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Maintaining tight glucose levels during pregnancy is crucial and challenging. We describe a pregnant woman with type 1 diabetes and obesity, treated with an advanced hybrid closed-loop MiniMed 780G since pre-pregnancy, who displayed a sustained improvement in her glucometrics after switching to lispro U-200., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: L.M reports receiving non-financial support for travel from Ypsomed and Medtronic. R.C reports receiving non-financial support for travel from Ypsomed, Medtronic, Roche and Novalab, and research support from Ypsomed and Medtronic. O.C and V.S are Medtronic employees., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Objective: Rescue benzodiazepine medication can be used to treat seizure clusters, which are intermittent, stereotypic episodes of frequent seizure activity that are distinct from a patient's usual seizure pattern. The NeuroPace RNS® System is a device that detects abnormal electrographic activity through intracranial electrodes and administers electrical stimulation to control seizures. Reductions in electrographic activity over days to weeks have been associated with the longer-term efficacy of daily antiseizure medications (ASMs). In this pilot study, electrographic activity over hours to days was examined to assess the impact of a single dose of a proven rescue therapy (diazepam nasal spray) with a rapid onset of action., Methods: Adult volunteers (>18 years old) with clinically indicated RNS (stable settings and ASM usage) received a weight-based dose of diazepam nasal spray in the absence of a clinical seizure. Descriptive statistics for a number of detections and a sum of durations of detections at 10-min, hourly, and 24-h intervals during the 7-day (predose) baseline period were calculated. Post-dose detections at each time interval were compared with the respective baseline-detection intervals using a 1 SD threshold. The number of long episodes that occurred after dosing also were compared with the baseline., Results: Five participants were enrolled, and four completed the study; the excluded participant had recurrent seizures during the study. There were no consistent changes (difference >1 SD) in detections between post-dose and mean baseline values. Although variability was high (1 SD was often near or exceeded the mean), three participants showed possible trends for reductions in one or more electrographic variables following treatment., Significance: RNS-assessed electrographic detections and durations were not shown to be sensitive measures of short-term effects associated with a single dose of rescue medication in this small group of participants. The variability of detections may have masked a measurable drug effect., Plain Language Summary: Rescue drugs are used to treat seizure clusters. Responsive neurostimulation (RNS) devices detect and record epilepsy brain waves and then send a pulse to help stop seizures. This pilot study looked at whether one dose of a rescue treatment changes brain activity detected by RNS. There was a very wide range of detections, which made it difficult to see if or how the drug changed brain activity. New studies should look at other types of brain activity, multiple doses, and larger patient groups., (© 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

Aims: Changes in maternal serum C-peptide have been described during pregnancy in women with Type 1 diabetes. We aimed to determine whether in these women, C-peptide, as measured by the urinary C-peptide creatinine ratio (UCPCR), display changes during the course of pregnancy and in the postpartum period., Methods: In this longitudinal study including 26 women, UCPCR was measured in the first, second, and third trimester of pregnancy, and postpartum, using a high sensitivity two-step chemiluminescent microparticle immunoassay., Results: UCPCR was detectable in 7/26 (26.9%) participants in the first trimester, 10/26 (38.4%) in the second trimester, and 18/26 (69.2%) in the third trimester. Changes in UCPCR concentrations were observed throughout pregnancy, significantly increasing from first to third trimester. UCPCR concentration in the three trimesters was associated with a shorter duration of diabetes and in the third trimester also with first trimester UCPCR., Conclusion: UCPCR detects longitudinal changes during pregnancy in women with type 1 diabetes mellitus, more marked in those with shorter diabetes duration., (© 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)

Concentrations of heavy metals (HMs) were assessed in Tilapia spp. from selected communities in Calapan City, Philippines. Eleven (11) inland farmed tilapia samples were collected and analyzed for HMs concentration using X-ray fluorescence (XRF). The 11 fish samples were cut into seven pieces, according to the fish body parts, constituting a total of 77 samples. These fish samples were then labeled as bone, fins, head, meat, skin, and viscera. Results showed that the mean concentration of Cd in all parts of tilapia exceeded the Food and Agriculture Organization/World Health Organization (FAO/WHO) limits. The highest concentration was recorded in the fins, which was sevenfold higher than the limit. The trend of the mean concentration of Cd in different parts of tilapia was fins > viscera > skin > tail > head > meat > bone. The target hazard quotient ( THQ ) recorded a value less than 1. This means that the population exposed to tilapia, within the area where fish samples originated, were not at risk to non-carcinogens. The concentrations of Cu, Pb, Mn, Hg, and Zn in different parts, particularly in skin, fins, and viscera, also exceeded the FAO/WHO limits. The calculated cancer risk ( CR ) in consuming the fish skin, meat, fins, bone, viscera, and head was higher than the USEPA limit. This indicated a possible carcinogenic risk when consumed regularly. Most of the correlations observed between HMs in various parts of the tilapia had positive (direct) relationships, which were attributed to the HM toxicity target organ characteristics. Results of the principal component analysis (PCA) showed that most of the dominating HMs recorded in tilapia were attributable to anthropogenic activities and natural weathering within the watershed of agricultural areas. The agriculture area comprises about 86.83% of the overall land area of Calapan City. The identified carcinogenic risks were associated with Cd. Therefore, regular monitoring of HMs in inland fishes, their habitat, and surface water quality shall be carried out. This information is useful in creating strategies in metals concentration monitoring, health risks reduction program, and relevant guidelines that would reduce the accumulation of HM in fish.

Vitamin D deficiency is a common finding in overweight/obese pregnant women and is associated with increased risk for adverse pregnancy outcome. Both maternal vitamin D deficiency and maternal obesity contribute to metabolic derangements in pregnancy. We aimed to assess the effects of vitamin D3 supplementation in pregnancy versus placebo on maternal and fetal lipids. Main inclusion criteria were: women <20 weeks’ gestation, BMI ≥ 29 kg/m2. Eligible women (n = 154) were randomized to receive vitamin D3 (1600 IU/day) or placebo. Assessments were performed <20, 24−28 and 35−37 weeks and at birth. Linear regression models were used to assess effects of vitamin D on maternal and cord blood lipids. In the vitamin D group significantly higher total 25-OHD and 25-OHD3 levels were found in maternal and cord blood compared with placebo. Adjusted regression models did not reveal any differences in triglycerides, LDL-C, HDL-C, free fatty acids, ketone bodies or leptin between groups. Neonatal sum of skinfolds was comparable between the two groups, but correlated positively with cord blood 25-OH-D3 (r = 0.34, p = 0.012). Vitamin D supplementation in pregnancy increases maternal and cord blood vitamin D significantly resulting in high rates of vitamin D sufficiency. Maternal and cord blood lipid parameters were unaffected by Vitamin D3 supplementation.

Studies on the relationship between vitamin D (VitD) and glucose homeostasis usually consider either total VitD or 25OHD3 but not 25OHD2 and epimers. We aimed to evaluate the cross-sectional association of VitD compounds with glucose homeostasis measurements in pregnant women with overweight/obesity participating in the Vitamin D And Lifestyle Intervention for Gestational Diabetes Mellitus Prevention study. Methods: The analysis included 912 women. Inclusion criteria: <20 weeks gestation, body mass index ≥29 kg/m2 and information on exposure and outcome variables at baseline. Measurements: A 75 g OGTT at <20, 24−28 and 35−37 weeks gestation (except if previous diabetes diagnosis). Exposure variables: 25OHD2, 25OHD3 and C3-epimer. Outcome variables: fasting and post-challenge insulin sensitivity and secretion indices, corresponding disposition indices (DI), plasma glucose at fasting and 1 and 2 h, hyperglycemia in pregnancy (HiP). Statistics: Multivariate regression analyses with adjustment. Results: Baseline VitD sufficiency was 66.3%. Overall, VitD compounds did not show strong associations with any glucose homeostasis measures. 25OHD3 showed direct significant associations with: FPG at <20 and 24−28 weeks (standardized β coefficient (β) 0.124, p = 0.030 and 0.111, p = 0.026 respectively), 2 h plasma glucose at 24−28 weeks (β 0.120, p = 0.018), and insulin sensitivity (1/HOMA-IR, β 0.127, p = 0.027) at 35−37 weeks; it showed an inverse association with fasting DI (QUCKI*HOMA-β) at <20 and 24−28 weeks (β −0.124, p = 0.045 and β −0.148, p = 0.004 respectively). 25OHD2 showed direct associations with post-challenge insulin sensitivity (Matsuda, β 0.149, p = 0.048) at 24−28 weeks) and post-challenge DI (Matsuda*Stumvoll phase 1) at 24−28 and 35−37 weeks (β 0.168, p = 0.030, β 0.239, p = 0.006). No significant association with C3-epimer was observed at any time period. Conclusions: In these women with average baseline VitD in sufficiency range, VitD compounds did not show clear beneficial associations with glucose homeostasis measures.

Laboratory tests in which a fluid or combination of fluids that are injected into a core rock are designed to determine oil reservoir rock petrophysical properties, understand the mobility of fluid flow in the porous samples, and calibrate porous media fluid flow models. The core material is extracted from the oil reservoir. However, the manufacture of core plugs is challenging because of the complexity of extracting natural rocks from the reservoir and their morphological and atypical heterogeneity. In addition, core flooding tests are essentially destructive, making it impossible to achieve experimental repeatability by using identical cores. The use of 3D printing in digital rock physics has permitted the production and replication of synthetic rock samples with the morphological characteristics of natural rocks for core analysis and core flooding tests. This study proposes the 3D manufacture of artificial core plugs from microcomputed tomography of Berea sandstone. The digital samples were constructed using a digital particle packing approach by systematically manipulating rock textural parameters, such as the grain size and shape, cementation pattern, and sorting grain, making it possible to obtain a core plug that fulfills experimental requirements. Before the 3D printing of the sample, the flow distribution through the porous media structure was numerically simulated using the Lattice Boltzmann method to obtain the core plug samples' permeability and porosity. The core plug was digitally embedded within a core holder to generate a stereolithography file for 3D printing of the core flooding setup, which can be used directly in conventional experiments. The permeabilities of the 3D printed plugs were experimentally determined to permit a direct comparison to the numerical results and evaluate the utility of printed plugs for displacement experiments., Competing Interests: No competing financial interests exist., (Copyright 2022, Mary Ann Liebert, Inc., publishers.)

Background & Aims: As vitamin D deficiency is associated with an increased risk of gestational diabetes mellitus (GDM), we aimed to test vitamin D supplementation as a strategy to reduce GDM risk (evaluated after fasting plasma glucose (FPG), insulin resistance and weight gain) in pregnant overweight/obese women., Methods: The DALI vitamin D multicenter study enrolled women with prepregnancy body mass index (BMI) ≥ 29 kg/m 2 , ≤19 + 6 weeks of gestation and without GDM. Participants were randomized to receive 1600 IU/day vitamin D3 or placebo (each with or without lifestyle intervention) on top of (multi)vitamins supplements. Women were assessed for vitamin D status (sufficiency defined as serum 25-hydroxyvitamin D (25(OH)D) ≥ 50 nmol/l), FPG, insulin resistance and weight at baseline, 24-28 and 35-37 weeks. Linear or logistic regression analyses were performed to assess intervention effects., Results: Average baseline serum 25(OH)D was ≥50 nmol/l across all study sites. In the vitamin D intervention arm (n = 79), 97% of participants achieved target serum vitamin 25(OH)D (≥50 nmol/l) at 24-28 weeks and 98% at 35-37 weeks vs 74% and 78% respectively in the placebo arm (n = 75, p < 0.001). A small but significantly lower FPG (-0.14 mmol/l; CI95 -0.28, -0.00) was observed at 35-37 weeks with the vitamin D intervention without any additional difference in metabolic status, perinatal outcomes or adverse event rates., Conclusion: In the DALI vitamin D trial, supplementation with 1600 IU vitamin D3/day achieved vitamin D sufficiency in virtually all pregnant women and a small effect in FPG at 35-37 weeks. The potential of vitamin D supplementation for GDM prevention in vitamin D sufficient populations appears to be limited., Trial Registration Number: ISRCTN70595832., (Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Objective: Risk factors are widely used to identify women at risk for gestational diabetes mellitus (GDM) without clear distinction by pregnancy period or oral glucose tolerance test (OGTT) time points. We aimed to assess the clinical risk factors for Hyperglycemia in pregnancy (HiP) differentiating by these two aspects., Design and Methods: Nine hundred seventy-one overweight/obese pregnant women, enrolled in the DALI study for preventing GDM. OGTTs were performed at ≤19 + 6, 24-28 and 35-37 weeks (IADPSG/WHO2013 criteria). Women with GDM or overt diabetes at one time point did not proceed to further OGTTs. Potential independent variables included baseline maternal and current pregnancy characteristics., Statistical Analysis: Multivariate logistic regression., Results: Clinical characteristics independently associated with GDM/overt diabetes were at ≤19 + 6 weeks, previous abnormal glucose tolerance (odds ratio (OR): 3.11; 95% CI: 1.41-6.85), previous GDM (OR: 2.22; 95% CI: 1.20-4.11), neck circumference (NC) (OR: 1.58; 95% CI: 1.06-2.36 for the upper tertile), resting heart rate (RHR, OR: 1.99; 95% CI: 1.31-3.00 for the upper tertile) and recruitment site; at 24-28 weeks, previous stillbirth (OR: 2.92; 95% CI: 1.18-7.22), RHR (OR: 3.32; 95% CI: 1.70-6.49 for the upper tertile) and recruitment site; at 35-37 weeks, maternal height (OR: 0.41; 95% CI: 0.20-0.87 for upper tertile). Clinical characteristics independently associated with GDM/overt diabetes differed by OGTT time point (e.g. at ≤19 + 6 weeks, NC was associated with abnormal fasting but not postchallenge glucose)., Conclusion: In this population, most clinical characteristics associated with GDM/overt diabetes were non-modifiable and differed by pregnancy period and OGTT time point. The identified risk factors can help define the target population for future intervention trials., (© 2018 European Society of Endocrinology.)

Aims: To assess urinary C peptide creatinine ratio (UCPCR) used in a modified Matsuda equation to measure insulin sensitivity (IS) in pregnancy., Research and Design Methods: In this cross-sectional study, two IS measurements were calculated in 73 pregnant women at ~28 weeks of gestation by two separate methods using modified Matsuda equations. The first using the 0 and 120 min serum C peptide concentration during a 75 g oral glucose tolerance test (OGTT) and the second using the 0 and 120 min UCPCR values. The calculated IS measurements from the two methodologies were evaluated using Person's test and linear regression analysis. The relationship between IS OGTT UCPCR and the fasting second void UCPCR and 120 min UCPCR was assessed using Pearson correlation and linear regression analysis after logarithmic transformation of the variables. Statistical analysis was performed using SPSS V.22., Results: The IS measured using serum C peptide (IS OGTTc-pep ) in the modified Matsuda equation correlated with the IS measurement using serum UCPCR (IS OGTT-UCPCR ) (r 0.704, p<0.0001). A strong correlation was found between the IS OGTT-UCPCR and the fasting UCPCR (r -0.916, p<0.0001), displaying a hyperbolic relationship., Conclusion: The UCPCR provides a practical methodology to assess IS and β-cell function in pregnancy., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Aims: Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling., Methods: We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt., Outcome Variable: case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject., Statistics: proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis., Results: We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area., Conclusions: A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.