Touch Ultra Research Articles

IMPACT OF MELATONIN ON SOME INDICATORS OF CARBOHYDRATE METABOLISM IN LIVER OF RATS WITH DEXAMETHASONE-INDUCED DIABETES

One frequently employed experimental model, particularly in pre-clinical studies examining the hypoglycemic effects of potential antidiabetic medications, is the metasteroid diabetes model induced by the prolonged administration of glucocorticoids to animals. This experimental study aimed to elucidate the effects of exogenous melatonin (10 mg/kg) on glycogen content and the activity of key enzymes—pyruvate kinase (PK) [EC 2.7.1.40], lactate dehydrogenase (LDH) [EC 1.1.1.27], glucose-6-phosphate dehydrogenase (G-6-PDH) [EC 1.1.1.49], and glucose-6-phosphatase (G-6-P-ase) [EC 3.1.3.9]—in the livers of rats with dexamethasone-induced diabetes. Materials and Methods. The experiments were performed on 44 male 18-month-old white non-linear rats, divided into three groups: 1) control (intact rats), 2) rats with dexamethasone-induced diabetes, 3) rats that amid the progression of dexamethasone-induced diabetes, underwent daily oral administration of melatonin (Sigma, USA) in a dose of 10 mg/kg. Dexamethasone diabetes was modeled by subcutaneous injection of dexamethasone (injection solution 4 mg/ml, KRKA, Slovenia) at a dose of 0.125 mg/kg body weight daily for 13 days (O.V. Stefanov, 2001). Decapitation of animals was carried out in accordance with the norms of the "European Convention for the Protection of Vertebrate Animals Used for Experimental and Other Scientific Purposes" (Strasbourg, 1986). Glucose content in blood from the tail vein of rats, taken on the 14th day of fasting before decapitation of the animals, was determined using a portable glucometer (One Touch Ultra Easy, Life Scan, USA). The content of glycogen and the activity of the studied enzymes of carbohydrate metabolism in the liver were determined according to the generally accepted, previously described methods. A 5% homogenate was prepared from the cold-isolated rat liver in a chilled 50 mM Tris-HCI buffer (pH=7.4) to study the activities of pyruvate kinase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase and glucose-6-phosphatase in the cytosolic fraction. The reliability of the difference between the obtained indicators was assessed using the parametric Student's t-test (for normal distribution) and the non-parametric Mann-Whitney U-test (for non-normal distribution). Differences were considered probable at p≤0.05. Results and discussion. According to our results, in the liver of diabetic rats that did not receive any means of correction of carbohydrate metabolism disorders, the glycogen content was 33% lower than in intact animals. The activities of enzymes such as pyruvate kinase and glucose-6-phosphate dehydrogenase were also reduced in the liver of rats with impaired glucose tolerance by 31.6 and 21.5%, respectively, compared to intact animals, indicating inhibition of glucose oxidation pathways, both at the level glycolysis (decrease of pyruvate kinase), as well as at the level of the oxidative stage of the pentose-phosphate pathway of glucose-6-phosphate oxidation. At the same time, the activity of lactate dehydrogenase and especially glucose-6-phosphatase in the liver of rats with diabetes by 19.5 and 56%, respectively, exceeded the indicators of animals of the control group, which demonstrates the increased activity, intensity of glycogenolysis and gluconeogenesis under conditions of insulin resistance, because glucose-6-phosphatase is the terminal enzyme of these processes. Regarding the investigated parameters of carbohydrate metabolism, both the glucose content in the blood of rats, as well as the glycogen content and the activity of all studied enzymes in the liver of rats that were injected with melatonin against the background of the development of diabetes, did not reliably differ from the parameters of intact animals, which confirms the assumption of the probable hypoglycemic effect of melatonin against the background of the development of diabetes. Conclusions: The daily two-week use of melatonin (10 mg/kg), against the background of the development of dexamethasone diabetes in rats, contributes to the normalization of certain indicators of carbohydrate metabolism in the liver of animals.

Pandan Wangi rice as reference food and the use of 25 g portion in glycemic index test

The notion of the Glycemic Index (GI) can be utilized to aid in the choosing of foods for a healthy diet, leading to low GI claims that have been commonly found in various food products. The convenience of the test subject could affect GI results, such as the type of reference food and how much of it to be consumed. Therefore, the goals of this research were to see if white rice (Pandan Wangi) could be used as a reference food and to compare GI result obtained from a different portion of available carbohydrate. The recruited subjects ranged in age from 21-36 years old with BMI of 18.5-24.9 kg/m 2 ). Glucose measurement and sample testing (white rice and cookies) were conducted in the experiment. Overnight fasting was required of volunteers, and blood samples were obtained using One Touch Ultra Lifescan. There were seven points of blood sampling with triplication of glucose testing GI values were calculated with Incremental Area Under Curves (IAUC). The result means of GI were 74±16 (white rice), 60±24 (wheat cookies), 38±14 (NS-cookies), and 39±16 (HMT-cookies). The correlation between IAUC glucose and rice was significant with r=0.834 (n=10, p<0,01). GI of white rice based on 25g available carbohydrates (AVCHO) was significantly different from GI based on 50g AVHCO (n=10, p<0.05). Pandan Wangi white rice can be used to substitute glucose or white bread in GI tests with a conversion factor of 0.74. It needed further study regarding the use of 25 g AVCHO as the basic portion in GI test.

Should we assume accuracy of point of care glucose meters? an observation from a tertiary health care centre

Background: Self-monitoring of blood glucose is important in the management of patients with diabetes mellitus in the community as well as in the hospital. It has been used for calculation of insulin doses of individuals with dysglycaemia and monitoring of glucose control. Errors in the measurement of the blood glucose can lead poor management of a patient. There is therefore the need to ensure standardization of these meters in order to achieve accuracy and precision. Objectives: To evaluate the precision and accuracy of four glucose meters commonly used for self-monitoring of blood glucose (SMBG) in a tertiary health care Centre compared to the reference laboratory method. Materials and Methods: We analyzed blood glucose samples of 55 diabetic patients who came to diabetes clinic using 4 different glucose meters (Accucheck active, Novo max extra, One touch Ultra 2 and On call plus (accoson)). Capillary and Venous blood samples were taken simultaneously from each patient for analysis using four blood glucose meters and laboratory reference method respectively. The laboratory value was used as a tool for comparison. The accuracy and precision were evaluated by the ISO and ADA criteria. The results obtained were analysed using Bland Altman graphs, correlation coefficients, scatter plots and Clarke's error grid analysis. Results: We observed good correlation between two glucose meters (Accucheck TM and Novomax TM ) and laboratory analyzed values. Among the glucose meters Accucheck TM , Novomax TM , One touch Ultra TM and On call plus TM , the correlation coefficient was 0.97, 0.96, 0.88 and 0.69 respectively. The degree of agreement of the laboratory method and the Accucheck TM , Novomax TM , One touch ultra TM and On call plus TM glucose meters was 89.09, 80.00, 76.20 and 71.32% respectively. Accucheck and Novomax TM were within ±20% accuracy (14.5% and 16.1%). Conclusion: There is a need for adequate and appropriate evaluation of all glucose meters in our setting before that we deploy them for use. None of glucose meters met the ISO target. Only one glucose meter (Accucheck TM ) met the ADA guideline for accuracy. Keywords: Accuracy; glucose meters; diabetes mellitus; self-monitoring of blood glucose

Гостра токсичність та гіпоглікемічна активність 7-хлоро-4-тіозаміщених хіноліну

The search for effective and safe pharmacological drugs for the treatment of diabetes is remaining highly valuable issue due to the chronic course of the disease and the need to use antipyretic drugs during the rest of life. Currently, various hypoglycemic agents are presented in the pharmaceutical market and the safety of their application is in priority. The activity of 4-thio-7-chloroquinoline derivatives as potential hypoglycemic drugs was studied here. The hypoglycemic activity was determined using a One Touch Ultra Plus Flex meter. The approach to glucose determination by this method is based on the reaction of glucose contained in the blood sample with flavin adenine dinucleotide dependent glucose dehydrogenase in the test strip, with the formation of a small electric current. The strength of this current calculates the level of glucose in the blood serum. Sodium 3-(7-chloroquinolin-4-ylthio)propionate demonstrates a high hypoglycemic activity after its intragastric administration. This compound significantly reduces glucose levels in rats up to 18.1% when compared with baseline and other compounds. 2-(7-Chloroquinoline-4-ylthio)propane and 2-acetamido-3-(7-chloroquinolin-4-ylthio)propanoic acid had little or no effect on serum glucose. The administration of compound 3 3-(7-chloroquinolin-4-ylthio)propionic acid in experimental animals increases the serum glucose on 19,6% comparing to the basic level. Acute toxicity of 4-thio7-chloro-substituted quinoline was determined with the Prozorovsky express method. The substances were administered once intraperitoneally as a thin aqueous suspension in saline solution (stabilizer - Twin 80) or as a solution of not more than 1 ml. The relationship between the structure of the test compounds and their toxicity is analyzed. It has been established that the mean lethal dose (LD50) of these compounds ranges from 200-800 mg/kg and is classified as low toxic that corresponds to the fourth class of toxicity.

Enhancement of adiponectin ameliorates non‐alcoholic fatty liver disease via inhibition of FoxO1 in type I diabetic rats

Non‐alcoholic fatty liver disease (NAFLD) is a common liver disease which is previously associated with Type 2 Diabetes Mellitus (T2DM). Recent research has indicated Type 1 Diabetes Mellitus (T1DM) is also involved in the development of non‐alcoholic fatty liver disease, whereas the underlying mechanisms are not utterly understood. Forkhead box O1 (FoxO1) and adiponectin (APN) have been proposed to play an important role in the processes in NAFLD in T1DM. We herein investigated the effects of FoxO1 and APN on the NAFLD and the underlying mechanism in T1DM. Serum AST and ALT was determined by commercially available kits. Blood glucose levels were measured by One Touch Ultra Glucose Meter. Relevant protein expression was tested by Western blot analysis. We found that serum AST and ALT were both increased in T1DM rats, which was ameliorated by application of APN or block of FoxO1. Moreover, APN and FoxO1 inhibitor both decreased the expression of FoxO1 which was significantly increased in diabetic rats. However, the inhibition of FoxO1 didn't alter the expression of APN and its receptors. We also found that Akt1 expression was significantly declined in diabetic rat which was restored by APN. Together, these results suggest that APN ameliorates NAFLD via inhibition of FoxO1 through Akt1/FoxO1 signaling pathway. The present study demonstrated the effort of T1DM on NAFLD and presented a novel role of APN in the underlying mechanism.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The Usability of Blood Glucose Meters: Task Performance Differences Between Younger and Older Age Groups

This study examines the overall usability of current, commercially available self-monitoring blood glucose (SMBG) meters in order to highlight how the design affects the performance of younger and older adults. Sixteen younger participants (18-27) and 29 elderly participants (65-85) attempted to complete two tasks: 1) set date/time and 2) perform a control solution test, using two meters: the Accu-Check Compact Plus® and 2) the One Touch Ultra 2®. Overall, elderly participants had significantly more difficulty completing the two tasks and committed significantly more errors than younger participants. When using the Accu-Chek® meter to set the date and time 79% of elderly adults failed compared to 12% of younger adults. When using the One Touch® meter, 21% of elderly adults failed to complete the task while none of the younger adults failed. Across the two tasks, elderly participants made, on average, an additional 1.6 errors compared to those in the younger group.

A Model of Self-Monitoring Blood Glucose Measurement Error.

A reliable model of the probability density function (PDF) of self-monitoring of blood glucose (SMBG) measurement error would be important for several applications in diabetes, like testing in silico insulin therapies. In the literature, the PDF of SMBG error is usually described by a Gaussian function, whose symmetry and simplicity are unable to properly describe the variability of experimental data. Here, we propose a new methodology to derive more realistic models of SMBG error PDF. The blood glucose range is divided into zones where error (absolute or relative) presents a constant standard deviation (SD). In each zone, a suitable PDF model is fitted by maximum-likelihood to experimental data. Model validation is performed by goodness-of-fit tests. The method is tested on two databases collected by the One Touch Ultra 2 (OTU2; Lifescan Inc, Milpitas, CA) and the Bayer Contour Next USB (BCN; Bayer HealthCare LLC, Diabetes Care, Whippany, NJ). In both cases, skew-normal and exponential models are used to describe the distribution of errors and outliers, respectively. Two zones were identified: zone 1 with constant SD absolute error; zone 2 with constant SD relative error. Goodness-of-fit tests confirmed that identified PDF models are valid and superior to Gaussian models used so far in the literature. The proposed methodology allows to derive realistic models of SMBG error PDF. These models can be used in several investigations of present interest in the scientific community, for example, to perform in silico clinical trials to compare SMBG-based with nonadjunctive CGM-based insulin treatments.

Bệnh gan trên chó tiểu đường tại quận Ninh Kiều, thành phố Cần Thơ

The study was carried out on 2,191 dogs kept in Ninh Kieu district, Can Tho city and those examined at some veterinary clinics in this city from January, 2015 to May, 2016. Through records, clinical diagnosis, capillary blood glucose concentrations were used for diagnosis. Determination of capillary blood sugar concentration at 8 hours after feeding was done using One Touch Ulra 2 test paper based on glucose- oxydase reaction. The test results were read after 5 seconds by One Touch Ultra glucose meter (Johnson&Johnson Company, USA). Diagnosis of diabetes in dogs was based on criteria of WSAVA, 2010 (World Small Animal Veterinary Association, 2010). Determining diabetic hepatopathy in dogs was based on quantilative analysis AST (Aspartate Aminotransferase,) and ALT (Alanine Aminotransferase) enzyme in serum of diabetic dogs. Diagnosis of determining diabetic hepatopathy in dogs was based on criteria of The Mecrk, 2013. The results show that 124 out of 2,191 dogs (5.66%) got diabetes. Sixty seven out of 124 cases (54.03%) were positive with liver disease. The prevalence of diabetic hepatopathy disease was 50.62% in female dogs and 60.47% in males. The prevalence of canine diabetes was highest in above 7 year-old dogs (67.74%) and lowest in 3-5 year-old dogs (26.1%). In addition, the diabetic hepatopathy disease showed common clinical signs (40.30%) including anorexia, vomit; pain in the area of beneath rib when performed clinical diagnosis (31.34%) and jaundice (7.46%) and less common clinical signs (22.39%).

Accuracy of devices for self-monitoring of blood glucose: A stochastic error model.

Self-monitoring of blood glucose (SMBG) devices are portable systems that allow measuring glucose concentration in a small drop of blood obtained via finger-prick. SMBG measurements are key in type 1 diabetes (T1D) management, e.g. for tuning insulin dosing. A reliable model of SMBG accuracy would be important in several applications, e.g. in in silico design and optimization of insulin therapy. In the literature, the most used model to describe SMBG error is the Gaussian distribution, which however is simplistic to properly account for the observed variability. Here, a methodology to derive a stochastic model of SMBG accuracy is presented. The method consists in dividing the glucose range into zones in which absolute/relative error presents constant standard deviation (SD) and, then, fitting by maximum-likelihood a skew-normal distribution model to absolute/relative error distribution in each zone. The method was tested on a database of SMBG measurements collected by the One Touch Ultra 2 (Lifescan Inc., Milpitas, CA). In particular, two zones were identified: zone 1 (BG≤75 mg/dl) with constant-SD absolute error and zone 2 (BG>75mg/dl) with constant-SD relative error. Mean and SD of the identified skew-normal distributions are, respectively, 2.03 and 6.51 in zone 1, 4.78% and 10.09% in zone 2. Visual predictive check validation showed that the derived two-zone model accurately reproduces SMBG measurement error distribution, performing significantly better than the single-zone Gaussian model used previously in the literature. This stochastic model allows a more realistic SMBG scenario for in silico design and optimization of T1D insulin therapy.

Performance of Point-of-Care Diagnostics for Glucose, Lactate, and Hemoglobin in the Management of Severe Malaria in a Resource-Constrained Hospital in Uganda

Severe malaria is frequently managed without access to laboratory testing. We report on the performance of point-of-care tests used to guide the management of a cohort of 179 children with severe malaria in a resource-limited Ugandan hospital. Correlation coefficients between paired measurements for glucose (i-STAT and One Touch Ultra), lactate (i-STAT and Lactate Scout), and hemoglobin (Hb; laboratory and i-STAT) were 0.86, 0.85, and 0.73, respectively. The OneTouch Ultra glucometer readings deviated systematically from the i-STAT values by +1.7 mmol/L. Lactate Scout values were systematically higher than i-STAT by +0.86 mmol/L. Lactate measurements from either device predicted subsequent mortality. Hb estimation by the i-STAT instrument was unbiased, with upper and lower limits of agreement of -34 and +34 g/L, and it was 91% sensitive and 89% specific for the diagnosis of severe anemia (Hb < 50 g/L). New commercially available bedside diagnostic tools, although imperfect, may expedite clinical decision-making in the management of critically ill children in resource-constrained settings.

Inhibitory Mechanism of an Allosteric Antibody Targeting the Glucagon Receptor

Elevated glucagon levels and increased hepatic glucagon receptor (GCGR) signaling contribute to hyperglycemia in type 2 diabetes. We have identified a monoclonal antibody that inhibits GCGR, a class B G-protein coupled receptor (GPCR), through a unique allosteric mechanism. Receptor inhibition is mediated by the binding of this antibody to two distinct sites that lie outside of the glucagon binding cleft. One site consists of a patch of residues that are surface-exposed on the face of the extracellular domain (ECD) opposite the ligand-binding cleft, whereas the second binding site consists of residues in the αA helix of the ECD. A docking model suggests that the antibody does not occlude the ligand-binding cleft. We solved the crystal structure of GCGR ECD containing a naturally occurring G40S mutation and found a shift in the register of the αA helix that prevents antibody binding. We also found that alterations in the αA helix impact the normal function of GCGR. We present a model for the allosteric inhibition of GCGR by a monoclonal antibody that may form the basis for the development of allosteric modulators for the treatment of diabetes and other class B GPCR-related diseases.

Effects of small interfering RNA-mediated hepatic glucagon receptor inhibition on lipid metabolism in db/db mice

Hepatic glucose overproduction is a major characteristic of type 2 diabetes. Because glucagon is a key regulator for glucose homeostasis, antagonizing the glucagon receptor (GCGR) is a possible therapeutic strategy for the treatment of diabetes mellitus. To study the effect of hepatic GCGR inhibition on the regulation of lipid metabolism, we generated siRNA-mediated GCGR knockdown (si-GCGR) in the db/db mouse. The hepatic knockdown of GCGR markedly reduced plasma glucose levels; however, total plasma cholesterol was increased. The detailed lipid analysis showed an increase in the LDL fraction, and no change in VLDL HDL fractions. Further studies showed that the increase in LDL was the result of over-expression of hepatic lipogenic genes and elevated de novo lipid synthesis. Inhibition of hepatic glucagon signaling via siRNA-mediated GCGR knockdown had an effect on both glucose and lipid metabolism in db/db mice.

Pseudohypoglycemia or hyperglycemia caused by interference with self-monitoring blood glucose measurements in anticancer ascorbic acid therapy.

Self‐monitoring blood glucose (SMBG) meters are now commonly used in diabetes management1. Many drugs, including ascorbic acid, are known to interfere with glucose measurements using these meters2. However, so far, misdiagnosis caused by interference has rarely occurred at the conventional doses. Recently, intravenous high‐dose ascorbic acid treatment has been widely used in 11,233 patients in 2006 and 8,876 patients in 2008 in the USA as one of the complementary and alternative medicines for infection and fatigue, as well as various cancers3. A 71‐year‐old woman with advanced esophageal cancer and diabetes presented to the Department of Metabolic Medicine, Osaka University Hospital, Suita, Japan, for glycemic control in November 2012. At the first visit, her glycosylated hemoglobin level was 8.8%. SMBG was carried out using the Medisafe® meter (TERUMO Corp., Tokyo, Japan) to determine the dosage of regular insulin before every meal. One day, she was given a high ascorbic acid dose (50 g) in another hospital. Her blood ascorbic acid concentration just after administration was 342 μg/mL (normal range 4.7–17.8 μg/mL), and her blood glucose level determined with the Medisafe® meter was below 1.1 mmol/L, which was ‘low’. Simultaneously, glucose levels were measured using the Glucocard® meter (ARKRAY Inc., Kyoto, Japan). According to the Glucocard® meter, her blood glucose level was above 33.3 mmol/L, which was “high.” She had neither hypoglycemic nor hyperglycemic symptoms. The fasting blood glucose level (9.3 mmol/L) determined with the Medisafe® meter 2 days after administration was close to the level (9.2 mmol/L) determined using the intra‐hospital laboratory test based on the hexokinase method (Quickauto‐Neo GLU‐HK; SHINO‐TEST Corp., Tokyo, Japan) and using an automated analyzer (JCA‐BM6050; JEOL Ltd., Tokyo, Japan). Then, the treatment with intravenous high‐dose ascorbic acid was discontinued with her consent. We prepared blood samples that contained 4.4 and 11.1 mmol/L glucose, and 0–500 μg/mL ascorbic acid. The glucose levels increased in accordance with the increased ascorbic acid concentrations using the Glucocard® meter, whereas they decreased using the Medisafe® meter. However, the glucose levels measured using the intrahospital laboratory test did not change in response to any ascorbic acid concentration (Figure 1). Figure 1 Glucose measurement interference after administration of various concentrations of ascorbic acid. Glucose concentrations were measured using Medisafe® (diamond symbols) and Glucocard® (triangular symbols) blood glucose meters, and an intra‐hospital ... The Medisafe® meter is based on the colorimetric method, which is applied to several types of Accu‐Chek® meters (Roche Diagnostics, Mannheim, Germany), whereas the Glucocard® meter is based on the electrochemical method, which is applied to many glucose meters, including the One Touch Ultra® (LifeScan Inc., Milpitas, CA, USA), FreeStyle® (Abbott Diabetes Care, Alamdea, CA, USA) and Contour® (Bayer Healthcare, Tarrytown, NY, USA) meters. As hydrogen peroxide is consumed by ascorbic acid, less hydrogen peroxide is available to react with the dye on the test strips, leading to falsely lower glucose readings by the Medisafe® meter. In contrast, ascorbic acid is oxidized at the electrode surface, and more electrons and more current are produced, leading to falsely higher glucose readings by the Glucocard® meter2. The critical glucose measurement interferences by high‐dose ascorbic acid could cause inappropriate insulin therapy or glucose administration, resulting in serious hypoglycemia or hyperglycemia. We need to understand that this type of interference occurs at the bedside; therefore, blood glucose levels just after intravenous administration of high‐dose ascorbic acid should be measured using the hexokinase method, not with these SMBG meters.

Evaluation of Four Point‐Of‐Care Glucose Meters in Alpacas

Hospitalized alpacas are often hyperglycemic requiring frequent blood glucose testing. To compare the performance of 4 brands of glucometers with a laboratory-based analyzer (LCA) over a range of glucose concentrations in alpacas. Four healthy male alpacas. A 2-treatment cross-over study was utilized. The alpacas were given 0.4 U/kg of regular insulin intravenously and then 500 mg/kg of dextrose intravenously with a 1 week washout period between treatments. Blood samples were collected from 10 minutes before until 6 hours after drug administration. Glucose concentrations were measured in whole blood and plasma samples on 4 glucometers, and serum glucose was measured on an LCA. Glucometer performance varied depending on whether glucose concentrations were measured in plasma or whole blood. Based on error grid analysis, the Precision Xtra and One Touch Ultra 2 glucometers were clinically acceptable for testing whole blood samples, whereas the Accu-Chek Aviva and Nova StatStrip Xpress glucometers were clinically acceptable for testing plasma samples in comparison with serum glucose concentrations determined by the LCA. All glucometers had systematic and proportional biases that varied based on sample type. Human-based glucometers in alpacas should be used cautiously, particularly at higher blood glucose concentrations. The blood sample type (plasma or whole blood) can alter meter performance when compared with serum glucose concentrations and potentially lead to errors in clinical decisions.

Comparison of glucometers used in hospitals and in outpatient settings with the laboratory reference method in a tertiary care hospital in Mumbai.

Background:Glucometers allow self-monitoring of blood glucose in a convenient manner. With the availability of various glucometers, there is a persistent attempt to improve the accuracy and the precision of these glucometer readings, so as to match the laboratory values of blood glucose.Objective:We compared the glucometers used in hospital and out-patient settings with the laboratory reference method.Materials and Methods:We analyzed a total of 105 blood samples collected from in-patient and out-patient from our tertiary care hospital. Venous blood samples were collected and checked on six glucometers and the same blood sample was sent to the laboratory for glucose estimation. The laboratory value was used as a reference for comparison. The accuracy was evaluated by the ISO criteria. The results were evaluated by Bland Altman graphs, correlation coefficients, scatter plots and Clarke's error grid analysis.Results:We observed good correlation between bed side glucometer and laboratory automated analyzer. Among the in-patient glucometers Breeze 2, Performa and SureStep, the correlation coefficient was 0.97, 0.96 and 0.88 respectively. Among the outpatient glucometers One touch ultra 2, Active and Contour, the correlation coefficient was 0.97, 0.97 and 0.95 respectively.Conclusions:There is a good correlation between different glucometers and laboratory values especially in the out-patient settings. Among all in-patient glucometers, SureStep by Johnson and Johnson had least correlation coefficient, whereas all three out-patient glucometers correlated well with the laboratory values.

Anti-diabetic Effects of Methanol Extract of the Seeds of Buchholzia coriacea and its Synergistic Effects with Metformin

Diabetes Mellitus (DM) has an estimated world prevalence of 285 million adults with high morbidity and mortality rates especially in the developing countries. The preparations of the seeds of Buchholzia coriacea commonly known as wonder kola is used for the management of DM in Nigerian ethnomedicine. In view of this, we studied the antidiabetic effects of the methanol extract of the seeds to scientifically ascertain the folkloric use. Alloxan induced diabetic rats were used in the study. Determination of the blood glucose concentration was done using the One Touch Ultra mini glucometer. Also acute toxicity test was performed using the Lorke’s method. Result showed an oral median lethality dose (LD50) greater than 5000 mg/kg, an indication of high safety profile. The extract at 100, 200, 400 mg/kg doses exhibited percentage blood glucose reduction (PBGR) of 37.73, 12.30 and 11.30 % respectively after 4 hours treatment. The combination of extract (100 mg/kg) and metformin (100 mg/kg) gave a PBGR at 4th and 7th day treatment of 73.4 and 72.2 % respectively. Therefore, the extract of the seeds of B. coriacea has potential hypoglycaemic effects and exhibited synergistic actions with metformin, a standard oral hypoglycaemic agent.

To reduce pain to heel prick in newborn: comparison with six lancet devices

Heel prick is an usual method performed to get a blood sample for newborn screening. Its wide use justifies the effort in reducing the pain as much as possible and some simple steps, including the use of spring heelsticks, are recommended by national and international guide-lines. But not all the heelsticks cause the same pain and allow to get enough blood for the screening. The aim of this work was to test six automatic heelstick devices with regard to the pain in heel prick measured with NIPS scale and, at the same time, to value their effectiveness in getting a blood sample suitable for filter paper for newborn screening. The following devices were assessed: Amnes Minilet Lancets, Wuxi Xinda Ltd, Exxe Safe Blade, Lifescan Stik Johnson & Johnson, One Touch Ultra Soft, Accu-Chek Safe T Pro Plus. The device Exxe Safe Blade statistically differs from all others: it is the least painful and it doesn't need any prick repetition.

The diagnostic efficacy of anthropometric and body composition cut‐off values in assessing risk factors for cardiovascular disease among university students

ObjectiveIn this study, we investigated the ability of various anthropometric and body composition cut‐off values in predicting fasting blood sugar (FBS), blood pressure (BP) and HDL cholesteroal levels in a group of healthy volunteers.MethodsParticipants had fasting finger‐stick blood sugar and HDL cholesterol measured with hand‐held automated monitors(One Touch Ultra and Cardio Chek PA respectively). Blood pressures was measures on both arms after ten minutes of rest in the sitting position using an automated blood pressure monitor(Omron HEM 712C). the average of four readings was used as the indexed blood pressure. In addition, antropometry was measured using standard procedure. Percentage body fat (%BF), visceral fat, skeletal muscle mass was measured with the OMRON Full Body Sensor (HBF‐510W). Participation in the study was voluntary.ResultsNinety‐eight persons (58 females and 43 males) participated in the investigation. Anthropometric and body composition cut‐off values had low sensitivities (3%–50%) and high specificities (70%–100%) in detecting elevated FBS,BP and HDL cholesterol levels.ConclusionOur findings suggest similar predictive ability among the various anthropometric and body composition cut–offs in detecting elevated blood sugar, blood pressure and HDL among participants.

Prevalence of hypoglycaemia in under-five children presenting with acute diarrhoea in University of Calabar Teaching Hospital, Calabar.

Background: The clinical features of hypoglycaemia and severe dehydration are similar, and these two can occur in a child presenting with acute diarrhoea. Hypoglycaemia occurring in a growing brain is deleterious and must be detected and treated. Objective: To determine the prevalence of hypoglycaemia among under-five children presenting with acute diarrhoea in UCTH, Calabar. Method: This was a prospective study of 150 children aged six weeks to five years presenting with acute diarrhoea in UCTH, Calabar from June 1st to October 31st 2008. Consecutive children who met the inclusion criteria were recruited into the study. Blood samples were collected for random blood sugar and serum electrotype estimation using One Touch Ultra Test Strips 2006 model and Flame photometry respectively. Results: The overall prevalence of hypoglycaemia in under-five children presenting with acute diarrhoea was 4%. There was no sex difference. It was commonest among children of the low socioeconomic class (83.3%). Risk factors to developing hypoglycaemia were longer duration of last feeds greater than five hours and severe&nbsp; dehydration, both reaching statistically significant differences (p=0.022 and 0.002; FET respectively). Forty percent of patients who died had hypoglycaemia constituting 33.3% of patients with hypoglycaemia. Conclusion: Children with diarrhoea complicated with severe dehydration are prone to developing hypoglycaemia. It causes high mortality and thus this parameter should be checked for and managed on time.Key words: Hypoglycaemia, acute diarrhoea, under-five children.

A comparison of methodologies for measuring glucose concentrations in the horse

<h2>ABSTRACT</h2> Five methods of measuring glucose in the horse were compared with plasma glucose reference values generated with an Autoanalyzer3 (Seal Analytical Ltd., Hampshire, UK). Plasma glucose was measured with a One Touch Ultra (LifeScan, Milpitas, CA) hand-held glucose meter and a YSI 2300 Stat Plus Glucose and Lactate Analyzer (YSI; YSI Inc., Yellow Springs, OH). Glucose also was measured in whole blood using One Touch Ultra and YSI. Finally, interstitial glucose measurements were obtained with a SEVEN continuous glucose monitoring device (Dexcom, San Diego, CA). Glucose measurements were obtained on 2 consecutive days in 6 American Quarter Horses maintained on native prairie hay and water. Each morning, 2 baseline glucose measurements were obtained 30 min apart. After a meal of sweet feed, glucose measurements were obtained every 30 min for 4 h. Patterns of postprandial glucose increases and subsequent decreases were similar across all methods but were displaced vertically from one another. Of the 5 methods, the YSI method with plasma appeared to have the best reproducibility of Autoanalyzer3 glucose values based on a random coefficients model with intercept not statistically different from zero (P = 0.08) and slope not statistically different from one (P = 0.08) and by having the highest Lin's concordance coefficient (r = 0.77). The other methods had biased random coefficients models with intercepts not equal to zero (P > 0.05) and slopes not equal to one (P > 0.05) and Lin's concordance coefficient values that ranged from 0.39 to 0.64. Technical difficulties with the SEVEN device limited its utility as a reliable method for evaluating glucose in the equine.