Sugar Levels Research Articles

Metformin in COVID-19: a magical role beyond the hyperglycemia

Coronavirus disease-2019 (COVID-19) has emerged as an aggressive viral infection in the last few years. Initially reported in the Wuhan area of the People’s Republic of China, it soon emerged across the globe. Researchers confront a worrying situation to rapidly develop effective strategies to combat this novel infection and its long-term aftereffects. To date, there have been myriad reports ranging from the repurposing of the classical antimalarial drug hydroxychloroquine to several other antiviral and anti-bacterial agents like remdesivir, favipiravir, and most recently azithromycin, which has entered clinical use in many countries for combating COVID-19 infections. Several studies have highlighted the nexus between COVID-19-associated morbidity and diabetes in a wide-ranging class of subjects ranging from pediatric cases to adults and patients with other co-morbidities. Metformin is a mainstay in the treatment of type 2 diabetes (T2D). It is safe, inexpensive, and effective and does more than merely control blood sugar levels. Important metabolites that encourage blood clotting and inflammation are also suppressed by metformin. Pro-inflammatory molecules are linked to obesity and T2D. Both are major risk factors for aggravated COVID-19. These characteristics gave rise to a hypothesis that metformin may find use as an efficacious treatment for COVID-19 especially if it decreases the inflammatory molecules that fuel the COVID-19 virus-induced effects. In this review, we attempt to elucidate the role of classical anti-diabetic medicine metformin in the treatment of COVID-19 infections by highlighting the pharmacological role of this drug during elevated glucose levels and insulin resistance. We examine how COVID-19 has correlations to diabetic physiology and thereby the possibility of repurposing metformin for COVID-19 treatment.

Health behaviors, knowledge, and attitudes toward cardiovascular disease risk factors in young Iraqi adults: a sample from Erbil, Iraq

Background: Cardiovascular disease continues to be a leading cause of death among young people globally. This cross-sectional study was designed to assess the health behaviors, knowledge, and attitudes regarding cardiovascular disease risk factors among young adults in Erbil, Iraq.Methods: Data were collected using the WHO STEPS Instrument for Chronic Disease Risk Factor Surveillance and the Heart Disease Fact Questions.Results: Ninety percent of participants demonstrated moderate to high knowledge and exhibited a positive attitude. Multiple linear regression analysis revealed that while a history of smoking, a lack of knowledge, and the absence of formal education negatively impacted knowledge levels, being aged 38 to 45 years, recognizing the importance of consuming less salt, walking for at least 10 minutes on 5 or more days per week, and regularly checking blood sugar levels positively contributed to knowledge. Unwillingness to change lifestyle had the most significant negative influence on knowledge.Conclusions: Establishing effective educational interventions may increase knowledge and promote more positive attitudes.

Assessment of Interleukin 6 and Interleukin 8 in type 2 Diabetic patients recovered from SARS_COV_2 induced Covid 19 infection in Kirkuk City, Iraq

This study aimed to measure the levels of interleukin 8 and interleukin 6 in type 2 diabetic patients who were infected with Covid-19 and recovered and to compare them with diabetic patients who did not have Covid-19 and healthy people. The patients were divided into three groups. The first group was for diabetic patients recovering from Covid and the total number of samples included 41 samples. In addition, 18 samples were taken from diabetics who were not infected with Covid-19 as a second group and a third group was also taken with the number of samples as 25 from healthy people not infected with the Corona virus or diabetes or any other disease. For the period from September 2022 - February 2023, their ages ranged between 39-64 years. Samples were obtained from patients attending private clinics and hospitals in Kirkuk Governorate. Patients were diagnosed with diabetes according to WHO criteria. This study excluded patients with hypertension, cardiovascular disease, kidney disease, smokers and those taking any other treatment except diabetes treatment: metformin and glimepiride. The results of the current study with regard to blood sugar level showed that there were statistically significant differences at a significance level of p<0.05 between the second and third group. As for the first and second group, there was a slight increase, but not significant, p>0.05. The results of the study also showed that there was a significant difference (p<0.01) between the first group and the third group. As for the level of interleukin 8, there was a significant difference at the significance level of p<0.05 between the three groups.

Potential use of other starch sources in the treatment of glycogen storage disease type Ia – an in vitro study

BackgroundGlycogen storage disease type Ia (GSD-Ia) is one of the most common hepatic GSD. Its treatment mainly consists of a diet including a high intake of slow-digestion carbohydrates such as raw cornstarch and the restriction of simple sugars. This enables the maintenance of euglycemia and prevents secondary metabolic disorders. Starch is a glucose polymer formed by amylose and amylopectin, which can be obtained from distinct sources. Although uncooked cornstarch has been successfully used in the treatment of GSD-Ia, it can lead to hyperglycemia and weight gain. in vitro andin vivo tests indicated that sweet manioc starch can be potentially used in the treatment of GSD-Ia.ResultsThe moisture analysis revealed a variation from 10.3 to 12.8% in the sweet manioc starch samples, whereas the moisture content of uncooked cornstarch ranged from 7.3 to 11.1%. Quantifiable sugar was detected in 3/5 samples of sweet manioc starch and 1/3 samples of uncooked cornstarch. Notably, this uncooked cornstarch brand is widely employed in GSD-Ia treatment in Brazil. Products B and E had higher values of amylopectin and undetectable levels of sugars. A clinical trial is warranted to compare samples F and G and determine the impact of sugar trace in the same dietary source of starch.ConclusionsCollectively, the results demonstrated possible therapeutic alternatives for GSD-Ia in addition to traditional uncooked cornstarch.

The Influence of Sucrose on Biomass and Glycosides Content of Callus Cultured from the Leaves of Stevia rebaudiana Bertoni

Stevia rebaudiana Bertoni contains diterpenoid steviol glycosides that have no adverse impact on blood sugar levels despite being 300 times sweeter than sugar. This study aimed to investigate the rate of callus induction from stevia leaves and the content of glycosides when changing the sucrose percentage in the culture medium.. Murashige and Skoog (MS) culture medium supported by 4.0 mg/l naphthalene acetic acid (NAA) and 1.0 mg/l benzyl adenine (BA) was used, and different concentrations of sucrose (2, 3, 4, 5 and 6%) were tested .The extraction of glycosides from leaf and callus tissues was performed by using methanol. Extracted glycosides were analyzed by high-performance liquid chromatography (HPLC). The results showed significant influences of sucrose on callus initiation. The concentration of 3% sucrose had the highest fresh and dry weight. No callus was induced in the MS medium with a high concentration of sucrose (5% and 6%). However, the highest glycoside content, stevioside and rebaudioside were obtained from callus treated with 4% concentration followed by 3% sucrose the treatment . The highest fresh and dry weight average was obtained with a 3% concentration of sucrose, this treatment also increased the concentration of glycosides in the callus twice as much as in the leaves, and concentrations of 3% and 4% of sucrose gave very similar concentrations of glycosides in callus in terms of being double what was found in the leaves something which may aid in the development of a stevia glycosides based industry.

Assessment of glycemic index of the unripe green papaya in mice

Papaya (Carica papaya L.) is a rich-nutrition fruit include vitamins (A, B and C), carbohydrates, proteins, alkaloids, proteolytic enzymes, and benzyl isothiocyanate. Papaya contains papain, which helps strengthen the constitution of diabetes patients. Its water-soluble fiber can stabilize blood sugar levels, reducing the risk of complications. Papaya has benefits such as lowering blood lipids and softening blood vessels due to the fruit acids it contains, which is advantageous for patients with diabetes complicated by hypertension, arteriosclerosis, and dyslipidemia. Additionally, the proteolytic enzymes in papaya are beneficial for the digestive system. Unripe green bananas have been found to contain a significant amount of resistant starch, giving them potential as a low glycemic index (GI) food. Therefore, the aim of this study was to determine the effects of unripe green papaya on blood glucose regulation. The blood glucose values were measured in C57BL/6 mice before and within 120 minutes after consuming 50 mg of glucose and the grated unripe green papaya containing 50 mg of starch was conducted to calculate the incremental area under the curve (IAUC) for blood glucose changes post-consumption of glucose and the grated unripe green papaya. The results showed that the average IAUC for the grated unripe green papaya was 11,176.67, while the average IAUC for glucose was 7,666.25. According to the GI calculation formula, GI of the grated unripe green papaya was determined to be 146. Therefore, based on the results of this study, these results will be used as the basis for the development of related blood glucose regulation products of the unripe green papaya (Carica papaya L.) in the future.

Dietary patterns associated with obesity and its comorbidities

Obesity is a major public health challenge, in Spain the prevalence of excess of weight and obesity and is 56 % and 19 %, respectively, and it is linked to numerous preventable chronic diseases. Nutritional epidemiology focused on nutrients has evolved towards the study of dietary patterns that consider synergistic interactions between foods and nutrients. This study aims to investigate the relationship between obesity and its treatment by healthy dietary patterns. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH), based on plant products, whole grains and low levels of salt, sugars and red meat, have been shown to promote weight loss and reduce comorbidities associated with obesity. Although vegetarian and vegan diets are adequate options for disease management and prevention, they require planning to avoid nutritional deficiencies. In conclusion, healthy dietary patterns such as the Mediterranean diet, DASH and vegetarian options are effective in both the prevention and treatment of obesity, highlighting the importance of considering the synergy between foods and nutrients in the management of this health condition.

Role of Horticultural Crops in Food and Nutritional Security: A Review

Horticultural crops perform a very important role in both food and nutritional security more especially in developing countries. Fruit and vegetables have high content of both nutritional and health promoting compounds which consist mostly of essential vitamins, minerals and anti-oxidant that is not present in major staple food crops. Fruits and vegetables supply a large constituent of human nutrition, as they are vital sources of minerals, vitamins, nutrients, dietary fiber, ant-oxidant and phytochemicals that are easy to produce and have short production cycle. A diet rich in fruits and vegetables can help in reducing high blood pressure, lower the risk of heart disease and stroke, provide protection against most types of cancer, reduce the risk of eye and digestive problems, and have a significant effect controlling blood sugar levels which serve as appetite booster. The higher the amount of daily intake of fruits and vegetables, the lower the risk of developing cardiovascular diseases. Fruits and vegetables also contain fiber that assist in bowel movements and can relieve or prevent constipation. Eating fruits and vegetables can also keep eyes healthy and may help prevent two common eye diseases like cataracts and macular degeneration. The FAO, IFAD, UNICEF, WFP and WHO report on state of World food and nutrition security for the year 2021 painted a gloomier picture. The report estimated that between 720 and 811 million people in the world faced hunger in 2020 with close to 2.37 billion people did not have access to adequate food in 2020. Thus the need to encourage the production of horticultural crops can help in enhancing food and nutritional security since it is an enterprise that maximizes small space in terms of value and health benefits.

Prevalence, Characteristics and Risk Factors Analysis of Prediabetes: A Cross-Sectional Study

Background Prediabetes, a reversible condition before the onset of diabetes, is a significant concern in healthcare globally. The global prediabetes epidemic has emerged and has considerably impacted health expenditures. Various risk factors play important roles in the progression of prediabetes to diabetes. Intensive lifestyle and pharmacological interventions can significantly reduce the risk of diabetes progression. Objective This study aimed to determine the prevalence, characteristics, and risk factors of prediabetes state of Medan in August 2023. Methods The sample consisted of 89 participants. This was an analytical cross-sectional study in the community that met the inclusion and exclusion criteria. The determination of prediabetes is based on the results of blood tests, namely, the examination of fasting blood sugar levels (FBGL), 2-hour postprandial oral glucose tolerance test (OGTT), and hemoglobin A1c (HbA1C). Other examinations included lipid profiling (total cholesterol, HDL-C, LDL-C, and triglycerides). Data processing was performed using SPSS via univariate and bivariate analyses (chi-square test). Results Of the 89 participants, the prevalence of prediabetes based on HbA1c, FBGL and 2-hours OGTT levels was 28.1%, 50.6%, and 28.1%, respectively. 82% of the participants were female, and 53.9% were overweight or obese based on body mass index (BMI). The risk factors related to the prevalence of prediabetes were HbA1c level, impaired FBGL, and impaired 2-hours OGTT. Other risk factors such as age, sex, daily exercise, diet, BMI, waist-hip ratio, acanthosis nigricans, lipid profile, and blood pressure did not correlate significantly with the risk factors (p>0.05). Conclusion This study found that the prevalence of prediabetes was 67.4% in Medan, 82% of the participants were female, and more than 50% of participants were overweight or obese. HbA1c, FBGL, and 2-hour postprandial OGTT were the most important risk factors for prediabetes.

Fermented Ananas comosus and Carica papaya harbour putative probiotic Limosilactobacillus fermentum and Lacticaseibacillus paracasei strains with inhibitory activity against α-glucosidase and α-amylase

Diabetes mellitus (DM) is the condition represented by persistent hyperglycaemia, owing to the altered glucose metabolism. The current research aims to assess the capabilities of strains of lactic acid bacteria (LAB) that were obtained from fermented Ananas comosus (A. comosus) and Carica papaya (C. papaya) (non-dairy sources) as probiotics for the prevention of DM. The capacity of the strains to endure or survive extreme conditions was evaluated using bile tolerance using oxgall at varying concentrations, hydrophobicity, coaggregation ability, adhesion ability, and hemolytic activity, and their survival rate in gastric and intestinal juices. The LAB strains demonstrated the following results: phenol (>7 Log CFU/mL), acid-bile conditions (6.53–7.11 Log CFU/mL), gastric and intestinal juice tolerance (6.18–7.33 Log CFU/mL), thereby fulfilling the requirements to be a prospective probiotic agent. The LAB strains showed characteristics of cell surface hydrophobicity (≥ 40 %), autoaggregation (≥ 70 %), and coaggregation (≤ 48 %). Furthermore, they demonstrated antioxidant activity (≥ 59 %) as well as the ability to lower blood sugar levels by inhibiting α-glucosidase (≤ 57 %) and α-amylase (≤ 64 %). The development of antidiabetic probiotics from fermented papaya and pineapple has several potential uses. These probiotics may be used as functional foods or supplements to improve glycemic control in individuals with DM. They may also be used as adjunct therapies to conventional diabetes treatments to enhance their efficacy. The results of this research may pave way for creating probiotic products that function as food additives or supplements, with the aim of enhancing health and preventing long-term illnesses like diabetes. Additionally, probiotics have been proven to boost intestinal health, regulate the immune system, and decrease inflammation.

GLUCOSE AND PROXIMATE ANALYSIS IN CEREALS SUBSTITUTING CASSAVA FLOUR AND RED BEANS

Diabetes mellitus is a disease or chronic metabolic disorder characterized by high blood sugar levels accompanied by disorders of carbohydrate, lipid and protein metabolism as a result of insulin function insufficiency. Diabetics are advised to pay attention to the food they consume, preferably low in sugar. In general, cereals on the market are made from wheat flour which contains quite a lot of sugar, so it is necessary to modify cereal recipes to increase nutritional value. Cassava flour is a food source of carbohydrates with a lower calorie content than wheat flour. Red bean flour has a fairly high protein content and a low glycemic index, so the substitution of cassava flour and red bean flour is expected to increase the nutritional value. This study aims to determine the effect of substituting cassava flour and red bean flour on the nutritional value of cereals. This research used True Experimental with 4 treatment levels and 6 replications. The treatment applied was the ratio of wheat flour: cassava flour: red bean flour at each P0 (100:0:0), P1 (10:50:40), P2 (10:60:30), P3 (10: 70:20). Based on the research results, it shows that there is an effect of reducing glucose, energy, fat, carbohydrate and water levels compared to those without substitution. There was an increase in protein and ash content in the treatment. The cereal formulation that has the expected nutritional content is the P3 formulation

Investigating the relationship between shift work schedule and blood and metabolic parameters: a 10-years retrospective cohort study

Shift work has become increasingly common in modern society. Shift work has been associated with a range of negative health outcomes. Therefore, this 10-years retrospective cohort study, aimed to investigate the relationship between shift work and blood and metabolic parameters. This retrospective cohort study was conducted in a metal parts manufacturing industry in 2023. In this study, 204 shift workers and 204 day workers were examined. All the studied blood and metabolic parameters were collected by reviewing the medical records of all participants during a 10-years period (2013–2022). Moreover, the amounts of physical, chemical, and ergonomics harmful agents in the work environment were investigated. All the collected data were analyzed using SPSS version 25.0. The values of Body Mass Index (BMI), Red Blood Cell Count (RBC), Platelets Count (PLT), Thyroid-Stimulating Hormone Level (TSH), Fasting Blood Sugar Level (FBS), Creatinine, Triglyceride (TG), Liver Enzymes level (SGOT and SGPT), and Systolic Blood Pressure (SBP) were higher among the shift work employees, and a significant difference was observed between the values of these parameters between the two groups. The results of logistic regression showed that the highest effect of shift work was observed on the parameters of FBS, TG, SGPT, TSH, Physical activity, BMI, Sleep duration, PLT, and Sleep quality with beta coefficient values of 0.49, 0.33, 0.29, 0.29, 0.20, 0.18, 0.14, 0.13 and, 0.11, respectively (p-value < 0.01). The present study contributes to a growing body of evidence that blood and metabolic factors are likely to be influenced by shift work. These findings have important implications for policy makers, highlighting the need for interventions to mitigate the negative health effects of shift work on workers.

Nanoselenium foliar application boosts antioxidant capacity and soluble solids in kiwifruit

Nanoselenium is an important pleiotropic and non-toxic signaling molecule with multiple roles in regulating plant responses to environmental stresses. The aim of this study was to explore the effect of nanoselenium on the soluble solids content and antioxidant capacity of kiwifruit. The effects of nanoselenium on kiwifruit's antioxidant capacity and soluble solids content were investigated by foliar spraying at different concentrations during a two-year field trial. We demonstrated that nanoselenium (15 mg/L) was the most effective treatment strategy, resulting in increased total soluble solids content (34.9%), as well as increased selenium (0.025 mg/kg), superoxide dismutase (25.9%), peroxidase (22.5%) and catalase (29.5%) content in kiwifruit. In addition, nanoselenium treatment activated the signal transduction and galactose pathways of the plant and increased the expression of genes related to secondary metabolism. These changes led to higher antioxidant and sugar levels, enhancing the taste of the selenium-enriched kiwifruit. This study established a nanoselenium agricultural strategy to improve kiwifruit's value and functionality.

Comparison of Binary Logistic Regression and SVM to Classify Diabetes Sufferers

Diabetes is a chronic metabolic disorder characterized by high levels of glucose in the blood due to disruption of the insulin hormone which functions as a regulator of the balance of blood sugar levels. This disease continues to increase in prevalence in various countries, making it a global health problem. Diabetes has trigger factors that contribute to the incidence of the disease, such as age, gender, smoking habits, healthy eating patterns, high blood pressure, and others. Diagnosis of diabetes can be done by carrying out a fasting blood sugar test, a 2-hour postprandial (PP) blood sugar test, and a random blood sugar test. However, it is very possible for diagnoses made by health workers to have errors due to subjectivity and different experiences, so a fast and precise classification method is needed to classify patients undergoing diabetes examination based on variables related to diabetes. The classification method used in this research is binary logistic regression and Support Vector Machine (SVM). A similar study carried out classification of diabetes sufferers using the Naive Bayes and KNN methods by comparing the results with SVM, so in this study the binary logistic regression method and SVM will be used to determine the performance of the classification method. The data used is secondary data. Next, the data is divided into training and testing data. The analysis results show that the SVM method is slightly superior in classification accuracy of testing data, namely 97.75%. With this research, it is hoped that decisions on patients undergoing diabetes examination will be faster, more precise and effective, and classification methods with better performance can be applied

Knowledge, attitudes, and practices of Lebanese patients with type II diabetes towards the use and abuse of dietary supplements: A cross-sectional study.

Dietary supplements (DS) use among Lebanese patients with type 2 diabetes mellitus (T2DM) increased widely due to the country's economic and financial situation. This study was conducted (1) to estimate the prevalence of DS use among persons with T2DM amid the escalating economic crisis in Lebanon; (2) to explore the knowledge, attitude, and practice (KAP) of DS use; and (3) to determine any significant association between socio-economic and socio-demographic factors and the use of DS modality. A cross-sectional study was conducted during the worst episode of the economic crisis between October and April 2022 on 460 adult patients with T2DM of both sexes. Patients were interviewed using a pre-tested questionnaire. Almost 4 out of 10 patients with T2DM in our study were found to be using DS, where 27.6% take multivitamins frequently. One-third of the participants agreed that nutritional supplements are necessary to control diabetes symptoms and complications. Around 41.1% of the participants complained about hypoglycemia and used DS to control their blood sugar levels (56.4%), while the rest used it to improve their health (35.5%) and control their diet (2.2%). The predictors of DS usage were the patient's level of education [OR=3.9, CI=1.5-10, p=0.003), self-monitoring of blood sugars (OR=4.9, CI=1.68-14.6; p=0.004) and reading the nutrition label [OR=59.3, CI=6.3-55.8, p=0.000]. This study estimated the prevalence of DS use and abuse, among persons with diabetes type II and found three significant predictors of DS use among patients with T2DM. Public health experts should encourage healthy discussions and awareness with their patients to comprehend their views regarding DS use.

DETEKSI DINI KELUHAN YANG LAZIM MUNCUL PADA LANSIA DI UPT PESANGGRAHAN PMKS MOJOPAHIT KABUPATEN MOJOKERTO

The decision to live at Pesanggrahan PMKS Mojopahit can come from the family or the wishes of the elderly themselves. Many elderly people experience physical and psychological complaints, some of which cannot be conveyed. Sometimes this complaint will cause depression. At this time, early detection of these complaints is needed. The method used for physical health examination is blood pressure measurement, a simple laboratory form random blood sugar levels and uric acid levels, mental health using a questionnairegeriatric depression scale. The target is all 48 elderly people at Pesanggrahan PMKS Mojopahit. The results show that the blood pressure of the elderly has a tendency to increase starting from grade 1 to grade 2 hypertension and isolated systolic hypertension as much as 29%. Uric acid levels show that the majority have uric acid levels within normal limits (56%), but 36% have uric acid levels that are high. high, blood glucose levels tend to lead to pre-diabetes mellitus as much as 21% and as many as 12% of elderly people have diabetes mellitus status. The results of mental health detection using GDS show that the majority of elderly people experience moderate depression. It is hoped that the management of the PMKS Mojopahit guesthouse will pay attention to these findings with the following steps; regular check-ups to maintain the health of the elderly, physical activity, leisurely walking and cardio exercise for the elderly, treatment of depression problems through group activity therapy and psychoreligious therapy.

Alleviation of High-Fat Diet-Induced Hyperlipidemia in Mice by Stachys sieboldii Miq. Huangjiu via the Modulation of Gut Microbiota Composition and Metabolic Function.

Hyperlipidemia is a chronic disease that is difficult to cure, and long-term pharmacotherapy may have negative consequences. Dietary therapy is a very promising strategy, and Chinese rice wine (Huangjiu) will play an important role because of its many biologically active components. In this work, the alleviating effect of Stachys sieboldii Miq. Huangjiu (CSCHJ) on high-fat diet-induced hyperlipidemia in mice was investigated, which is brewed from the wheat Qu with the addition of Stachys sieboldii Miq. and contains 15.54 g/L of polysaccharides. The experimental results showed that CSCHJ inhibited appetite, reduced body weight and blood sugar levels, and downregulated the serum levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) while concurrently upregulating high-density lipoprotein cholesterol (HDL-C) in the high-fat diet-induced hyperlipidemia mice. At the same time, it was discovered that alcohol worsens hyperlipidemia symptoms and related physiological markers, implying that CSCHJ polysaccharides may play a role in hyperlipidemia treatment. Through the assessment of organ indices, liver and kidney function, and tissue staining, CSCHJ demonstrated efficacy in repairing liver, kidney, and colon mucosal damage in hyperlipidemic mice. Furthermore, 16S rDNA sequencing and gas chromatography studies revealed that CSCHJ effectively restored the intestinal microbial structure and enhanced the quantity of fecal short-chain fatty acids (SCFAs) in hyperlipidemic mice. Therefore, the alleviating effect of CSCHJ on hyperlipidemia in mice may be attributed to its regulation of energy metabolism by repairing liver, kidney, and colon mucosal damage and restoring the gut microbiota structure, among other mechanisms. Overall, our findings provide evidence that CSCHJ contains active ingredients capable of alleviating hyperlipidemia, thereby laying a theoretical foundation for the extraction of bioactive substances from Huangjiu for future medical or dietary use.

Long-term outcome of patients with diabetic-range hyperglycemia first detected during admission for COVID-19: A single-center observational study.

Diabetic-range hyperglycemia has been reported for the first time in many patients during their hospitalization with coronavirus disease 2019 (COVID-19). This study was undertaken to determine the proportion of such patients who actually have new-onset diabetes mellitus rather than transient hyperglycemia during acute illness. This descriptive study included patients with diabetic-range hyperglycemia first detected at or during admission for COVID-19 but no prior history of diabetes. The study protocol involved patient identification, data recording from the case-notes, and telephonic follow-ups. Blood sugar levels done at least two weeks after discharge or the last dose of steroids, whichever was later, were recorded, and patients were categorized as diabetic, pre-diabetic, or non-diabetic accordingly. Out of 86 patients, ten (11.6%) were found to have developed diabetes, and 13 (15.1%) had pre-diabetes on follow-up. About 63 (73.3%) patients had become normoglycemic. Eight (80%) out of the ten patients with new-onset diabetes were on treatment, with five (50%) achieving the target glycemic levels. The associations of new-onset diabetes with age, gender, comorbidities, intensive care stay, and steroid administration were not found to be statistically significant (p-values 0.809, 0.435, 0.324, 0.402, and 0.289, respectively). While a majority of post-COVID patients with diabetic-range hyperglycemia returned to a normoglycemic state after the acute illness had settled down, one in ten developed new-onset diabetes, and an additional one in seven had impaired glucose tolerance. Thus, regular glucose screening is crucial for such patients and lifestyle modifications should be encouraged to reduce the risk of diabetes. Loss to follow-up and reliance on a single set of blood sugar readings for classification were some of the limitations of this study.

Supercritical fluid extrusion of dairy and fruit products to generate GOS-enriched and nutritionally superior snack puffs

The consumption of ultra-processed snacks is often considered unhealthy because such foods generally are energy-dense with low nutritive value. They contain high levels of starch, fat, and sugar and low levels of essential nutrients such as fiber, protein, and bioactive compounds. Nutritionally balanced snack foods that cater to today’s on-the-go lifestyles and do not get in the way of better eating are in high demand. The present study aims to create nutritionally attractive extruded puffs by valorizing food manufacturing byproducts and to elucidate the uniqueness of hybrid extrusion processing and its effect on product quality parameters. Supercritical fluid extrusion (SCFX) was used to transform apple pomace, starch or dairy ingredient-based formulations into value-added products in a zero-waste system. Acid whey, a byproduct of yogurt and cheese manufacturing, was used in lieu of water in the extruder to mitigate environmental issues related to its disposal. The SCFX system was also used for in-process polymerization of galactose, sourced from lactose hydrolyzed skim milk powder (LHSMP), with lactose from milk protein concentrate (MPC) and acid whey sources to produce galacto-oligosaccharides (GOS), a prebiotic associated with various health benefits and making the product acceptable to lactose intolerant consumers. Analysis of the extruded puffs showed that a combination of pomace and dairy ingredients significantly improved the nutritional profile of the product, notably increasing the fiber (5.0 g/30 g serving), protein (13.6 g/30 g serving), bioactive compounds (phenolics 21.4 mg GAE/30 g and vitamin C 0.3 mg/30 g serving), minerals, and GOS (0.4 g/30 g serving) contents. A sensory acceptance test (n=91) showed that incorporation of fruit and dairy by-products in snacks either improved or maintained Just About Right (JAR) scores compared to Market Keto puffs. Overall, utilizing fruit pomace and acid whey in extruded products made by SCFX is not only able to generate nutritious and functional snacks with balanced nutrients profile, derived from inexpensive agro-food by-products feedstock, but also can help mitigate environmental and waste issues.

Self-Efficacy Improvement in Diabetes Mellitus Patients After Implementing Discharge Planning Based on Diabetes Self Care Management Education in Inpatient Room, dr. Haryoto Hospital, Lumajang

Diabetes (DM) is a chronic disease and is characterized by high blood sugar (glucose) levels, diabetes that is not well controlled, can cause various complications that endanger the patient. One of the pillars of DM management is health education. Health education can increase the self-efficacy of patients so that diabetes management can be optimized. Diabetes Self Management Education (DSME) is a diabetes management education and support program that can be a place for diabetes patients to get education, support development and maintain the behavior of diabetes patients. The management that will be implemented is implementing DSME-based discharge planning and measuring self-efficacy before and after the intervention. The design of this scientific paper uses a case study design. The subjects used were two patients with diabetes mellitus. Data analysis was carried out using descriptive analysis. Self-efficacy in (Mrs. S) patients who were given DSME-based charge planning increased from an initial self-efficacy score of 58 in the low category to 87 in the high category, Meanwhile the self-efficacy of (Mrs. P) patients who were given charge planning not based on DSME experienced a difference from the initial self-efficacy score of 54 in the low category to 59 in the low category. There is a change in self-efficacy in diabetes mellitus patients (Mrs.S) after implementing DSME-based discharge planning and there was no change in self-efficacy in diabetes mellitus patients (Mrs.P) who applied non-DSME-based discharge planning inpatient RSUD. dr. Haryoto Lumajang.