Two-hour Postprandial Blood Research Articles

Impact of WhatsApp-Based Self-Care Education on Self-Care Behaviors and Lifestyle in Overweight and Obese Pregnant Women with Diabetes: A Randomized Controlled Trial

Background: Self-care education for overweight and obese pregnant women with diabetes can empower them to make informed decisions during pregnancy. Objectives: This study aimed to evaluate the effect of WhatsApp-delivered self-care education on self-care behaviors and lifestyle in this population. Methods: This randomized controlled trial involved eighty pregnant women with diabetes in Ahvaz, Iran. Participants were randomly assigned to two groups: One receiving face-to-face education and the other receiving a combination of face-to-face and WhatsApp-delivered online education. Blood glucose levels [fasting blood sugar (FBS), 2-hour postprandial (2HPP)], oral glucose tolerance test (OGTT) results, lifestyle scores, and self-care scores were measured before and after the intervention. Data were analyzed using SPSS. Results: Post-intervention, the intervention group demonstrated significantly lower one-hour (119.32 ± 16.54 vs. 163.55 ± 27.07, P=0.007) and two-hour (106.25 ± 15.65 vs. 147.77 ± 24.73, P = 0.028) postprandial blood glucose levels compared to the control group. Furthermore, lifestyle scores improved significantly in the intervention group (154.27 ± 23.24 vs. 42.65 ± 17.58), and self-care scores were markedly higher (141.85 ± 26.64 vs. 56.02 ± 11.63), both showing strong statistical significance (P < 0.001). Conclusions: WhatsApp-based self-care education is an effective intervention for reducing blood glucose levels and enhancing lifestyle and self-care behaviors in pregnant women with diabetes.

Correlation Between the First Trimester Two-Hour Postprandial Blood Glucose Greater Than 110 mg/dL for the Prediction of Gestational Diabetes Mellitus.

To determine the correlation between first-trimester two-hour postprandial blood glucose (PPBG) > 110 mg/dL for predicting gestational diabetes mellitus (GDM). This prospective cohort study enrolled 200 women between 8 and 10 weeks of gestation from February 2022 to February 2024. All recruited pregnant women underwent testing for two-hour PPBS at 8-10 weeks and were followed up till delivery. GDM screening was done during 14-16, 24-28, and 32-34 weeks of gestation. Amongst women having PPBS > 110 mg/dL, 95.9% developed GDM, while in the group with PPBS < 110 mg/dL, only 4% developed GDM. In the PPBS > 110 mg/dL group, a significantly higher number of women were in the older age group (p < 0.049), had a higher BMI (p < 0.001), a family history of diabetes (p < 0.001), and previous history of abortion (p < 0.001). Women with PPBS > 110 mg/dL had significantly higher rates of cesarean section (p < 0.01), preterm delivery (p < 0.001), and macrosomia (p < 0.001). A positive correlation (r = 0.677; p < 0.001) was observed between first trimester two-hour PPBS and cord blood glucose levels. Similarly, a positive correlation (r = 0.465; p < 0.001) was present between insulin levels measured during the first trimester with cord blood insulin. The area under the curve (AUC) for PPBS was 0.969 (p < 0.001) with 95% CI: 0.933-0.988. PPBS > 110 mg/dL has a sensitivity of 95.9%, specificity of 95.6%, positive predictive value (PPV) of 95.9%, negative predictive value (NPV) of 95.7%, and diagnostic accuracy of 95.77% to predict GDM. PPBS > 110 mg/dL at two hours exhibits high levels of diagnostic accuracy for the prediction of GDM and is associated with adverse fetomaternal outcomes. PPBG is a superior, physiologic, and low-cost option compared to HbA1c for early prediction of GDM and can also be performed as a simple point-of-care test with a glucometer at home or in the periphery by healthcare workers (HCW) and in wellness centers.

Effects of DPP4 Inhibitors as Neuroprotective Drug on Cognitive Impairment in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis and Systematic Review.

Type 2 diabetes mellitus is considered as one of the risk factors for cognitive impairment. DPP4 inhibitors are effective drugs for the treatment of type 2 diabetes mellitus. However, the relationship between DPP4 inhibitors and cognitive dysfunction remains unclear. Therefore, we used a meta-analysis to determine the association between DPP4 inhibitors and cognitive impairment in type 2 diabetes mellitus. We systematically searched PubMed, CNKI, and the Cochrane Library at the time of establishment, 2022, and then made inclusion criteria and screened strategies to identify studies with more precise correlations. We included 10 studies with 5,583 participants. The data showed that DPP4 inhibitors significantly reduced the incidence rate of cognitive impairment in type 2 diabetes mellitus (SMD: 0.99; 95% CI [0.59, 1.38]). Furthermore, there was a linear correlation found between cognitive impairment in type 2 diabetes mellitus and fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin. DPP4 inhibitors decreased fasting blood glucose (FPG) (SMD: 0.52; 95% CI [-0.68, -0.37]), blood glucose (2hPPG) at 2 hours after the meal (SMD: 0.82; 95% CI, [-1.2, -0.43]), and HbA1c (SMD: 0.34; 95% CI [-0.48, -0.21]). All data were statistically significant (P < 0.0001). Furthermore, we conducted subgroup analyses of the following measures at various treatment durations and ages: cognitive scores, fasting blood glucose, glycosylated hemoglobin, and two-hour postprandial blood glucose. DPP4 inhibitors significantly improved type 2 diabetic mellitus individuals' cognitive impairment and reduced fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin. Subgroup analysis showed that people aged 60 to 70 years had better treatment effects at 0-180 days. This trial is registered with CRD42023399473.

Association between common mental disorder and glycemic control in women with gestational diabetes: A mixed-method study.

Gestational diabetes mellitus (GDM) is associated with an increased risk of mental health disorders among pregnant women. Poor mental health can negatively impact glycemic control in women with GDM, leading to adverse outcomes for both the mother and the baby. To determine the prevalence of common mental disorder (CMD) in women with GDM and its association with poor glycemic control. Additionally, to explore the reasons and coping strategies for CMD in women with GDM. A sequential explanatory mixed-method study was conducted among 351 women with GDM visiting a tertiary care hospital. The prevalence of CMD was assessed using Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Perceived Stress Scale (PSS). Glycemic control was determined based on two-hour postprandial blood glucose levels. In-depth interviews were conducted with six women who screened positive for CMD and had poor glycemic control. Data were analyzed using SPSS v23 and stats v12. Chi-square test and Poisson regression were performed, and adjusted prevalence ratios (aPRs) were reported. The prevalence of CMD was found to be 19.08% (95% CI: 15.32%-23.52%), with 18.2% (95% CI: 14.5%-22.6%) anxiety symptoms 8.3% (95% CI: 5.8%-11.6%) depressive symptoms and stress each. CMD was significantly related to poor glycemic control (aPR: 1.58; 95% CI: 1.23-2.03; P value <0.001). The qualitative analysis revealed individual, family, health, and facility factors influencing mental health and glycemic control. Common mental health disorders are prevalent in women with GDM. It has a negative association with glycemic control. Implementing a routine screening program in the ANC clinic can aid in early identification and prompt management of the CMD and its associated complications.

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

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

Community-based non-pharmacological interventions for pregnant women with gestational diabetes mellitus: a systematic review

BackgroundNon-pharmacological interventions are the first line of Gestational diabetes mellitus (GDM) management. Community-based interventions are cheaper, more accessible, with higher patient satisfaction.ObjectivesTo systematically review community-based non-pharmacological interventions and evaluate their effectiveness for GDM.Search strategyTwelve bibliographic databases and reference list of related studies from inception until January 2022.Selection criteriaAll primary studies of community-based non-pharmacological interventions for GDM reported in English which investigated any behavioural or clinical outcome(s).Data collection and analysisData were extracted using modified Cochrane’s data extraction template. Studies were evaluated using Cochrane Collaboration’s risk of bias tool. Narrative synthesis was used to summarise findings. This study is registered with PROSPERO (CRD42021257634).Main resultsTwenty-seven studies involving 6,242 pregnant women with GDM investigated self-management programmes, medical nutrition/diet therapy, exercise/physical activity, combined diet and exercise, calcium plus vitamin D supplementation, and continuous glucose monitoring. Self-management programmes were more effective than routine care in improving self-efficacy, two-hour postprandial blood glucose, and lifestyle behaviours but were as effective as routine care in improving infant birth weight. Self-management programmes were superior to or as effective as usual care in improving fasting blood glucose, blood glucose control, glycated haemoglobin, macrosomia, and preterm delivery. Medical nutrition/diet therapy was more effective than usual care in improving postprandial blood glucose levels. Postprandial blood glucose levels were better improved by regular supervised exercise plus daily brisk walks or a daily walking intervention than routine obstetric care or no treatment. The effects of exercise/physical activity programmes were mostly inconsistent for other outcomes. Diet and exercise were superior to diet alone in reducing maternal weight gain although there were similar outcomes for other pregnancy and foetal outcomes. Limited or conflicting evidence was found for other outcomes and interventions including calcium and vitamin D supplementation and continuous glucose monitoring intervention.ConclusionsCommunity-based non-pharmacological interventions are more effective than placebo; and are more or as effective as usual care. Self-management programmes and medical nutrition/diet therapy had the most promising GDM outcomes.FundingThere was no funding for this study. The study design, data collection, data analysis and interpretation, and writing of this manuscript were not influenced externally by any funder.

Influence of one-day diabetes mellitus clinic management on blood glucose control and prognosis in patients with gestational diabetes mellitus

Objective To explore the influence of the one-day diabetes mellitus (DM) clinic management model on blood glucose control and prognosis in patients with gestational diabetes mellitus (GDM). Methods A total of 930 patients diagnosed with GDM by oral glucose tolerance test screening at 24–28 weeks of gestation were selected from those who underwent outpatient prenatal checkups at our hospital and were randomly divided into one-day DM clinic group (n = 509) and control group (n = 421). A one-day DM clinic intervention was conducted in the one-day DM clinic group, and individualized dietary interventions and exercise instruction were given in the control group. Results The compliance rates of fasting blood glucose and two-hour postprandial blood glucose (2-h PPBG) were higher in the one-day DM clinic group than in the control group (p < .05). The compliance rates of the oral glucose tolerance test and insulin release test were higher in the one-day DM clinic group than in the control group (p < .05). There existed statistically significant differences in fasting blood glucose before delivery, together with the difference between fasting blood glucose at enrollment and before delivery and the difference between glycated hemoglobin at enrollment and before delivery (p < .05). Conclusion The one-day diabetes mellitus clinic management model is more conducive to blood glucose control in patients with GDM and more conducive to the recovery of blood glucose and islet function in patients with GDM after delivery and to reduce the occurrence of adverse pregnancy outcomes.

Effect of Yam Gruel on Blood Glucose Control and Insulin Resistance in Patients with Gestational Diabetes Mellitus

<sec><title>Objective</title> To explore the effects of yam gruel on blood glucose and insulin resistance in patients with gestational diabetes mellitus (GDM). </sec><sec><title>Methods</title> A total of 144 patients with GDM were recruited from the Obstetric Department of 900th Hospital of Joint Service Support Force of Chinese Peoples Liberation Army (Center Hospital Area and Cangshan Hospital Area) and Fujian Provincial Jinshan Hospital from July 2019 to December 2020, which were randomly divided into the control group and the observation group, with 72 cases in each group. The control group was given routine treatment and nursing care including regular outpatient examination, diet guidance, exercise guidance, blood glucose self-monitoring and health education. The observation group was given yam gruel on the basis of the routine treatment and care in the control group. Yam gruel was used to replace the carbohydrates in the breakfast [125 g peeled yam, 70 kcal (1 kcal=4.186 kJ)] under the condition of maintaining the total calories of breakfast. The yam gruel was taken every morning, five times a week, continous treatment for 10 weeks. The difference of blood glucose indicators [fasting blood glucose (FBG), two-hour postprandial blood glucose (2 h PBG), glycosylated hemoglobin (HbA1c)], insulin resistance indicators [fasting serum insulin (FINS), homeostasis model assessment insulin resistance index (HOMA-IR)], and pregnancy outcome indicators (delivery method, adverse pregnancy outcome) between two groups. </sec><sec><title>Results</title> ① Blood glucose indicators: compared with before intervention, 2 h PBG in the two groups after intervention for four,eight and ten weeks were significantly decreased, and HbA1c in the two groups after intervention for ten weeks was significantly increased, the differences were statistically significant (<italic>P</italic><0.05). Compared with the control group at the same time, the FBG of the observation group after intervention for eight and ten weeks was significantly decreased, the 2 h PBG of the observation group after intervention for four weeks, eight weeks and ten weeks was significantly decreased, and the HbA1c of the observation group after intervention for ten weeks was significantly decreased, the differences were statistically significant (<italic>P</italic><0.05).② Insulin resistance indicators: compared with before intervention, FINS and HOMA-IR in the control group after intervention for ten weeks were significantly increased, the difference was statistically significant (<italic>P</italic><0.05), but the differences of FINS and HOMA-IR in the observation group after intervention for 10 weeks were not statistically significant (<italic>P</italic>>0.05). Compared with the control group, FINS and HOMA-IR in the observation group after intervention for ten weeks were significantly decreased, the differences were statistically significant (<italic>P</italic><0.05). ③ Pregnancy outcomes: the difference of adverse pregnancy outcomes between two groups was not statistically significant (<italic>P</italic>>0.05). </sec><sec><title>Conclusion</title> Yam gruel can effectively improve blood glucose and IR in patients with GDM, but the effect of improving pregnancy outcomes is not obvious, which is worthy of clinical application. </sec>

The effect of interdisciplinary and diversified health education combined with personalized nutrition intervention on FPG, 2hPG, SDS, SAS scores and the pregnancy outcomes of gestational diabetes mellitus.

This study aimed to explore the effect of interdisciplinary and diversified health education combined with personalized nutrition intervention on FPG, 2hPG, SDS, SAS scores and pregnancy outcome of gestational diabetes mellitus (GDM). A total of 180 GDM patients, who were admitted to our hospital between June 2019 and June 2020, were enrolled as the research subjects and randomly divided into two groups: a research group and a control group (n = 90, each). The patients in the control group received routine care while the patients in the research group received interdisciplinary and diversified health education combined with personalized nutrition intervention. The fasting blood-glucose (FPG), two-hour postprandial blood glucose (2hPBG), glycated hemoglobin (HbA1C), SDS, SAS scores, and pregnancy outcome of the two groups of pregnant women were analyzed and compared. The differences in the levels of FBG, 2hPBG and HbA1C between the two groups before nursing were not statistically significant. After nursing, the levels of FBG, 2hPBG, and HbA1C of the two groups of patients decreased, and the differences in each group before and after intervention were statistically significant. These indexes were lower in the research group than in the control group, the differences being statistically significant. There were no significant differences between the two groups in SAS and SDS scores before nursing, but there were statistically significant differences after nursing. The incidence of unfavorable pregnancy outcome was lower in the research group (8.89%) than in the control group (14.44%), but the difference was not statistically significant (p > 0.05). Interdisciplinary and diversified health education combined with personalized nutrition intervention can effectively reduce FPG, 2hPG, SDS, and SAS scores in GDM women.

The Effectiveness of the “Panjang” Poffertjes Consumption on Blood Glucose Level

Background: Fragrant pandan leaf extract (Pandanus amayllifolius Roxb.) has pharmacological activity as an anti-diabetes, while sweet corn is believed to be a staple food or snack for people with diabetes mellitus. Thus, the foods could be used as an alternative to anti-diabetic functional food. Objective: This study aims to investigate the effectiveness of “Panjang” poffertjes consumption with the addition of pandan leaves extract and sweet corn on the blood glucose level. Methods: This study employs a randomized controlled trial approach with the pre-and post-test design. The data collected on the value of the glycemic index, glycemic load, and the results of 2 hours postprandial (pp) blood sugar level examination after consuming two Poffertjes formulas. The glycemic index (GI) was calculated by employing incremental area under the blood glucose response curve method for ten subjects and a 2-hour postprandial (pp) blood sugar level examination in 25 subjects with the range age between 18-24 years, with normal nutritional status (BMI = 18.58-23.88), 100% had no history of diabetes, did not smoke or alcohol and were not allergic to the tested food ingredients. Results: the results show that the glycemic index of control Poffertjes obtained a value of 71.88 (high category), and “Panjang” Poffertjes got 52.82 (low category). The glycemic load of control Poffertjes obtained a value of 12.78 (medium category), while “Panjang” Poffertjes attained a value of 6.37 (low category). The difference in the average reduction in blood glucose with the intervention poffertjes was 11.08 mg/dl. Conclusion: the provision of “Panjang” poffertjes has a significant effect on the decrease in twohour postprandial blood glucose level.

Effect of vitamin D drops combined with conventional western medicine on children with Type 1 diabetes mellitus

We investigated the therapeutic effect of vitamin D (VitD) drops, combined with conventional western medicine (insulin), on children with type 1 diabetes mellitus (T1DM). Eighty-four children with T1DM were divided into a routine group and an observation group (42 cases in each group). The routine group was treated with insulin; while the observation group was treated with insulin plus VitD drops. The serum levels of 25-hydroxyvitamin D3 (25(OH)D3) were compared between the two groups before and after treatment. The daily dosage of insulin, time needed for glucose control, two-hour postprandial blood sugar and frequency of episodes of hypoglycemia, were recorded. Flow cytometry was used to detect and compare interferon gamma (INF-γ), interleukin 4 (IL4), and INF-γ/IL-4 expression in CD4+ T cells of peripheral blood before and after treatment. Complication rates and readmission rates were documented during the six-month follow-ups. VitD drops significantly improved serum vitamin D levels in the routine group (P&lt;0.05). Compared with this group, the daily doses of insulin were lower, the time of blood sugar reaching normal ranges was shorter and the frequency of hypoglycemia was lower in the observation group (P&lt;0.05). There were significant differences in the 2-hour postprandial blood sugar levels, and flow cytometry results between the two groups (P&lt;0.05). VitD drops combined with insulin are beneficial for blood glucose control of children with T1DM, effectively reducing the insulin utilization rate, reducing the frequency of hypoglycemia, and helping to regulate the Th1/Th2 balance disorder. Complementary treatment with this vitamin is safe and reliable, and can reduce the incidence of complications and readmission rates.

Simultaneous genotyping of rs3752462 and rs4821480 at non-muscle myosin-9 in diabetic nephropathy

BackgroundTo the best of our knowledge, this is the first study evaluating the involvement of MYH9 polymorphisms in diabetic nephropathy (DN) in the Middle East. ObjectiveOur objective is to assess MYH9 SNPs (rs3752462 and rs4821480) as risk factors for DN. MethodsThis study included 80 individuals: 55 patients (Group I: 30 patients with DN; Group II: 25 patients with diabetes mellitus type 2) and 25 age- and sex-matched healthy subjects as the control group (Group III). Laboratory investigations included fasting and two-hour postprandial blood glucose, serum lipid profile (total cholesterol, triglycerides, LDL-C, and HDL-C), glycated Hb (HbA1c %), serum creatinine and urea, albumin-to-creatinine ratio (ACR) in urine, estimated rate of glomerular filtration (eGFR), and detection of MYH9 (rs3752462 and rs4821480) SNPs using PCR real-time technique. ResultsRegarding genotype frequency and allelic distribution of MYH9 SNP (rs3752462), a significant statistical increase of TT genotype and T allele was observed in Group I compared to that in Groups II and III. Our results revealed that the existence of TT genotype and T allele increases the risk for developing DN (OR: 5.600 and 95% CI: 1.14–27.37; 2.37 and 1.25–6.0, resp.). ConclusionOur findings propose that MYH9 rs3752462 is significantly related to an elevated DN risk in Egyptian individuals.

Neonatal outcomes in case of euglycemic control in gestational diabetes using insulin versus metformin. Randomized controlled trial

Background: Gestational diabetes mellitus (GDM) is a major global public health issue, with prevalence increasing in recent years due to the epidemic of obesity and type 2 diabetes. Aim of the Work: to compare different neonatal outcomes according to the different treatment modalities used in the management of GDM. Our hypothesis was that Metformin is as effective and safe as insulin in patients with gestational diabetes. Patients and Methods: The current non inferiority-Randomized controlled trial was conducted at Ain Shams Maternity hospital between June 2020 to February 2021. The study included 140 outpatient cases or admitted patients for antenatal care: Group A: women were given Metformin (Total 70) and Group B: Women were given insulin. (Total 70). Results: there was no significant difference between Metformin and Insulin groups regarding age, enrollment BMI, parity and family history of DM. There was no significant difference between Metformin and Insulin groups regarding gestational age at enrollment and delivery as well as pregnancy duration after intervention. BMI at delivery, BMI increase as well as BMI increase rate were significantly lower in Metformin group. There were no significant differences between Metformin and Insulin groups regarding fasting, two-hour postprandial and HbA1c blood glucose at enrollment and throughout treatment as well as their reduction after intervention. Maternal complications as hypoglycemia, hyperglycemia and preeclampsia were non-significantly less frequent among Metformin group than among Insulin group. Compliance to treatment was significantly more frequent among Metformin group than among Insulin group. Cesarean delivery was non­significantly less frequent among Metformin group than among Insulin group. There was no significant difference between Metformin and Insulin regarding birth weight APGAR-1, but APGAR-5 was significantly higher in Metformin group. Neonatal complications as IUFD, IUGR, macrosomia, congenital anomalies, neonatal hypoglycemia, respiratory distress and NICU admission were non-significantly less frequent among Metformin group. Conclusions: From the results of current study we can conclude that: Oral metformin was effective as insulin injection in control and management of GDM. BMI was controlled with oral metformin better than insulin injection. Maternal and neonatal complications specially birth weight were the same with both types of treatment. Women had better compliance to metformin treatment. Type of delivery wasn’t affected by type of treatment.

Diurnal variation in gene expression of human peripheral blood mononuclear cells after eating a standard meal compared with a high protein meal: A cross-over study

Eating at night has been linked to impaired glucose metabolism and dyslipidaemia that is likely a consequence of an underlying disrupted circadian rhythm in metabolic processes. The aim of this study was to explore the gene expression differences after eating a standard test meal or high protein test meal at night compared with the same meal in the morning. In a cross over design, 10 healthy adults fasted for >10h and then completed four acute meal challenges at 8am and 8pm on non-consecutive days separated by a wash out, consuming either a high protein low carbohydrate test meal or an isocaloric standard protein and carbohydrate test meal. Fasting and two-hour postprandial blood samples were collected to measure gene expression. For a subset of five participants RNA sequencing was completed on the Illumina NextSeq500. The time of day a meal is consumed had an effect on which genes were differentially regulated in the acute postprandial period, with only 6.5% of differentially expressed genes the same both morning and night. More genes were involved in lipid metabolic pathways in the morning and immune pathways at night. RTqPCR analysis of target genes suggested that key regulatory genes responsible for nutrient sensing and lipid and glucose metabolism are differentially expressed at night. These may play a role in improved blood glucose control in peripheral tissues that is observed after eating in the morning but to a lesser extent or not at all at night. Modulation of the macronutrient composition of a meal led to changes in expression of genes involved in the circadian clock and metabolism. Investigating the differences in the transcriptomic response to food at night provides a greater understanding of the mechanisms underlying the changing metabolic phenotypes, characterised by circulating metabolic biomarkers, according to the time of day.

Relationship between bone markers and cardiovascular risk factors in healthy Nigerian adults

Background: Osteoporosis and cardiovascular diseases are global public health concerns. Both diseases have been linked through common risk factors and biological mechanisms. Objective: To evaluate the association between bone turnover markers (BTM) and some cardiovascular risk factors among healthy Nigerian adults. Methods: This was a cross-sectional, observational study of 80 healthy participants of less than 50 years of age. Clinical data were obtained through an interviewer-based questionnaire. Fasting blood samples were analysed for Osteocalcin (OC), Total Alkaline phosphatase (ALP), 25-hydroxyvitamin D (25-OHVitD), Calcium (Ca), Fasting Blood Glucose (FBG). Two-hour postprandial blood glucose (2HPP) Calcium-phosphorus product calculated (CAP) and 24-hour urinary calcium excretion (CaE) were determined. Results: The mean age of the participants was 32.1±5.8 years, mean BMI was 26.3±4.0kg/m2 and the mean waist circumference (WC) was 79.6±16.0cm. OC was directly correlated with ALP (r = 0.4, p = 0.006) but not with CaE (p = 0.8). Serum OC was inversely correlated with age, BMI and WC. ALP was negatively correlated with FBG (r = - 0.3, p = 0.04), 2HPP (r = - 0.65, p = 0.000). Multivariate regression showed that BTMs-OC, ALP and CAE independently predicted BMI, 2HPP, DBP and FBG respectively. Conclusion: This study showed a relationship between bone markers and selected cardiovascular risk factors in Nigerian adults. Therefore, patients with cardiovascular disease may benefit from bone health screening or vice versa.

The effect of glimepiride on glycemic control and fasting insulin levels

Glimepiride is a new once-daily sulfonylurea. Animal studies have shown that it lowers blood glucose through extrapancreatic process. The aim of our study is to observe the effect of glimepiride on glycemic control, body weight change and insulin levels during fasting. Thirty two Type 2 diabetic patients, whose blood glucose levels cannot be controlled adequately with diet and exercise alone, received a 12-week course of glimepiride treatment. They were followed up after 2 weeks, 4 weeks, 8 weeks and 12 weeks. Their fasting, two-hour postprandial blood glucose and body weight were recorded during each visit. Hemoglobulin A1c (HbA1c) and fasting insulin levels were measured at the beginning and end of the study. Fasting plasma glucose (FPG), two-hour postprandial plasma glucose (PPG) and HbA1c values decreased significantly after treatment. The paired mean FPG decreased from 237 ± 66.58 mg/dL to 149 ± 41.31 mg/dL (P ≤ 0.001), PPG from 352 ± 112.44 mg/dL to 159 ± 22.86 mg/dL (P ≤ 0.001) and HbA1c from 11.04 ± 2.91% to 6.98 ± 1.52% (P ≤ 0.001). In contrast, fasting insulin levels and body weight did not have meaningful differences at 0 week and 12 weeks. The paired mean fasting insulin level increased from 13.19 ± 1.52 μIU/mL to 16.76 ± 9.48 μIU/mL (P = 0.594). The paired mean body weight increased from 65.01 ± 8.94 kg at baseline to 68.25 ± 9.80 kg at endpoint (P = 0.023). Glimepiride lowers blood glucose effectively without much effect on fasting insulin levels and body weight gain. These results suggested that glimepiride lowers blood glucose not only by stimulating insulin secretion but also by its extrapancreatic effects. This metabolic effect is desirable because hyperinsulinemia increases body weight, atherosclerosis and risk of hypoglycemia in diabetic patients.

Comparative Study on Clinical Characteristics and Outcomes of Overt Diabetes Mellitus and Gestational Diabetes Mellitus in Late Pregnancy

Background: With the rising prevalence in recent years, gestational diabetes mellitus has become one of the leading causes of maternal and child mortality and morbidity worldwide and has raised health concern. It is seriously detrimental to both the women and fetuses. However, there are limited evidences of two types of gestational diabetes mellitus on clinical characteristics and outcomes. Therefore, this study was aimed to explore the clinical characteristics and outcomes of patients with overt diabetes mellitus (ODM) and gestational diabetes mellitus (GDM) at the late pregnancy. Methods: From January 2015 to August 2016, totally 63 gestational diabetes mellitus from the Department of Clinical Nutrition in Beijing Anzhen Hospital were enrolled in the study. Patients were classified into two groups. 31 patients with gestational overt diabetes mellitus were grouped into ODM group and 32 patients with gestational diabetes mellitus were grouped into GDM group. Clinical characteristics and outcomes were compared between ODM and GDM. We collected records of the age, gestational week, family history, past history, pregnancy complications, insulin use, blood pressure, clinical nutrition indexes, blood pressure. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), total protein (TP), albumin (ALB), prealbumin (PALB), hemoglobin (HGB), urea nitrogen (BUN), serum creatinine (CREA), and dynamic blood glucose monitoring were measured. And we recorded the changes of blood glucose and the test data. We statistically analyzed the data of two groups. Results: In the ODM group, HbA1c, FBG, average blood glucose, two-hour postprandial blood glucose (2hPBG) after breakfast, 2hPBG after dinner, the number of hyperglycemic events and high blood glucose time ratio are significantly higher than those of GDM and two groups compared with statistical significance (P 0.05). The number of patients treated with insulin (10/31) in ODM is significantly more than that in GDM (1/32) (P 0.05). 45% (14/31) of ODM have a family history of diabetes patients. The ratio is significantly higher than 13% (4/32) of GDM (P 0.05). There was significant difference in urinary ketone positive rate between the two groups (P 0.05), but there was no significant difference in urinary microalbumin abnormal rate between them (P > 0.05). The number of preeclampsia in ODM (8/31) is significantly higher than that of GDM (P 0.05). The level of HGB in ODM is lower than that of GDM (P 0.05). There was no difference in the pregnancy outcomes between the two groups. Conclusion: Late pregnancy women with ODM have obvious family history, higher HbA1c, higher FBG, higher glucose levels of two-hours after breakfast and dinner, higher average blood glucose, longer hypoglycemia time, higher probability of hyperglycemic events and greater opportunity to use insulin in the treatment of symptomatic patients, higher risk of preeclampsia, lower HGB level than GDM, while GDM has higher positive rate of urine ketone than ODM.

The Effect of Dayak Onion Bulb Ethanol Extract (Sisyrinchium palmifolium L.) on Triglyceride Level and Aorta Histopathology in Diabetes Melitus White Rat Induced by Alloxan

The high prevalence of diabetes mellitus in Indonesia has made antidiabetic treatment efforts increasingly popular. In addition, the many side effects caused by the use of chemical drugs, triggered the development of research on herbal therapy. The purpose of this study was to determine the effectiveness of Dayak onion bulb extract in reducing two-hour postprandial blood glucose, triglyceride levels, and the amount of lipid vacuoles in aorta blood vessels of diabetic rat. The long-term goal of this study is the creation of innovation products in the form of standardized herbs as complementary therapies that can be used daily by the community, so that the risk of morbidity can be reduced. The research design used was randomized control group pretest posttest design. The results of blood glucose analysis showed that there were significant differences between the positive control group with the 400 mg/KgBW and 800 mg/KgBW extract group, with a significance value of 0,000. In the extract group, 400 mg/KgBW with 800 mg/KgBW extract group showed no significant difference with a significance value of 0.390. The results of the analysis of triglyceride levels showed no significant difference between the positive control group with the 400 mg/KgBW extract group, with a significance value of 0.981. However, there were significant differences between the positive control group with the 800 mg/KgBW extract group with a significance value of 0.025. Between the 400 mg/KgBW and 800 mg/KgBW extract groups, there was a difference with a significance value of 0.024. Aorta histopathology results showed that there was a significant difference in the number of lipid vacuoles between the positive control group and the 400 mg/KgBW extract group and 800 mg/KgBW extract group. Based on the research, it can be concluded that the extract dose of 400 mg/KgBW is a dose that is able to influence the decrease in blood glucose levels, triglycerides and the amount of lipid vacuoles in the aorta blood vessels.

Correlation between plasma 25-hydroxyvitamin D levels and the CD4+ /CD8+ ratio in elderly men in different states of glucose metabolism

Objective To investigate the correlation between plasma 25-hydroxyvitamin D(25-OHVD)levels and the CD4+ /CD8+ ratio in elderly men in different states of glucose metabolism. Methods Clinical data of 206 elderly male patients at the geriatrics department of our hospital from April 2011 to August 2017 were collected and retrospectively analyzed.There were 85 patients with type 2 diabetes mellitus(T2DM), 39 patients with impaired glucose tolerance(IGT)and 82 patients with normal glucose tolerance(NGT). Locally weighted regression and multivariate generalized linear regression models were used to analyze the correlation between plasma 25-OHVD levels and the CD4+ /CD8+ ratio. Results There were significant differences in two-hour postprandial blood glucose and homeostasis model assessment of insulin resistance(HOMA-IR)between the NGT, IGT and T2DM groups(6.5 mmol/L, 9.2 mmol/L vs.11.0 mmol/L, 11.92±10.57, 16.46±10.89 vs.32.67±7.39, respectively, P 0.05). The CD4+ /CD8+ ratios in the T2DM and IGT groups were not significantly different from each other(1.4 vs.1.6, P>0.05), but were lower than that in the NGT group(2.7, P<0.01). After adjusting for the influence of related confounders, CD4+ /CD8+ increased by 0.4 on average with each standard deviation(7.62 μg/L)increase of 25-OHVD.Compared with 25-OHVD patients in the first quartile, CD4+ /CD8+ in the second, third and fourth quartile increased by 0.7, 0.9 and 1.1 respectively on average, showing a significant positive correlation and a significant linear trend in the level of 25-OHVD and the CD4+ /CD8+ ratio(P<0.01). Conclusions With the aggravation of glucose tolerance, plasma 25-OHVD levels and the CD4+ /CD8+ ratio decrease by varying degrees in elderly men.The deficiency of plasma 25-OHVD may be an independent risk factor for a low CD4+ /CD8+ ratio. Key words: Diabetes mellitus, type 2; 25-hydroxyvitamin D2; CD4-CD8 ratio

Early kidney injury in patients with non-alcoholic fatty liver disease: a cross-sectional study

Objective To investigate early kidney injury in the patients with non-alcoholic fatty liver disease (NAFLD) without hypertension, diabetes and history of kidney diseases, as so to provide evidence for preventing early kidney injury in patients with NAFLD. Methods From December 2014 to January 2016, 169 subjects visiting Sichuan Provincial People′s Hospital were recruited. Among them, 104 cases were in NAFLD group, 31 cases were in simple obesity group (overweight or obesity), and 34 subjects were in the healthy control group. The general data, biochemical indexes, metabolic indexes, biochemical indexes of kidney, and early kidney injury makers, including serum β2-microglobulin, urinary albumin and creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR), were detected. Least significant difference-t test, chi-square test and Spearman correlation analysis were performed for statistical analysis. Results Compared with simple obesity group, alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptadase (GGT), fasting insulin level, homeostasis model assessment-insulin resistance (HOMA-IR), serum creatinine, ACR and β2 microglobulin were higher in NAFLD group ((21.13±8.14) U/L vs. (66.20±44.34) U/L, (24.80±9.57) U/L vs. (49.78±25.41) U/L, (19.26±7.88) U/L vs. (66.53±56.34) U/L, (7.03±1.52) mU/L vs. (9.55±5.41) mU/L, 1.22±0.38 vs. 2.23±2.01, (62.90±10.01) μmol/L vs. (71.75±10.80) μmol/L, (4.41±1.16) μg/mg vs. (13.76±9.56) μg/mg, (1.46±0.26) mg/L vs. (2.01±0.53) mg/L); however the eGFR was lower (112.46±11.90) mL·min-1·(1.73 m2)-1 vs. (101.09±17.17) mL·min-1·(1.73 m2)-1). The differences were statistically significant (t=9.825, 8.250, 8.288, 4.229, 4.121, 4.007, 9.732, 7.792 and -3.443, all P 0.05). Compared with healthy control group, the renal injury indexes serum creatinine, ACR and β2 microglobulin of NAFLD group were higher((58.78±7.77) μmol/L vs. (71.75±10.80) μmol/L, (1.01±0.32) μg/mg vs. (13.76±9.56) μg/mg, (1.12±0.15) mg/L vs. (2.01±0.53) mg/L), and the eGFR was lower ((115.10±12.59) mL·min-1·(1.73 m2)-1 vs. (101.09±17.17) mL·min-1·(1.73 m2)-1). The differences were statistically significant (t=7.621, 13.591, 15.126 and -5.120, all P<0.01). Compared with healthy control group, the renal injury indexes ACR and β2 microglobulin of simple obesity group were higher ((1.01±0.32) μg/mg vs. (4.41±1.16) μg/mg, (1.12±0.15) mg/L vs. (1.46±0.26) mg/L), and the differences were statistically significant (t=9.732 and 7.792, both P<0.01). ACR of NAFLD patients was positively correlated with body mass index, waist circumference, triglyceride level, total cholesterol level, low density lipoprotein level, fasting blood glucose level, two-hour postprandial blood glucose, fasting insulin level and HOMA-IR (r=0.554, 0.327, 0.314, 0.353, 0.176, 0.195, 0.552, 0.364 and 0.987, all P<0.05), and was negatively correlated with high density lipoprotein (r=-0.330, P<0.01). Conclusions NAFLD is closely related with chronic kidney disease at same baseline of gender, age, blood glucose, blood lipids, and blood pressure. Abnormal metabolism of glycolipids, obesity and insulin resistance may be the mechanisms of early kidney injury in NAFLD patients. Combination of ACR and β2 microglobulin are more sensitive than serum creatinine and eGFR in detecting early renal injury in NAFLD patients. Key words: Nonalcoholic fatty liver disease; Obesity; Chronic kidney disease; Early kidney injury