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Serum Glucose (serum + glucose)
Terms modified by Serum Glucose Selected AbstractsThe vitamin D receptor gene variant and physical activity predicts fasting glucose levels in healthy young menDIABETIC MEDICINE, Issue 6 2003J. R. Ortlepp Abstract Aims Vitamin D can influence lipolysis and insulin secretion. A common genetic polymorphism of the vitamin D receptor (VDR), which has been found to be associated with bone mineral density, has been reported to be also associated with Type 2 diabetes mellitus (DM). To test the influence of the VDR polymorphism on fasting glucose in healthy young men before the onset of Type 2 DM, we studied a homogeneous population of aircrew members. Methods A total of 1539 individuals were recruited during routine medical qualification for flying duty. Physical activity was assessed in all individuals and categorized into low physical activity (, 3 h per week) and high physical activity (> 3 h per week). The BsmI VDR polymorphism was analysed by polymerase chain reaction. On the day of blood testing the individuals were fasting for at least 8 h overnight. Serum glucose was measured within 60 min after sampling venous blood. Results In young males with low physical activity (n = 752) gene carriers with the VDR genotype BB (n = 137) have significantly (P < 0.001) higher levels of fasting glucose (5.61 ± 0.49 mmol/l) than gene carriers with the genotype Bb (n = 370; 5.44 ± 0.44 mmol/l) or bb (n = 245; 5.38 ± 0.44 mmol/l). Of BB gene carriers, 47% had fasting glucose levels > 5.55 mmol/l compared with 36% of Bb gene carriers and 34% of bb gene carriers (P = 0.018). This effect is absent in gene carriers with high physical activity (n = 787). Conclusions The VDR genotype is associated with altered fasting glucose levels in young men with low physical activity. If this association is confirmed in other populations it might be worthwhile studying the particular benefits of an exercise programme in dependents of the VDR genotype. Diabet. Med. 20, 451,454 (2003) [source] Telomere length in relation to insulin resistance, inflammation and obesity among Arab youthACTA PAEDIATRICA, Issue 6 2010OS Al-Attas Abstract Aim:, The aim of this study was to determine the associations of telomere length to markers of obesity, insulin resistance and inflammation in Saudi children. Methods:, A total of 69 boys and 79 girls, aged 5,12 years, participated in this cross-sectional study. Anthropometrics were measured. Serum glucose and lipid profile were measured using routine laboratory methods. Serum insulin, leptin, adiponectin, resistin, tumour necrosis factor-alpha and active plasminogen activator inhibitor 1 were quantified using customized multiplex assay kits. C-reactive protein and angiotensin II were quantified using ELISA. Leucocyte telomere length was examined by quantitative real time PCR utilizing IQ cycler. Results:, Mean telomere length was significantly shorter in obese boys compared with their lean counterparts (p = 0.049), not in girls. It was not associated to insulin resistance, adipocytokines and markers of inflammation. In girls, the significant predictor of telomere length was waist circumference, explaining 24% of variance (p = 0.041) while in boys, systolic blood pressure explained 84% of the variance (p = 0.01). Conclusion: Childhood obesity in boys corresponds to shorter leucocyte telomere length which is not evident in girls. The association of leucocyte telomere length to blood pressure and waist circumference in children suggests clinical implications as to the contribution of these parameters in premature ageing. [source] Continuous gastric drip versus intravenous fluids in low birthweight infantsACTA PAEDIATRICA, Issue 4 2002M Becerra This multicentre randomized study compared a continuous gastric drip (CGD) with intravenous (i.v.) fluid administration. Healthy newborns with birthweight from 1501 to 2000 g whose physician ordered i.v. fluids were randomized before the 2nd hour of life to CGD or i.v. fluids. The major outcome variable was the need for an i.v. line in the CGD group. Serum glucose was measured at 30 min, 1 h and every 6 h thereafter. Serum sodium and potassium were measured at least once during the first 72 h of life. Enteral feedings, feeding intolerance, number of venous lines and i.v. line-related complications were recorded until the interruption of CGD or the i.v. line. Twenty-nine infants were randomized to each group. The two groups were comparable in terms of birthweight and gestational age. Ten percent (3/29) of the infants randomized to the CGD group required i.v. fluids and 90% of them received electrolytes and glucose through an orogastric tube. The incidence of hypoglycaemia, hyponatraemia and episodes of feeding intolerance did not differ between the groups. Conclusion: Fluid administration by CGD reduces the need for i.v. lines without increasing the risk of complications. [source] An exploratory study of the effect of using high-mix biphasic insulin aspart in people with type 2 diabetesDIABETES OBESITY & METABOLISM, Issue 7 2009U. Dashora Objective:, To compare blood glucose control when using biphasic insulin aspart (BIAsp) three times a day (using 70/30 high-mix before breakfast and lunch), with biphasic human insulin (BHI, 30/70) twice daily in adults with type 2 diabetes already treated with insulin. Research design and methods:, In a 60-day, open-label, crossover study, people with insulin-treated type 2 diabetes [n = 38, baseline haemoglobin A1c 8.3 ± 0.9 (s.d.) %] were randomized to BIAsp three times a day before meals, as BIAsp 70 (70% insulin aspart and 30% protamine-complexed insulin aspart) before breakfast and lunch and BIAsp 30 (30/70 free and protamine-complexed insulin aspart) before dinner, or to human premix insulin (BHI) 30/70 twice a day before meals. A 24-h in-patient plasma glucose profile was performed at the end of each 30-day treatment period. The total daily insulin dose of BIAsp regimen was 110% of BHI and the doses were not changed during the study. Results:, There was no difference between BIAsp and BHI in geometric weighted average serum glucose over 24 h [7.3 vs. 7.7 mmol/l, BIAsp/BHI ratio 0.95 (95% CI 0.88,1.02), not significant (NS)], but daytime geometric weighted average glucose concentration was significantly lower with the BIAsp regimen than with BHI [8.3 vs. 9.2 mmol/l, BIAsp/BHI ratio 0.90 (0.84,0.98), p = 0.014]. The mealtime serum glucose excursion was also lower with BIAsp than with BHI with statistically significant differences at lunchtime [difference ,4.9 (,7.0 to ,2.7) mmol/l, p = 0.000); the difference in glucose excursions above 7.0 mmol/l was also significant [,5.8 (,8.3 to ,3.2) mmol/l, p = 0.000). The proportion of participants experiencing confirmed hypoglycaemic episodes was similar between regimens (42 vs. 43%, NS). Conclusions:, An insulin regimen using high-mix BIAsp (BIAsp 70) before breakfast and lunch and BIAsp 30 before dinner can achieve lower blood glucose levels during the day through reduced mealtime glucose excursions in particular at lunchtime than a twice-daily premix regimen. [source] Discordance between intramuscular triglyceride and insulin sensitivity in skeletal muscle of Zucker diabetic rats after treatment with fenofibrate and rosiglitazoneDIABETES OBESITY & METABOLISM, Issue 5 2007K. J. Nadeau Aim:, Intramyocellular triglyceride (IMTG) correlates with insulin resistance, but there is no clear causal relationship. Insulin resistance and associated hyperinsulinaemia may increase IMTG, via the insulin-regulated transcription factor, sterol regulatory element,binding protein 1 (SREBP-1). PPAR agonists may also affect IMTG via changes in insulin sensitivity, SREBP-1 or other factors. Methods:, We examined skeletal muscle IMTG and SREBP-1 expression, and metabolic parameters in Zucker diabetic fatty rats (ZDF) after 25 weeks of PPAR-, or PPAR-, administration. Results:, Compared with Zucker lean rats (ZL), untreated ZDF had significantly higher weights, serum glucose, insulin, free fatty acids, total cholesterol and triglycerides. IMTG and SREBP-1c messenger RNA (mRNA) were also higher in untreated ZDF; both were decreased by fenofibrate (FF). Rosiglitazone (Rosi), despite marked improvement in glycaemia, hyperinsulinaemia and hyperlipidaemia, failed to affect SREBP-1 expression, and increased body weight and IMTG. Rosi/FF combination caused less weight gain and no IMTG increase, despite metabolic effects similar to Rosi alone. Conclusions:, IMTG and SREBP-1c mRNA are high in the ZDF. FF and Rosi both improved insulin sensitivity but had opposite effects on IMTG. Thus, there was a clear discordance between insulin sensitivity and IMTG with PPAR agonists, indicating that IMTG and insulin sensitivity do not share a simple relationship. [source] Ethnic differences in the timely diagnosis of children with Type 1 diabetes mellitus in the Netherlands: clinical presentation at onsetDIABETIC MEDICINE, Issue 3 2007J. J. N. Van Laar Abstract Aims Little is known about ethnic differences in the timely diagnosis of Type 1 diabetes mellitus (Type 1 DM). This study aimed to assess ethnic inequalities in the timely diagnosis of Type 1 DM, as indicated by a more adverse clinical condition at onset. In addition, we assessed whether these differences could be explained by differences in socio-economic status. Methods From a national register, we selected 3128 children aged < 15 years with newly diagnosed Type 1 DM. Ethnic differences in serum glucose, blood pH, bicarbonate, presence of ketonuria, level of consciousness, hydration status, and diabetic ketoacidosis were assessed by logistic regression. A measure of socio-economic status based on postal codes was used as an explanatory variable. Results The risk of adverse clinical presentation was 1.5,2 times higher in non-Western immigrants than Dutch children, while Western immigrant children did not differ from Dutch children. Blood pH, bicarbonate level, and level of consciousness were lower in Turkish and Antillean children in particular. The adverse socio-economic position of immigrant children contributed very little to these differences in clinical presentation. Conclusions Non-Western children were likely to be sicker at first presentation of Type 1 DM, and thus diagnosis may have been delayed. These disparities were not accounted for by differences in socio-economic status. Possible explanations may be difficulties in recognition of symptoms, failure of GPs to take symptom reporting seriously and lack of awareness of the fact that Type 1 DM occurs more often in certain ethnic groups. [source] Metabolic consequences of pancreatic systemic or portal venous drainage in simultaneous pancreas-kidney transplant recipientsDIABETIC MEDICINE, Issue 6 2006P. Petruzzo Abstract Aims The aim was to investigate pancreatic B-cell function and insulin sensitivity in simultaneous pancreas-kidney (SPK) recipients with systemic or portal venous drained pancreas allograft using simple and easy tests. Methods The study included 44 patients with Type 1 diabetes and end-stage renal disease who had undergone SPK transplantation: 20 recipients received a pancreas allograft with systemic venous drainage (S-SPK) and 24 with portal venous drainage (P-SPK). We studied only recipients with functioning grafts, with normal serum glucose, HbA1c and serum creatinine values, on a stable drug regimen. The subjects were studied at 6, 12, 24, 36, 48 and 60 months after transplantation. Insulin sensitivity and B-cell function indices were derived from blood samples and oral glucose tolerance tests. Results All patients from both groups had normal fasting glucose, body mass index and HbA1c values by selection. The homeostatic model (HOMA) ,-cell index was significantly lower in P-SPK recipients at several points of the follow-up. HOMA-IR was significantly higher in S-SPK recipients at 6 and 24 months after transplantation and was positively correlated with fasting insulin values, but never exceeded 3.2. There was no significant difference in QUICKI index values between the two groups. Although all patients from both groups always had normal glucose tolerance, the area under the insulin curve was higher in the S-SPK group. Cholesterol, low-density lipoprotein-cholesterol and triglycerides were higher in the P-SPK group. Conclusions The results suggest sustained long-term endocrine function in both groups and show that portal venous drainage does not offer major metabolic advantages. [source] Pathophysiology of ketoacidosis in Type 2 diabetes mellitusDIABETIC MEDICINE, Issue 10 2005P. Linfoot Abstract Aims Despite an increasing number of reports of ketoacidosis in populations with Type 2 diabetes mellitus, the pathophysiology of the ketoacidosis in these patients is unclear. We therefore tested the roles of three possible mechanisms: elevated stress hormones, increased free fatty acids (FFA), and suppressed insulin secretion. Methods Forty-six patients who presented to the Emergency Department with decompensated diabetes (serum glucose > 22.2 mmol/l and/or ketoacid concentrations , 5 mmol/l), had blood sampled prior to insulin therapy. Three groups of subjects were studied: ketosis-prone Type 2 diabetes (KPDM2, n = 13) with ketoacidosis, non-ketosis-prone subjects with Type 2 diabetes (DM2, n = 15), and ketotic Type 1 diabetes (n = 18). Results All three groups had similar mean plasma glucose concentrations. The degree of ketoacidosis (plasma ketoacids, bicarbonate and anion gap) in Type 1 and 2 subjects was similar. Mean levels of counterregulatory hormones (glucagon, growth hormone, cortisol, epinephrine, norepinephrine), and FFA were not significantly different in DM2 and KPDM2 patients. In contrast, plasma C-peptide concentrations were approximately three-fold lower in KPDM2 vs. non-ketotic DM2 subjects (P = 0.0001). Type 1 ketotic subjects had significantly higher growth hormone (P = 0.024) and FFA (P < 0.002) and lower glucagon levels (P < 0.02) than DM2. Conclusions At the time of hospital presentation, the predominant mechanism for ketosis in KPDM2 is likely to be greater insulinopenia. [source] Insulin pump therapy vs. multiple daily injections in obese Type 2 diabetic patientsDIABETIC MEDICINE, Issue 8 2005J. Wainstein Abstract Aims To compare the efficacy of insulin pump treatment with multiple daily injections in the treatment of poorly controlled obese Type 2 diabetic patients already receiving two or more daily injections of insulin plus metformin. Methods Forty obese Type 2 diabetic subjects (using insulin) were randomized to treatment with continuous subcutaneous infusion pump (CSII) (Minimed®) or multiple daily insulin injections (MDI). At the end of the first 18-week treatment period, patients underwent a 12-week washout period during which they were treated with MDI plus metformin. They were then crossed-over to the other treatment for an 18-week follow-up period. Patients performed 4-point daily self blood-glucose monitoring (SBGM) on a regular basis and 7-point monitoring prior to visits 2, 8, 10 and 16. A subset of patients underwent continuous glucose monitoring using the Minimed® continuous glucose monitoring system (CGMS) at visits 2, 8, 10 and 16. A standard meal test was performed in which serum glucose was tested at fasting and once each hour for 6 h following a test meal. Glucose levels were plotted against time and the area under the curve (AUC) was calculated. HbA1c, weight, daily insulin dose and hypoglycaemic episodes were recorded. Results In obese Type 2 diabetic patients already treated with insulin, treatment with CSII significantly reduced HbA1c levels compared with treatment with MDI. An additional CSII treatment benefit was demonstrated by reduced meal-test glucose AUC. Initial reduction of daily insulin requirement observed in CSII-treated subjects during the first treatment period was attributable to a period effect and did not persist over time. Conclusions In the intent-to-treat analysis, CSII appeared to be superior to MDI in reducing HbA1c and glucose AUC values without significant change in weight or insulin dose in obese, uncontrolled, insulin-treated Type 2 diabetic subjects. [source] Glibenclamide improves postprandial hypertriglyceridaemia in Type 2 diabetic patients by reducing chylomicrons but not the very low-density lipoprotein subfraction levelsDIABETIC MEDICINE, Issue 10 2001I. Skrapari Abstract Aim, There are scarce data dealing with the degree of postprandial lipaemia after sulphonylurea administration. The aim of this study was to examine the effect of acute glibenclamide administration on postprandial lipaemia in Type 2 diabetic patients. Methods, Eight randomly selected Type 2 diabetic individuals, aged 43,65 years (mean, 54 years), who had never received any anti-diabetic drug, were included in the study. Each patient was given a 485 kcal mixed meal (45% fat, 40% carbohydrate and 15% protein) twice on separate days after an overnight fast: once with placebo and once with 5 mg glibenclamide, per os, in a random order. The two tests were performed with an interval of 7 days. Venous blood samples were drawn just before and 2 h, 4 h and 6 h after meal consumption. Total triglyceride levels in plasma, in chylomicrons (CM), in CM-deficient plasma, in very low-density lipoprotein (VLDL) subfractions (VLDL-1, VLDL-2) and in intermediate-density lipoprotein (IDL) were determined. Free fatty acid (FFA) and total cholesterol levels in plasma, as well as high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol levels in CM-deficient plasma, were also measured. Finally, serum glucose, insulin and C-peptide concentrations were measured in each sample. Results, As expected there was a significant decrease in postprandial glycaemia after glibenclamide administration compared to placebo (mean area under the curve values: AUC = 53.3 ± 18.2 and 69.1 ± 21.6 mm/h, P = 0.00009). In addition, the mean AUC values of insulin and C-peptide were significantly greater after drug administration. The AUC values of total plasma triglyceride and of CM triglyceride following glibenclamide administration were significantly lower compared to placebo, while the AUC values of postprandial triglyceride in CM-deficient plasma and of postprandial triglyceride in VLDL-1, VLDL-2 and IDL were not different after drug administration compared to placebo. Finally, no significant differences were noted in the AUC values of total cholesterol, LDL cholesterol, HDL cholesterol and plasma FFA levels after glibenclamide administration. Conclusions, These results demonstrate that glibenclamide administration improves postprandial hypertriglyceridaemia acutely by reducing postprandial triglycerides of intestinal origin. Diabet. Med. 18, 781,785 (2001) [source] Testing the outcome score of spontaneous intracerebral haemorrhage in haemodialysis patientsINTERNAL MEDICINE JOURNAL, Issue 10 2009B.-R. Huang Abstract The aim of this study is to determine the predictive value of the spontaneous intracerebral haemorrhage (ICH) outcome score (which we described previously) in haemodialysis (HD) patients who develop spontaneous ICH. The validation cohort consisted of all HD patients with spontaneous ICH presenting to Chang Gung Memorial Hospital in Taiwan during 2005,2007. The data were collected from one hospital and prospectively analysed, and the predictive model was tested using an external validation dataset. The prognostic factors were confirmed by chi-squared testing. We calculated the 30-day mortality in different groups of the validation cohort divided according to outcome score and tested the predictive value of the outcome score. The overall mortality rate was 52.6% in 38 HD patients. The originally identified prognostic factors were Glasgow Coma Scale score, age ,70 years, systolic blood pressure <130 or ,200 mmHg, ICH volume ,30 mL, presence of intraventricular haemorrhage and serum glucose ,8.8 mmol/L. All but one (serum glucose ,8.8 mmol/L (P= 0.07)) were subsequently found to be associated with 30-day mortality. In patients scoring 6 and 7, mortality was 100%, but in patients scoring 0, it was only 11.1%. The 30-day mortality in the validation cohort increased steadily with score and had good predictive value (correlation coefficient = 0.986, P < 0.001). Similar results in two different cohorts indicate that the ICH outcome score is a reliable outcome measure. [source] Cigarette smoking, elevated fasting serum glucose, and risk of pancreatic cancer in Korean menINTERNATIONAL JOURNAL OF CANCER, Issue 1 2006Ji Eun Yun Abstract Pancreatic cancer is one of the most fatal human cancers and continues to be a major unsolved health problem. The goal of this study was to estimate the independent effects and interactions between cigarette smoking and diabetes on the risk of pancreatic cancer in Korean male population. Cigarette smoking and the risk of incidence and death from pancreatic cancer were examined in a 10-year prospective cohort study of 446,407 Korean men aged 40 to 65 years who received health insurance from the National Health Insurance Corporation and who had a medical evaluation in 1992. Relative risks (RR) and 95% confidence intervals (CI) were calculated using a Cox proportional hazards model after adjusting for age, body mass index, exercise and alcohol use. Current smoking was associated with an increased risk of incidence (RR = 1.7, 95% CI = 1.6,1.9) and mortality (RR = 1.6, 95% CI = 1.4,1.7) from pancreatic cancer. The RR for pancreatic cancer increased with both duration and amount of smoking. Diabetes was also associated with an increased risk of both incidence (RR = 1.8, 95% CI = 1.5,2.2) and mortality (RR = 1.7, 95% CI = 1.4,2.1) from pancreatic cancer. There was no interaction between smoking and fasting serum glucose in terms of pancreatic cancer risk. Thus, our prospective study has demonstrated that cigarette smoking and elevated fasting serum glucose are independently associated with an increased risk of pancreatic cancer in a large cohort of Korean males. © 2006 Wiley-Liss, Inc. [source] Subcutaneous lispro and intravenous regular insulin treatments are equally effective and safe for the treatment of mild and moderate diabetic ketoacidosis in adult patientsINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2006H. Ö. Ersöz Summary In this prospective, randomised, open trial, we wanted to evaluate the efficacy and safety of hourly subcutaneous (SC) insulin lispro administration in the treatment of diabetic ketoacidosis (DKA) in comparison with intravenous (IV) regular insulin treatment. Twenty patients were enroled in the study. The patients were randomly assigned into two groups. Following a bolus injection of 0.15 U/kg IV regular insulin, group L received half of this dose as hourly SC insulin lispro while group R was treated conventionally with IV regular insulin infusion. At the end of treatment period, time that needed for normalisation of serum glucose, ,-hydroxybutyrate, blood pH and urine ketone levels were not different in groups L and R. There was no mortality or serious side effects in both groups. In this study, we revealed that treatment of mild and moderate DKA with SC insulin lispro is equally effective and safe in comparison with IV regular insulin. [source] Serum Insulin-Like Growth Factor-1 Binding Proteins 1 and 2 and Mortality in Older Adults: The Health, Aging, and Body Composition StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2009Donglei Hu PhD OBJECTIVE: To evaluate the relationship between serum insulin-like growth factor 1 (IGF-1), IGF-1 binding protein 1 (IGFBP-1), and IGF-1 binding protein 2 (IGFBP-2) and fasting insulin, fasting glucose, adiposity, and mortality in older adults. DESIGN: A prospective cohort study with mean follow-up of 6.2 years. SETTING: Participants were recruited and followed at two centers affiliated with academic medical institutions. PARTICIPANTS: Six hundred twenty-five men and women aged 70 and older and in good health at the time of enrollment. MEASUREMENTS: Serum IGF-1, IGFBP-1, and IGFBP-2; fasting serum insulin; fasting serum glucose; visceral fat; and total percent fat. RESULTS: Higher IGFBP-1 and higher IGFBP-2 were significantly associated with lower fasting insulin, lower fasting glucose, and lower adiposity, but higher IGFBP-1 and IGFBP-2 were associated with greater mortality. In multivariate adjusted models, the hazard ratio for all-cause mortality was 1.48 (95% confidence interval (CI)=1.14,1.92) per standard deviation (SD) increase in IGFBP-2 and 1.34 (95% CI=1.01,1.76) per SD increase in IGFBP-1. No association was found between IGF-1 and all-cause mortality. CONCLUSIONS: Higher IGFBP-1 and IGFBP-2 are associated with lower adiposity and decreased glucose tolearance but also with greater all-cause mortality. Higher levels of serum IGF-1 binding protein (IGFBP) may indicate greater IGF-1 activity and thus represent an association between higher IGF-1 activity and mortality in humans. [source] Hyperglycemia as a Predictor of In-Hospital Mortality in Elderly Patients without Diabetes Mellitus Admitted to a Sub-Intensive Care UnitJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2008Intissar Sleiman MD OBJECTIVES: To investigate the association between hyperglycemia and in-hospital and 45-day mortality in acutely ill elderly patients. DESIGN: Retrospective cohort. SETTING: Hospital medical patients admitted to a sub-intensive care unit (sub-ICU) for elderly patients, which is a level of care between ordinary wards and intensive care. PARTICIPANTS: One thousand two hundred twenty-nine patients (mean age 79.6±8.4) admitted to the sub-ICU from January 2003 to January 2006. Forty patients with acute myocardial infarction and 34 patients with extreme fasting glucose values (<60 or >500 mg/dL) were excluded. Eight hundred twenty-two patients without a history of diabetes mellitus (DM) and 333 patients with a diagnosis of DM were selected and subdivided into three categories according to serum fasting blood glucose: 60 to 126 mg/dL (Group A), 127 to 180 mg/dL (Group B), and 181 to 500 mg/dL (Group C). MEASUREMENTS: Age, sex, mental and functional status, Acute Physiology Score, comorbid conditions, serum albumin, serum cholesterol, fasting serum glucose, and length of stay. In-hospital mortality was the primary outcome, and 45-day mortality was the secondary outcome. RESULTS: Total in-hospital mortality was 14.5%. In patients with and without DM, mortality was 8.8% and 11.3%, respectively, in Group A; 13.6% and 17.3% in Group B, and 12.6% and 34.3% in Group C. After controlling for confounders, newly recognized hyperglycemia (>181 mg/dL) was independently associated with in-hospital mortality (adjusted odds ratio=2.7, 95% confidence interval=1.6,4.8). Forty-five-day mortality in newly recognized hyperglycemic patients was 17.5%, 25.7%, and 42% in Groups A, B, and C, respectively, whereas it was 21.2% in patients with DM. CONCLUSION: In elderly patients, newly recognized hyperglycemia was associated with a higher mortality rate than in those with a prior history of DM. These data suggest that further randomized clinical trials are needed to assess the efficacy and the risk of a target glucose of greater than 180 mg/dL. [source] Comparative study of total protein, and total and lipid-associated serum sialic acid levels in patients with type 2 diabetes mellitusJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 4 2003Suat Ekin Abstract The aim of the present study was to investigate the serum total protein (TP), total sialic acid (TSA), lipid-associated sialic acid (LSA), LSA/TP, and LSA/TP values in type 2 diabetes mellitus (DM) patients. Two study groups (healthy controls and type 2 DM subjects) were examined. For the type 2 DM group, 120 patients (60 females and 60 males) who had been diagnosed and treated for type 2 DM in the Yuzuncu Yil University Hospital, Van, Turkey, were selected consecutively. Forty healthy individuals (20 females and 20 males) were selected from hospital staff and other outpatient clinics to serve as the control group. They were matched for age, sex, body mass index, and smoking status. None of the participants had taken vitamin or mineral supplements for at least 2 weeks before sampling. To determine serum glucose, TP, TSA, and LSA levels, blood samples were drawn after all of the subjects fasted overnight. It was found that diabetics had higher TSA, LSA, TSA/TP, and LSA/TP levels than controls. However, the TP levels were not significantly different between the groups. Our results showed that TSA, LSA, TSA/TP, and LSA/TP have interactive connections with DM. These parameters can be used as a diagnostic index for patients with DM. J. Clin. Lab. Anal. 17:124,126, 2003. © 2003 Wiley-Liss, Inc. [source] Plasma levels of tumour necrosis factor- , in patients with chronic periodontitis and type 2 diabetesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2007S. Engebretson Abstract Objectives: Studies suggest that elevated circulating tumour necrosis factor- , (TNF- ,) may contribute to insulin resistance in patients with type 2 diabetes. The source of plasma TNF has been thought to be adipocytes associated with obesity, but inflammation and infection result in TNF- , production as well. Methods: We studied 46 patients with type 2 diabetes and chronic periodontitis to determine the relationship between plasma TNF- , levels and clinical measures of periodontitis, gingival crevicular fluid (GCF) interleukin-1, (IL-1,), plasma endotoxin, serum glucose, and glycated haemoglobin (HbA1c). TNF- , levels were measured using a high sensitivity enzyme-linked immunosorbent assay. Results: TNF- , showed a significant positive correlation with attachment loss (r=0.40, p=0.009), plasma endotoxin (r=0.33, p=0.03), and GCF IL-1, (r=0.33, p=0.035), but not probing depth (r=0.28, p=0.07), bleeding on probing (r=0.30, p=0.053), plaque index (r=0.22, p=0.17), serum glucose, HbA1c (r=0.10, p=0.50), or body mass index (r=0.077, p=0.62). A dose,response relationship was observed between periodontitis severity and TNF- , (p=0.012). Conclusion: The finding that chronic periodontitis is associated with plasma TNF- , levels in subjects with type 2 diabetes supports the hypothesis that periodontal infection and inflammation may contribute to insulin resistance. [source] Evaluation of a primary care-oriented brief counselling intervention for obesity with and without orlistatJOURNAL OF INTERNAL MEDICINE, Issue 4 2006W. S. C. POSTON Abstract. Objective., There is a significant need for an obesity treatment model suitable for the primary care environment. We examined the effectiveness of a brief counselling intervention alone, in combination with orlistat, and drug-alone in a 12-month randomized-clinical trial at a medical school obesity centre. Methods., Participants (N = 250) with body mass index (BMI) ,27 were randomized. Changes in body weight, lipids, blood pressure and serum glucose were examined. Drug adherence and attendance were also evaluated. Results., Completers analysis was conducted on 136 participants with data at baseline, 6 and 12 months and intention-to-treat analyses (ITT) for the total sample. Amongst completers, participants in the drug only (P = 0.012) and drug + brief counselling (P = 0.001) groups lost more weight (mean ± SD: ,3.8 ± 5.8 kg and ,4.8 ± 4.4 kg, respectively) than participants in the brief counselling only group at 6 months (,1.7 ± 3.3 kg), but there were no significant group differences at 12 months. ITT model results were similar to completers at 6 months and remained significant at 12 months, but the weight losses were more modest (<3 kg) for both groups receiving orlistat. For brief counselling alone, participants gained weight (1.7 ± 4.2 kg). Cardiovascular disease (CVD) parameter changes were negligible. Conclusions., Pharmacotherapy alone or combined with brief counselling resulted in modest weight losses that had minimal impact on cardiovascular parameters, but were greater than brief counselling alone. Whilst brief interventions and primary pharmacotherapy have been suggested as viable treatments for implementation in primary care settings, our study suggests that such minimal interventions provide minimal benefits. [source] Protective effects of the Alisma orientalis extract on the experimental nonalcoholic fatty liver diseaseJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 10 2006Xuezhi Hong The aim of this investigation was to evaluate the efficacy of Alisma orientalis methanolic extract (AOME) on the experimental nonalcoholic fatty liver disease (NAFLD) induced by high-fat diet. Rats were fed with high-fat diet for six weeks and then gavaged the AOME for another six weeks. Typical pathological symptoms of NAFLD occurred in the high-fat diet rats. Administration with the AOME (150,300 and 600 mg kg,1) markedly decreased the serum and liver lipids; the high level of fasting serum glucose was reduced and insulin resistance was improved. The AOME treatment was also helpful in preventing the oxidative stress by lessening lipid peroxidation and activating antioxidant enzymes. Markers of the liver injury, aminotransferase abnormalities and hepatomegaly were improved and morphological changes, such as liver steatosis, mixed inflammation and collagen deposition, were lessened in rats treated with the AOME. These results suggested that the AOME showed hepatoprotective effects on NAFLD and may be a potential clinical application for treatment of this chronic liver disease. [source] Antinociceptive efficacy of levetiracetam in a mice model for painful diabetic neuropathyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2008M. OZCAN Background and Objective: Despite important advances in available knowledge, management of neuropathic pain remains incomplete, and results from experimental and clinical studies indicate that some anticonvulsants show promise for treating neuropathic pain. The aim of this study was to assess the antinociceptive efficacy of levetiracetam (LEV, ucb L059) in a mice model for painful diabetic neuropathy using the in vivo nociceptive behavioral ,hot-plate test.' Methods: The hot-plate test consisted of placing individual mice (adult male Balb/C) on the hot plate at 50±0.1 °C and timing the delay for the first hind paw lift (nociceptive threshold). After obtaining control values, diabetes was induced by injection of streptozotocin [200 mg/kg intraperitoneally (i.p.)] and 2 weeks after induction of diabetes (serum glucose ,400 mg/dL) LEV was administered i.p. and hot-plate tests were repeated. Pain threshold values were determined and analyzed by Kruskal,Wallis one-way analysis of variance (ANOVA) followed by a pairwise comparison using a Dunnett's t -test on the ranked data. Results: LEV (60, 300 and 900 mg/kg) had no significant effect on the nociceptive threshold in normal mice (n=8 for each dose, P>0.05). There were significant decreases in pain threshold latency in diabetic mice compared with the normal healthy group and these were significantly and dose-dependently restored by much lower doses of LEV (20, 100 and 200 mg/kg) in a reversible manner. Conclusion: Results obtained from the in vivo behavioral test lend support to the validation of the promising therapeutic potential of the novel antiepileptic agent LEV in the treatment of neuropathic pain. [source] Seasonal Variation in Serum Concentrations of Selected Metabolic Hormones in HorsesJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2010N.J. Place Background: Determination of adrenocorticotropic hormone (ACTH) concentration is a commonly used test in the evaluation of endocrine causes of equine laminitis, but the concentration in healthy horses can be high at certain times of year, which alters the specificity of the ACTH test. Objective: To determine if circulating concentrations of ACTH, cortisol, glucose, insulin, and thyroxine vary month to month in healthy horses and in horses with equine metabolic syndrome (EMS). Animals: Nine healthy adult horses were studied on their farm/stable over the course of 1 year. After the diagnosis of EMS, 10 laminitic horses residing at the same farm/stable were also studied. Methods: Prospective study of healthy and laminitic horses. Plasma/serum samples were analyzed for concentrations of hormones and glucose. Results: ACTH was the only analyte to show a discrete seasonal pattern, with concentrations in healthy and EMS horses frequently outside of the reference range (9,35 pg/mL) in August through October. Insulin was elevated (>40 ,IU/mL) in EMS horses during most months and median serum glucose was generally higher in EMS horses (100 mg/dL, range, 76,163 mg/ dL) than in controls (94 mg/dL, range, 56,110 mg/dL), but no seasonal patterns for insulin or glucose were found. Conclusions and Clinical Importance: An increased ACTH concentration in horses in late summer or autumn should be interpreted with caution. In contrast, insulin concentration is maintained within the reference range throughout the year in healthy horses, thus an increased insulin concentration at any time of year should raise suspicions of EMS, ECD, or both. [source] Determination of serum glucose by horseradish peroxidase-catalysed imidazole chemiluminescence coupled to a micro-flow-injection systemLUMINESCENCE: THE JOURNAL OF BIOLOGICAL AND CHEMICAL LUMINESCENCE, Issue 5 2007Osamu Nozaki Abstract The reactivity of flow-injection (FI)-horseradish peroxidase (HRP)-catalysed imidazole chemiluminescence (CL) was studied for continuous determination of hydrogen peroxide (H2O2) and serum glucose with immobilized glucose oxidase. Light emission by the HRP-catalysed imidazole CL was obtained when immobilized HRP, alkaline imidazole (in Tricine solution, pH 9.3) and H2O2 were reacted at room temperature. The optimal pH for the CL reaction was 9.3 and the optimal concentration of imidazole was 100 µmol/L. When no imidazole was added, the light intensity of the same H2O2 specimen decreased to a level that could not be quantitatively determined. The spectrum of the light emitted by imidazole CL was in the range 400,600 nm with a peak at 500 nm. The calibration equation for determination of H2O2 was y = 9860x2 + 3830x + 11 700, where y = light intensity (RLU) and x = concentration of H2O2 (µmol/L). The detection limit of H2O2 was 5 pmol, and the reproducibility of the H2O2 assay was 2.3% of the coefficient of variation (H2O2 48 µmol/L, n = 13). The CL method was successfully applied to assay glucose after on-line generation of H2O2 with the immobilized glucose oxidase column, resulting in good reproducibility (CV = 3.3% and 1.0% for the standard glucose and the control serum, respectively). Copyright © 2007 John Wiley & Sons, Ltd. [source] Effect of coriander seed (Coriandrum sativum L.) ethanol extract on insulin release from pancreatic beta cells in streptozotocin-induced diabetic ratsPHYTOTHERAPY RESEARCH, Issue 3 2009Maryam Eidi Abstract Coriander (Coriandrum sativum L.) is grown as a spice crop all over the world. The seeds have been used to treat indigestion, diabetes, rheumatism and pain in the joints. In the present study, an ethanol extract of the seeds was investigated for effects on insulin release from the pancreatic beta cells in streptozotocin-induced diabetic rats. Blood samples were drawn from the retro-orbital sinus before and 1.5, 3 and 5 h after administration of the seed extract. Serum glucose levels were determined by the glucose oxidase method. To determine the insulin releasing activity, after extract treatment the animals were anaesthetized by diethyl ether, the pancreas was excised, fixed in 10% formaldehyde and embedded in paraffin for sectioning. Pancreatic sections of 5 µm were processed for examination of insulin-releasing activity using an immunocytochemistry kit. The results showed that administration of the ethanol extract (200 and 250 mg/kg, i.p.) exhibited a significant reduction in serum glucose. Administration of streptozotocin decreased the number of beta cells with insulin secretory activity in comparison with intact rats, but treatment with the coriander seed extract (200 mg/kg) increased significantly the activity of the beta cells in comparison with the diabetic control rats. The extract decreased serum glucose in streptozotocin-induced diabetic rats and increased insulin release from the beta cells of the pancreas. Copyright © 2008 John Wiley & Sons, Ltd. [source] The effect of Anethum graveolens L. (dill) on corticosteroid induced diabetes mellitus: involvement of thyroid hormonesPHYTOTHERAPY RESEARCH, Issue 12 2008Sunanda Panda Abstract An investigation was made to evaluate the role of Anethum graveolens L. (dill) leaf extract in the regulation of corticosteroid-induced type 2 diabetes mellitus in female rats. In dexamethasone-treated animals (1 mg/kg for 22 days) an increase in serum concentration of insulin and glucose and in hepatic lipid peroxidation (LPO) was observed. However, there was a decrease in serum concentration of thyroid hormones and in the endogenous antioxidant enzymes, such as superoxide dismutase (SOD), catalase (CAT) and reduced glutathione (GSH) in liver. In animals treated with an equivalent amount of dexamethasone for a similar period (22 days) when received the leaf extract (100 mg/kg b.wt/d.) for last 15 days a decrease in the concentration of both serum glucose and insulin was observed, indicating the potential of the plant extract in the regulation of corticosteroid-induced diabetes. Dexamethasone-induced alterations in the levels of thyroid hormones as well as in hepatic LPO, SOD, CAT and GSH were also reversed by the plant extract. Copyright © 2008 John Wiley & Sons, Ltd. [source] Evaluation of the Association between Lower Urinary Tract Symptoms and Erectile Dysfunction, Considering its Multiple Risk FactorsTHE JOURNAL OF SEXUAL MEDICINE, Issue 11 2008Ernani Luis Rhoden MD ABSTRACT Aim., To investigate the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), while considering multiple risk factors for ED, including an anthropometric evaluation of central obesity. Methods., A cross-sectional study was carried out with 192 consecutive male subjects (,40 years old). Conditions clearly associated with ED, other than obesity and age, were considered exclusion criteria. Men were evaluated routinely for clinical history, received a physical examination, and were subjected to blood analysis for fasting serum glucose, lipid profile, and serum testosterone. Patients with previous known history of diabetes mellitus or hypertension were excluded. Anthropometric measures taken included body mass index (general obesity) and waist circumference, waist-hip index, and sagittal abdominal diameter (visceral obesity). Analyses were performed using bivariate and multivariate models (multiple logistic regression). Age, education, alcohol consumption, smoking, sedentary lifestyle, fasting blood glucose level, dyslipidemia, hypogonadism, general obesity, and visceral obesity were taken into account as potential confounding factors. Main Outcome Measures., All men completed the International Index of Erectile Function and International Prostate Symptom Score (IPSS). Results., IPSS scores were low, intermediate, and high in 89 (46.4%), 76 (39.6%), and 27 (14.1%) men, respectively. Overall IPSS scores were significantly associated with ED (P = 0.002). In addition, an association between the severity of ED and LUTS was observed (P = 0.008). The mean quality of life assessment in the IPSS revealed a statistically significant difference between individuals with varying degrees of ED (P = 0.008). The logistic regression analyses showed that IPSS scores and ED remained independently associated even after the control for confounding factors (odds ratio = 1.07, 95% CI = 1.02,1.13, P = 0.01). Conclusion., This study suggests that LUTS are independently associated with ED, taking into account various risk factors for ED, including visceral obesity. Rhoden EL, Riedner CE, Fornari A, Fuchs SC, and Ribeiro EP. Evaluation of the association between lower urinary tract symptoms and erectile dysfunction, considering its multiple risk factors. J Sex Med 2008;5:2662,2668. [source] Incidence of changes and predictive factors for sexual function after coronary stentingANDROLOGIA, Issue 1 2007H. Shi Summary The study was aimed at determining the incidence of changes in sexual function and identifying the possible associated variables of erectile dysfunction (ED) in coronary artery disease (CAD) patients undergoing coronary stenting. Four hundred and sixty-seven patients were retrospectively contacted with a questionnaire regarding sexual function from 6 months pre-stenting to 6 months post-stenting by telephone follow up. Univariate analyses were used to determine prognostic variables. ED changed following stenting in CAD (P < 0.05), in acute coronary syndrome (ACS) (P > 0.05) and in chronic coronary syndrome (CCS) (P < 0.05). Sexual activity was not resumed in 8.1%, was unchanged in 33.8%, increased in 0% and decreased in 58.0%. The average frequency of sexual activity decreased every month in CAD (P < 0.05), in ACS (P < 0.05) and in CCS (P < 0.01) after undergoing coronary stenting respectively. The mean time interval between the onset of ED and CAD was 33 months. Resuming sexual activity after stenting varied from 2 weeks to 30 months. Significant predictors of ED after coronary stenting were mean age, diabetes mellitus, 2,3-vessel disease or current smoking status. It was concluded that coronary stenting had a significant incidence of ED. Mean age, diabetes mellitus, 2,3-vessel disease or current smoking status showed to be the main variables associated with ED. Attempts to improve individual secondary prevention outcomes (controlling serum glucose and smoking cessation) should be designed. [source] An INSIG2 Polymorphism Affects Glucose Homeostasis in Sardinian Obese Children and AdolescentsANNALS OF HUMAN GENETICS, Issue 5 2010Patrizia Zavattari Summary Allelic variants of a single nucleotide polymorphism (SNP), rs7566605, located approximately 10 kb upstream of the INSIG2 gene have been found in association with body weight and with other clinical features related to obesity in some populations but not in others. Our objective was to test the association of this SNP in obese children and adolescents from the genetically isolated population of Sardinia. We tested the association of rs7566605 with body mass index (BMI) and with serum glucose and insulin concentrations and a surrogate measure of insulin resistance (HOMA-IR) in a cohort of 747 Sardinian obese children and adolescents. A case control analysis was performed using 548 ethnically-matched healthy controls. Allelic frequencies of the SNP were similar between patients and controls. Mean glucose and insulin concentration and mean HOMA-IR values were significantly higher in patients carrying the CC genotype than in the CG and GG carriers. In the patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), allele C was significantly more frequent than in controls. Although INSIG2 polymorphisms do not consistently associate with BMI, the observation of an association with glucose concentration would support a role for this gene in the metabolic complications of obesity. [source] Haematological and biochemical characteristics of two aquacultured carnivorous cyprinids, topmouth culter Culter alburnus (Basilewsky) and yellowcheek carp Elopichthys bambusa (Richardson)AQUACULTURE RESEARCH, Issue 9 2010Xiaojuan Cao Abstract The haematological and biochemical characteristics of two healthy farmed cyprinids, the topmouth culter Culter alburnus and yellowcheek carp Elopichthys bambusa, were investigated in this study. Erythrocytes, thrombocytes, lymphocytes, monocytes and granulocytes (i.e. neutrophils and eosinophils) were observed in these two fish. Every type of these cells (excluding the erythrocyte and lymphocyte) showed similar sizes in the topmouth culter and yellowcheek carp. Thrombocytes and neutrophils were the two most abundant leucocytes in the topmouth culter while thrombocytes and lymphocytes were the two most frequent leucocytes observed in the yellowcheek carp. The erythrocyte counts, haemoglobin concentrations and values of serum glucose in these two fish were high. There were significant differences in the leucocyte counts, haemoglobin concentrations, mean cellular haemoglobin contents, mean cell haemoglobin concentrations and values of serum glucose, triglyceride, total bilirubin, alkaline phosphatase and chlorine between the topmouth culter and the yellowcheek carp. The information of haematology and blood biochemistry obtained here would be useful for the prevention and diagnosis of diseases of farmed topmouth culter and yellowcheek carp. [source] Detection of Undiagnosed Diabetes and Prediabetic States in High-risk Emergency Department PatientsACADEMIC EMERGENCY MEDICINE, Issue 5 2009Michelle A. Charfen MD Abstract Background:, Diabetes is often not diagnosed until complications appear, and one-third of those with diabetes may be undiagnosed. Prediabetes and diabetes are conditions in which early detection would be appropriate, because the duration of hyperglycemia is a predictor of adverse outcomes, and there are effective interventions to prevent disease progression and to reduce complications. Objectives:, The objectives were to determine the prevalence of diabetes mellitus and prediabetes in emergency department (ED) patients with an elevated random glucose or risk factors for diabetes but without previously diagnosed diabetes and to identify which at-risk ED patients should be considered for referral for confirmatory diagnostic testing. Methods:, This two-part study was composed of a prospective 2-year cohort study, and a 1-week cross-sectional survey substudy, set in an urban ED in Los Angeles County, California. A convenience sample was enrolled of 528 ED patients without previously diagnosed diabetes with either 1) a random serum glucose , 140 mg/dL regardless of the time of last food intake or a random serum glucose , 126 mg/dL if more than 2 hours since last food intake or 2) at least two predefined diabetes risk factors. Measurements included presence of diabetes risk factors, ED glucose, cortisol, insulin and glycosylated hemoglobin (HbA1c), and 2-hour oral glucose tolerance test results, administered at 6-week follow-up. Results:, Glycemic status was confirmed at follow-up in 256 (48%) of the 528 patients. Twenty-seven (11%) were found to have diabetes, 141 (55%) had prediabetes, and 88 (34%) had normal results. Age, ED glucose, HbA1c, cortisol, and random serum glucose , 140 mg/dL were associated with both diabetes and prediabetes on univariate analysis. A random serum glucose , 126 mg/dL after 2 hours of fasting was associated with diabetes but not prediabetes; ED cortisol, insulin, age , 45 years, race, and calculated body mass index (BMI) were associated with prediabetes but not diabetes. In multivariable models, among factors measurable in the ED, the only independent predictor of diabetes was ED glucose, while ED glucose, age , 45 years, and symptoms of polyuria and polydipsia were independent predictors of prediabetes. All at-risk subjects with a random ED blood glucose > 155 mg/dL had either prediabetes or diabetes on follow-up testing. Conclusions:, A substantial fraction of this urban ED study population was at risk for undiagnosed diabetes and prediabetes, and among the at-risk patients referred for follow-up, the majority demonstrated diabetes or prediabetes. Notably, all patients with two risk factors and a random serum glucose > 155 mg/dL were later diagnosed with prediabetes or diabetes. Consideration should be given to referring ED patients with risk factors and a random glucose > 155 mg/dL for follow-up testing. [source] Cardiovascular risk factors correlate with prostate size in men with bladder outlet obstructionBJU INTERNATIONAL, Issue 1 2003L. Sandfeldt OBJECTIVE To study whether the risk profile for cardiovascular disease correlates with prostate size in elderly men seeking medical attention for lower urinary tract symptoms (LUTS), by assessing physiological, biochemical and personality traits. PATIENTS AND METHODS Fifty-two men (mean age 68 years, range 52,85) with bladder outlet obstruction, as verified by urodynamic testing, had their prostate size measured by transrectal ultrasonography. Their blood and urine was also examined, and their personality and heart rate variability tested. The measured variables were assessed statistically in relation to whether the prostate volume was smaller (22 men) or larger (30 men) than 50 mL. RESULTS Patients with a large prostate (mean 104 mL) had a higher mean arterial pressure (105 vs 95 mmHg, P < 0.01), and serum glucose (5.3 vs 4.8 mmol/L, P < 0.01) and serum cortisol (423 vs 362 nmol/L, P = 0.06) concentrations than those with a small gland (mean 31 mL). The personality test showed that they were also less assertive than the others (P < 0.03). The components of the heart rate variability indicated that men with a large prostate had increased sympathetic activity. CONCLUSION Men with LUTS caused by a very large prostate have more risk factors for cardiovascular disease than those with a smaller gland. [source] | |||||||||||||||||||||||||||||||