. The metabolic and immunological responses are intertwined but the specific impact of localized disease on systemic metabolism is not well defined. We investigated the impact of low dose aerosol infection of the lung with Mtbon the systemic metabolic regulatory organ – the liver. Using an unbiased approach we defined the mRNA and protein dysregulation occurring in the early stage of infection. We found that infection leads to immune pathway activation and reduced metabolic activity in liver. Comparison of the gene expression patterns between of the lung, liver and blood revealed organ specific metabolic gene dysregulation in the context of non-organ specific activation of interferon response pathways. We have also found that infection leads to suppression of carbohydrate and lipid metabolism, without alteration of fasting or random blood glucose levels. Infected mice show reduced sensitivity to exogenous insulin but the glucose tolerance remains intact indicating insulin resistance. Analysis of metabolomics data from public repository reveals a metabolic signature of insulin resistance correlates with TB progression. Taken together, our finding shows that aerosol Mtbinfection influences hepatic metabolism very soon after infection and may contribute to early metabolic disease. Defining the early interplay between localised infection, inflammation and metabolic regulation is key to understanding the impact of latent and subclinical TB on the large proportion of the World’s population who do not exhibit TB symptoms but who are infected with Mtb. Supported by Grants from Royal Society Wolfson Merit Award (AMC) Newton Fellowship (MKD), Wellcome Trust Institutional Support Fund Fellowship (MKD), MRC award MR/P011136/1 (AMC).

Glycemic Control Effect on Acid-Fast Bacteria Conversion in Diabetic Patients with Tuberculosis

Background Diabetic people have a 2-3 times higher risk of tuberculosis than non-diabetic people. Immunocompromised conditions due to diabetes increase the risk of therapeutic failure and delayed sputum conversion, which may cause by poor glycemic control. This study was conducted to determine the glycemic control effect on AFB conversion in diabetic patients with tuberculosis. Methods A cross-sectional study has been conducted on 100 diabetic patients with the new emergence of pulmonary tuberculosis. All patients were in intensive phase treatment of tuberculosis for two months at Bhayangkara R. Said Sukanto's Hospital. Data collected from medical records were random blood glucose level, percentage of random blood glucose decrement, HbA1C, and the microscopic AFB sputum smear. Fisher exact test analysis was conducted to determine the effect of random blood glucose level, percentage of blood glucose decrement and HbA1C to AFB smear results using SPSS V25.0 software for Windows with a significance level of 0.05. Results The analysis between glycemic control and AFB sputum smear conversion using random blood glucose, percentage of random blood glucose decrement and HbA1C showed a p-value of 0.000, indicating a significant relationship (p<0.05), so it showed that glycemic control affects AFB sputum smear conversion. Conclusions A significant relationship exists between glycemic control and AFB-negative conversion in patients with DM and TB. RBG showed the best sensitivity and specificity as a glycemic control parameter compared to others.

Salivary aquaporin-3 as a screening biomarker for xerostomia in patients with periodontal disease and the effects of xerostomia on oral health-related quality of life.

Xerostomia is a subjective condition of dryness of the oral cavity that may lead to several oral problems deteriorating oral health-related quality of life. This study aimed to (1) determine the prevalence of xerostomia, (2) compare the general health status, unstimulated salivary flow rate, and oral health-related quality of life in xerostomics and non-xerostomics, and (3) investigate the potential of salivary aquaporin-3 (AQP-3) as a screening biomarker for xerostomia in patients with periodontal disease. Demographics and systemic health data were collected from 109 healthy participants, 20 to 55 years old, with Community Periodontal Index (CPI) score ≥ 3. For subjective assessment of xerostomia, Shortened Xerostomia Inventory (SXI) was used. For objective assessment of xerostomia, unstimulated salivary flow rate was measured. Shortened Oral Health Impact Profile (S-OHIP) was utilized for oral health-related quality of life assessment. The collected saliva samples were processed and stored at -80°C. Quantification of salivary AQP-3 protein was done with enzyme-linked immunosorbent assay. Xerostomia was reported in 78% of the subjects based on SXI score. Median concentration of AQP-3 was significantly higher in xerostomics compared to non-xerostomics, p = 0.001. Moreover, oral health-related quality of life was significantly poor in xerostomics compared to non-xerostomics, p = 0.002. Furthermore, there were significant correlations between AQP-3 and SXI (r = 0.21, p = 0.025), AQP-3 and S-OHIP (r = 0.2, p = 0.042), S-OHIP and SXI (r = 0.37, p < 0.001), unstimulated salivary flow rate and random blood glucose level (r = 0.32, p = 0.001), and body mass index and mean arterial pressure (r = 0.44, p < 0.001). Regression analysis showed that body mass index, CPI score 3, and salivary AQP-3 were suitable predictors for presence of xerostomia. AQP-3 could be a potential screening biomarker for xerostomia in patients with periodontal disease for its early identification may help improve oral health-related quality of life of the individuals.

Pre-Procedure Blood Sugar Levels in Diabetic and High-Risk Patients Visiting King Abdulaziz University Dental Hospital: The Role of the Dentist in Diabetes Screening.

Diabetes mellitus (DM) is a widespread problem. Satisfactory control of DM is essential for maintaining oral health and optimizing the outcomes of dental treatment; DM patients with poor glycaemic control have a high risk of dental treatment-related complications. Furthermore, the dentist and dental office can play an important role in DM screening. Therefore, this study aimed at measuring random blood glucose (RBG) levels in patients with established DM or high risk of DM seeking dental treatment at the King Abdulaziz University Dental Hospital to avoid treatment complications and execute an immediate physician referral. This cross-sectional study included patients presenting to our institution for dental treatment, who were categorized as diabetic (established diagnosis) or at high risk of DM according to the American Diabetes Association criteria. Participants' pre-procedure RBG level was assessed via a glucometer. High-risk participants were classified as per their blood glucose level into two groups (<200 mg/dL and >200 mg/dL), while the diabetic participants were placed into four groups (<140 mg/dL; 140 to <200 mg/dL; 200-300 mg/dL; and >300 mg/dL). This study included 695 patients (361 females and 334 males), of which 354 (52%) had established DM and 341 (48%) were high-risk patients. Around 31% of patients in the high-risk group were potentially diabetic but unaware of it; 46% of the diabetic patients had RBG levels >200 mg/dL. For the high-risk participants, age had a statistically significant association (P-value 0.03) with the RBG level. Pre-procedure RBG measurement in diabetic and high-risk patients undergoing dental treatment is crucial for the prevention of DM-related complications. Dental health-care professionals have a vital role in screening, early detection, and referral of these patients.

Acute onset of diabetes and rapid cognitive decline in a patient with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes syndrome.

Mitochondrial diseases are a group of rare diseases presenting with heterogeneous clinical, biochemical, and genetic disorders caused by mutations in the mitochondrial or nuclear genome. Multiple organs can be affected, particularly those with high energy demand. Diabetes is a common endocrine manifestation of mitochondrial diseases. The onset of mitochondrial diabetes can be latent or acute, and the presenting phenotype can be type 1- or type 2-like. Studies show that diabetes ais associated with latent progression of cognitive decline in patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome. Herein, we report a case of rapid cognitive decline after the acute onset of diabetes in a patient with MELAS syndrome. The patient was a 36-year-old woman who was hospitalized due to hyperglycemic crisis and seizures. She was diagnosed with MELAS syndrome two years previously, and had gradually progressing dementia and hearing loss. However, following the acute onset of diabetes, she developed rapid cognitive decline and loss of ability to perform daily activities. In conclusion, the acute onset of diabetes could be an associated risk factor for rapid cognitive decline in patients with MELAS syndrome. Thus, these patients as well as healthy carriers with related genetic mutations should undergo diabetes education and screening tests. Moreover, clinicians should be aware of the possibility for acute onset of hyperglycemic crisis, particularly in the presence of triggering factors. Diabetes is a common endocrine manifestation of mitochondrial diseases, presenting with a type 1- or type 2-like phenotype depending on the level of insulinopenia. Metformin should be avoided in patients with mitochondrial diseases to prevent metformin-induced lactic acidosis. Mitochondrial diabetes can manifest before or after the onset of MELAS syndrome. In patients with MELAS syndrome, diabetes can initially manifest with a life-threatening severe hyperglycemic crisis and can cause rapid cognitive decline. Diabetes screening tests (e.g. hemoglobin A1c, oral glucose tolerance test, or random blood glucose level measurement) should be performed either systematically or in the presence of symptoms, particularly after triggering events. Genetic testing and counseling should be provided to patients and their families for the purpose of better understanding the inheritance, progression, and possible outcomes of the disease.

Could the serum glucose/potassium ratio offer an early reliable predictor of life-threatening events in acute methylxanthine intoxication?

Methylxanthines are widely used to manage pulmonary disorders, particularly in developing countries. Methylxanthines are unsafe due to their narrow therapeutic index and associated morbidity and mortality. The current study aimed to investigate the role of glucose/potassium ratio as a substantially useful early predictor of life-threatening events (LTEs) in the form of cardiovascular and neurological complications among methylxanthine users. A retrospective cohort study was conducted using medical records of patients diagnosed with acute methylxanthine intoxications and presented to an Egyptian Poison Control Center for 2 years. A total of 366 patients were enrolled. Of them, 59 patients (16.1%) were complicated with LTEs. The most frequent serious arrhythmia was T wave inversion (45.6% of patients with LTEs). Laboratory investigations that could significantly predict LTEs were the random blood glucose and potassium levels, glucose/potassium ratio, pH, liver transaminases, HCO3 level, hemoglobin, and platelet count (P<0.05). The glucose/potassium ratio was the best predictor of LTEs (odds ratio=2.92, and 95% confidence interval=2.02-4.23). With an excellent area under the curve (0.906) and at a cutoff of 2.44, that ratio could correctly classify the patients based on their risk of LTEs with an overall accuracy of 73% (sensitivity of 88% and specificity of 70%). The current study endorsed an important, feasible, and easily obtainable ratio that could predictor stratify the patients according to severity and risk of LTEs, which guides the decision-making and prioritizes the treatment lines in methylxanthine intoxicated patients.

Prevalence of anemia and its association with random blood glucose levels and anthropometric indices in the Saudi female population

Prevalence of anemia and its association with random blood glucose levels and anthropometric indices in the Saudi female population

Prevalence of diabetic retinopathy in patients with diabetes in Alexandria and North-West Delta, Egypt

PurposeThe purpose of this research was to estimate the prevalence of DR in Alexandria and the North-West Delta region.MethodsAll diabetic patients attending the general ophthalmology clinics (Group 1), diabetic internal medicine clinics (Group 2), or reached out in the local communities (Group 3) were eligible to participate. Fundus photographs were graded according to the Scottish DR grading system by three independent UK-certified graders. Adjudication by a consultant was done when needed.ResultsOut of 11,033 screened patients, 10,811 had a gradable fundus photograph in at least one eye and were included. The numbers of cases in groups 1, 2 and 3 were 3940, 2826, and 4045, respectively. Males represented 38.35% of the cases. Mean age was 55 ± 12.63. For the whole sample, groups 1, 2 and 3, the DR prevalence was 32.49, 46.4%, 29.13%, and 21.29%, respectively. The prevalence of proliferative DR (grade R4) was 6.16%, 11.83%, 5.02%, and 1.45%, respectively, and of referable maculopathy (Grade M2) was 19.95%, 31.42%, 15.92%, and 11.59%, respectively.In univariate analysis, older age, higher random blood glucose, and longer DM duration were associated with a higher risk of both DR and referable diabetic maculopathy. This association was maintained in multivariate analysis for the high random blood glucose level and the longer duration of DM (but not for the older age).ConclusionA significantly higher prevalence of DR, grades R4 and M2 was found in the hospital-recruited patients than in diabetics from the local communities.

Development and validation of a risk prediction nomogram for disposition of acute clozapine intoxicated patients to intensive care unit.

Clozapine is an atypical antipsychotic drug used for the treatment of refractory schizophrenia. It is reported as the most toxic in its class. Using serum clozapine level as a severity indicator is doubtful and unfeasible, particularly in low resourced countries. This is an extended two-phase retrospective study that utilized medical records of patients diagnosed with acute clozapine intoxication and admitted to Tanta University Poison Control Center, Egypt during the past 6years. Two hundred and eight medical records were used to establish and validate a nomogram for predicting the need for intensive care unit (ICU) admission in acute clozapine intoxicated patients. A reliable simple bedside nomogram was developed and proved its significant ability to predict the need for ICU admission, with an area under the curve (AUC) of 83.9% and 80.8% accuracy. It encompassed the age of admitted patients (AUC = 64.8%, p = .003), respiratory rate (AUC = 74.7%, p < .001), O2 saturation (AUC = 71.7%, p < .001), and random blood glucose level upon admission (AUC = 70.5%, p < .001). External validation of the proposed nomogram showed a high AUC (99.2%) with an overall accuracy of 96.2%. There is a need to develop a reliable objective tool predicting the severity and need for ICU admission in acute clozapine intoxication. The proposed nomogram is a substantially valuable tool to estimate ICU admission probabilities among patients with acute clozapine intoxication and will help clinical toxicologists make rapid decisions for ICU admission, especially in countries with low resources.

Hyperglycemia and Glycemic Variability Associated with Glucocorticoids in Women without Pre-Existing Diabetes Undergoing Neoadjuvant or Adjuvant Taxane Chemotherapy for Early-Stage Breast Cancer

Glucocorticoids, which are administered with chemotherapy, cause hyperglycemia. Glycemic variability among breast cancer patients without diabetes is not well known. A retrospective cohort study was conducted involving early-stage breast cancer patients without diabetes who received dexamethasone prior to neoadjuvant or adjuvant taxane chemotherapy between August 2017-December 2019. Random blood glucose levels were analyzed, and steroid-induced hyperglycemia (SIH) was defined as a random glucose level of >140 mg/dL. A multivariate proportional hazards model was used to identify the risk factors of SIH. Out of 100 patients, the median age was 53 years (IQR: 45-63.5). A total of 45% of patients were non-Hispanic White, 28% Hispanic, 19% Asian, and 5% African American. The incidence of SIH was 67%, and glycemic fluctuations were highest in those with glucose levels of >200 mg/dL. Non-Hispanic White patients represented a significant predictor for time to SIH, with a hazard ratio of 2.5 (95% CI: 1.04, 5.95, p = 0.039). SIH was transient in over 90% of the patients, and only seven patients remained hyperglycemic after glucocorticoid and chemotherapy completion. Pretaxane dexamethasone-induced hyperglycemia was observed in 67% of the patients, with the greatest glycemic lability in those patients with blood glucose levels of >200 mg/dL. The non-Hispanic White patients had a higher risk of developing SIH.

Hemichorea Associated With Nonketotic Hyperglycemia.

Hemichorea associated with nonketotic hyperglycemia (HC-NH) is a rare diabetic complication for which the pathogenesis remains unclear. This study reported 16 cases of HC-NH to improve the understanding of the disease and avoid misdiagnosis and missed diagnosis. Data of 16 patients with HC-NH in a single center from 2000 to 2021 were analyzed retrospectively, and the relevant literature was reviewed. The participants (8 men and 8 women) had a mean age of 67.6 ± 16.4 years. Bilateral limbs were involved in 2 cases, and the others had hemichorea (6 in the left side and 8 in the right side). The average random blood glucose level was 17.51 ± 7.67 mmol/L, and the glycated hemoglobin A1c level was 11.9%±3.1% at admission. Eleven patients had a history of diabetes, and the other 5 patients were diagnosed with new-onset diabetes mellitus, but no remarkable differences were observed in the presentation or treatment of chorea. Ketonuria was detected in 7 patients. The basal ganglia (putamen, globus pallidus, and caudate nucleus) of 9 cases had typical hyperdensity on computed tomography and/or hyperintensity signals from magnetic resonance imaging. The chorea symptoms of 15 patients improved within 5.0 ± 1.9 days after treatment. This study provides additional valuable information about the clinical and neuroimaging features of HC-NH. We hypothesize that chronic ischemia of the basal ganglia due to cerebral atherosclerosis combined with hyperglycemia is associated with HC-NH.

Atypical Neurological Presentation in a Patient with Uncontrolled Diabetes

Chorea is a disorder characterized by irregular and involuntary hyperkinetic movements associated with malfunctioning the basal ganglia. One of the rarest acquired causes of unilateral or bilateral chorea is hyperglycemia. This is a case of an elderly female diabetic who presented With 3 days history of unilateral involuntary movements of the upper limb and lower limb, irrelevant talk, and altered sensorium. She had a random blood glucose level of 418 mg/dl with hemoglobin A1C (HbA1c) of 15% and normal ketones. Magnetic resonance imaging brain demonstrated T1 hyperintense and T2 flair hypointense right basal ganglia. Diagnosis of nonketotic hyperglycemic chorea was considered. The patient was treated with insulin, antipsychotics, and benzodiazepines and the chorea resolved after proper control of glucose levels. This condition can be reversible with early identification and treatment. This disorder can be prevented with good glycemic control.

Trends in Quantification of HbA1c Using Electrochemical and Point-of-Care Analyzers.

Glycated hemoglobin (HbA1c), one of the many variants of hemoglobin (Hb), serves as a standard biomarker of diabetes, as it assesses the long-term glycemic status of the individual for the previous 90-120 days. HbA1c levels in blood are stable and do not fluctuate when compared to the random blood glucose levels. The normal level of HbA1c is 4-6.0%, while concentrations > 6.5% denote diabetes. Conventionally, HbA1c is measured using techniques such as chromatography, spectroscopy, immunoassays, capillary electrophoresis, fluorometry, etc., that are time-consuming, expensive, and involve complex procedures and skilled personnel. These limitations have spurred development of sensors incorporating nanostructured materials that can aid in specific and accurate quantification of HbA1c. Various chemical and biological sensing elements with and without nanoparticle interfaces have been explored for HbA1c detection. Attempts are underway to improve the detection speed, increase accuracy, and reduce sample volumes and detection costs through different combinations of nanomaterials, interfaces, capture elements, and measurement techniques. This review elaborates on the recent advances in the realm of electrochemical detection for HbA1c detection. It also discusses the emerging trends and challenges in the fabrication of effective, accurate, and cost-effective point-of-care (PoC) devices for HbA1c and the potential way forward.

THE INFLUENCE BOILING OF FRAGRANT PANDAN AND CINNAMON TO REDUCING BLOOD GLUCOSE LEVELS IN DIABETES MELLITUS

Introduction. Diabetes mellitus is a metabolic disease characterized by high levels of glucose in the blood, if not treated many body systems can be damaged, especially nerves and blood vessels. The purpose of this study was to explain the effect of pandan leaves and cinnamon decoction on random blood glucose reduction in patients with diabetes mellitus. Method.This research design uses Quasy-Experimental with a pre post test control group design approach. The study population was 35 respondents in Gurangwetan Hamlet. In the selection of samples using purposive sampling method which amounted to 32 respondents. The independent variable in this study is a decoction of fragrant pandanus and cinnamon, while the dependent variable is random blood glucose levels in patients with diabetes mellitus. Instruments used SOP fragrant pandanus and cinnamon decoction, observation sheet, Glucose meter (Esay touch). Data analysis using the Wilcoxon Signed Rank Test and Mann Whitney U-test. Result &amp; Analysis. The results of the Wilcoxon Signed Rank Test statistical test of random blood glucose in the intervention group (p=0.001) means that there is an effect of fragrant pandanus and cinnamon decoction on reducing random blood glucose levels, in the control group (p=0.008) means that there is a difference in random blood glucose levels before and after intervention. Discussion. The results of the Mann Whitney U-test showed no difference in the intervention and control groups after being given the intervention to reduce random blood glucose levels (p=0.382). Discussion. The intervention of fragrant pandanus and cinnamon decoction has the same effectiveness as pharmacological drugs that can reduce random blood glucose levels, so this complementary therapy of fragrant pandanus and cinnamon decoction can be used as a companion therapy for people with diabetes mellitus.