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Purpose: The aim was to assess the accuracy of a continuous blood glucose monitoring (CGM) device (Abbott FreeStyle Libre 3) against capillary blood glucose measurement (BGM) before, during, and after an intense lower body strength training session in connection with high- versus low-carbohydrate breakfasts. Methods: Nine adults (22 ± 2 years) completed a strength training session (10 × 10 at 60% 1RM) twice after high-carbohydrate and twice after low-carbohydrate breakfasts. CGM accuracy versus BGM was assessed across four phases: post-breakfast, pre-exercise, exercise, and post-exercise. Results: Overall fed state mean BGM levels were 84.4 ± 20.6 mg/dL. Group-level Bland–Altman analysis showed acceptable agreement between CGM and BGM across all phases, with mean biases between − 7.95 and − 17.83 mg/dL; the largest discrepancy was in the post-exercise phase. Mean absolute relative difference was significantly higher post-exercise compared to pre-exercise and exercise phases, for overall data and after the high-carbohydrate breakfast (all p ≤ 0.02). Clark Error Grid analysis showed 50.5–64.3% in Zone A and 31.7–44.6% in Zone B, with an increase in treatment errors during and after exercise. Conclusion: In this group of healthy participants undergoing strength training, CGM showed satisfactory accuracy in glucose monitoring but varied substantially between individuals compared to BGM and fails in meeting clinical criteria for diabetic monitoring. CGM could aid non-diabetic athletes by tracking glucose fluctuations due to diet and exercise. Although utilization of CGM shows potential in gathering, analyzing, and interpreting interstitial glucose for improving performance, the application in sports nutrition is not yet validated, and challenges in data interpretation could limit its adoption. [ABSTRACT FROM AUTHOR]

Background andAims: Guidelines now recommend inpatient continuous glucose monitor (CGM) use with confirmatory blood glucose measurements. However, the Food and Drug Administration has not yet officially approved CGM for inpatient use in large part because its accuracy has not been established in this setting. We tested the accuracy of the Dexcom G6 (G6) in 28 adults on an insulin infusion in a medical–surgical intensive care unit with 1064 matched CGM and arterial point-of-care pairs. Methods: The participants were on average 57.29 (SD 2.39) years, of whom 13 had a prior diagnosis of diabetes and 14 were admitted for a surgical diagnosis. The first 19 participants received the G6 without calibration and had a mean absolute relative difference (MARD) of 13.19% (IQR 5.11, 19.03) across 659 matched pairs, which just meets the critical care expert recommendation of MARD <14%. We then aimed to improve accuracy for the subsequent 9 participants using a calibration protocol. Results: The MARD for calibrated participants was 9.65% (3.03, 13.33), significantly lower than for uncalibrated participants (P < 0.001). Calibration also demonstrated excellent safety with 100% of values within the Clarke Error Grid zones A and B compared with 99.07% without calibration. Our protocol achieved the lowest MARD and safest CEG profile in the critical care setting and well exceeds the critical care expert recommendations. Our large sample of heterogenous critically ill patients also reached comparable accuracy to the MARD of 9% for G6 in outpatients. We believe our calibration protocol will allow G6 to be used with sufficient accuracy in inpatients. [ABSTRACT FROM AUTHOR]

Background and purpose: Maintaining mitochondrial quality is attracting attention as a new strategy to treat diabetes and diabetic complications. We previously reported that mitochondrial hyperfission by forming a protein complex between dynamin‐related protein (Drp) 1 and filamin, mediates chronic heart failure and cilnidipine, initially developed as an L/N‐type Ca2+ channel blocker, improves heart failure by inhibiting Drp1‐filamin protein complex. We investigated whether cilnidipine improves hyperglycaemia of various diabetic mice models. Experimental Approach: Retrospective analysis focusing on haemoglobin A1c (HbA1c) was performed in hypertensive and hyperglycaemic patients taking cilnidipine and amlodipine. After developing diabetic mice by streptozotocin (STZ) treatment, an osmotic pump including drug was implanted intraperitoneally, followed by weekly measurements of blood glucose levels. Mitochondrial morphology was analysed by electron microscopy. A Ca2+ channel‐insensitive cilnidipine derivative (1,4‐dihydropyridine [DHP]) was synthesized and its pharmacological effect was evaluated using obese (ob/ob) mice fed with high‐fat diet (HFD). Key Results: In patients, cilnidipine was superior to amlodipine in HbA1c lowering effect. Cilnidipine treatment improved systemic hyperglycaemia and mitochondrial morphological abnormalities in STZ‐exposed mice, without lowering blood pressure. Cilnidipine failed to improve hyperglycaemia of ob/ob mice, with suppressing insulin secretion. 1,4‐DHP improved hyperglycaemia and mitochondria abnormality in ob/ob mice fed HFD. 1,4‐DHP and cilnidipine improved basal oxygen consumption rate of HepG2 cells cultured under 25 mM glucose. Conclusion and implications: Inhibition of Drp1‐filamin protein complex formation becomes a new strategy for type 2 diabetes treatment. [ABSTRACT FROM AUTHOR]

Background: We conducted a systematic review and meta-analysis on dairy consumption and its association with anthropometric measurements, blood glucose status, insulin levels, and testosterone levels in women with Polycystic Ovary Syndrome. Methods: This study conducted a comprehensive literature search using electronic databases like MEDLINE, Scopus, PubMed, Web of Science, and Google Scholar to identify observational and interventional studies investigating the relationship between dairy product consumption and Polycystic Ovary Syndrome. A meta-analysis was performed on clinical trial studies that examined the effect of a low starch/low dairy diet in Polycystic Ovary Syndrome subjects. Statistical analyses were performed using Stata version 16.0 (Stata Corporation, College Station, Texas, USA), and statistical significance was defined as p-value < 0.05. Results: Of the 1,313 citations reviewed, our systematic review identified 11 studies that met the inclusion criteria, comprising six case-control studies, four clinical trials, and one cross-sectional study. The case-control studies found limited evidence of an association between dairy consumption and Polycystic Ovary Syndrome. The result of the clinical trial studies in meta-analysis showed that reducing dairy intake along with reducing starch intake led to statistically significant improvements in anthropometric and metabolic measures including mean weight (Standardized mean difference: -8.43 (95% CI: -9.01, -7.86)), Body mass index (-3.14 (95% CI: -3.35, -2.92), waist circumference (-6.63 (95% CI: -10.70, -2.57)) and Waist-to-Height Ratio (-0.04 (95% CI: -0.07, -0.01), insulin fasting (-18.23 (95% CI: -22.11, -14.36)), insulin 120 minutes (-94.05 (95% CI: -157.67, -30.42)), HbA1c (-0.27 (95% CI: -0.37, -0.17)), Ferryman-Gallwey score (-2.07 (95% CI: -2.98, -1.16)) and total testosterone (-9.97 (95% CI: -14.75, -5.19)). No significant reduction was found in fasting glucose, 2 hours glucose, percent of fat mass, and mean free testosterone after intervention. Conclusions: The findings of this systematic review show limited evidence about the association between dairy consumption and Polycystic Ovary Syndrome. The interventional studies suggest that a low-dairy/low-starch diet may improve some anthropometric and metabolic measures in women with Polycystic Ovary Syndrome. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims/Introduction Materials and Methods Results Conclusions This study aimed to evaluate the problems in screening for gestational diabetes mellitus (GDM) by casual blood glucose (CBG) measurements at 24–28 gestational weeks.Overall, 763 pregnant women who underwent the 50‐g glucose challenge test (GCT) at 24–28 gestational weeks were enrolled. The preload blood glucose (0‐h BG) level of 50‐g GCT was considered as CBG.A total of 240 women with BG levels at 1‐h after loading (1‐h BG) on 50‐g GCT ≥140 mg/dL underwent the 75‐g oral glucose tolerance test, and 98 (40.8%) were diagnosed with GDM. Of the 99 women with GDM, 71 (71.7%) had 0‐h BG on 50‐g GCT <100 mg/dL.This study, where pregnant women underwent both CBG and 50‐g GCT simultaneously, showed that when CBG at 24–28 gestational weeks ≥100 mg/dL alone was used for screening GDM, many pregnant women with GDM were overlooked. [ABSTRACT FROM AUTHOR]

Non-invasive/minimally invasive continuous monitoring of blood glucose and blood glucose administration have a high impact on chronic disease management in diabetic patients, but the existing technology is yet to achieve the above two purposes at the same time. Therefore, this study proposes a microfluidic microneedle patch based on 3D printing technology and an integrated control system design for blood glucose measurement, and a drug delivery control circuit based on a 555 chip. The proposed method provides an improved preparation of a PVA-PEG-MoS2 nanosheet hydrogel, making use of its dielectric properties to fabricate a microcapacitor and then embedding it in a microfluidic chip. When MoS2 nanosheets react with interstitial liquid glucose (and during the calibration process), the permittivity of the hydrogel is changed, resulting in changes in the capacitance of the capacitor. By converting the capacitance change into the square-wave period change in the output of the 555 chip with the control circuit design accordingly, the minimally invasive continuous measurement of blood glucose and the controlled release of hypoglycemic drugs are realized. In this study, the cross-linking structure of MoS2 nanosheets in hydrogel was examined using infrared spectroscopy and scanning electron microscopy (SEM) methods. Moreover, the critical doping mass fraction of MoS2 nanosheets was determined to be 2% via the measurement of the dielectric constant. Meanwhile, the circuit design and the relationship between the pulse cycle and glucose concentration is validated. The results show that, compared with capacitors in series, the microcapacitors embedded in microfluidic channels can be connected in parallel to obtain better linearized blood glucose measurement results. [ABSTRACT FROM AUTHOR]

In non-invasive blood glucose measurement, the sensitivity of glucose-induced optical signals within human tissue is a crucial reference point. This study evaluates the sensitivity of glucose-induced diffuse reflectance in the 1000–1700 nm range. A key factor in understanding this sensitivity is the rate at which the scattering coefficient changes due to glucose, as it is significantly higher than in non-living media and predominantly influences the diffuse light signal level when blood glucose levels change. The study measured and calculated the changes in the scattering coefficient at 1314 nm, a wavelength chosen for its minimal interference from glucose absorption and other bodily constituents. Based on the Mie scattering theory and the results at 1314 nm, the changes in the scattering coefficient within the 1000–1700 nm range were estimated. Subsequently, the sensitivity of the glucose signal across this range was determined through Monte Carlo (MC) simulations. The findings from 25 human trials indicate that the measured sensitivities at five other typical wavelengths within this band generally align with the sensitivities calculated using the aforementioned method. This research can guide the identification of blood glucose signals and the selection of wavelengths for non-invasive blood glucose measurements. [ABSTRACT FROM AUTHOR]

Background: Cardiac fibrosis is often associated with various heart-related problems such as heart failure, atrial arrhythmia, and sudden cardiac death, making it a leading cause of death globally. Diabetes-associated fibrosis, on the other hand, is influenced by activated cardiac fibroblasts and potentially involves fibrosis-inducing activity of macrophages, cardiomyocytes, and vascular cells. Streptozotocin (STZ) is a known diabetogenic agent, but inadequate preclinical data in animal models hinders its clinical success. Aim: This study aims to provide practical guidelines for STZ utilization in inducing diabetes-associated cardiac fibrosis. Methods: The research was conducted in vivo using white rats (Rattus norvegicus) of the Wistar strain, induced with STZ at doses of 30 mg/KgBW and 50 mg/KgBW per injection. Observations were carried out in the 4th and 8th weeks, consisting of the measurement of blood sugar levels and the examination of heart muscle cell fibrosis. Subsequently, in silico validation of STZ's affinity with inflammatory receptors causing diabetes pathology, such as TNFa and Bcl2, was performed. Results: The study results indicated that the administration of STZ led to an increase in random blood sugar levels and extensive fibrosis of heart muscle cells in mice. The optimal dose for the diabetes model experimented in this study was 50 mg/KgBW for 8 weeks. In silico tests revealed an affinity for TNFa (PDB ID 2AZ5) and Bcl2 (PDB ID 6QGH). Conclusion: Consequently, it can be concluded that administering STZ to mice at a dose of 50 mg/KgBW for 8 weeks is an effective inducer of a diabetes-associated cardiac fibrosis model. [ABSTRACT FROM AUTHOR]

Introduction: Reliable and accurate measurement of blood glucose concentration is of crucial importance for making clinical decisions in diagnosis diabetes, gestational diabetes and impaired fasting glucose tolerance. Materials and methods: Survey was performed in form of questionnaire. Questionnaire was sent to all Croatian laboratories (N = 204) in electronic form using SurveyMonkey cloud-based software (SurveyMonkey, Inc., San Mateo, USA) as an extra-analytical module of the Croatian EQA (External Quality Assessment) provider Croatian center for external quality assessment (CROQALM) in June 2023. Results: In total 148 (73%) of laboratories responded to the survey. Large proportion of laboratories never use glucose inhibitor tubes for random glucose measurement (more than half) or for glucose function tests (one quarter). Only three laboratories use recommended glycolysis inhibitor citrate. Many other inhibitors are also used, even if some of them are not recommended for plasma glucose measurement. Glucose is almost never (93%) sampled on ice when glucose inhibitor tube is not available. Conclusions: Laboratories in Croatia do not follow the recommended procedures regarding glycolysis inhibitors for glucose determination. [ABSTRACT FROM AUTHOR]

Impaired peripheral perfusion in the legs is the most common complaint experienced by patients with type 2 Diabetes Mellitus (DM). One nursing intervention in the form of physical exercise that can be administered to DM patients to prevent peripheral perfusion disorders and increase vascularization of the lower extremities is the Buerger-Allen Exercise (BAE). The goal of this study was to analyze the effectiveness of BAE in improving lower extremity circulation. The population consisted of patients with type 2 DM. The research design employed a quasi-experiment with pre-test and post-test, including a control group. A sample of 24 respondents was divided into an intervention group and a control group. The sampling technique used was purposive sampling. Data were obtained through direct Ankle-Brachial Index (ABI) measurement using a Doppler ultrasound and an aneroid sphygmomanometer, temporary blood sugar level measurements using a glucometer, and leg sensitivity measurements using a monofilament tool. Paired T-tests and independent T-tests were used as statistical tests. The results of the Paired T-test for lower limb circulation in the intervention group yielded a p-value of 0.000, indicating a significant difference in the circulation of the lower extremities before and after the intervention. The results of the independent T-test also showed a p-value of 0.000, indicating significance. Thus, BAE can improve lower limb circulation in patients with type 2 DM. [ABSTRACT FROM AUTHOR]

Background: It is important that blood glucose concentrations be accurately and conveniently measured in infants. However, especially in the early neonatal period, point-of-care testing devices used for adults may not accurately measure blood glucose concentrations in neonates. Methods: In Study 1, the accuracy of neonatal whole-blood glucose measurements was evaluated for the existing glucose analyser Glutest Mint® (hereinafter MINT1; Sanwa Kagaku Kenkyusho, Nagoya, Japan) by comparing the data with reference blood glucose concentrations. In Study 2, we used MINT2, which was modified based on the findings from Study 1, to measure whole-blood glucose concentrations in newborns, and the accuracy of the measurements was compared with that of MINT1. Results: Blood glucose concentrations were measured in 100 infants each in Study 1 and 2. In Study 1, the whole-blood glucose concentrations measured using MINT1 were found to be significantly lower than the reference blood glucose concentrations in early neonates. The results of Study 1 suggested that characteristics of erythrocyte membranes in early neonates affected the measurements. Therefore, we conducted Study 2 using MINT2, which was modified to be less susceptible. MINT2 was found to accurately measure whole-blood glucose concentrations in the early neonatal period. Conclusion: The study showed that the point-of-care testing device could be improved to allow for accurate whole-blood glucose measurements in the early neonatal period. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine the clinical and analytical accuracy of a new veterinary-calibrated portable blood glucose monitor (PBGM) compared to a reference laboratory analyzer. ANIMALS Client-owned dogs (n = 77) and cats (n = 64). METHODS Peripheral and paired capillary whole-blood glucose concentrations measured via PBGM were compared to plasma glucose concentrations measured via a Cobas c501 reference analyzer (Roche). Analytical accuracy was evaluated with the Spearman rank correlation coefficient, Bland-Altman difference plot analysis, and Deming regression. Clinical accuracy was evaluated with Parkes error grid analysis. Paired peripheral and capillary blood samples were compared with the Wilcoxon matched-pairs signed-rank test. RESULTS There was a high correlation between PBGM and reference analyzer readings in dogs and cats. Human quality assurance standards (International Organization for Standardization 15197:2013 guidelines) for analytical accuracy were met for 95% of feline peripheral blood samples and 89% of canine samples. Similar veterinary standards (American Society of Veterinary Clinical Pathology guidelines) were met for 89% of canine and 92% of feline peripheral blood glucose measurements. Error grid analysis showed that all peripheral canine and 97% of feline measurements were clinically accurate (zone A). Any altered clinical decision for the remaining feline measurements was expected to minimally impact outcome (zone B). No significant difference was found between peripheral and capillary blood glucose measurements in either species. CLINICAL RELEVANCE The PBGM produced clinically accurate results and is suitable for use in veterinary and home settings to measure blood glucose. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) is a prevalent metabolic disorder often accompanied by oxidative stress, which contributes to various diabetic complications. Investigating the antioxidant activity of linalool (LIN) is crucial as it may offer a natural therapeutic approach to mitigate oxidative damage in DM. The aim of the present study was to investigate the antioxidant activity of LIN in a DM rat model. A total of 40 male Wistar albino rats (age, 8 weeks; weight, 250-300 g) were used. CONTROL and DM groups were administered physiological saline solution by oral gavage for 21 days. In rats in the DM + LIN and LIN groups, 100 mg/kg LIN was administered intragastrically after streptozotocin injection (n=10 per group). In the first (48 h after STZ injection), second (1 week later), third (2 weeks later), and fourth (3 weeks later) blood glucose measurements, a statistically significant increase was found in the blood glucose values of the DM and DM + LIN groups compared with those of the CONTROL group. During the 21-day experimental period, there was no reduction in blood glucose levels of the DM + LIN group. Consequently, no discernible anti-hyperglycemic effect of LIN was observed. Catalase enzyme activity, superoxide dismutase (SOD) enzyme activity, malondialdehyde (MDA) levels and glutathione (GSH) levels were measured spectrophotometrically. All assays were conducted according to the protocols provided in the respective kits. The results were analyzed to assess the oxidative status and antioxidant capacity in the experimental groups. Catalase (CAT) activity was decreased in the DM group compared with that in the CONTROL group in both the serum and liver. However, LIN administration restored CAT activity in the DM + LIN group to the level of the CONTROL group. In the liver, the DM + LIN-treated group showed a notable reduction in malondialdehyde (MDA) levels compared with those in the DM group. In conclusion, the present results suggest that the antioxidant properties of LIN may have a regulatory effect on the oxidative status in diabetes-affected systems, potentially offering therapeutic benefits in managing oxidative stress associated with diabetes. [ABSTRACT FROM AUTHOR]

In recent years, the Internet of medical things (IoMT) has become a significant technological advancement in the healthcare sector. This systematic review aims to identify and summarize the various applications, key challenges, and proposed technical solutions within this domain, based on a comprehensive analysis of the existing literature. This review highlights diverse applications of the IoMT, including mobile health (mHealth) applications, remote biomarker detection, hybrid RFID-IoT solutions for scrub distribution in operating rooms, IoT-based disease prediction using machine learning, and the efficient sharing of personal health records through searchable symmetric encryption, blockchain, and IPFS. Other notable applications include remote healthcare management systems, non-invasive real-time blood glucose measurement devices, distributed ledger technology (DLT) platforms, ultra-wideband (UWB) radar systems, IoT-based pulse oximeters, accident and emergency informatics (A&EI), and integrated wearable smart patches. The key challenges identified include privacy protection, sustainable power sources, sensor intelligence, human adaptation to sensors, data speed, device reliability, and storage efficiency. The proposed mitigations encompass network control, cryptography, edge-fog computing, and blockchain, alongside rigorous risk planning. The review also identifies trends and advancements in the IoMT architecture, remote monitoring innovations, the integration of machine learning and AI, and enhanced security measures. This review makes several novel contributions compared to the existing literature, including (1) a comprehensive categorization of IoMT applications, extending beyond the traditional use cases to include emerging technologies such as UWB radar systems and DLT platforms; (2) an in-depth analysis of the integration of machine learning and AI in IoMT, highlighting innovative approaches in disease prediction and remote monitoring; (3) a detailed examination of privacy and security measures, proposing advanced cryptographic solutions and blockchain implementations to enhance data protection; and (4) the identification of future research directions, providing a roadmap for addressing current limitations and advancing the scientific understanding of IoMT in healthcare. By addressing current limitations and suggesting future research directions, this work aims to advance scientific understanding of the IoMT in healthcare. [ABSTRACT FROM AUTHOR]

Elderly individuals face an increased likelihood of developing chronic diseases such as diabetes. Self-care practices and medication adherence play crucial roles in preventing complications and adverse effects of this condition. Therefore, this study aimed to determine self-care behaviors, medication adherence status, and related factors among elderly patients with type 2 diabetes. This descriptive-analytical study was conducted on 374 elderly patients with type 2 diabetes who visited educational healthcare centers in Qazvin, Iran, during 2023 (March–September). Sampling was performed using the convenience method. Data collection instruments included a demographic characteristics checklist, the summary of diabetes self-care activities questionnaire, and the Morisky medication adherence scale. Data analysis was conducted using SPSS-22 software, employing the Kolmogorov–Smirnov test, mean, standard deviation, univariate and multivariate regression analyses. The significance level was set at p ≤ 0.05. The mean age of participants was 67.56 ± 5.93 years. In the self-care questionnaire, the highest score pertained to adherence to the diet recommended by the treating physician (3.16 ± 1.87). In contrast, the lowest scores were related to the frequency of checking inside shoes (0.17 ± 0.93) and foot examination (0.31 ± 1.07), respectively. Furthermore, results in self-care behaviors indicated that with increasing education levels, self-monitoring of blood glucose (SMBG) significantly decreased (P = 0.048). This variable was considerably higher in rural residents than in urban dwellers (P = 0.016). Additionally, the frequency of blood glucose measurements was significantly higher in urban residents than in rural inhabitants (p = 0.006). Based on the results, the mean score for medication adherence among patients was 5.53 ± 1.65. Based on our findings, the level of self-care in physical activity, SMBG, and foot care among the elderly is below average. Furthermore, medication adherence in these patients is poor. We expect that managers and policymakers take steps to reduce complications and improve these two variables by developing educational programs on self-care and emphasizing the importance of treatment adherence for these patients. [ABSTRACT FROM AUTHOR]

Cerebrocardiovascular diseases are a major global public health concern, significantly impacting morbidity, mortality, and posing substantial socio-economic challenges. In Cabo Verde, non-communicable diseases have become the leading causes of morbidity and mortality. This study aimed to estimate the prevalence of risk factors for cerebrocardiovascular diseases and their association with cardiac electrical alterations in adults on Santiago Island, Cabo Verde. A cross-sectional population-based study using simple random sampling was conducted on individuals over 18 years of age. The sample size of 599 was based on Santiago Island's 2021 population projection. Data collection occurred in October and November 2021, involving questionnaires on risk factors and cerebrocardiovascular diseases; blood pressure assessments; and capillary blood glucose measurements. The sample was predominantly female, with the 18–27 age group being the largest. Key risk factors included physical inactivity (65.1%), BMI ≥ 25 kg/m2 (42.6%), hypertension (32.6%), and family history of cerebrocardiovascular diseases (19.9%). Other factors were alcoholism (14.4%), hypercholesterolemia (8.3%), smoking (7.3%), diabetes (4.5%), and hypertriglyceridemia (1.3%). Notably, 9.3% had no risk factors, 27.5% had one, 36.2% had two, and 26.9% had three or more. There is a high prevalence of risk factors for cerebrocardiovascular diseases on Santiago Island, particularly among females. [ABSTRACT FROM AUTHOR]

Background: Nowadays, flap surgery is a dependable reconstructive technique. It makes it possible to heal nearly any vascularized tissue defect in the body. The present work aimed to assess the effectiveness of flap blood glucose measurement as a sensitive and reliable indicator in early detection of venous congestion. Methods: In an experimental study, twenty-six adult male Sprague-Dawley rats were subjected to vertical rectus abdominis muscle flaps with upper pedicles, were split into two equal groups (n=13): with venous occlusion of the pedicle (Cases group) and without (Control group). Between the beginning and end of the experiment, we monitored the rats' glycemia in the caudal vein of their feet at regular intervals of ten minutes, and we measured the interstitial glucose in the flaps every ten minutes. Results: Statistically significant decrease was revealed at 0 min, 20 min, and 30 min of flap glucose level when compared with 0 min, 20 min, 30 min foot glucose level (p=0.01, p=0.005, p=0.002 respectively), and high statistically significant decrease was revealed at 10 min, 40 min, 50 min, 1-hour of flap glucose level when compared with 10 min foot glucose level (p-value < 0.001). High statistically significant decrease was found (p-value < 0.001) of mean flap glucose level (mean = 179.7 ± 54.3, range = 89.7 - 297.2) when compared with mean foot glucose level (mean = 228.1 ± 65.1, range = 114.7 - 342.1) in Cases group. Using ROC curve, it was shown that mean glucose level can be used to discriminate between flap glucose level and foot glucose level in cases group at a cutoff level of 187.2, with 69.2% sensitivity, 69.2% specificity, 69.2% PPV and 69.2% NPV (AUC = 0.7 & p-value = 0.054). Conclusions: Monitoring blood glucose levels may serve as a promising indicator for detecting venous congestion in tissue flaps, offering a non-invasive and cost-effective approach for early intervention. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine the sodium correction factor for clinical use in hyperglycemic diabetic dogs. SAMPLE Retrospective analysis of 76 hospitalization episodes from 67 different dogs presenting to the University of Georgia Veterinary Teaching Hospital between January 1, 2015, and January 1, 2023. METHODS For each hospitalization episode, paired blood sodium and glucose concentration measurements were recorded from the time of presentation until glucose concentration was ≤ 201 mg/dL. Therapies administered, primary diagnosis, and concurrent diseases were also recorded for each episode. A linear mixed model was used to determine the sodium correction factor per 100-mg/dL increase in glucose. Piecewise linear mixed models were also constructed for blood glucose measurements ≤ 400 mg/dL and > 400 mg/dL to explore potential correction factor differences between low and high glucose concentrations. RESULTS A sodium correction factor of a 1.6-mEq/L (95% CI, 1.3 to 1.9 mEq/L) decrease in sodium concentration per 100-mg/dL increase in blood glucose concentration was calculated. Differences in the correction factor between conditions of low and high glucose concentrations could not be determined due to a small sample size of blood glucose values > 400 mg/dL. Most dogs received similar treatments throughout the study period, including balanced isotonic crystalloids (97% [74/76]), electrolyte supplementation (84% [64/76]), and regular insulin (97% [74/76]). Almost all patients (93% [71/76]) had 1 or more concurrent diseases. CLINICAL RELEVANCE A sodium correction factor of 1.6 mEq/L (decrease in sodium per 100-mg/dL increase in glucose) is recommended for clinical use in hyperglycemic diabetic dogs. [ABSTRACT FROM AUTHOR]

Objective: To investigate the differences in efficacy and possible related mechanisms between Shenqi Pill with raw and ripened Dihuang in diabetic kidney disease(DKD) mice. Methods: Eight male db/m mice of SPF grade 6-8 weeks old were selected as the normal control group (Control group, and another 24 male db/db mice of SPF grade 6-8 weeks old were selected and randomly grouped according to the measurement of blood glucose as follows: the model control group (Model group), the Shenqi Pill raw Dihuang group (S-L group) and Shenqi Pill ripened Dihuang group (S-R group), with 8 db/db mice in each group. After successful modeling, the S-L group and the S-R group were dosed daily with a decoction of Shenqi Pill containing raw and cooked Dihuang (10.4 g/kg), and the normal group and the model group were dosed daily with an equal amount of saline for 56 d. The effects of these two drugs on the levels of fasting blood glucose, 24-h urinary protein (UP), microalbumin (mAIB), urinary creatinine (Ucr), total cholesterol (TC), total triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipopro-tein (HDL-C), creatinine (SCr), blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin (TBIL) were measured HE staining was conductedto observe the pathomorphologic changes of renal tissues, and Western blot assay to detect protein content of PI3K and Akt in each group. Results: Compared with the control group C, fasting blood glucose, GSP, mAIB, Scr, UP, Ucr, TC, TG, LDL-C, ALT, AST, and TBIL were increased and HDL-C and Ucr were decreased in mice in the model Mo group, and H & E staining showed that glomerular thylakoid membrane hyperpla-sia, glomerular thylakoid cell increase, thylakoid matrix deposition were obvious, and the expressions of PI3K and Akt proteins were down-regulated. Compared with the model group, both the S-L group and the S-R group showed an improvement in biochemical indexes, and H& E staining showed that glomerular pathological injury was improved, and the expression of PI3K and Akt proteins were significantly up-regulated, and the difference was statistically significant (P<0.05); however, when comparing the two groups after treatment, BUN, SCr, UP and AST contents of the S-R group were significantly lower (P<0.05).Conclusion : Both raw and ripened Dihuang in Shenqi Pill can improve the renal function injury induced by DKD, while the efficacy of the ripened Dihuang group of Shenqi Pill is more significant in the treatment of DKD mice, and the mechanism may be related to the up-regulation of the expression levels of PI3K and Akt in renal tissues. [ABSTRACT FROM AUTHOR]

Purpose: The present study aimed to clarify the effects of a hyperglycemic condition on the clinical consequences of long COVID. Methods: Among 643 patients who visited the outpatient clinic of our hospital from February 2021 to September 2023, long COVID patients were classified into a hyperglycemic (HG) group with casual blood glucose levels above 140 mg/dL and a normoglycemic (NG) group. The patients' backgrounds, clinical symptoms, health status including the QOL evaluation scale (EQ-5D-5L), self-rating depression scale (SDS), and F-scale questionnaire (FSSG), blood test data, and recovery periods were analyzed. Results: The NG group included 607 patients with long COVID and the HG group included 36 patients with long COVID. Patients in the HG group were older than those in the NG group (55 vs. 41 years; p < 0.001) and included a larger percentage of males (67% vs. 44%; p = 0.009). The HG group had a larger percentage of patients with moderate-to-severe conditions in the acute infection phase (28% vs. 12%; p = 0.008), a higher BMI (25 vs. 22 kg/m2; p < 0.001), higher blood pressure (138/81 vs. 122/72 mmHg; p < 0.001), and a larger percentage of patients with an alcohol drinking habit (53% vs. 34%; p = 0.031). Long COVID symptoms and self-rated scales were not differed between the two groups; however, the laboratory data showed that liver and renal functions and metabolic data were significantly worse in the HG group. Although there was no apparent difference between the two groups in duration from the infection to the first visit, the HG group had a significantly longer period of recovery from long COVID (median period of 421 vs. 294 days; p = 0.019). Conclusion: A hyperglycemic state associated with other lifestyle-related diseases is associated with the prolongation of recovery from long COVID. [ABSTRACT FROM AUTHOR]

Background/Aim: Emprit ginger (Zingiber officinale var. amarum) is an Indonesian natural plant with various bioactivities, including antidiabetic properties. Several studies have shown that bioactivities can be attributed to the presence of flavonoids and also melatonin which playing a role in carbohydrate metabolism and blood sugar levels regulation. Ginger also has an effect on the lipid profile in studies in experimental animals. Therefore, this study aimed to determine the in vivo antidiabetic activity of melatonin-rich extract of Emprit ginger using blood sugar and lipid profiles parameters. Methods: The study procedure comprised 30 male white rats of Wistar strain, which were divided into 5 groups. These included: I - K-: negative control; II - K+: injected with streptozotocin (STZ) - nicotinamide (NA); III - P1: given STZ-NA + 100 mg/kg body weight (BW)/day ginger extract; IV - P2: given STZ-NA + 200 mg/kg BW/day ginger extract; and V - P3: injected with STZ-NA + metformin 300 mg/kg BW/day. In addition, the treatment was carried out for a total of 21 days, followed by the measurement of random blood sugar (RBS) levels and lipid profiles. Results: The highest pre-treatment RBS, triglyceride, cholesterol, HDL and LDL levels were 426.8 ± 55.8 mg/dL (P2), 142 ± 39.8 mg/dL (P2), 130.8 ± 21.7 mg/dL (K+), 53.4 ± 4.92 mg/dL (P1) and 61.67 ± 17.69 mg/ dL (K+), respectively. The results showed that the largest decrease in RBS was obtained in P3 by 262.8 ± 70.6 mg/dL, while P2 experienced the highest decrease in triglyceride levels by 83.66 ± 52.04 mg/dL. In addition, the largest decrease in cholesterol was in P3 by 50.2 ± 26.30 mg/dL, with P1 possessing the highest reduction in HDL by 15.4 ± 15.88 mg/dL. In terms of LDL, the largest decrease was obtained in P3, 20.44 ± 16.68 mg/dL. Based on the results, changes in biochemical parameters levels between all groups showed significant differences except for HDL. Conclusion: STZ-NA injection caused an increase in RBS and cholesterol in rats. Administration of melatonin-rich ginger extract led to a decrease in RBS, cholesterol and LDL and was more effective in the group given metformin. Melatonin-rich ginger extract at a dose of 200 mg/kg BW/day was more effective in reducing triglycerides compared to other clinical parameters. [ABSTRACT FROM AUTHOR]

The glucose level in the blood is measured through invasive methods, causing discomfort in the patient, loss of sensitivity in the area where the sample is obtained, and healing problems. This article deals with the design, implementation, and evaluation of a device with an ESP-WROOM-32D microcontroller with the application of near-infrared photospectroscopy technology that uses a diode array that transmits between 830 nm and 940 nm to measure glucose levels in the blood. In addition, the system provides a webpage for the monitoring and control of diabetes mellitus for each patient; the webpage is hosted on a local Linux server with a MySQL database. The tests are conducted on 120 people with an age range of 35 to 85 years; each person undergoes two sample collections with the traditional method and two with the non-invasive method. The developed device complies with the ranges established by the American Diabetes Association: presenting a measurement error margin of close to 3% in relation to traditional blood glucose measurement devices. The purpose of the study is to design and evaluate a device that uses non-invasive technology to measure blood glucose levels. This involves constructing a non-invasive glucometer prototype that is then evaluated in a group of participants with diabetes. [ABSTRACT FROM AUTHOR]

This study aimed to develop and test a behavior modification intervention to prevent type 2 diabetes (T2DM) among at-risk individuals. The primary goal was to compare diabetes prevention behaviors and fasting blood sugar levels between the intervention and comparison groups. This study utilizes a quasi-experimental design to develop a behavior modification intervention for preventing diabetes. It involves two groups, each with pre- and post-intervention assessments, comprising 60 at-risk individuals equally divided into intervention and comparison groups. The 8-week intervention includes components like risk assessment, dietary skill enhancement, exercise, stress management, and social media platforms (data recording training, follow-up visits, reminders, and visual aids). Data collection includes self-administered questionnaires and blood sugar level measurements. Statistical analysis involved paired t-tests for within-group comparisons and independent t-tests for between-group differences. The findings showed that the intervention group achieved significantly higher average scores in nutrition, exercise, and stress management, and had significantly lower average blood sugar levels compared to the comparison group. These results suggest that healthcare providers and policymakers should develop community health programs and public health policies that incorporate integrative care, leverage social media platforms, and foster collaboration with other health professionals to improve outcomes for individuals at risk of T2DM. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare the pharmacokinetics (PK) and pharmacodynamics (PD) of T‐glu (GP40321, test drug), and reference insulin glulisine in a hyperinsulinemic‐euglycemic clamp procedure. During this study, 34 healthy male volunteers underwent the hyperinsulinemic‐euglycemic clamp procedure following subcutaneous 0.3 U/kg injection of T‐glu or reference insulin glulisine in a randomized, double‐blind, crossover study. Plasma glucose levels were monitored every 5 minutes for 8 hours. Glucose infusion rate adjustment was based on the blood glucose measurements. Evaluation of PD was performed using the glucose infusion rate values, while PK was calculated using insulin concentrations measured via enzyme‐linked immunosorbent assay. The study results showed that the 90% CI for the geometric mean ratios of primary PK and PD of T‐glu and reference insulin glulisine were within 80%‐125% comparability limits, and that the safety profiles were comparable. PK, PD, and safety similarity of T‐glu and reference insulin glulisine was demonstrated. [ABSTRACT FROM AUTHOR]

Introduction: The recommended social distancing measures to prevent the spread of Covid-19 caused high mental suffering, mainly for those affected by diabetes mellitus due to multiple metabolic, inflammatory and vascular changes. Objective: This work aims to test the association between the perception of feelings, the measurement of blood glucose and the conditions of social distancing due to the Covid19 pandemic in adults with type 1 diabetes in Brazil. Materials and methods: The research was approved by the Ethics Committee and Research with Human Beings, carried out through an online form, it is a cross-sectional, descriptive and analytical study, carried out during the month of July 2020. Results: 472 adults with DM1 participated, 50.4% said that social distancing was causing stress in their home environment. For statistical analysis, the Statistical Package for Social Sciences software, version 21, was used, a relationship was found between stress, hyperglycemia and less willingness to remain in social isolation; normoglycemia feeling of joy and greater willingness to remain in social isolation. Conclusion: Given this, it is observed that social distancing caused glycemic and mood changes in these individuals. Therefore, the inclusion of care in the health of this population should be considered, through different interventions with the multidisciplinary team. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate GFR decline in elderly subjects with varying physical conditions and analyze key risk factors impacting renal function changes. Methods: We obtained data from patients between 2017 and 2019, and matched healthy elderly subjects based on gender and age. Data collected for all subjects included annual measurements of fast blood glucose (GLU), glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-c), blood albumin (ALB), blood uric acid (UA), urine protein (UP), and systolic blood pressure (SBP). Additionally, information on coexisting diseases was gathered. The Full Age Spectrum (FAS) equation was used to calculate eGFR. Results: A total of 162 patients with complete 3-year renal dynamic imaging were included, including 84 patients in the kidney disease group (K group) and 78 patients in the non-kidney disease group (NK group). Ninety individuals were selected as the healthy group (H group). The annual decline rate in the K group was the fastest, which exceeded 5mL/min/1.73m2 (P < 0.05). Group (K group: β=− 40.31, P< 0.001; NK group: β=− 26.96, P< 0.001), ALB (β=− 0.38, P=0.038) and HbA1c (β=1.36, P=0.029) had a significant negative impact on the eGFR changes. For participants who had negative proteinuria: K group had the most significant annual eGFR decline. Conclusion: The presence of kidney disease, along with proteinuria nor not, can lead to a marked acceleration in kidney function decline in elderly. We categorize elderly individuals with an annual eGFR decline of more than 5 mL/min/1.73m2 as the "kidney accelerated aging" population. [ABSTRACT FROM AUTHOR]

The article discusses the proposal to change the name of diabetes insipidus to 'Arginine Vasopressin Deficiency (AVP‐D)' for central etiologies and 'Arginine Vasopressin Resistance (AVP‐R)' for nephrogenic etiologies. The rationale for this change includes avoiding confusion with diabetes mellitus, improving patient care, and aligning disease names with underlying pathophysiology. The proposal has been endorsed by various national and international endocrinology and pediatric societies. The working group suggests using the new terms alongside the old name initially to facilitate the transition. [Extracted from the article]

In this short document we propose an update on the latest AACC 2023 standards for the diagnosis and monitoring of diabetes at the laboratory level. In particular we will focus on some recommendations expressed in relation to the measurement of blood glucose, both with laboratory methods and through systems for continuous blood glucose monitoring, on the measurement of glycated hemoglobin and other glycated proteins, in particular glycated albumin. Some statements relating to the diagnosis of gestational diabetes, the measurement of ketone bodies, autoantibodies and C-peptide will also be considered. Particular attention is given to the quantitative measurement of albumin in urine. [ABSTRACT FROM AUTHOR]

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Background: High-frequency hearing loss (HFHL) stands as a prevalent occupational morbidity globally, with numerous associated risk factors, some of which are modifiable. In the context of a comprehensive hearing conservation program, the initial steps involve early screening and identification of workers with these modifiable risk factors, aiming to reduce the prevalence of hearing loss. Our objective was to estimate the prevalence of HFHL and determine its predictors among mine workers. Methods: We conducted a cross-sectional study among 226 mine workers in ten open-cast mines in Gujarat state, the western part of India, in November 2020. We collected data on socio-demography, addiction, occupation history and comorbidities, along with anthropometric, blood pressure, and blood sugar measurements. Audiometric evaluations using a portable diagnostic audiometer were employed to assess HFHL, defined as a hearing threshold exceeding 25 decibels (dB) at high frequencies (3000, 4000, 6000, and 8000 Hz). A generalized linear model (GLM) with a binomial family was performed to determine the predictors significantly predicting HFHL after adjusting for confounding variables. Results: The prevalence of HFHL was 35% (95% CI: 29–42%) in our study setting. Office workers demonstrated a prevalence of 19%, whereas other job categories displayed a higher prevalence of 42%, resulting in a significant prevalence difference of 23% and a prevalence ratio of 2.2. The GLM analysis revealed that variables, such as noise exposure during work [adjusted prevalence ratio (aPR) 2.3 (95% CI: 1.2–4.7, p = 0.018)] and noise exposure duration [aPR 1.1 (95% CI: 1.0–1.1, p = 0.042)], were significant predictors of HFHL. Conclusions: In our study setting, mine workers exhibited a high prevalence of HFHL, with exposure to workplace noise and duration being modifiable predictors. Because HFHL advances slowly and is generally undetected by the individual, we recommend periodic testing using audiometry to identify it among mine workers and, if possible, shifting them from mining activities to office. Furthermore, we advocate for the implementation of a comprehensive hearing conservation program to the extent possible. [ABSTRACT FROM AUTHOR]

The soluble glucose dehydrogenase (sGDH) from Acinetobacter calcoaceticus has been widely studied and is used, in biosensors, to detect the presence of glucose, taking advantage of its high turnover and insensitivity to molecular oxygen. This approach, however, presents two drawbacks: the enzyme has broad substrate specificity (leading to imprecise blood glucose measurements) and shows instability over time (inferior to other oxidizing glucose enzymes). We report the characterization of two sGDH mutants: the single mutant Y343F and the double mutant D143E/Y343F. The mutants present enzyme selectivity and specificity of 1.2 (Y343F) and 5.7 (D143E/Y343F) times higher for glucose compared with that of the wild-type. Crystallographic experiments, designed to characterize these mutants, surprisingly revealed that the prosthetic group PQQ (pyrroloquinoline quinone), essential for the enzymatic activity, is in a cleaved form for both wild-type and mutant structures. We provide evidence suggesting that the sGDH produces H2O2, the level of production depending on the mutation. In addition, spectroscopic experiments allowed us to follow the self-degradation of the prosthetic group and the disappearance of sGDH's glucose oxidation activity. These studies suggest that the enzyme is sensitive to its self-production of H2O2. We show that the premature aging of sGDH can be slowed down by adding catalase to consume the H2O2 produced, allowing the design of a more stable biosensor over time. Our research opens questions about the mechanism of H2O2 production and the physiological role of this activity by sGDH. [ABSTRACT FROM AUTHOR]

Introduction: Telehealth is an applicable, acceptable, cost-effective, easily accessible, and speedy method for pregnant women. This study aimed to examine the impact of telehealth applications on pregnancy outcomes and costs in high-risk pregnancies. Methods: Studies were selected from PubMed, Science Direct, Web of Science, EBSCO, Scopus, and Clinical Key databases according to the inclusion and exclusion criteria from January to February 2021. Cochrane risk-of-bias tools were used in the quality assessment of the studies. Results: Four observational and eight randomized controlled studies were included in this meta-analysis (telehealth: 135,875, control: 94,275). It was seen that the number of ultrasound (p < 0.01) and face-to-face visits (p < 0.01), fasting insulin (p < 0.01), hemoglobin A1C before delivery (p < 0.01), and emergency cesarean section rates (p = 0.05) were lower in the telehealth group. In the telehealth group, the women's use of antenatal corticosteroids (p = 0.03) and hypoglycemic medication at delivery (p = 0.03), the total of nursing interventions (p < 0.01), compliance with actual blood glucose measurements (p < 0.01), induction intervention at delivery (p = 0.003), and maternal mortality (p < 0.001) rates were higher. Two groups were similar in terms of the use of medical therapy, total gestational weight gain, health problems related to pregnancy, mode and complications of delivery, maternal intensive care unit admission, fetal-neonatal growth and development, neonatal health problems and mortality, follow-up, and care costs. Discussion: Telehealth and routine care yielded similar maternal/neonatal health and cost outcomes. It can be said that telehealth is a safe technique to work with in the management of high-risk pregnancies. [ABSTRACT FROM AUTHOR]

The soluble glucose dehydrogenase (sGDH) from Acinetobacter calcoaceticus has been widely studied and is used, in biosensors, to detect the presence of glucose, taking advantage of its high turnover and insensitivity to molecular oxygen. This approach, however, presents two drawbacks: the enzyme has broad substrate specificity (leading to imprecise blood glucose measurements) and shows instability over time (inferior to other oxidizing glucose enzymes). We report the characterization of two sGDH mutants: the single mutant Y343F and the double mutant D143E/Y343F. The mutants present enzyme selectivity and specificity of 1.2 (Y343F) and 5.7 (D143E/Y343F) times higher for glucose compared with that of the wild-type. Crystallographic experiments, designed to characterize these mutants, surprisingly revealed that the prosthetic group PQQ (pyrroloquinoline quinone), essential for the enzymatic activity, is in a cleaved form for both wild-type and mutant structures. We provide evidence suggesting that the sGDH produces H2O2, the level of production depending on the mutation. In addition, spectroscopic experiments allowed us to follow the self-degradation of the prosthetic group and the disappearance of sGDH's glucose oxidation activity. These studies suggest that the enzyme is sensitive to its self-production of H2O2. We show that the premature aging of sGDH can be slowed down by adding catalase to consume the H2O2 produced, allowing the design of a more stable biosensor over time. Our research opens questions about the mechanism of H2O2 production and the physiological role of this activity by sGDH. [ABSTRACT FROM AUTHOR]

The demographic transition poses a significant challenge for health systems, especially in Central and Eastern European (CEE) countries, where the healthcare needs of aging populations are on the rise. This study aimed to describe and compare the health status and utilization of health services among the elderly residing in urban and rural areas of the most deprived region in Hungary. A comprehensive health survey was conducted in 2022, involving a randomly selected sample of 443 older adults (≥ 65 years) in Northeast Hungary. Multivariable logistic regression models adjusting for age, sex, education, financial status, chronic diseases, and activity limitations were used to investigate the association between type of residence and health service use. Among the study participants, 62.3% were female, 38.3% attained primary education, 12.5% reported a bad or very bad financial situation and 52.6% lived in urban areas. Overall, 24% of the elderly rated their health as very good or good (27.8% in urban and 19.7% in rural areas), while 57.8% (52.6% and 63.5% in urban and rural areas) reported limitations in daily activities. Compared to urban residents, rural residents reported lower rates of dentist visits (p = 0.006), specialist visits (p = 0.028), faecal occult blood testing (p < 0.001), colorectal cancer screening with colonoscopy (p = 0.014), and breast cancer screening (p = 0.035), and a higher rate of blood pressure measurement (p = 0.042). Multivariable models indicated that urban residence was positively associated with faecal occult blood testing (OR = 2.32, p = 0.014), but negatively associated with blood pressure (OR = 0.42, p = 0.017) and blood glucose measurements (OR = 0.48, p = 0.009). These findings highlight the influence of residence on health service utilization among older adults in Hungary. Further comprehensive studies are needed to better understand the health needs of the elderly population and to develop policies aimed at promoting healthy aging in CEE countries. [ABSTRACT FROM AUTHOR]

The primary objectives of the study were (a) to confirm that glucose 6-phosphate dehydrogenase (G6PD) deficiency affects HbA1c values in a sample of children and adolescents with type 1 diabetes (T1D) and (b) to quantify this effect so that a correction can be applied to the HbA1c values found in current clinical practice. The following data were collected: age, sex, G6PD, number of daily capillary blood glucose measurements, 90-day average blood glucose levels prior to the study, HbA1c, and glycated hemoglobin estimated (eA1c) obtained from blood glucose levels. Patients were divided into three groups based on G6PD values: deficient, intermediate, and nondeficient. In each group, a comparison between the average eA1C and HbA1c values was performed. Then, the difference between the eA1c and HbA1c values of each patient and the mean of the differences (MD) of all patients was calculated within the three groups. Finally, a comparison of the MD values between groups was performed. Seventy-four subjects with T1D were studied. Based on the G6PD value, 33 subjects were deficient, 8 were intermediate, and 33 subjects were nondeficient. In deficient patients, the eA1c values were significantly higher than the HbA1c values. In the other two groups, however, there were no differences. The MD values between the three groups were significantly different. In deficient patients, MD values were higher than those in intermediate and in nondeficient patients. No difference was found between intermediate and nondeficient subjects. Our study confirms that G6PD deficiency affects HbA1c values in children and adolescents with T1D, both in deficient subjects and, to a much lesser extent, in intermediate subjects. In deficient subjects, there is an average reduction in HbA1c attributable to enzyme deficiency of 1.3% (14 mmol/mol) and in intermediate subjects of 0.3% (3 mmol/mol). [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the feasibility of using the FreeStyle Libre (a continuous glucose monitoring system [CGMS]) for instantaneous continuous monitoring of interstitial glucose in adult horses and examine the applicability and accuracy of this system in horses submitted to combined glucose–insulin test (CGIT). Design: Laboratory measurements and continuous glucose monitoring system (CGMS) readings were analyzed using a 2 × 2 factorial statistical model with repeated measures over time. This analysis assessed the effects of the test (factor 1), group (factor 2), and their interactions (test × group, test × time, and group × time). Pearson's correlation analysis was applied to blood glucose values. Mean comparisons were conducted using the t‐test, and agreement between techniques was assessed via the Bland–Altman method, with a 95% confidence interval. Setting: Field study on private horse farms in association with a veterinary school. Animals: Ten healthy stallions were assigned to one of two groups based on their body condition scores (BCS). Group 1 (G1, n = 5) consisted of nonobese horses with a BCS of 5 or 6, while Group 2 (G2, n = 5) consisted of obese horses with a BCS of 7 or higher. Interventions: A CGMS sensor was attached to the dorsolateral aspect of the proximal one third of each horse's neck. Laboratory blood glucose measurements and CGMS interstitial glucose readings were compared at different time points for up to 7 days after sensor fixation. Obese horses were also submitted to CGIT on Day 4. Measurements and Main Results: A comparative analysis of glucose measurements obtained in G1 and G2 horses using the CGMS and enzymatic methods revealed significant group × time interactions (P < 0.001) and time effects (P < 0.001). No interactions were detected between group (P = 0.45), test (P = 0.62), group and test (P = 0.28), or time and test (P = 0.92). In G1 and G2, tests were significantly correlated (r = 0.84 and P = 0.00) at all time points (T0–T5). Agreement between the glucose values obtained using different methods was excellent despite a small time delay in CGMS detection of rapid changes in blood glucose. Conclusions: It was concluded that the CGMS can be used for indirect assessment of glycemic status (ie, based on interstitial glucose measurements) in nonobese and obese adult horses submitted to CGIT. [ABSTRACT FROM AUTHOR]

In free flap operation, temporary hyperemia of the transferred flaps can often be encountered in the early postoperative period, appearing reddish and rapid capillary refilling time, which mimics venous congestion. This study aimed to investigate the factors associated with the development of hyperemia and evaluate clinical course. Consecutive patients who underwent free flap-based reconstruction between December 2019 and October 2021 were reviewed. Independent risk factors associated with its development were assessed. Flap showing initial hyperemic features were assessed using flap blood glucose measurement (BGM). If it showed over 60 mg/dL, they were closely observed without management. Their clinical outcomes were evaluated. In total, 204 cases were analyzed, of which 35 (17.2%) showed initial hyperemia. Multivariable analyses showed that using thoracodorsal artery perforator flaps and muscle containing flaps (musculocutaneous/muscle-chimeric flaps) and conducting end-to-end arterial anastomosis (vs. end-to-side) were independent predictors. All cases with initial hyperemia showed over 60 mg/dL in BGM. The phenomenon resolved spontaneously within 6.9 h averagely. Overall perfusion-related complications developed in 10 (4.9%) cases, which rate did not differ between the two groups. Several factors might be associated with the development of initial hyperemia after free flap surgery. With proper assessment, this condition can be successfully managed without unnecessary intervention. [ABSTRACT FROM AUTHOR]

Diabetes mellitus in pregnancy is associated with adverse maternal and neonatal outcomes. Optimal glycemic control is associated with improved outcomes. Continuous glucose monitoring is a less invasive alternative to blood glucose measurements. Two types of continuous glucose monitoring are available in the market: real time and intermittently scanned. Continuous glucose monitoring is gaining popularity and is now recommended by some societies for glucose monitoring in pregnant women. In this review, we discuss the differences between the two types of continuous glucose monitoring, optimal treatment goals, and whether there is an improvement in maternal or neonatal outcomes. [ABSTRACT FROM AUTHOR]

DPP-4 inhibitors are frequently used as first-line agents for the treatment of type 2 diabetes in Japan. This study aimed to examine the effects of vildagliptin on glucose metabolism and arterial stiffness. Twenty treatment-naïve patients with type 2 diabetes (8 males and 12 females) received vildagliptin 50 mg twice daily for 6 months. Self-monitored blood glucose measurements and a 75 g OGTT were performed. Arterial stiffness was assessed using the CAVI. After the vildagliptin treatment, a significant decrease in the median HbA1c (from 8.3 to 6.4%) and fasting HOMA-β (from 26.1 to 34.5%), and a marginally significant decrease in the CAVI (from 8.9 to 8.4, p = 0.087) were observed. The glycemic variability parameters also improved, whereas the insulin sensitivity and oxidative stress remained unchanged. Participants with a lower glycemic variability on the 75 g OGTT after vildagliptin treatment showed a significant decrease in their CAVI. The baseline BMI was significantly higher for the participants with a decreased CAVI than in those with no change in their CAVI (24.5 vs. 20.8 kg/m2). After vildagliptin treatment, a decrease in the CAVI was observed, especially in the individuals with improved glycemic variability on the 75 g OGTT. Vildagliptin may be suitable for vascular protection in individuals with high glycemic variability and/or an elevated BMI. [ABSTRACT FROM AUTHOR]

Introduction. Diabetes mellitus is a metabolic disorder that might result in short and long-term health complications and even death if not properly managed. This disease affected 451 million people in 2017 worldwide and these fi gures are expected to increase to 693 million by 2045. Currently, there is no cure for diabetes. However, self-management, especially keeping BG in the recommended range, is crucial to the treatment. Aim. The aim of this paper is to offer an overview of current literature regarding CGM technologies. We outline mechanism of action, current use of CGM and discuss pros and cons of using this method in DM management. Material and methods. A review of the literature available in PubMed and Google Scholar databases was conducted. Results and conclusions. Blood glucose measurement using a glucometer is an invasive method, not very comfortable for the patient, it detects only one temporary blood glucose level. This method does not reflect glucose fluctuations and trends, which makes effective diabetes management diffi cult. Even supplementing this method with HbA1c measurement does not bring as much relevant information for making therapeutic decision as CGM. The abundance of data provided by CGM and the ability to analyze them in greater detail, provide additional information to help achieve glycemic goals. It is a discreet and minimally invasive method, and the reading of blood glucose values can be easily read from mobile device. Data storage allows the doctor to view the past course of the disease and modify treatment. Manufacturers are constantly improving their devices, eliminating flaws, and the benefi ts of CGM improve treatment outcomes, which should translate into a reduction in the long-term complications of diabetes. Further research is needed, leading to the development of CGM technology. [ABSTRACT FROM AUTHOR]

Introduction: Patients with diabetes mellitus monitor their blood glucose at home with monitors that require a drop of blood or use a continuous glucose monitoring device that implants a small needle in the body. However, both cause discomfort to the patients which may inhibit them for regular blood glucose checks. Photoplethysmogram (PPG) sensing technology is an approach for non-invasive blood glucose measurement and PPG sensors can be used to predict hypoglycaemic episodes. InChcek is a PPG-based non-invasive glucose monitor. However, its accuracy has not been checked yet. Hence, this study aimed to evaluate the accuracy of InCheck, a non-invasive glucose monitor for the estimation of blood glucose. Methods: In a tertiary care hospital, patients who came for blood glucose estimation were tested for blood glucose non-invasively on the InCheck device and then by the laboratory method (glucose oxidase-peroxidase). These two readings were compared. We used International Organization for Standardization (ISO) 15197:2013 (95% of values should be within ± 15 mg/dL of reference reading if reference glucose <100 mg/dL or within ± 15% of reference reading if reference glucose ≥100 mg/dL and 99% of the values should be within zones A and B in consensus error grid), and Surveillance Error Grid for analyzing the accuracy. Results: A total of 1223 samples were analyzed. There was a significant difference between the reference method glucose level (135 [Q1-Q3: 97 – 179] mg/dL) and monitor-measured glucose level (188.33 [Q1-Q3: 167.33-209.33] mg/dL) (P < 0.0001). A total of 18.5% of readings were following ISO 15197:2013 criteria and 67.25% of coordinates were within zone A and zone B of the consensus error grid. In the surveillance error grid analysis, about 29.4% of values were in the no-risk zone, 51.8% in slight risk, 18.6% in moderate risk, and 0.2% were in the severe risk zone. Conclusion: The accuracy of the InCheck device for the estimation of blood glucose by PPG signal is not following the recommended guidelines. Hence, further research is necessary for programming or redesigning the hardware and software for a better result from this optical sensor-based non-invasive home glucose monitor. [ABSTRACT FROM AUTHOR]

The treatment of type 1 diabetes through islet cell transplantation is a complex process, facing challenges such as allograft rejections and a limited supply of donors. One potential solution is to utilize the liver as an alternative for natural insulin production, as hepatocytes can secrete proteins and respond to glucose levels. Recent research has shown promising results in using mesenchymal stem cells as a potential cure for diabetes. The study utilized a diabetic rat model, confirmed through blood sugar measurement. A plasmid vector was designed with specific genetic components, synthesized by biotech company, and then Inserted vector into a plasmid with resistance genes and bacterial origin. Bone marrow‐derived mesenchymal stem cells (BM‐MSCs) were cultured and transfected with the plasmid using Lipofectamine 3000. Polymerase chain reaction was employed to confirm successful transfection using specific primers. For the animal study, 30 male Wistar rats were divided into six groups, each comprising five rats. The control group did not receive any treatment, while the second group received MSCs via Portal Vein Injection. The third group received MSCs transfected with a specific construct via Portal Vein Injection. The fourth group was induced to develop diabetes through streptozotocin (STZ) injection, the fifth group developed diabetes and received untransfected MSCs via Portal Vein Injection, and the sixth group received MSCs transfected with the specific construct via Portal Vein Injection. To manage Pain, appropriate pain control was administered to the rats for 3 days after the surgery. Fixed liver tissues obtained from the euthanized rats were utilized for immunohistochemistry. In this study, immunohistochemical techniques were used to examine insulin expression in different groups of rats. The control groups showed high levels of insulin expression, while the diabetic groups exhibited lower expression. However, there was a significant difference between the diabetic groups treated with MSC and transgenic MSC cells. All groups had similar baseline glucose levels, but the diabetic groups showed a significant increase after STZ injection, whereas the control and MSC groups did not. Postintervention, both the control and MSC groups had similar glucose levels to the post‐STZ levels. However, diabetes‐induced groups experienced a significant decrease in glucose levels, with the transfected MSCs showing a greater decrease than the untransfected MSCs. The study suggested that treatment with MSCs, especially transfected ones, can effectively reduce glucose levels in rats with diabetes. In this research, rat BM‐MSCs were utilized to create insulin‐producing mesenchymal cells with glucose‐sensitive insulin expression. The cells were transferred to the liver of diabetic rats via portal vein injection, leading to an increase in insulin expression. This study proposes a novel approach for cell therapy and delivery in the treatment of type 1 diabetes. Significance Statement: Type 1 diabetes arises from autoimmune destruction of pancreatic β cells, leading to insulin deficiency. Cell therapy, presents a promising avenue. cells can be genetically engineered to produce insulin in response to glucose fluctuations. Mesenchymal stem cells are potential candidates for generating insulin‐producing cells. This study employed a novel approach, genetically engineered using a plasmid vector with glucose‐responsive elements in bone marrow‐derived mesenchymal stem cells and cell transfer to rat liver through portal vein injection. Differing from conventional methodologies, this research utilized undifferentiated rat BM‐MSCs. The hypothesis revolved around the potential of rat BM‐MSCs to migrate into the rat liver via the Portal Vein Injection method, offering a distinctive perspective on diabetes treatment. [ABSTRACT FROM AUTHOR]

High‐resolution interference pattern images are vital for spatial heterodyne Raman spectroscopy to produce quality Raman spectra with a good signal‐to‐noise ratio. A sought‐after super‐resolution algorithm can enhance Raman interference pattern images, reducing reliance on expensive imaging sensors. This enables miniaturization and portability for point‐of‐care testing. This study proposes a generative adversarial network (GAN)‐based super‐resolution reconstruction algorithm explicitly designed for Raman interference patterns. Employing GAN adversarial training, the algorithm effectively reconstructs interference pattern images at higher resolution, improving Raman spectra signal‐to‐noise ratio. Considering Raman spectra analysis mainly focuses on characteristic peaks, a Raman characteristic peak‐focused network training scheme is used. For instance, acetaminophen is studied with two selected Raman characteristic peaks centered at 388 and 858 cm−1. These peaks are observed in Fourier transformed Raman spectra from corresponding low‐resolution interference pattern images obtained by down‐sampling high‐resolution ones by twofold and fourfold. The proposed GAN‐based algorithm successfully reconstructs low‐resolution interference patterns into high‐resolution ones, achieving high R‐square values (96.05% for twofold and 91.1% for fourfold). This innovation holds potential for point‐of‐care applications, like noninvasive blood glucose concentration measurements, enabling cost‐effective, portable Raman spectrometers with improved capabilities. [ABSTRACT FROM AUTHOR]

Continuous glucose monitors (CGMs) are valuable tools for improving glycemic control, yet their accuracy might be influenced by physical activity. This study sought to assess the accuracy of the three latest factory-calibrated CGM systems available in Europe at the time the study was conducted, both during aerobic exercise and in typical daily scenarios. The accuracy evaluation, based on metrics such as the median absolute relative difference (MARD) and point and rate error-grid analyses (PEGA and REGA), involved 13 adults with type 1 diabetes. Participants wore all sensors during a 1 h in-clinic exercise session followed by a subsequent 3-day home period, with blood glucose measurements serving as reference values in both contexts. During exercise, no statistically significant differences in MARD were observed (Dexcom G6: 12.6%, Guardian 4: 10.7%, and Freestyle Libre 2: 17.2%; p = 0.31), and similarly, no significant differences emerged in PEGA-zone-AB (100%, 100%, 96.8%; p = 0.37). Nevertheless, Freestyle Libre 2 showed comparatively diminished accuracy in estimating glucose trends during exercise (REGA-zone-AB: 100%, 93.0%, 73.3%; p = 0.0003). In the home environment, Freestyle Libre 2 exhibited a significantly higher MARD when compared to the other systems (10.2%, 11.9%, 16.7%, p = 0.02). Overall, Dexcom G6 and Guardian 4 demonstrated superior accuracy in both exercise and daily life scenarios compared to Freestyle Libre 2. [ABSTRACT FROM AUTHOR]

Background: The association of glycemic variability with severe consciousness disturbance and in-hospital all-cause mortality in critically ill patients with cerebrovascular disease (CVD) remains unclear, This study aimed to investigate the association of glycemic variability with cognitive impairment and in-hospital death. Method: We extracted all blood glucose measurements of patients diagnosed with CVD from the Medical Information Mart for Intensive Care IV (MIMIC-IV). Glycemic variability was defined as the coefficient of variation (CV), which was determined using the ratio of standard deviation and the mean blood glucose levels. Cox hazard regression models were applied to analyze the link between glycemic variability and outcomes. We also analyzed non-linear relationship between outcome indicators and glycemic variability using restricted cubic spline curves. Results: The present study included 2967 patients diagnosed with cerebral infarction and 1842 patients diagnosed with non-traumatic cerebral hemorrhage. Log-transformed CV was significantly related to cognitive impairment and in-hospital mortality, as determined by Cox regression. Increasing log-transformed CV was approximately linearly with the risk of cognitive impairment and in-hospital mortality. Conclusion: High glycemic variability was found to be an independent risk factor for severe cognitive decline and in-hospital mortality in critically ill patients with CVD. Our study indicated that enhancing stability of glycemic variability may reduced adverse outcomes in patients with severe CVD. [ABSTRACT FROM AUTHOR]