Glucose Values Research Articles

Joint quaternion valued features and quaternion valued long short term memory based recurrent neural network for non-invasive blood glucose estimation

For the four channel photoplethysmograms (PPGs), this paper proposes a quaternion valued based method for performing the non-invasive blood glucose estimation. First, these four channel PPGs form a quaternion valued signal. Then, the quaternion valued means and the quaternion valued medians of this quaternion valued PPGs are employed as features. Next, the quaternion valued long short term memory (QLSTM) based recurrent neural network (RNN) is employed for estimating the non-invasive blood glucose values. Unlike the traditional methods based on extracting the features in each channel of the PPGs independently and fusing all the features together in the conventional neural networks, the quaternion valued operations performed on the quaternion valued PPGs only fuse the same features among these four channels together while do not fuse different features among these four channels together. Hence, the physical interpretations of the features preserve. To demonstrate the effectiveness and the robustness of our proposed method, two datasets are evaluated. The computer numerical simulation results show that our proposed method can yield 81.43% and 83.09% of the test data falling in the zone A of the Clark error grid for the test data in the first dataset and in the second dataset, respectively. Also, it can yield the mean absolute relative difference (MARD) at 14.41% and 14.31% for the test data in the first dataset and the second dataset, respectively. This demonstrates the superior performance of our proposed method over the existing methods for the test data in the both datasets.

Relationship of Medication Adherence to Clinical Outcome in Patients Type 2 Diabetes with Modified Morisky Adherence Scale 8 (MMAS 8)

Diabetes melitus is a chronic condition desease that requires continued use of medication. High adherence to treatment will produce good clinical results and play a role in improving the quality of life of diabetes melitus sufferers. The following research aims to assess the relationship between adherence to medication use and clinical outcomes for patients with type 2 diabetes mellitus at RSUD DR. Moewardi Surakarta which was conducted in the period April – June 2024. This research used a cross sectional method with a total of 98 patients as respondents who met the inclusion and exclusion criteria. Adherence data was assessed using the Modified Morisky Adherence Scale 8 (MMAS 8) questionnaire, and clinical outcomes were assessed from fasting or fasting blood glucose values ​​and %HbA1C from medical record data. Analysis of the relationship between adherence and clinical outcomes using chi-square. The results of the level of treatment compliance can be divided into 3 categories, namely: high treatment compliance has a percentage of 24.5%, moderate treatment compliance has a percentage of 46.9%, and low treatment compliance has a percentage of 28.6%. Clinical outcomes were achieved by 38.8% and not achieved by 62.2%. There is a relationship between adherence medication and therapeutic outcomes in type 2 diabetes melitus patients with a Pearson chi square value of 0.011. Based on these data, pharmacist professionals need to place greater emphasis on adherence with medication use in type 2 diabetes mellitus patients to obtain good clinical outcomes.

Evaluation of Triglyceride Glucose Index in Patients with Patent Foramen Ovale Who Experienced Cryptogenic Stroke.

Background/Objectives: The prevalence of patent foramen ovale (PFO) has been found to be increased in patients with cryptogenic stroke, suggesting an association between these two clinical settings. Insulin resistance is a risk factor for the occurrence of stroke. The triglyceride glucose (TyG) index is a biomarker that reflects the IR status of the body. Our aim was to evaluate the TyG index values in patients with PFO who experienced cryptogenic stroke. Methods: One hundred and twenty nine patients with PFO who experienced embolic stroke and one hundred and eight control subjects were enrolled. All patients in the study group experienced embolic stroke within 2 weeks of enrollment. The TyG index value of each patient was calculated. Results: Patients with stroke were significantly older, had higher levels of glucose, creatinine, triglyceride (TG), leukocyte, and TyG index and lower high-density lipoprotein-cholesterol values. The TyG index had the highest sensitivity for the prediction of stroke in comparison to TG and glucose values. Comparison of ROC curves showed that the TyG index had the highest AUC compared to that of TG and glucose. The TyG index value of 8.89 predicted stroke occurrence with a sensitivity and specificity of 63.2% and 72.3%, respectively. The results of multivariable regression analyses showed that the TyG index had a higher odds ratio than TG, which indicated that it had a better predictive value. Conclusions: Assessment of the TyG index in cryptogenic stroke patients with PFO might be helpful for the management of these patients.

Flat oral glucose tolerance test during pregnancy and risk for type 2 diabetes - a five-year cohort study.

To evaluate the risk of type 2 diabetes mellitus (T2DM) in women with flat response in the 100-gram oral glucose tolerance test (OGTT) performed during pregnancy in a large cohort of women with up to 5 years of follow-up. A retrospective analysis of women with documented OGTT during pregnancy and T2DM data up to 5 years after pregnancy. Gestational diabetes (GDM) screening was done by two-step strategy. Glucose levels during pregnancy were extracted from the computerized laboratory system of Meuhedet HMO and cross-tabulated with the Israeli National Diabetes Registry. Flat OGTT was defined as fasting glucose < 95mg/dl and 3 postprandial values lower than 100mg/dl. The cohort was stratified by OGTT results to normal glucose values, flat OGTT, and GDM according to Carpenter & Coustan thresholds. Cumulative risk for T2DM was evaluated and compared between groups. Statistical analysis included univariate analysis followed by survival analysis. 14,122 parturients entered analysis. Of them, 965(6.8%) had flat OGTT, 11,427(80.9%) had normal OGTT, and 1,730(12.3%) had GDM. Women with flat OGTT were younger, had lower BMI, and lower rates of hypertension. Their glucose values throughout pregnancy were lower compared to the other groups (p<0.001 for all). During the study period and following adjustment to maternal age, obesity, and hypertension, women with flat OGTT had a low incidence of T2DM, even when compared to women with normal OGTT (aHR 0.212, 95% CI 0.052-0.856). Parturients with flat OGTT during pregnancy are at low risk of developing T2DM up to 5 years following pregnancy.

Postnatal glycaemic outcomes in women with high-risk gestational diabetes: Identifying key predictors for early intervention.

Women with gestational diabetes (GDM) have increased lifetime risk of developing diabetes. We aim todetermine the factors contributing to poor adherence of the postpartum oral glucose tolerance test (OGTT) and identify key predictors to postpartum dysglycaemia in our Asian cohort. We conducted a retrospective cohort study of women with high-risk GDM (n = 561). High-risk women with GDM were defined as (1) women with diabetic-range glucose excursions on an antepartum OGTT, (2) women diagnosed GDM on early OGTT and (3) women requiring ≥20 units of insulin during antepartum period. We use logistic regression predictive models to associate maternal variables with postpartum OGTT attendance and glucose tolerance status postnatally. Between March 2020 to March 2024, 58.7% (n = 329) of women returned for postpartum OGTT. Predictors for attendance of postpartum OGTT were Chinese ethnicity (odds ratio [OR] 2.11, 95% confidence interval [CI] [1.14-3.89]), pre-pregnancy body mass index (BMI) (OR 0.95 [95% CI 0.90-0.99]), first GDM (OR 2.34 [95% CI 1.39-3.96]) and 2-h glucose threshold on antepartum OGTT (OR 0.87 [95% CI 0.76-0.99]). Ethnicity influences postnatal dysglycaemia outcomes in our cohort. Chinese women, compared to women of Malay ethnicity, had a 4.5-odds of persistent postpartum dysglycaemia. An antenatal HbA1c of ≥5.7% and an elevated 2-h post-OGTT glucose value significantly predict postpartum dysglycaemia independent of ethnicity. Ethnicity-specific prediction models integrating antepartum OGTT and HbA1c predict postpartum dysglycaemia in a multiethnic Southeast Asian cohort. Using these predictive models, we could identify high-risk patients for early intervention.

Effect of a weight loss diet with or without Spirulina supplementation on serum lipids and antioxidant capacity of overweight dogs

Obesity is a major health issue in dogs associated with disturbances in lipid metabolism and oxidative stress. Spirulina has been shown to have hypolipidemic and antioxidant effects in various animal species. No such data regarding dogs are available, however. The present study aimed to investigate the effect of a therapeutic high-protein, high-fiber weight loss diet, with or without Spirulina supplementation, on biochemical parameters of overweight dogs, with particular reference to serum lipids and plasma antioxidant capacity. Thirty-two dogs completed a double-blind randomized placebo-controlled trial in which they received either Spirulina (S) or placebo (P) tablets in a body weight-dependent amount for 12 weeks; at the same time, both groups were fed the same calorie-restricted diet. Dogs were weighed weekly and calorie restriction was adjusted accordingly to ensure a 1% body weight loss per week. Blood samples were collected at baseline (T0), after 6 weeks (T1), and after 12 weeks (T2). No difference in body weight loss (S: -11.9 ± 0.8%, P: -10.6 ± 0.8%, p = 0.229) was detected between groups at T2. After 6 weeks and an average weight loss of around 6% (S: -6.7 ± 0.6%, P: -5.9 ± 0.6, p = 0.276), significant reductions of serum total cholesterol, glucose, alkaline phosphatase, paraxonase-1 (all p < 0.0001) and gamma-glutamyltransferase (p < 0.018) were observed in both groups, regardless of supplementation. Plasma antioxidant capacity increased significantly in both groups at T2 (p = 0.0003). Serum triglycerides decreased significantly from T0 to T1 in the Spirulina group (p < 0.0001) but not in the placebo group (p = 0.28); as for the difference between groups, a non-significant trend (p = 0.098) was detected. A significantly higher percentage of dogs (p = 0.028) in the Spirulina group achieved a serum triglycerides reduction > 15% compared to baseline at T1 and > 30% at T2. A treatment effect (p = 0.0416) was found for bilirubin, which decreased only in the Spirulina group. In conclusion, a weight loss of around 6% achieved with a high-protein, high-fiber hypocaloric diet is sufficient to induce significant positive metabolic effects and improve lipid, glucose, and liver enzyme values. Plasma antioxidant capacity was tested in dogs undergoing a weight loss program for the first time, demonstrating that overweight individuals are in a deficient status and that a weight loss of around 10% is able to restore values comparable to those of healthy individuals. The results of this study suggest that Spirulina may manifest a hypotriglyceridemic effect in dogs, even if further research is needed to infer causation. The role Spirulina that supplementation plays in bilirubin metabolism and its related beneficial effect is also worth exploring.

Analysis of missing data in electronic health records of people with diabetes in primary care in Spain: A population-based cohort study

IntroductionResearchers conducting studies based on electronic health records (EHRs) often have to deal with missing data. We aimed to analyze patterns of missing data in lipid profile, sociodemographic variables and risk factors contained in the EHRs of the CARDIABETES project and compare different strategies for addressing the issue. MethodsWe conducted a retrospective cohort study of people with diabetes, based on EHRs in the Spanish Pharmacoepidemiological Research Database for Public Health Systems (BIFAP). Our response variable was major adverse cardiovascular events (MACE), including all-cause death and hospital admission for cerebrovascular disease or ischemic heart disease. We analyzed patterns of missing data, associations between missingness and MACE, and the effect of eliminating cases with missing data or imputing missing data. ResultsOur total sample included 309,556 people with diabetes. The proportion of individuals with at least one missing value was 76.0%. Regarding diabetes control measures, 10.8% of records had missing glycated hemoglobin values, and 21.4% had missing basal blood glucose values. We observed a non-random pattern of association between missingness and MACE. The strategy of eliminating records with missing data greatly reduced the number of cases and statistical power, and altered the average participant characteristics and cumulative incidence of MACE. By imputing missing data, we were able to circumvent these problems. ConclusionA considerable proportion of missing data was observed for variables such as fasting blood glucose and glycated hemoglobin, and also for other variables such as blood test parameters, BMI, and tobacco and alcohol use. The missing data show a non-random pattern and are associated with a higher incidence of MACE. The strategy of eliminating records with missing data greatly reduced the number of cases and statistical power. The recommended solution is to impute missing data with methods that take all the variables into account, such as MICE with PPM.

Elucidating the Mechanism of Electrochemical Inactivation of Direct Electron Transfer Type Glucose Dehydrogenase Enzyme-Employing Biosensor

Introduction: Diabetes management has evolved through the introduction of self-monitoring blood glucose (SMBG) and continuous glucose monitoring (CGM) systems, enabling real-time patient feedback.[1] Of these, CGM systems, capable of prolonged, continuous monitoring, hinge upon the dependable performance of the enzymes to maintain precise measurements and long-term sensing capabilities. Current CGM systems utilize fungi-derived glucose oxidase (GOx) to catalyze the reaction with glucose. This enzyme is able to record glucose values within the physiological range with high accuracy; however, this enzyme also creates hydrogen peroxide during continuous operation leading to self-inactivation via radical oxygen species(ROS) formation. Our group has been involved in the characterization and functional engineering of a FAD-dependent glucose dehydrogenase enzyme derived from Burkholderia cepacia (BcGDH) which is capable of direct electron transfer (DET) with an electrode.[2, 3] By eliminating the need for hydrogen peroxide or toxic external mediators—as are common with 1st and 2nd generation CGM sensors, respectively—we are able to simplify our sensing platform and create the ideal sensing modality. Additionally, we have improved the thermal stability of BcGDH by introducing inter-subunit disulfide bonds which has greatly improved the in vitro half-life of our enzyme.[4] Although we have been able to engineer our BcGDH to have a much greater half-life in vitro than the wild type BcGDH or GOx, we observe uncharacteristic inactivation during continuous applied potential electrochemistry experiments. This study focuses on the elucidation of the electrochemical inactivation mechanism of a DET-type BcGDH enzymatic sensor. Materials & Methods: BcGDH engineered enzyme, from the introduction of inter-subunit disulfide bonds was recombinantly produced and purified. A ϕ=2mm gold disk electrode was polished and electrochemically cleaned before functionalized with dithiobis(succinimidyl hexanoate) to form a self-assembled monolayer(SAM). The purified BcGDH mutant was then immobilized to the SAM. Variations in potentials (none, 100mV or 400mV vs Ag/AgCl), glucose concentration (none or 20mM), and oxygen (argon purged or ambient oxygen) were used for the incubation conditions. Every three hours (0 to 9 hours) calibration curves were investigated unilaterally at 45°C, 400mV vs Ag/AgCl applied potential, ambient oxygen, and varying concentrations from 0 to 20mM glucose. Results & Discussion: The disulfide bond stabilized BcGDH engineered enzyme was stable at more than 80°C confirming its thermal stability and extended half-life at supraphysiological temperatures. However, when utilized in a sensor format at 45°C, engineered enzyme was inactivated much more rapidly than expected. The largest rate of inactivation was revealed to be due to application of a high over-potential (+400mV vs Ag/AgCl) coupled with hyper-physiological glucose levels with ambient oxygen showing a sensor half-life of 2.89±0.74 hours at 45°C. The impact of oxygen-purging the system by utilizing argon gas was shown to improve the sensor half-life to 35.04±6.17 hours at 45°C. Additionally, without the high over-potential, the hyper-physiological glucose concentrations had no detriment to the sensor and no sensor inactivation was observed. . The high over-potential combined with hyper-physiological glucose and ambient oxygen were assumed to produce radical oxygen species (ROS) which are responsible for the inactivation of the enzyme. Conclusions: We demonstrate the ability to use this DET-type GDH electrochemical sensor to investigate the factors which accelerate its inactivation. While hyper-physiological glucose levels do not significantly inactivate the enzyme-sensor, the high over-potential incubation inactivates the sensor much faster—likely due to the formation of ROS from generation of H2O2 at the cathode. By removing oxygen from the system via an Argon purge, the conversion of oxygen to hydrogen peroxide is thwarted. In the future, studies should be done to mitigate the ROS generation as glucose levels cannot be controlled. This strategy may be done by applying a lower over-potential to the sensor would minimize the formation of ROS even in the presence of hyper-physiological glucose.

Energy Metabolite, Immunity, Antioxidant Capacity, and Rumen Microbiota Differences Between Ewes in Late Gestation Carrying Single, Twin, and Triplet Fetuses.

The objective of this study was to investigate the differences in the energy metabolites, immunity, antioxidant capacity, and rumen microbiota of ewes with different numbers of fetuses. Thirty healthy ewes were selected and divided into single- (SL, n = 10), twin- (TL, n = 10), and triplet-fetal (PL, n = 10) ewes according to the number of fetuses. Sampling was carried out on days 21 (Q21) and 7 (Q7) before lambing. The results show no differences (p > 0.05) in the DMI and BW of ewes with different numbers of fetuses, and the body condition score (BCS) of PL ewes was lower (p < 0.05) than that of SL ewes. The concentrations of β-hydroxybutyric acid (BHBA), non-esterified fatty acids (NEFA), interleukin-2 (IL-2), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) in the PL ewes were higher (p < 0.05), while the glucose (Glu), triglyceride (TG), total cholesterol (TC), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and total antioxidant capacity (T-AOC) values were lower (p < 0.05) than those of the SL ewes. ANOSIM analysis showed that the rumen bacterial structure of the SL, TL, and PL ewes was different on days Q21 and Q7. The relative abundance of Firmicutes and Bacteroidota in the rumen was affected (p < 0.05) by the number of fetuses: the relative abundance of Firmicutes (Ruminococcus, Butyrivibrio, Christensenellaceae_R-7_group, Lachnospiraceae_AC2044_group, Lachnospiraceae_XPB1014_group, and Anaeroplasma) was higher (p < 0.05), while that of Bacteroidota (Prevotella, Prevotellaceae_UCG-003, and Prevotellaceae_UCG-001) was lower (p < 0.05) in the SL ewes than in the PL ewes. In summary, the rumen microbial structure and energy metabolites of ewes in late gestation with different numbers of fetuses were different. Triplet-fetal ewes were characterized by lower BCS and antioxidant capacity and were prone to the triggering of inflammatory responses.

Validation of Electrochemical Biosensor based Hand-held Device for the Measurement of Blood Glucose in Lactating Buffaloes (Bubalus bubalis)

Background: Bovine ketosis is a major metabolic disorder emerging as a result of negative energy balance in the post calving period and subsequent lactation of lactating dairy animals. The measurement of the concentration of blood glucose was reported to be helpful for the early diagnosis of subclinical ketosis in buffaloes. Also, blood glucose will provide the overall energy status of the buffalo. Methods: The experiment was conducted on 56 healthy lactating Murrah buffaloes. Blood samples were collected in two slots for two consecutive days in the morning hour in an anticoagulant-added sodium fluoride bulb and in clot activator plain tubes by jugular venipuncture. Also, glucose concentration was measured by a handheld device (“Gluco One”, Model BG-03) by puncturing the small branches of the ear vein and the results were recorded. The estimation of blood glucose plasma and serum was done by standard laboratory enzymatic method i.e. Glucose Oxidase- Peroxidase (GOD-POD) on an automated chemistry analyzer. Result: There was no significant difference between the mean values of plasma glucose measured by the GOD-POD method and by the biosensor. But the regression analysis showed the blood glucose in plasma do not have a significant correlation with that measured by biosensor. The glucose measured in serum is significantly less than in plasma and measured by the biosensor. It is advisable to use fluoride-added preservative anticoagulant tubes and not to use a serum for the estimation of blood glucose.

Impact of dextrose supplementation on intraoperative blood glucose levels in pediatric patients undergoing major surgeries under general anesthesia with caudal analgesia

Abstract Background and Aims: In children undergoing surgery, the stress responses of surgery can result in blood glucose elevation consequent to release of cortisol and catecholamines. The use of a regional block could attenuate the stress responses and lower the blood glucose levels. We compared the blood glucose values at specified time points during surgery with and without additional dextrose to evaluate the need for glucose supplementation as our primary outcome. Intraoperative hemodynamics and the need for any intervention for correction of blood sugars were noted secondarily. Material and Methods: Children aged between 6 months and 8 years undergoing elective major surgery were randomized to group D (received 1% dextrose in Ringer’s lactate) or group P (received only Ringer’s lactate). Blood sugars were measured half hourly for 2 h following intubation, and data was analyzed using Student’s t-test and Chi-square test. Results: Demographic variables and the duration of surgery were comparable. The baseline blood glucose value was lower in group D. Analysis of covariates test for a comparison of adjusted mean blood glucose (MBG) showed the values at 30, 60, and 90 min to be comparable. However, toward the end of surgery, the MBG value was significantly higher in group D (P = 0.019). Heart rate and mean arterial pressure were comparable at the same points of measurement. Conclusion: Dextrose supplementation is not needed for children receiving caudal analgesia for major surgeries of 2–3 h duration and may raise blood sugars at the end of surgery. Key Messages: Caudal analgesia could attenuate the stress response and lower the blood glucose levels. In our study, we observed that children undergoing major surgeries with caudal analgesia do not need supplemental dextrose for correction of hypoglycemia. Additional dextrose could increase blood sugars at the end of surgery.

Fidelity of BMI, Waist, and Waist-to-Height Ratio as Adiposity Measures in Normoglycemic Black vs White American Adults.

To assess ethnic disparities in the association between indirect and direct measures of adiposity in African American (AA) and European American (EA) adults. We analyzed the indirect [weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR)] and direct [total fat, trunk fat, fat-free mass (FFM)] adiposity measures in healthy AA and EA adults. Assessments included anthropometry, oral glucose tolerance test, body composition by dual-energy X-ray absorptiometry (DXA), and calculation of direct-to-indirect adiposity ratios (total fat/BMI, trunk fat/WC, trunk fat/WHtR, and FFM/weight). A total of 314 subjects (167 AA, 147 EA) underwent DXA. All participants (mean age 44.2 ± 10.6 years) had normal fasting and 2-hour glucose values. The BMI (AA vs EA) was 31.2 ± 7.42 kg/m2 vs28.8 ± 6.78 kg/m2 (P = .0014); WC 95.3 ± 16.0 cm vs 92.9 ± 15.0 cm (P = .15). Significant correlations (P < .0001) were observed between BMI and total fat (r = 0.68), WC, and trunk fat (r = 0.61) and WHtR vs trunk fat (r = 0.77) for the combined cohort, with heterogeneity in the strength of association by sex and ethnicity. Fat-free mass was higher in AA vs EA participants (P = .03). Total fat/BMI was lower in AA vs EA participants (P = .0047); trunk fat/WC (P = .004) and trunk fat/WHtR (P = .0026) were lower in AA men vs EA men. The BMI overestimated body fat in AA participants vs EA participants, and WC overestimated trunk fat in AA men vs EA men. These data indicate ethnic disparities in the fidelity of indirect measures of adiposity and argue for ethnic-specific BMI thresholds for determination of overweight/obesity.

Ground Flaxseed Supplementation Improved the Energy Utilization and Reduced Oxidative Stress in Buffalo Calves

The present study was conducted at the Department of Veterinary Physiology &amp; Biochemistry and Animal Nutrition, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India during the period of October, 2018 to November, 2019 to evaluate the effect of ground flaxseed supplementation on blood biochemical and metabolic status of buffalo calves. The experiment was performed on four apparently healthy male buffalo calves of 2.0–2.5 years age in this present investigation. They were divided in 2 groups in a switch over design. The animals of Group I were kept as control. The animals of group II were supplemented with Ground Flaxseed @ 15% on dry matter basis replacing oil seed cakes in TMR for 21 days. Blood samples were collected at weekly intervals over a period of 21 days. The results revealed a significant (p&lt;0.05) decrease in plasma glucose and cholesterol values in group II supplemented with ground flaxseed. There was no significant alteration with respect to the plasma total protein, triglycerides, creatinine, urea and total immunoglobulins in any of the groups. The erythrocytic lipid peroxidation was significantly reduced in the flaxseed supplemented group as compared to non-supplemented group. Thus, the present investigation revealed that flaxseed supplementation improved the energy utilization reduced the oxidative stress in animals.

Relationship between thyroid-stimulating hormone and blood lipids in patients with first-episode depression

BackgroundPrevious studies demonstrated thyroid stimulating hormone (TSH) plays an important role in regulating lipid metabolism, but the relationship between the two is controversial. Meanwhile, it has not been reported in a population with major depressive disorder (MDD).MethodsWe divided 1718 first-episode and drug naïve patients with MDD into a TSH abnormal group (TSH-AB) and a TSH normal group (TSH-NOR). The participants in the two groups were assessed by the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and the positive subscale of Positive and Negative Syndrome Scale. The patients’ blood was tested for TSH, free T3, free T4, fasting blood glucose, lipid indexes and body mass index was recorded.ResultsThe participants in the TSH-AB group had significantly higher HAMD scores, HAMA scores and total scores of positive symptoms, as well as higher incidence of suicide attempts than those in the TSH-NOR group, accompanied by significantly higher thyroglobulin antibodies, thyroid peroxidase antibodies, fasting blood glucose values, total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) levels compared with those of TSH-NOR patients. However, the high-density lipoprotein cholesterol (HDL-C) of TSH-AB patients was lower than those of TSH-NOR patients. TSH values were positively correlated with TC, TG, and LDL-C values, and negatively correlated with HDL-C value.ConclusionTSH was highly correlated with abnormal lipid metabolism in patients with MDD. The specific molecular mechanism of the relationship between TSH, lipid metabolism and the development of depression needs to be further in-depth investigation.

Predicting Dysglycemia in Patients with Diabetes Using Electrocardiogram.

Background: In this study, we explored the potential of predicting dysglycemia in patients who need to continuously manage blood glucose levels using a non-invasive method via electrocardiography (ECG). Methods: The data were collected from patients with diabetes, and heart rate variability (HRV) features were extracted via ECG processing. A residual block-based one-dimensional convolution neural network model was used to predict dysglycemia. Results: The dysglycemia prediction results at each time point, including at the time of blood glucose measurement, 15 min prior to measurement, and 30 min prior to measurement, exhibited no significant differences compared with the blood glucose measurement values. This result confirmed that the proposed artificial intelligence model for dysglycemia prediction performed well at each time point. Additionally, to determine the optimal number of features required for predicting dysglycemia, 77 HRV features were individually eliminated in the order of decreasing importance with respect to the prediction accuracy; the optimal number of features for the model to predict dysglycemia was determined to be 12. The dysglycemia prediction results obtained 30 min prior to measurement, which exhibited the highest prediction range in this study, were as follows: accuracy = 90.5, sensitivity = 87.52, specificity = 92.74, and precision = 89.86. Conclusions: Furthermore, we determined that no significant differences exist in the blood glucose prediction results reported in previous studies, wherein various vital signs and blood glucose values were used as model inputs, and the results obtained in this study, wherein only ECG data were used to predict dysglycemia.

Comparison effect of hyperglycaemia induced mixed meal tolerance and oral glucose tolerance test on body oxidative stress

Abstract Objectives The mixed meal tolerance test (MMTT) and oral glucose tolerance test (OGTT) are used in the diagnosis of prediabetes and hypoglycaemia. Data suggest that oxidative stress caused by hyperglycaemia during OGTT may have adverse metabolic effects in prediabetic patients. In this study, we aimed to evaluate oxidant and antioxidant levels in OGTT and MMTT. Methods The study included 72 patients who underwent MMTT and OGTT at one-week intervals. Total Oxidant Status (TOS) and total antioxidant status (TAS) levels were analysed in samples taken from patients at zero, first and second hours of MMTT and OGTT and Oxidative Stress Index (OSI) was calculated, and the data were compared. Results OGTT and MMTT results were compared with each other within the patient group. While significant differences were found between first-hour glucose, TOS and OSI values (p&lt;0.01), no significant differences were observed for zero and second-hour values (p&gt;0.05). There was no significant difference in TAS values (p&gt;0.05). When zero, first, and second-hour results were compared for OGTT and MMTT within the same test, no significant differences were found for the other parameters except for glucose (p&lt;0.01 for both tests). The correlation between glucose and TOS, TAS and OSI values in MMTT and OGTT was not found. Conclusions Our study concludes that the body experiences more oxidative stress in the first hour following an OGTT than the oxidative stress induced by hyperglycaemia in a mixed-meal diet. Further research is needed to determine whether oxidative stress in the first hour triggers dysmetabolic events in the body.

Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients with Endometrial Cancer and Hyperplasia

Aim: To analyze insulin resistance and related parameters in patients with endometrial cancer and hyperplasia. Methods: The study included 102 patients in 3 groups. Group I and II included patients with a histologic diagnosis of endometrial cancer (n=41, 40.2%) and endometrial hyperplasia (n=31, 30.4%) based on the final pathology report. Group III was the control group and included patients who had undergone surgery for a benign indication other than endometrial hyperplasia (n=30, 29.4%). Age, body mass index (BMI), menarcheal age, menopausal status, gravidity, parity score, diabetes, oral contraceptive status, fasting glucose levels, insulin levels, endometrial thickness, HOMA-IR and QUICKI scores were assessed. Results: The mean age of group I was statistically higher than that of group II (55.3±9.5 vs. 48.8±7.1, p=0.002). The average BMI of the two groups was similar (p=0.076). When fasting glucose values were evaluated, group I showed significantly higher values compared to group II. The mean insulin and HOMA-IR values in the control group were significantly higher than those in group I (p

Effects of atmospheric pressure change during flight on insulin pump delivery and glycaemic control of pilots with insulin-treated diabetes: an in vitro simulation and a retrospective observational real-world study

Aims/hypothesisGlycaemic control and clinical outcomes in diabetes are improved by continuous subcutaneous insulin infusion (CSII). Atmospheric pressure changes during flights may affect insulin delivery from pumps and cause unintended metabolic consequences, including hypoglycaemia, in people with type 1 diabetes. The present report evaluates both hypobaric flight simulation and real-world data in pilots using insulin pumps while flying.MethodsIn the flight simulation part of this study, an in vitro study of insulin pumps was conducted in a hypobaric chamber, de-pressurised to 550 mmHg to mimic the atmospheric pressure changes in airliner cabins during commercial flights. Insulin delivery rates and bubble formation were recorded for standard flight protocol. Insulin infusion sets, without pumps, were tested in a simulated rapid decompression scenario. The real-world observational study was a 7.5-year retrospective cohort study in which pre- and in-flight self-monitored blood glucose (SMBG) values were monitored in pilots with insulin-treated diabetes. Commercial and private pilots granted a medical certificate to fly within the European Union Aviation Safety Agency approved protocol and receiving insulin either by pump or multiple daily injections (MDI) were included.ResultsIn the flight simulation study, full cartridges over-delivered 0.60 U of insulin during a 20 min ascent and under-delivered by 0.51 U during descent compared with ground-level performance. During emergency rapid decompression, 5.6 U of excess insulin was delivered. In the real-world study, seven pilots using CSII recorded 4656 SMBG values during 2345 h of flying across 1081 flights. Only 33 (0.7%) values were outside an acceptable safe range (5.0–15.0 mmol/l [90–270 mg/dl]). No clinically significant fall in the median SMBG concentration was observed after aircraft ascent and no in-flight SMBG values were within the hypoglycaemic range (<4.0 mmol/l [<72 mg/dl]). Compared with pilots receiving MDI therapy, pilots using CSII recorded more SMBG values within the acceptable range (99.3% vs 97.5%), fewer values in the low red range (0.02% vs 0.1%), fewer in-flight out-of-range values (0.2% vs 1.3%) and maintained stricter glycaemic control during flight.Conclusions/interpretationAmbient pressure reduction during simulated flights results in bubble formation and expansion within insulin cartridges. This causes unintended delivery of small insulin doses independent of pre-determined delivery rates and represents the maximum amount of insulin that could be delivered and retracted. However, in vivo, pilots using CSII in-flight did not experience a fall in blood glucose or episodes of hypoglycaemia during these atmospheric pressure changes and the use of insulin pumps can be endorsed in view of their clinical benefits.Graphical

Relationship between proxy behavior in clinic attendance and disease control among persons with hypertension and diabetes at a rural primary health center: A cohort analysis in South India.

Among persons with hypertension and diabetes on treatment for at least 1 year at the Rural Health Centre (RHC) noncommunicable disease (NCD) clinic, 1. To determine the control status for hypertension and diabetes. 2. To assess the relationship between proxy behavior for collection of medications and the control status. Rural Health Centre, Ramanathapuram, Puducherry, India; record-based retrospective observational study. The study employed a universal sampling of 396 eligible persons with diabetes and hypertension who had been on medication for over a year at the RHC NCD clinic and had recorded blood pressure and glucose values within the last 4 months. Case sheets of these patients were retrieved from the Medical Registration Department, and data from the past 12 months were collected and analyzed to assess proxy behaviors and absenteeism. Data were entered from the case sheets in Epicollect5 and analyzed using Stata v17. Among hypertensive patients, 48.01% were aged 60 and above, with 55.63% being female. Fifty-six percent of hypertensive patients had their condition controlled. For diabetic patients, 40.88% were aged 45-59 years, with 59.75% being female. Only 18.24% of diabetic patients had their condition controlled. The multivariable analysis examined factors associated with the control status of hypertension and diabetes. Those aged 30-44 (aRR: 1.47, 95% CI: 1.01-2.15) and 45-59 (aRR: 1.37, 95% CI: 1.03-1.82) had a higher risk of uncontrolled hypertension compared to those aged 60 and above. Gender did not show significant associations with hypertension control status. Regarding attendance status, patients who had both proxy and missed visits (RR: 1.46, 95% CI: 1.02-2.07) had a higher risk of uncontrolled hypertension. There was also a significant association with patients having more than three proxies (aRR: 1.51, 95% CI: 1.10-2.17) exhibiting a higher risk of uncontrolled hypertension. Absenteeism status showed that those absent for 1-3 visits had a higher relative risk (RR: 1.37, 95% CI: 1.03-1.82) of uncontrolled hypertension compared to those with no absenteeism. Proxy behavior affects the control status of persons with hypertension and diabetes. A longitudinal study is warranted to assess the relationship between proxy visits and control status.

Extracting Data from Medical Records for Monitoring Diseases and Generating Medical Alerts

Background: Automated data processing is creating and implementing technology that automatically processes data. This computer tool is recommended for doctors because it supports their everyday work, assists in medical diagnosis, and enhances patient care. The aim of this paper is to propose an informatic tool that can extract the values of some parameters of interest from blood test sheets in order to get medical alerts and to monitor the chronic disease. Methods: An application, written in Python, was developed Results: The computer tool extracted automatically the values of glucose, triglycerides, HDL-cholesterol, total cholesterol, and LDL-cholesterol from medical sheets (text-based file or graphic file, respectively), and saved them in a database, accessed and represented in a graphic form the most recent values of these parameters; alerts according to metabolic syndrome criteria and Framingham risk score were generated. Conclusions: This tool contributes to the management of the medical process, saving precious time and helping the doctor in detecting current or future health problems.