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Statin drugs lower blood cholesterol levels for cardiovascular disease prevention. Women are more likely than men to experience adverse statin effects, particularly new-onset diabetes (NOD) and muscle weakness. Here we find that impaired glucose homeostasis and muscle weakness in statin-treated female mice are associated with reduced levels of the omega-3 fatty acid, docosahexaenoic acid (DHA), impaired redox tone, and reduced mitochondrial respiration. Statin adverse effects are prevented in females by administering fish oil as a source of DHA, by reducing dosage of the X chromosome or the Kdm5c gene, which escapes X chromosome inactivation and is normally expressed at higher levels in females than males. As seen in female mice, we find that women experience more severe reductions than men in DHA levels after statin administration, and that DHA levels are inversely correlated with glucose levels. Furthermore, induced pluripotent stem cells from women who developed NOD exhibit impaired mitochondrial function when treated with statin, whereas cells from men do not. These studies identify X chromosome dosage as a genetic risk factor for statin adverse effects and suggest DHA supplementation as a preventive co-therapy.

OBJECTIVE: Real-time continuous glucose monitoring (CGM) is effective for diabetes management in cases of type 1 diabetes and adults with type 2 diabetes (T2D) but has not been assessed in adolescents and young adults (AYAs) with T2D. The objective of this pilot interventional study was to assess the feasibility and acceptability of real-time CGM use in AYAs with T2D. METHODS: Adolescents and young adults (13-21 years old) with T2D for six months or more and hemoglobin A1c (A1c) greater than 7%, on any Food and Drug Administration-approved treatment regimen, were included. After a blinded run-in period, participants were given access to a real-time CGM system for 12 weeks. The use and acceptability of the real-time CGM were evaluated by sensor usage, surveys, and focus group qualitative data. RESULTS: Participants (n = 9) median age was 19.1 (interquartile range [IQR] 16.8-20.5) years, 78% were female, 100% were people of color, and 67% were publicly insured. Baseline A1c was 11.9% (standard deviation ±2.8%), with median diabetes duration of 2.5 (IQR 1.4-6) years, and 67% were using insulin. Seven participants completed the study and demonstrated statistically significant improvement in diabetes-related quality of life, with the mean Pediatric Quality of Life inventory (PedsQL) diabetes score increasing from 70 to 75 after using CGM (P = .026). Focus group results supported survey results that CGM use among AYAs with T2D is feasible, can improve quality of life, and has the potential to modify behavior. CONCLUSION: Real-time CGM is feasible and acceptable for AYAs with T2D and may improve the quality of life of patients with diabetes. Larger randomized controlled trials are needed to assess the effects on glycemic control and healthy lifestyle changes.

ObjectiveHispanic/Latino individuals in the U.S. have the highest prevalence of undiagnosed and untreated diabetes and are at increased risk for cognitive impairment. In this study, we examine glycemic control in relation to cognitive aging and impairment in a large prospective cohort of middle-aged and older Hispanic/Latino individuals of diverse heritages.Research design and methodsStudy of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) is a Hispanic Community Health Study/Study of Latinos (HCHS/SOL) ancillary study. HCHS/SOL is a multisite (Bronx, NY; Chicago, IL; Miami, FL; and San Diego, CA), probability sampled prospective cohort study. SOL-INCA enrolled 6,377 diverse Hispanic/Latino individuals aged 50 years and older (2016-2018). The primary outcomes were cognitive function, 7-year cognitive decline, and mild cognitive impairment (MCI). The primary glycemia exposure variables were measured from fasting blood samples collected at HCHS/SOL visit 1 (2008-2011).ResultsVisit 1 mean age was 56.5 years ± 8.2 SD, and the average glycosylated hemoglobin A1C (HbA1c) was 6.12% (43.5 ± 14.6 mmol/mol). After covariate adjustment, higher HbA1c was associated with accelerated 7-year global (b = -0.045; 95% CI -0.070; -0.021; in z score units) and executive cognitive decline and a higher prevalence of MCI (odds ratio 1.20; 95% CI 1.11; 1.29).ConclusionsElevated HbA1c levels were associated with 7-year executive cognitive decline and increased MCI risk among diverse middle-aged and older Hispanic/Latino individuals. Our findings indicate that poor glycemic control in midlife may pose significant risks for cognitive decline and MCI later in life among Hispanic/Latino individuals of diverse heritages.

PurposeHigh blood glucose (hBG) in patients undergoing [18F]FDG PET/CT scans often results in rescheduling the examination, which may lead to clinical delay for the patient and decrease productivity for the department. The aim of this study was to evaluate whether long-axial field-of-view (LAFOV) PET/CT can minimize the effect of altered bio-distribution in hBG patients and is able to provide diagnostic image quality in hBG situations.Materials and methodsOncologic patients with elevated blood glucose (≥ 8.0 mmol/l) and normal blood glucose ( 11 mmol/l). Tracer uptake in the liver, muscle, and tumor was evaluated. Furthermore, image quality was compared between long acquisitions (ultra-high sensitivity mode, 360 s) on a LAFOV PET/CT and routine acquisitions equivalent to a short-axial field-of-view scanner (simulated (sSAFOV), obtained with high sensitivity mode, 120 s). Tumor-to-background ratio (TBR) and contrast-to-noise ratio (CNR) were used as the main image quality criteria.ResultsThirty-one hBG patients met the inclusion criteria and were matched with 31 nBG patients. Overall, liver uptake was significantly higher in hBG patients (SUVmean, 3.07 ± 0.41 vs. 2.37 ± 0.33; p = 0.03), and brain uptake was significantly lower (SUVmax, 7.58 ± 0.74 vs. 13.38 ± 3.94; p  11 mmol/l) patients examined with LAFOV PET/CT showed no statistical significant difference in CNR (19.84 ± 8.40 vs. 17.79 ± 9.3, p = 0.08).ConclusionWhile elevated blood glucose (> 11 mmol) negatively affected TBR and CNR in our cohort, the images from a LAFOV PET-scanner had comparable CNR to PET-images acquired from nBG patients using sSAFOV PET/CT. Therefore, we argue that oncologic patients with increased blood sugar levels might be imaged safely with LAFOV PET/CT when rescheduling is not feasible.

OBJECTIVE: Glycemia management in critical care is posing a challenge in frequent measuring and adequate insulin dose adjustment. In recent years, continuous glucose measurement has gained accuracy and reliability in outpatient and inpatient settings. The aim of this study was to assess the feasibility and accuracy of real-time continuous glucose monitoring (CGM) in ICU patients after major abdominal surgery. RESEARCH DESIGN AND METHODS: We included patients undergoing pancreatic surgery and solid organ transplantation (liver, pancreas, islets of Langerhans, kidney) requiring an ICU stay after surgery. We used a Dexcom G6 sensor, placed in the infraclavicular region, for real-time CGM. Arterial blood glucose measured by the amperometric principle (ABL 800; Radiometer, Copenhagen, Denmark) served as a reference value and for calibration. Blood glucose was also routinely monitored by a StatStrip bedside glucose meter. Sensor accuracy was assessed by mean absolute relative difference (MARD), bias, modified Bland-Altman plot, and surveillance error grid for paired samples of glucose values from CGM and acid-base analyzer (ABL). RESULTS: We analyzed data from 61 patients and obtained 1,546 paired glucose values from CGM and ABL. Active sensor use was 95.1%. MARD was 9.4%, relative bias was 1.4%, and 92.8% of values fell in zone A, 6.1% fell in zone B, and 1.2% fell in zone C of the surveillance error grid. Median time in range was 78%, with minimum (

Evaluating the quality of isolated human islets before transplantation is crucial for predicting the success in treating Type 1 diabetes. The current gold standard involves time-intensive in vivo transplantation into diabetic immunodeficient mice. Given the susceptibility of isolated islets to hypoxia, we hypothesized that hypoxia present in islets before transplantation could indicate compromised islet quality, potentially leading to unfavorable outcomes. To test this hypothesis, we analyzed expression of 39 hypoxia-related genes in human islets from 85 deceased donors. We correlated gene expression profiles with transplantation outcomes in 327 diabetic mice, each receiving 1200 islet equivalents grafted into the kidney capsule. Transplantation outcome was post-transplant glycemic control based on area under the curve of blood glucose over 4 weeks. In linear regression analysis, DDIT4 (R = 0.4971, P

Dietary glucose in excess is stored in the liver in the form of glycogen. As opposed to direct conversion of glucose into glycogen, the hypothesis of the postprandial lactate shuttle (PLS) proposes that dietary glucose uptake is metabolized to lactate in the gut, thereby being transferred to the liver for glycogen storage. In the present study, we provide evidence of a PLS in young healthy men and women. Overnight fasted participants underwent an oral glucose tolerance test, and arterialized lactate concentration and rate of appearance were determined. The concentration of lactate in the blood rose before the concentration of glucose, thus providing evidence of an enteric PLS. Secondary increments in the concentration of lactate in the blood and its rate of appearance coincided with those of glucose, which indicates the presence of a larger, secondary, systemic PLS phase driven by hepatic glucose release. The present study challenges the notion that lactate production is the result of hypoxia in skeletal muscles, because our work indicates that glycolysis proceeds to lactate in fully aerobic tissues and dietary carbohydrate is processed via lactate shuttling. Our study proposes that, in humans, lactate is a major vehicle for carbohydrate carbon distribution and metabolism.

Comparing the performance of different continuous glucose monitoring (CGM) systems is challenging due to the lack of comprehensive guidelines for clinical study design. In particular, the absence of concise requirements for the distribution of comparator (reference) blood glucose (BG) concentrations and their rate of change (RoC) that are used to evaluate CGM performance, impairs comparability. For this article, several experts in the field of CGM performance testing have collaborated to propose characteristics of the distribution of comparator measurements that should be collected during CGM performance testing. Specifically, it is proposed that at least 7.5% of comparator BG concentrations are 300 mg/dL (16.7 mmol/L), respectively, and that at least 7.5% of BG-RoC combinations indicate fast BG changes with impending hypo- or hyperglycemia, respectively. These proposed characteristics of the comparator data can facilitate the harmonization of testing conditions across different studies and CGM systems and ensure that the most relevant scenarios representing real-life situations are established during performance testing. In addition, a study protocol and testing procedure for the manipulation of glucose levels are suggested that enable the collection of comparator data with these characteristics. This work is an important step toward establishing a future standard for the performance evaluation of CGM systems.

We assessed the causal relation of four glycemic traits and type 2 diabetes liability with 167 metabolites using Mendelian randomization with various sensitivity analyses and a reverse Mendelian randomization analysis. We extracted instruments for fasting glucose, 2-h glucose, fasting insulin, and glycated hemoglobin from the Meta-Analyses of Glucose and Insulin-related traits Consortium (n = 200,622), and those for type 2 diabetes liability from a meta-analysis of multiple cohorts (148,726 cases, 965,732 controls) in Europeans. Outcome data were from summary statistics of 167 metabolites from the UK Biobank (n = 115,078). Fasting glucose and 2-h glucose were not associated with any metabolite. Higher glycated hemoglobin was associated with higher free cholesterol in small low-density lipoprotein. Type 2 diabetes liability and fasting insulin were inversely associated with apolipoprotein A1, total cholines, lipoprotein subfractions in high-density-lipoprotein and intermediate-density lipoproteins, and positively associated with aromatic amino acids. These findings indicate hyperglycemia-independent patterns and highlight the role of insulin in type 2 diabetes development. Further studies should evaluate these glycemic traits in type 2 diabetes diagnosis and clinical management.

OBJECTIVE: Modeling the effect of meal composition on glucose excursion would help in designing decision support systems (DSS) for type 1 diabetes (T1D) management. In fact, macronutrients differently affect post-prandial gastric retention (GR), rate of appearance (R[Formula: see text]), and insulin sensitivity (S[Formula: see text]). Such variables can be estimated, in inpatient settings, from plasma glucose (G) and insulin (I) data using the Oral glucose Minimal Model (OMM) coupled with a physiological model of glucose transit through the gastrointestinal tract (reference OMM, R-OMM). Here, we present a model able to estimate those quantities in daily-life conditions, using minimally-invasive (MI) technologies, and validate it against the R-OMM. METHODS: Forty-seven individuals with T1D (weight =78±13 kg, age =42±10 yr) underwent three 23-hour visits, during which G and I were frequently sampled while wearing continuous glucose monitoring (CGM) and insulin pump (IP). Using a Bayesian Maximum A Posteriori estimator, R-OMM was identified from plasma G and I measurements, and MI-OMM was identified from CGM and IP data. RESULTS: The MI-OMM fitted the CGM data well and provided precise parameter estimates. GR and R[Formula: see text] model parameters were not significantly different using the MI-OMM and R-OMM (p 0.05) and the correlation between the two S[Formula: see text] was satisfactory ( ρ =0.77). CONCLUSION: The MI-OMM is usable to estimate GR, R[Formula: see text], and S[Formula: see text] from data collected in real-life conditions with minimally-invasive technologies. SIGNIFICANCE: Applying MI-OMM to datasets where meal compositions are available will allow modeling the effect of each macronutrient on GR, R[Formula: see text], and S[Formula: see text]. DSS could finally exploit this information to improve diabetes management.

Background and aimsTo investigate associations between avocado intake and glycemia in adults with Hispanic/Latino ancestry.Methods and resultsThe associations of avocado intake with measures of insulin and glucose homeostasis were evaluated in a cross-sectional analysis of up to 14,591 Hispanic/Latino adults, using measures of: average glucose levels (hemoglobin A1c; HbA1c), fasting glucose and insulin, glucose and insulin levels after an oral glucose tolerance test (OGTT), and calculated measures of insulin resistance (HOMA-IR, and HOMA-%β), and insulinogenic index. Associations were assessed using multivariable linear regression models, which controlled for sociodemographic factors and health behaviors, and which were stratified by dysglycemia status. In those with normoglycemia, avocado intake was associated with a higher insulinogenic index (β = 0.17 ± 0.07, P = 0.02). In those with T2D (treated and untreated), avocado intake was associated with lower hemoglobin A1c (HbA1c; β = -0.36 ± 0.21, P = 0.02), and lower fasting glucose (β = -0.27 ± 0.12, P = 0.02). In the those with untreated T2D, avocado intake was additionally associated with HOMA-%β (β = 0.39 ± 0.19, P = 0.04), higher insulin values 2-h after an oral glucose load (β = 0.62 ± 0.23, P = 0.01), and a higher insulinogenic index (β = 0.42 ± 0.18, P = 0.02). No associations were observed in participants with prediabetes.ConclusionsWe observed an association of avocado intake with better glucose/insulin homeostasis, especially in those with T2D.

The global socioeconomic burden of T2D necessitates effective strategies to improve self-care behaviors for proper diabetes management. This study aims to compare the effectiveness of wearing continuous glucose monitoring (CGM) device versus CGM combined with regular exercise (CGM + EX) in promoting diabetes self-care behaviors and glycemic control among individuals with type 2 diabetes (T2D). The study included 65 participants with T2D who were randomly divided into three groups: control, CGM, and CGM + EX. The CGM group wore CGM devices for two weeks, the CGM + EX group wore CGM devices for the same duration while engaged in exercise prescription for 3 months. One-way ANOVA or repeated measure ANOVA, where appropriate, was performed to detect statistical differences (P < 0.05). Following the intervention, the Diabetes Self-care Scale (DSCS) scores in the control, CGM, and CGM + EX groups were 67.1 ± 11.9, 84.8 ± 19.3, and 112.7 ± 10.9, respectively. These results indicated improvements in DSCS scores for both interventions, with the combined use of CGM and exercise demonstrating greater enhancement compared to CGM alone (CGM vs. CGM + EX, P < 0.001). Notably, the combination of CGM and exercise was more effective in reducing 2-hour postprandial blood glucose values compared to the use of CGM alone (6.4 ± 1.3 vs. 9.5 ± 3.0, P < 0.01). These findings highlight the importance of combining CGM device with regular exercise into diabetes management to enhance self-care behaviors, maintain glycemic control, and reduce the risk of long-term complications associated with T2D. [ABSTRACT FROM AUTHOR]

Human-induced noise, particularly from shipping and construction, significantly affects the stress responses of swimming crabs (Portunus trituberculatus (Miers, 1876)). Prolonged exposure can lead to stress responses, impacting the overall health of the crabs. This study aimed to assess how noise affects stress responses in P. trituberculatus. The sound had an intensity of 163 dB 1 µPa for the noise condition and 114 dB 1 µPa for ambient sound. Portunus trituberculatus was continuously exposed to the noise stimulus for 6 h. Samples of serum, muscle tissue, gills, and hepatopancreas were collected at multiple time points: 0 min, 10 min, 30 min, 1 h, 3 h, 6 h, and 7 h. The serum cortisol levels in the noise-exposed group were significantly higher than those in the control group at 30 min and 6 h. The two groups had no significant differences regarding serum glucose and muscle lactic acid content. In the noise-exposed group, the gills exhibited significantly lower superoxide dismutase (SOD) levels. Conversely, for the hepatopancreas, the SOD levels in the noise-exposed group were notably lower than those in the control group at 10 min but significantly higher at 6 and 7 h. Malondialdehyde (MDA) levels were substantially higher in the noise-exposed group than in the control group at 30 min and 6 h. This study demonstrates that P. trituberculatus experiences a physiological stress response to acoustic sounds. [ABSTRACT FROM AUTHOR]

Uncertainties still existed about the effect of high-quality protein supplementation on cardiovascular disease (CVD) risk factors, although high-quality proteins such as soy and milk proteins have proposed to be beneficial for cardiometabolic health. A systematic search in PubMed, Web of Science, Cochrane Library, Scopus, and Embase was conducted to quantify the impact of high-quality protein on CVD risk factors. 63 RCTs on 4 types of high-quality protein including soy protein, milk protein, whey, and casein were evaluated. Soy protein supplementation decreased systolic blood pressure (SBP, −1.42 [-2.68, −0.17] mmHg), total cholesterol (TC, −0.18 [-0.30, −0.07] mmol/L), and low-density lipoprotein cholesterol (LDL-C, −0.16 [-0.27, −0.05] mmol/L). Milk protein supplementation decreased SBP (−2.30 [-3.45, −1.15] mmHg) and total cholesterol (−0.27 [-0.51, −0.03] mmol/L). Whey supplementation decreased SBP (−2.20 [-3.89, −0.51] mmHg), diastolic blood pressure (DBP, −1.07 [-1.98, −0.16] mmHg), triglycerides (−0.10 [-0.17, −0.03] mmol/L), TC (−0.18 [-0.35, −0.01] mmol/L), LDL-C (−0.09 [-0.16, −0.01] mmol/L) and fasting blood insulin (FBI, −2.02 [-3.75, −0.29] pmol/L). Casein supplementation decreased SBP (−4.10 [-8.05, −0.14] mmHg). In the pooled analysis of four high-quality proteins, differential effects were seen in individuals with different health status. In hypertensive individuals, high-quality proteins decreased both SBP (−2.69 [-3.50, −1.87] mmHg) and DBP (−1.34 [-2.09, −0.60] mmHg). In overweight/obese individuals, high-quality proteins improved SBP (−1.40 [-2.22, −0.59] mmHg), DBP (−2.59 [-3.20, −1.98] mmHg), triglycerides (−0.09 [-0.15, −0.02] mmol/L), TC (−0.14 [-0.22, −0.05] mmol/L), LDL-C (−0.12 [-0.16, −0.07] mmol/L), and HDL-C levels (0.02 [0.01, 0.04] mmol/L). According to the benefits on CVD risks factors, whey ranked top for improving cardiometabolic health in hypertensive or overweight/obese individuals. Our study supports a beneficial role of high-quality protein supplementation to reduce CVD risk factors. Further studies are still warranted to investigate the effects of different high-quality proteins on CVD risks in individuals with cardiometabolic disorders. [ABSTRACT FROM AUTHOR]

We assessed the effects of consuming a U.S.-style healthy dietary pattern (HDP) with lean, unprocessed beef (BEEF) compared to a U.S.-style HDP without meat (vegetarian, VEG) on short-term changes in cardiometabolic disease (CMD) risk factors in adults classified as overweight or obese. Forty-one adults (22 females, 19 males; age 39.9 ± 8.0 y; BMI 29.6 ± 3.3 kg/m2; mean ± SD) completed two 5-week controlled feeding periods (randomized, crossover, controlled trial). For the BEEF HDP, two 3-oz (168-g) servings/d of lean, unprocessed beef were predominately substituted for some starchy vegetables and refined grains in the VEG HDP. Baseline and post-intervention measurements were fasting CMD risk factors, with serum low-density lipoprotein (LDL), total cholesterol (TC), and total apolipoprotein B as primary outcomes. VEG reduced LDL, insulin, and glucose compared to BEEF. Reductions did not differ between VEG vs. BEEF for TC, high-density lipoprotein (HDL), apolipoprotein A1, small, dense LDL IV, buoyant HDL2b, TC-to-HDL ratio, and systolic blood pressure. Total apolipoprotein B and all other CMD risk factors measured were not influenced by HDP type nor changed over time. Adopting a U.S.-style HDP that is either vegetarian or omnivorous with beef improved multiple cardiometabolic disease risk factors among adults classified as overweight or obese. [ABSTRACT FROM AUTHOR]

Context The precise glycemic impact and clinical relevance of postprandial exercise in type 1 diabetes (T1D) has not been clarified yet. Objective This work aimed to examine acute, subacute, and late effects of postprandial exercise on blood glucose (BG). Methods A randomized, controlled trial comprised 4 laboratory visits, with 24-hour follow-up at home. Participants included adults with T1D (n = 8), aged 44 ± 13 years, with body mass index of 24 ± 2.1. Intervention included 30 minutes of rest (CONTROL), walking (WALK), moderate-intensity (MOD), or intermittent high-intensity (IHE) exercise performed 60 minutes after a standardized meal. Main outcome measures included BG change during exercise/control (acute), and secondary outcomes included the subacute (≤2 h after) and late glycemic effects (≤24 h after). Results Exercise reduced postprandial glucose (PPG) excursion compared to CONTROL , with a consistent BG decline in all patients for all modalities (mean declines −45 ± 24, −71 ± 39, and −35 ± 21 mg/dL, during WALK , MOD , and IHE, respectively (P <.001). For this decline, clinical superiority was demonstrated separately for each exercise modality vs CONTROL. Noninferiority of WALK vs MOD was not demonstrated, noninferiority of WALK vs IHE was demonstrated, and equivalence of IHE vs MOD was not demonstrated. Hypoglycemia did not occur during exercise. BG increased in the hour after exercise (more than after CONTROL ; P <.001). More than half of participants showed hyperglycemia after exercise necessitating insulin correction. There were more nocturnal hypoglycemic events after exercise vs CONTROL (P <.05). Conclusion Postprandial exercise of all modalities is effective, safe, and feasible if necessary precautions are taken (ie, prandial insulin reductions), as exercise lowered maximal PPG excursion and caused a consistent and clinically relevant BG decline during exercise while there was no hypoglycemia during or shortly after exercise. However, there seem to be 2 remaining challenges: subacute postexercise hyperglycemia and nocturnal hypoglycemia. [ABSTRACT FROM AUTHOR]

Background: The Uganda ministry of Health recommends frequent blood glucose monitoring for the first six months on dolutegravir, in people with HIV (PWH) having pre-diabetes mellitus (pre-DM). We sought to determine if indeed PWH with pre-diabetes started on dolutegravir had worse blood glucose outcomes at 48 weeks compared to those with normal blood glucose. Methods: In this matched cohort study, we compared 44 PWH with pre-DM and 88 PWH with normal blood glucose at baseline. The primary outcome was change in mean fasting blood glucose (FBG) from baseline to week 48 and 2-hour blood glucose (2hBG) from baseline to week 36 compared between the two groups. Results: There was significant increase in FBG in PWH with normal blood glucose (mean change in FBG(FBG): 3.9 mg/dl, 95% confidence interval (95% CI): (2.2, 5.7), p value (p) = < 0.0001) and decrease in those with pre-DM (FBG: -6.1 mg/dl, 95%CI (-9.1, -3.2), p = < 0.0001) at 48 weeks. 2hBG was significantly lower than at baseline in both groups with the magnitude of reduction larger in those with pre-DM at 12 weeks (adjusted differences in mean drop in 2hBG (a2hBG): -19.69 mg/dl, 95%CI (-30.19, -9.19), p = < 0.0001) and 36 weeks (a2hBG: -19.97 mg/dl, 95%CI (-30.56, -9.39), p = < 0.0001). Conclusion: We demonstrated that Ugandan ART naïve PWH with pre-diabetes at enrollment have consistent improvement in both fasting blood glucose and glucose tolerance over 48 weeks on dolutegravir. Intensified blood glucose monitoring of these patients in the first six months of dolutegravir may be unnecessary. [ABSTRACT FROM AUTHOR]

Background: Elevated blood glucose at hospital admission is frequently observed and has been associated with adverse outcomes in various patient populations. This meta-analysis sought to consolidate existing evidence to assess the association between elevated blood glucose at admission and clinical outcomes amongst pneumonia patients. Methods: We searched PubMed, Medline, Cochrane library, Web of Science (WoS), and Scopus databases for studies, published up to 31 August 2023, and reporting on the clinical outcomes and the blood glucose levels at admission. Data were extracted by two independent reviewers. Random-effects meta-analyses were used to pool odds ratios (ORs) with 95% confidence intervals (CI) for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes. Results: A total of 23 studies with 34,000 participants were included. Elevated blood glucose at admission was significantly associated with increased short-term (pooled OR: 2.67; 95%CI: 1.73–4.12) and long-term mortality (pooled OR: 1.70; 95%CI: 1.20–2.42). Patients with raised glucose levels were more likely to require ICU admission (pooled OR: 1.86; 95%CI: 1.31–2.64). Trends also suggested increased risks for hospital readmission and mechanical ventilation, though these were not statistically significant. Elevated blood glucose was linked with approximately 0.72 days longer duration of hospital stay. Conclusion: Elevated blood glucose level at the time of hospital admission is associated with several adverse clinical outcomes, especially mortality, in patients with pneumonia. These findings underscore the importance of recognizing hyperglycemia as significant prognostic marker in pneumonia patients. Further research is needed to determine whether targeted interventions to control glucose levels can improve these outcomes. [ABSTRACT FROM AUTHOR]

AbstractThe ability of oats to reduce blood cholesterol is well established but there is increasing evidence that its health benefits extend well beyond that. The purpose of this review was to critically evaluate the state of the science of oats in relation to all-cause mortality, cardiovascular and diabetes risk and the effects of oats on blood lipids, blood glucose, blood pressure, weight management and gut health from meta-analyses and systematic reviews. Limited epidemiological data indicated a possible beneficial effect of oats on all-cause mortality and incident diabetes when high versus low oat consumers were compared, but its effect on cardiovascular events was not adequately discerned. Observational data also showed an inverse association between oat intake and blood cholesterol, blood pressure, body weight and obesity variables in different populations. Randomized controlled oat intervention studies demonstrated a significant reduction in postprandial blood glucose in both diabetic and non-diabetic subjects, fasting blood glucose in diabetic subjects, blood pressure in prehypertensive individuals, and body weight and adiposity in overweight individuals. Increased fecal bulk was observed but clinical data for a potential gut barrier effect is lacking. The mechanism of action of each health effect was reviewed. While beta-glucan viscosity was once considered the only mode of action, it is evident that the fermentation products of beta-glucan and the associated gut microbial changes, as well as other components in oats (i.e., avenanthramides etc.) also play an important role. [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]

ABSTRACT Introduction Materials and Methods Results Conclusions The fasting blood glucose test is widely used for diabetes screening. However, it may fail to detect early‐stage diabetes characterized by elevated postprandial glucose levels. Hence, we developed and internally validated a nomogram to predict the diabetes risk in older adults with normal fasting glucose levels.This study enrolled 2,235 older adults, dividing them into a Training Set (n = 1,564) and a Validation Set (n = 671) based on a 7:3 ratio. We employed the least absolute shrinkage and selection operator regression to identify predictors for constructing the nomogram. Calibration and discrimination were employed to assess the nomogram's performance, while its clinical utility was evaluated through decision curve analysis.Nine key variables were identified as significant factors: age, gender, body mass index, fasting blood glucose, triglycerides, alanine aminotransferase, the ratio of alanine aminotransferase to aspartate aminotransferase, blood urea nitrogen, and hemoglobin. The nomogram demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.824 in the Training Set and 0.809 in the Validation Set. Calibration curves for both sets confirmed the model's accuracy in estimating the actual diabetes risk. Decision curve analysis highlighted the model's clinical utility.We provided a dynamic nomogram for identifying older adults at risk of diabetes, potentially enhancing the efficiency of diabetes screening in primary healthcare units. [ABSTRACT FROM AUTHOR]

Aim: Study results on blood glucose and the risk of delirium in patients receiving cardiac surgery are inconsistent, and there is also a gap in how to manage blood glucose after coronary artery bypass grafting (CABG). This study focused on patients with diabetes mellitus (DM) undergoing CABG and explored the associations of different blood glucose-related indexes and blood glucose change trajectory with postoperative delirium (POD), with the aim of providing some information for the management of blood glucose in this population. Methods: Data of patients with DM undergoing CABG were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database in this retrospective cohort study. The blood glucose-related indexes included baseline blood glucose, mean blood glucose (MBG), mean absolute glucose (MAG), mean amplitude of glycemic excursions (MAGE), glycemic lability index (GLI), and largest amplitude of glycemic excursions (LAGE). The MBG trajectory was classified using the latent growth mixture modeling (LGMM) method. Univariate and multivariate logistic regression analyses were utilized to screen covariates and explore the associations of blood glucose-related indexes and MBG trajectory with POD. These relationships were also assessed in subgroups of age, gender, race, estimated glomerular filtration rate (eGFR), international normalized ratio (INR), sepsis, mechanical ventilation use, and vasopressor use. In addition, the potential interaction effect between blood glucose and hepatorenal function on POD was investigated. The evaluation indexes were odds ratios (ORs), relative excess risk due to interaction (RERI), attributable proportion of interaction (AP), and 95% confidence intervals (CIs). Results: Among the eligible 1,951 patients, 180 had POD. After adjusting for covariates, higher levels of MBG (OR = 3.703, 95% CI: 1.743–7.870), MAG >0.77 mmol/L/h (OR = 1.754, 95% CI: 1.235–2.490), and GLI >2.6 (mmol/L)2 /h/per se (OR = 1.458, 95% CI: 1.033–2.058) were associated with higher odds of POD. The positive associations of MBG, MAG, and GLI with POD were observed in patients aged <65 years old, male patients, White patients, those with eGFR <60 and INR <1.5, patients with sepsis, and those who received mechanical ventilation and vasopressors (all p < 0.05). Patients with class 3 (OR = 3.465, 95% CI: 1.122– 10.696) and class 4 (OR = 3.864, 95% CI: 2.083–7.170) MBG trajectory seemed to have higher odds of POD, compared to those with a class 1 MBG trajectory. Moreover, MAG (RERI = 0.71, 95% CI: 0.14–1.27, AP = 0.71, 95% CI: 0.12–1.19) and GLI (RERI = 0.78, 95% CI: 0.19–1.39, AP = 0.69, 95% CI: 0.16–1.12) both had a potential synergistic effect with INR on POD. Conclusion: Focusing on levels of MBG, MAG, GLI, and MBG trajectory may be more beneficial to assess the potential risk of POD than the blood glucose level upon ICU admission in patients with DM undergoing CABG. [ABSTRACT FROM AUTHOR]

Fish involved in telemetry studies are usually handled, anaesthetized, and subjected to internal tag implantation, all of which have the potential to disrupt the fish's physiology, migratory patterns, food‐seeking behavior, growth, and survival. As fish tagging is a widespread standard method in aquaculture, it is crucial to gain a better understanding of the short‐ and long‐term effects on various aspects of fish welfare. The experimental outcomes of each phase of the surgical process and how it affects the fish's ability to recover during the post‐tagging period, particularly in small salmonids, are poorly understood. Thus, it is essential to measure the extent of these adverse effects to precisely extrapolate differences in surgical intervention for tagged fish compared to their unmanipulated counterparts. In our study, we explored the post‐tagging impacts on wild‐captured brown trout (Salmo trutta) (1+) juveniles. We examined the time effect on fish recovery after each phase of the surgical procedure, which included anaesthetized fish, followed by surgery with/without internal tagging, within the first 2 and 25 h post‐surgery. Common blood parameters (glucose levels and haematocrit) and endpoints related to swimming behavior, including fish movement, direction, and social distancing aspects, were studied. The findings of the study indicated no significant changes in glucose and haematocrit levels over the observational period. Fish subjected to anesthesia and tagging procedures exhibited a significant decrease in swimming activity, recovering to baseline levels 1 h after anesthesia and 24 h after surgical (tagging) procedures in recirculating aquaculture systems. Tagged fish showed less social proximity than non‐tagged fish in the first 2 h post‐surgery. A significant effect size was observed between nonsurgical (anesthesia) and surgical (non‐tagged/tagged) groups, highlighting a more pronounced impact associated with surgical tag interventions. Our data indicate that the magnitude of behavioral response was significantly influenced by tag weight (~1.4% body/tag weight ratio in water) among manipulated fish groups. Consequently, our study reveals that wild‐captured S. trutta juveniles, tagged with commercially available low‐weight acoustic tags (V6, 69 kHz), experienced negative effects on swimming performance. In surgical studies, acknowledging potential influences is crucial for accurately inferring fish physiological and behavioral status. Emphasizing fish recovery potential in both short‐ and long‐term periods is essential for quantifying tagging effects. Future research should prioritize exploring alternative tagging technologies and refining methodologies, with a particular focus on assessing telemetry's impact on socioeconomically relevant small salmonids. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effect of preoperative metabolic syndrome on early function of renal allografts in allogeneic kidney transplant recipients. Methods Clinical data of 117 kidney transplant recipients were retrospectively analyzed. According to the renal allograft function, they were divided into the delayed graft function (DGF) group (n=29) and non-DGF group (n=88). Relevant risk factors of DGF in recipients undergoing allogeneic kidney transplantation were assessed by univariate and multivariate regression analyses. The effect of preoperative metabolic syndrome on early function of renal allografts was analyzed. Results Among 117 kidney transplant recipients, 47 cases were complicated with preoperative metabolic syndrome, and 29 cases developed postoperative DGF. In the DGF group, 83% of the recipients were complicated with preoperative metabolic syndrome, higher than 74% in the non-DGF group (P<0.05). Univariate analysis showed that the body mass index (BMI) and terminal serum creatinine (Scr) level of the donors, and BMI, blood glucose level, triglyceride level and the proportion of preoperative metabolic syndrome of the recipients in the DGF group were higher than those in the non-DGF group (all P<0.05). Multivariate logistic regression analysis revealed that high Scr levels of the donors, high hemoglobin levels of the recipients and preoperative metabolic syndrome of the recipients were the independent risk factors for DGF after kidney transplantation (all P<0.05).Conclusions Preoperative metabolic syndrome is an independent risk factor for DGF in allogeneic kidney transplant recipients. Corresponding measures should be taken to lower the incidence of DGF and other metabolic complications. [ABSTRACT FROM AUTHOR]

Background: Intracranial branch atheromatous disease (BAD)‐type cerebral infarction is often associated with a progressive worsening of neurological symptoms in the acute phase. Aim: To investigate the factors influencing the occurrence of early neurological deterioration (END) in patients with BAD. Methods: We included and evaluated 198 consecutive patients (150 patients with lenticulostriate artery [LSA‐BAD] and 48 patients with paramedian pontine artery [PPA‐BAD]) with onset within 24 h and with a modified Rankin scale score of ≤1 before admission for END retrospectively out of 235 patients with BAD‐type cerebral infarction admitted to our hospital from January 2019 to March 2023. Results: END was observed in 26 (17%) and 15 (31%) patients with LSA‐BAD and PPA‐BAD, respectively. Patients in the END group with LSA‐BAD had significantly higher rates of diabetes mellitus and blood glucose (BG) levels on admission and lower rates of initial clopidogrel loading therapy than those in the non‐END group. Patients in the END group with PPA‐BAD had significantly higher BG levels on admission than those in the non‐END group. In LSA‐BAD multivariate analysis, the BG level on admission and initial clopidogrel loading were identified as factors influencing END (BG level [per 10 mg/dL], odds ratio [OR] 1.084, 95% confidence interval [CI] 1.008–1.166; initial clopidogrel loading, OR 0.302, 95% CI 0.101–0.901). Conclusions: Higher BG levels at stroke onset were associated with END in patients with LSA‐BAD and PPA‐BAD. Additionally, initial clopidogrel loading therapy suppressed END in patients with LSA‐BAD. [ABSTRACT FROM AUTHOR]

Background: Postoperative hyperglycemia is associated with morbidity and mortality in non-diabetic surgical patients. However, there is limited information on the extent and factors associated with postoperative hyperglycemia. This study assessed the magnitude and associated factors of postoperative hyperglycemia among non-diabetic adult patients who underwent elective surgery at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods: A facility-based cross-sectional study was conducted among 412 adult patients who underwent elective surgery at University of Gondar Comprehensive Specialized Hospital from April 14 to June 30, 2022 All consecutive postoperative non-diabetic elective surgical patients who were admitted to PACU during the data collection period and who fulfilled inclusion criteria were included in the study until the intended minimum sample size was achieved. And data were collected through interviews using a pretested semi-structured questionnaire. Postoperative hyperglycemia was defined as a blood glucose level of ≥ 140 mg/dl. Multivariable logistic regression was performed to identify the association between postoperative hyperglycemia and independent variables. Variables with a p-value less than 0.05 and a 95% confidence interval (CI) were considered statistically significant. Results: A total of 405 patients' data were evaluated with a response rate of 98.3%. The median (IQR) age was 40 (28-52) years. The prevalence of postoperative hyperglycemia was 34.1% (95% CI: 29.4–39.0). Factors significantly associated with postoperative hyperglycemia included being overweight (AOR = 5.45, 95% CI: 2.46-12.0), American Society of Anesthesiologists (ASA) classification II and III (AOR = 2.37, 95% CI: 1.17–4.79), postoperative low body temperature (AOR = 0.18, 95% CI: 0.069–0.48), blood loss ≥ 500 ml (AOR = 2.33, 95% CI: 1.27–4.27), long duration of surgery, mild pain (AOR = 5.17, 95% CI: 1.32–20.4), and moderate pain (AOR = 7.63, 95% CI: 1.811–32.20). Conclusion and recommendation: One-third of the study participants had postoperative hyperglycemia. Weight, ASA classification, postoperative body temperature, duration of surgery, intraoperative blood loss, and postoperative pain were identified as a modifiable risk factors. Maintaining normal body temperature throughout the procedure, treating postoperative pain, and monitoring and controlling blood glucose level in patients at risk of hyperglycemia is crucial. [ABSTRACT FROM AUTHOR]

Objective: Going extended periods of time without eating increases risk for binge eating and is a primary target of leading interventions for binge‐spectrum eating disorders (B‐EDs). However, existing treatments for B‐EDs yield insufficient improvements in regular eating and subsequently, binge eating. These unsatisfactory clinical outcomes may result from limitations in assessment and promotion of regular eating in therapy. Detecting the absence of eating using passive sensing may improve clinical outcomes by facilitating more accurate monitoring of eating behaviours and powering just‐in‐time adaptive interventions. We developed an algorithm for detecting meal consumption (and extended periods without eating) using continuous glucose monitor (CGM) data and machine learning. Method: Adults with B‐EDs (N = 22) wore CGMs and reported eating episodes on self‐monitoring surveys for 2 weeks. Random forest models were run on CGM data to distinguish between eating and non‐eating episodes. Results: The optimal model distinguished eating and non‐eating episodes with high accuracy (0.82), sensitivity (0.71), and specificity (0.94). Conclusions: These findings suggest that meal consumption and extended periods without eating can be detected from CGM data with high accuracy among individuals with B‐EDs, which may improve clinical efforts to target dietary restriction and improve the field's understanding of its antecedents and consequences. Highlights: Regular eating is an important treatment target for binge‐spectrum eating disorders (B‐EDs).The present study developed an algorithm for detecting extended periods of time without eating using blood glucose data.The developed algorithm may be used to improve interventions for B‐EDs. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the effects of glycemic control on refractive changes in diabetic patients, aiming to understand how fluctuations in blood sugar levels influence refractive errors and overall vision quality. Materials and methods: The study included 100 participants, divided into two groups based on their glycemic control: Group A (Controlled Glycemia) and Group B (Uncontrolled Glycemia). Over a 12-month period, data on HbA1c levels, fasting blood glucose, and refractive errors were collected and analyzed. Results: Group A, with better glycemic control, maintained stable HbA1c levels and experienced fewer significant refractive changes compared to Group B. Specifically, Group A had a lower incidence of refractive shifts of ≥0.50 diopters at all measured intervals (p < 0.05). Correlations between HbA1c levels and refractive changes were statistically significant, highlighting the impact of blood glucose management on refractive stability. Conclusion: The findings underscore the importance of stringent glycemic control in preventing vision-related complications in diabetic patients. Better glycemic management can minimize biochemical perturbations in the lens, thereby stabilizing refractive errors. [ABSTRACT FROM AUTHOR]

Objective: The effect of Etoricoxib (ETOR) on the link between blood glucose and seizure prevention in chemo-convulsive rats was investigated in this study. Methods: Pentylenetetrazol (PTZ-105 mg/kg i.p.) at the CD97 dosage was administered to rats to cause seizures. ETOR (10 mg/kg p.o.) was administered for two weeks prior to seizure induction. On the 14th day, the animals were exposed to chemo convulsions, and the efficiency of ETOR in lowering clonus-type chemo convulsions (CC) as well as blood glucose levels were assessed. Morphometric analysis and chimney tests were performed to evaluate ETOR's neurotoxic profile. Actophotometer, rotarod, and hole board tests were employed for behavioral analysis. Results: When compared to control mice, pretreatment with ETOR (10 mg/kg p.o) resulted in a substantial delay in the onset of CC (P<0.05) and duration of CC (P<0.01). Acute ETOR treatment also considerably lowered blood glucose levels. The chimney test findings show that it has no effect on motor control and is not neurotoxic to the animals. Conclusion: Behavioral tests also demonstrated that, except for the diazepam-treated groups, no significant changes in muscle coordination, locomotion, or apprehensive behavior were detected in all experimental animals. Finally, the primary findings of this study showed that the PTZ group had considerably greater levels of hyperglycemia, which is reflected in the rat's early onset and longer duration of chemo-convulsions. However, ETOR medication reduced high blood glucose levels as well as the onset and duration of seizures, indicating ETOR's impact on blood glucose reduction and the relationship between blood glucose and seizure responses. [ABSTRACT FROM AUTHOR]

Clostridial myonecrosis, commonly known as gas gangrene (GG), is a rapidly progressing and potentially fatal bacterial infection that primarily affects muscle and soft tissue. In the United States, the incidence of GG is roughly 1000 cases per year, while, in developing countries, the incidence is higher. This condition is most often caused by Clostridium perfringens, a Gram-positive, spore-forming anaerobic bacterium widely distributed in the environment, although other Clostridium species have also been reported to cause GG. The CP genome contains over 200 transport-related genes, including ABC transporters, which facilitate the uptake of sugars, amino acids, nucleotides, and ions from the host environment. There are two main subtypes of GG: traumatic GG, resulting from injuries that introduce Clostridium spores into deep tissue, where anaerobic conditions allow for bacterial growth and toxin production, and spontaneous GG, which is rarer and often occurs in immunocompromised patients. Clostridium species produce various toxins (e.g., alpha, theta, beta) that induce specific downstream signaling changes in cellular pathways, causing apoptosis or severe, fatal immunological conditions. For example, the Clostridium perfringens alpha toxin (CPA) targets the host cell's plasma membrane, hydrolyzing sphingomyelin and phosphatidylcholine, which triggers necrosis and apoptosis. The clinical manifestations of clostridial myonecrosis vary. Some patients experience the sudden onset of severe pain, swelling, and muscle tenderness, with the infection progressing rapidly to widespread tissue necrosis, systemic toxicity, and, if untreated, death. Other patients present with discharge, pain, and features of cellulitis. The diagnosis of GG primarily involves clinical evaluation, imaging studies such as X-rays, computer tomography (CT) scans, and culture. The treatment of GG involves surgical exploration, broad-spectrum antibiotics, antitoxin, and hyperbaric oxygen therapy, which is considered an adjunctive treatment to inhibit anaerobic bacterial growth and enhance the antibiotic efficacy. Early recognition and prompt, comprehensive treatment are critical to improving the outcomes for patients affected by this severe and life-threatening condition. [ABSTRACT FROM AUTHOR]

Oleuropein, a phenolic compound derived fromolives, has known glucoregulatory effects in mammalian models but effects in birds are unknown. We investigated effects of dietary supplementation and exogenous administration of oleuropein on broiler chick feed intake and glucose homeostasis during the first 7 days posthatch. One hundred and forty-eight day-of-hatch broiler chicks were randomly allocated to one of four dietary treatments with varying oleuropein concentrations (0, 250, 500, or 1,000 mg/kg). Body weight and breast muscle and liver weights were recorded on day 7. In the next experiment, chicks received intraperitoneal (IP) injections of oleuropein at doses of 0 (vehicle), 50, 100, or 200mg/kg on day 4 post-hatch, with feed intake and blood glucose levelsmeasured thereafter. Lastly, chicks fed a control dietwere fasted and administered intracerebroventricular (ICV) injections of oleuropein at doses of 0, 50, 100, or 200 μg, after which feed intake was recorded. Results indicated that IP and ICV injections led to decreased feed intake, primarily at 60min post-injection, with effects diminishing by 90 min in the IP study. Blood glucose levels decreased 1-h post-IP injection at higher oleuropein doses. These findings suggest that oleuropein acts as a mild appetite suppressant and influences energy metabolism in broiler chickens. [ABSTRACT FROM AUTHOR]

Background: To our knowledge, only one study has examined the association between glucose variability (GV) and mortality in the elderly population with diabetes. GV was assessed by HbA1c, and a J-shaped curve was observed in the relationship between HbA1c thresholds and mortality. No study of GV was conducted during the COVID-19 pandemic and its lockdown. This study aims to evaluate whether GV is an independent predictor of all-cause mortality in patients aged 75 years or older with and without COVID-19 who were followed during the first year of the COVID-19 pandemic and its lockdown measures. Methods: This was a retrospective cohort study of 407,492 patients from the AGED-MADRID dataset aged 83.5 (SD 5.8) years; 63.2% were women, and 29.3% had diabetes. GV was measured by the coefficient of variation of fasting plasma glucose (CV-FPG) over 6 years of follow-up (2015–2020). The outcome measure was all-cause mortality in 2020. Four models of logistic regression were performed, from simple (age, sex) to fully adjusted, to assess the effect of CV-FPG on all-cause mortality. Results: During follow-up, 34,925 patients died (14,999 women and 19,926 men), with an all-cause mortality rate of 822.3 per 10,000 person-years (95% confidence interval (CI), 813.7 to 822.3) (739 per 10,000; 95% CI 728.7 to 739.0 in women and 967.1 per 10,000; 95% CI 951.7 to 967.2 in men). The highest quartile of CV-FPG was significantly more common in the deceased group (40.1% vs. 23.6%; p < 0.001). In the fully adjusted model including dementia (Alzheimer's disease) and basal FPG, the odds ratio for mortality ranged from 1.88 to 2.06 in patients with T2DM and from 2.30 to 2.61 in patients with normoglycaemia, according to different sensitivity analyses. Conclusions: GV has clear implications for clinical practice, as its assessment as a risk prediction tool should be included in the routine follow-up of the elderly and in a comprehensive geriatric assessment. Electronic health records can incorporate tools that allow its calculation, and with this information, clinicians will have a broader view of the medium- and long-term prognosis of their patients. [ABSTRACT FROM AUTHOR]

Objective To analyze the results of thyroid examination, related physical examination and biochemical indexes of the health check-up population, and to investigate the risk factors for the occurrence of thyroid nodules in the health check-up population. Methods A total of 30 522 healthy checkups who underwent physical examination and thyroid ultrasonography at the Health Management Center of Affiliated Hospital of Yangzhou University from July to December 2022, along with physical examination and biochemical indexes, who were taken as the study subjects. The risk factors related to their occurrence of thyroid nodules were analyzed. Results The total detection rate of thyroid nodules was 38. 8%, with a higher detection rate in women (46. 9%) than in men (33. 6%). The detection rate of thyroid nodules was higher in the older age group, the high body mass index group, the high blood glucose group, the high triglyceride group, the high cholesterol group, the LDL abnormalities group, the high uric acid group, and the hypertension group, while the detection rate of thyroid nodules was lower in the HDL abnormalities group, the smoking group, the drinking group, and the differences were statistically significant significance (P <0. 05). Female, older age, overweight and obesity, blood sugar, cholesterol, and uric acid are independent risk factors for thyroid nodules (P <0. 05). Conclusion The detection rate of thyroid nodules in the population of Yangzhou region health checkup is high, gender, age, overweight and obesity and blood sugar, blood lipids, high uric acid will affect the occurrence of thyroid nodules [ABSTRACT FROM AUTHOR]

Glucagon-like peptide-1 (GLP-1) is an incretin hormone secreted by food intake from L cells of the ileum. GLP-1 contributes to blood glucose control through three main mechanisms: promoting glucose-dependent insulin secretion from pancreatic beta cells, suppressing glucagon hypersecretion from pancreatic alpha cells, and delaying gastric emptying time. GLP-1 receptor agonists (RAs) have been developed for administration twice daily, once daily, and once weekly as subcutaneous injection formulation and as a daily oral formulation. GLP-1 RAs have benefits in reducing glycated hemoglobin, weight, and blood pressure, as well as in managing lipid profiles. Additionally, some GLP-1 RAs have demonstrated cardiovascular benefits. Therefore, the guidelines recommend GLP-1 RA treatment of type 2 diabetes patients with preexisting atherosclerotic vascular disease. GLP-1 RA may also improve renal outcomes. The most frequently reported side effects of GLP-1 RA are gastrointestinal symptoms, which can be minimized by gradually starting treatment at a low concentration and then increasing to the final dosage. Considering the efficacy, administration frequency, and cost of each GLP-1 RA treatment, it can be selected as monotherapy or in combination with oral hypoglycemic agents and basal insulin in free or fixed dose formulation. [ABSTRACT FROM AUTHOR]

The scientific diagnosis and treatment of patients with diabetes require frequent blood glucose testing and insulin delivery to normoglycemia. Therefore, an artificial pancreas with a continuous blood glucose (BG) monitoring function is an urgent research target in the medical industry. The problem of closed-loop algorithmic control of the BG with a time delay is a key and difficult issue that needs to be overcome in the development of an artificial pancreas. Firstly, the composition, structure, and control characteristics of the artificial pancreas are introduced. Subsequently, the research progress of artificial pancreas control algorithms is reviewed, and the characteristics, advantages, and disadvantages of proportional-integral-differential control, model predictive control, and artificial intelligence control are compared and analyzed to determine whether they are suitable for the practical application of the artificial pancreas. Additionally, key advancements in areas such as blood glucose data monitoring, adaptive models, wearable devices, and fully automated artificial pancreas systems are also reviewed. Finally, this review highlights that meal prediction, control safety, integration, streamlining the optimization of control algorithms, constant temperature preservation of insulin, and dual-hormone artificial pancreas are issues that require further attention in the future. An Excellent Diabetes Treatment: Insulin Pump System [ABSTRACT FROM AUTHOR]

Summary: Individuals were given ERSR (enzyme‐resistant starch rusks) to consume for breakfast, and its effect on blood glucose was examined. Fifty‐four people participated in this study as two groups ((WWR (whole wheat rusks): 27 and ERSR: 27)). Each rusk contains 30 g of digestible CHO. After the consumption started, measurements were made at 30‐min intervals until 120 min. In total AUC (area under the curve) values between WWR and ERSR, ERSR was significantly higher (P < 0.001). In normal‐weight individuals, the total AUC value of ERSR consumption was significantly higher than WWR (P < 0.001), and in obese individuals, no significant difference was observed. Blood glucose fluctuations were higher in ERSR compared to WWR. It was also observed that this difference was observed in normal‐weight individuals, while no such difference was observed in individuals with obesity. Although ERSR consumption seems advisable for obese individuals, it should be supported by longer studies. [ABSTRACT FROM AUTHOR]

Background: Artichoke (Cynara scolymus L.) has the potential to treat diabetes, dyslipidemia, hypertension, and obesity. However, the evidence from previous studies is not consistent. Objectives: This meta-analysis evaluated the efficacy of products derived from artichokes on blood glucose, lipid level, blood pressure, and anthropometric parameters. Methodology: The literature was reviewed via international databases (PubMed, ScienceDirect, and Scopus). A total of 21 RCTs with high quality, assessed by the Cochrane risk-of-bias tool, were included. Results: Artichoke was linked to a significant reduction in fasting blood sugar (FBS) (WMD: −3.76 mg/dL: 95%CI −7.31, −0.22), insulin level (WMD: −1.35 mIU/L: 95%CI −2.29, −0.41), and HOMA-IR (WMD: −1.00: 95%CI −1.95, −0.06). Similar results were observed for LDL-c (WMD: −12.94 mg/dL: 95%CI −18.02, −7.87), total cholesterol (TC) (WMD: −19.64 mg/dL: 95%CI −23.94, −15.35), and triglyceride (TG) (WMD: −13.36 mg/dL: 95%CI −19.06, −7.66). Moreover, participants who administered artichoke experienced a significant reduction in SBP (WMD: −1.59 mmHg: 95%CI −3.02, −0.16), body weight (BW) (WMD: −1.17 kg: 95%CI −1.75, −0.60), and BMI (WMD: −0.30 kg/m2: 95%CI −3.02, −0.16). Conclusion: Artichoke may improve blood glucose, lipid profile, blood pressure, and anthropometric parameters. A large, well-designed RCT and head-to-head comparison using a standardized preparation of artichoke will provide definitive data on specific participants. [ABSTRACT FROM AUTHOR]

Disorders of glucose and lipid metabolism are important causes of type 2 diabetes mellitus (T2DM). Defining the molecular mechanisms of metabolic disorders and exploring drug targets are key to the treatment of T2DM. The study discovered the effects of catalpol on insulin resistance (IR) and lipid metabolism disorder (LMD) in type 2 diabetes mellitus (T2DM). A T2DM mouse model was established by a high-fat diet and a single intraperitoneal injection of streptozotocin. and injected with catalpol at 10 mg/kg for 12 weeks, and the lentiviral vector of miR-101-3p or Fosrelated antigen 2 (FOSL2) expression was interfered with intravenously mouse insulin resistance (IR) and lipid metabolism disorder (LMD)-related indices were then measured. Pancreatic histopathology was observed by hematoxylin and eosin (HE) staining and TUNEL staining. The miR-101-3p and FOSL2 were detected by RT-qPCR or Western blot. In results: catalpol improved IR and LMD (both P<0.05) in diabetic mice, and alleviated the histopathological changes in the pancreas. miR-101-3p was upregulated (P<0.05), and FOSL2 was downregulated (P<0.05) in T2DM mice, while catalpol rescued their expression pattern (both P<0.05). The miR-101-3p targeted FOSL2. Down-regulating miR-101-3p or up-regulating FOSL2 improved IR and LMD (all P<0.05) in diabetic mice, and alleviated pancreatic histopathological changes. Overexpressing miR-101-3p or suppressing FOSL2 weakened the ameliorative effects of catalpol in T2DM mice (all P<0.05). We conclude that catalpol improves IR and LMD in diabetic mice by inhibiting miR-101-3p to up-regulate FOSL2. [ABSTRACT FROM AUTHOR]

Obesity has been long known as a medical problem that needs to be tackled effectively and efficiently. Obesity raises the chance of acquiring several illnesses, including type 2 diabetes, heart attack, hypertension, hypercholesterolemia, and stroke. This research sought to ascertain the anti-obesity effects of Ocimum gratissimum leaf powder supplementation on obesity induced by high fat diet (HDF)in male Wistar rats. Twenty-four male Wistar rats (120 ± 20g) were housed in cages with 6 rats in each cage. Rats were maintained at room temperature during a two-week acclimatization period. Obesity was induced by feeding Groups 2, 3, and 4 with HFD for twelve weeks, while group 1 was fed a normal pellet diet (NPD). After that, the normal control group represented by Group 1 and obese control group by Group 2 were not treated. However, Groups 3 and 4 received HFD supplemented with 10% and 20% of the leaves powdered from Ocimum gratissimum respectively for 4 weeks. Feed intake, body weight, adiposity index, total fat mass, and low-density lipoprotein cholesterol were all considerably decreased (p <0.05) by the plant, while high-density lipoprotein cholesterol levels were increased (p < 0.05) when compared to the HFD obese control. The O. gratissimum leaves contained moderate amounts of some nutrients (magnesium, iron, zinc, and copper) and it decreased the number and size of fat deposit on rat liver. The study indicated that Ocimum gratissimum leaves have the potential to reduce body weight and feed intake in animals thus suggesting potent anti-obesity properties. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic syndrome (MS) is one of the conditions that may increase the risk of ischemic stroke (IS). This study focuses on factors of MS related to the incidence, years of life lost (YLL), and years of life disability (YLD) caused by IS. Materials and Methods: The age-adjusted data (incidence, YLL, and YLD) related to four factors of MS [fasting plasma glucose, body mass index (BMI), low-density lipoprotein, and systolic blood pressure, SBP] were extracted as risk factors for IS during the years 1990 to 2019 from global burden of disease study. ARC GIS V.10 software was used to investigate the geographical distribution and the Cochran–Armitage test was used to investigate the trend of these indices. Results: The highest incidence of IS was reported in Golestan provinces in 2019 [women: 180 (95% UI 153–213), men: 163 (95% UI 141–191), and both genders: 172 (95% UI 149–201)]. High SBP has the highest impact on YLD (96–102 per 100,000 population in some provinces) and YLL (688–824 per 100,000 population in some provinces) in men and women (YLD: 126–156, YLL: 586–785 per 100,000 population in some provinces). High BMI has increased YLD caused by IS from 1990 (35 per 100,000 population) to 2019 (53 per 100,000 population). Conclusion: Considering the importance of IS and the impact that MS has on this disease, it seems that one of the most effective possible measures is to eliminate MS. The factors of MS are mostly related to lifestyle, and MS can be controlled with a suitable plan, which can be considered as primary prevention for IS. [ABSTRACT FROM AUTHOR]

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance.