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Blood Glucose Concentrations (blood + glucose_concentration)
Selected AbstractsEvaluation of a continuous glucose monitoring system in diabetic dogsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 10 2003L. J. Davison The generation of a blood glucose curve is important for assessing the response to insulin therapy in diabetic dogs. Disadvantages of this technique include patient discomfort and the potential for missing transient hypo- or hyperglycaemic episodes. The aim of the current study was to evaluate a continuous glucose monitoring system (CGMS) for use in diabetic dogs. Interstitial fluid glucose concentrations were recorded in 10 diabetic dogs, every five minutes for up to 48 hours, using a subcutaneous sensor attached to the CGMS device. Blood glucose concentrations were measured simultaneously using a glucometer. The correlation between interstitial fluid and blood glucose values was 0·81 (P<0·01). The largest discrepancies between the two sets of data were seen during the one- to three-hour period following feeding, suggesting that postprandial hyperglycaemia might not be reflected in the interstitial fluid. The authors conclude that the CGMS is a potentially valuable tool in the management of canine diabetic patients. [source] Fetal cyclic motor activity in diabetic pregnancies: Sensitivity to maternal blood glucoseDEVELOPMENTAL PSYCHOBIOLOGY, Issue 1 2003Steven S. Robertson Abstract Spontaneous fetal movement in the last third of human gestation is dominated by irregular oscillations on a scale of minutes (cyclic motility, CM). The core properties of these oscillations are stable during the third trimester of gestation in normal fetuses, but disrupted by poorly controlled maternal diabetes. Here we investigated whether fetal CM is linked to short-term instabilities in maternal glucose metabolism. The fetuses of 40 mothers with type I (n,=,28) or gestational (n,=,12) diabetes were studied one to six times between 27 and 40 postmenstrual weeks of gestation. Fetal movement and maternal blood glucose concentration were measured during two separate periods of fetal activity in each session. Fetal CM was quantified with spectral analysis. Early in the third trimester, changes in the rate of oscillation in fetal CM between the two periods of activity were inversely related to changes in maternal blood glucose levels. Fetal CM was unrelated to concurrent maternal blood glucose levels at any point in the third trimester. The pattern of results suggests that disruption of the temporal organization of spontaneous fetal motor activity in pregnancies complicated by maternal diabetes represents an acute response to fluctuations in the metabolic environment rather than an alteration of CM development. © 2003 Wiley Periodicals, Inc. Dev Psychobiol 42: 9,16, 2003. [source] Rosiglitazone is more effective than metformin in improving fasting indexes of glucose metabolism in severely obese, non-diabetic patientsDIABETES OBESITY & METABOLISM, Issue 6 2008A. Brunani Aim:, In obese patients, the diet-induced weight loss markedly improves glucose tolerance with an increase in insulin sensitivity and a partial reduction of insulin secretion. The association with metformin treatment might potentiate the effect of diet alone. Methods:, From patients admitted to our Nutritional Division for diet programme, we selected obese, non-diabetic, uncomplicated patients with age 18,65 years and body mass index 35,50 kg/m2 and studied the effects of a 6-month pharmacological treatment with either metformin (850 mg twice daily) or rosiglitazone (4 mg twice daily) on possible changes in body weight, fat mass, glucose and lipids metabolism. Results:, A significant weight loss and reduction of fat mass was demonstrated with metformin (,9.7 ± 1.8 kg and ,6.6 ± 1.1 kg) and also with rosiglitazone (,11.0 ± 1.9 kg and ,7.2 ± 1.8 kg), without fluid retention in either treatment group. Rosiglitazone administration induced a significant decrease in glucose concentration (4.7 ± 0.1 vs. 4.4 ± 0.1 mmol/l, p < 0.005) and insulin-circulating level (13.6 ± 1.5 vs. 8.0 ± 0.,7 ,U/ml, p < 0.005), an increase in insulin sensitivity as measured by homeostatic model assessment (HOMA) of insulin sensitivity (68.9 ± 8.8 vs. 109.9 ± 10.3, p < 0.005) with a concomitant decrease in ,-cell function as measured by HOMA of ,-cell function (163.2 ± 16.1 vs. 127.4 ± 8.4, p < 0.005). In contrast, metformin did not produce any significant effect on blood glucose concentration, insulin level and HOMA2 indexes. No adverse events were registered with pharmacological treatments. Conclusion:, Our study shows that in severely obese, non-diabetic, hyperinsulinaemic patients undergoing a nutritional programme, rosiglitazone is more effective than metformin in producing favourable changes in fasting-based indexes of glucose metabolism, with a reduction of both insulin resistance and hyperinsulinaemia. In spite of previous studies reporting rosiglitazone-induced body weight gain, in our study the joint treatment with diet and rosiglitazone was accompanied by weight loss and fat mass reduction. [source] Effects of acute hyperglycaemia on anorectal motor and sensory function in diabetes mellitusDIABETIC MEDICINE, Issue 2 2004A. Russo Abstract Aims To determine the effects of acute hyperglycaemia on anorectal motor and sensory function in patients with diabetes mellitus. Methods In eight patients with Type 1, and 10 patients with Type 2 diabetes anorectal motility and sensation were evaluated on separate days while the blood glucose concentration was stabilized at either 5 mmol/l or 12 mmol/l using a glucose clamp technique. Eight healthy subjects were studied under euglycaemic conditions. Anorectal motor and sensory function was evaluated using a sleeve/sidehole catheter, incorporating a barostat bag. Results In diabetic subjects hyperglycaemia was associated with reductions in maximal (P < 0.05) and plateau (P < 0.05) anal squeeze pressures and the rectal pressure/volume relationship (compliance) during barostat distension (P < 0.01). Hyperglycaemia had no effect on the perception of rectal distension. Apart from a reduction in rectal compliance (P < 0.01) and a trend (P = 0.06) for an increased number of spontaneous anal sphincter relaxations, there were no differences between the patients studied during euglycaemia when compared with healthy subjects. Conclusions In patients with diabetes, acute hyperglycaemia inhibits external anal sphincter function and decreases rectal compliance, potentially increasing the risk of faecal incontinence. Diabet. Med. 21, 176,182 (2004) [source] Glucose intolerance and associated factors in Mongolia: results of a national surveyDIABETIC MEDICINE, Issue 6 2002J. Suvd Abstract Aims Prevalence of glucose intolerance,diabetes and impaired glucose tolerance (IGT),and of related conditions such as obesity and hypertension, was studied in six population samples in Mongolia in 1999. Methods Diagnosis of glucose intolerance was made on the basis of 2-h blood glucose concentration, according to criteria recommended by the latest report of a WHO Expert Group. Results Crude prevalence of diabetes was 2.9% (2.6% in men and 3.2% in women). Prevalence of IGT was 10.2% (9.3% in men and 10.8% in women). Age standardization to the standard world population of Segi resulted in a total sample prevalence of 3.1% for diabetes and 9.2% for IGT. Prevalence of abnormal glucose tolerance differed according to district of residence. Approximately one-third of the subjects with diabetes were diagnosed prior to the survey. Of those who were diagnosed previously, approximately one-half were not under any form of treatment. Subjects with abnormal glucose tolerance were older, more obese and had higher blood pressure and prevalence of hypertension than those with normoglycaemia. One-half of men and almost one-half of women were hypertensive. Three-quarters of the diabetic subjects were hypertensive. One-third of all subjects were centrally obese. Considering the conditions of principal interest,glucose intolerance, hypertension and obesity,one-half of all subjects demonstrated one or more of these conditions. Central obesity was the most common condition, followed by hypertension and then glucose intolerance. Central obesity and hypertension was the most common combination (17% of all subjects) and 4% exhibited all three conditions. Conclusions Non-communicable diseases are already a threat to public health in Mongolia. Although the prevalence of diabetes is not high by international standards, the relatively high prevalence of IGT suggests that the situation may deteriorate in the future in the absence of concerted action to prevent and control diabetes and related conditions. [source] Gastric emptying in diabetes: clinical significance and treatmentDIABETIC MEDICINE, Issue 3 2002M. Horowitz Abstract The outcome of recent studies has led to redefinition of concepts relating to the prevalence, pathogenesis and clinical significance of disordered gastric emptying in patients with diabetes mellitus. The use of scintigraphic techniques has established that gastric emptying is abnormally slow in approx. 30,50% of outpatients with long-standing Type 1 or Type 2 diabetes, although the magnitude of this delay is modest in many cases. Upper gastrointestinal symptoms occur frequently and affect quality of life adversely in patients with diabetes, although the relationship between symptoms and the rate of gastric emptying is weak. Acute changes in blood glucose concentration affect both gastric motor function and upper gastrointestinal symptoms. Gastric emptying is slower during hyperglycaemia when compared with euglycaemia and accelerated during hypoglycaemia. The blood glucose concentration may influence the response to prokinetic drugs. Conversely, the rate of gastric emptying is a major determinant of post-prandial glycaemic excursions in healthy subjects, as well as in Type 1 and Type 2 patients. A number of therapies currently in development are designed to improve post-prandial glycaemic control by modulating the rate of delivery of nutrients to the small intestine. [source] A study on non-invasive detection of blood glucose concentration from human palm perspiration by using artificial neural networksEXPERT SYSTEMS, Issue 3 2010Hamdi Melih Sarao Abstract: In this paper the relationship between blood glucose concentration and palm perspiration rate is studied as a non-invasive method. A glucose concentration range from 83 mg/dl to 116.5 mg/dl is examined. An artificial neural network (ANN) trained by the Levenberg,Marquardt algorithm is developed to detect the performance indices based on the one- and two-input variables. A data set for 72 volunteers is used for this study. Data of 36 volunteers are used for training the ANN and data of 36 volunteers were reserved for testing. Results of the study are acceptable with an error of 8.38% for the Elman neural network and 8.77% for the multilayer neural network. Therefore, the palm perspiration rate may be used as a good indicator for detecting glucose concentration in blood. This non-invasive method has advantages such as time saving, cost etc. over other methods and it is painless. The results of clinical experiments, follow-up methods and other applications are presented. [source] Amino acid ingestion and glucose metabolism,A reviewIUBMB LIFE, Issue 9 2010Mary C. Gannon Abstract Interest in the effect of proteins or amino acids on glucose metabolism dates back at least a century, largely because it was demonstrated that the amino acids from ingested protein could be converted into glucose. Indeed, these observations influenced the dietary information provided to people with diabetes. Subsequently it was shown that ingested protein did not raise the blood glucose concentration. It also was shown that proteins could stimulate a rise in insulin and glucagon but the response to various proteins was different. In addition, it was shown that individual amino acids also could stimulate a rise in insulin and in glucagon concentrations. When individual amino acids are ingested by normal subjects, there is an ordering of the insulin and glucagon responses. However, the order is not the same for insulin and glucagon. In addition, the metabolic response cannot be predicted based on the functional groups of the amino acids. Thus, empirical prediction of the metabolic response to ingested single amino acids is not possible. © 2010 IUBMB IUBMB Life, 62(9): 660,668, 2010 [source] ORIGINAL ARTICLE: Many patients with Type 1 diabetes estimate their prandial insulin need inappropriatelyJOURNAL OF DIABETES, Issue 3 2010Aila J. AHOLA Abstract Background:, Many factors contribute to the need for prandial insulin in Type 1 diabetes. However, patients' success in achieving normal postprandial glucose concentration is understudied. The aim of the present study was to determine how often patients with Type 1 diabetes achieve normal postprandial glucose concentrations and to evaluate factors associated with postprandial hypo- and hyperglycemia. Methods:, Data on food intake, physical activity, insulin administration, and blood glucose concentration were collected using a self-administered questionnaire from 331 patients with Type 1 diabetes (43% men; mean age 49 ± 12 years; mean diabetes duration 32 ± 13 years). Of these, 179 provided data on blood glucose concentrations measured 110,150 min postprandially. One such meal per patient was randomized for analyses. Results:, Hypoglycemia (<4.0 mmol/L), normoglycemia (4.0,7.9 mmol/L), and hyperglycemia (,8.0 mmol/L) were observed after 23%, 36%, and 41% of meals, respectively. The three postprandial glycemia groups did not differ with respect to the meal composition or the timing of the postprandial blood glucose measurement. In women, postprandial hyperglycemia was associated with shorter diabetes duration and higher preprandial blood glucose concentration, whereas postprandial hypoglycemia was associated with higher physical activity. No single factor explained the postprandial glycemic state in men. Conclusions:, A total of 64% of patients estimated their prandial insulin need inappropriately, suggesting that estimation of the optimal prandial insulin dose is not easy, even after a long duration of diabetes. [source] Advances in vertebrate aging research 2007AGING CELL, Issue 2 2008Steven Austad Summary Among this year's highlights in vertebrate aging research, we find a study in which, contrary to the oxidative stress hypothesis of aging, reduced expression of a major cellular antioxidant, glutathione peroxidase 4, led to a small increase in mouse lifespan. By contrast, a large comparative proteomic analysis discovered a remarkably robust and previous unsuspected inverse association between species lifespan and relative frequency of cysteine residues in mitochondrially encoded respiratory chain proteins only, which the authors attribute to cysteine's ease of oxidation. Another study evaluated more cleanly than any previous work the hypothesis that blood glucose concentration is a key mediator of aging, and concluded that it wasn't. Several new mouse longevity mutants were also reported this year, some (PAPP-A, IRS-1, and IRS-2 knockouts) supporting previous work on the importance of insulin/insulin-like growth factor-1 signaling and aging. However, there were inconsistencies between laboratories in some of the results, which merit further investigation. Also, somewhat inconsistent with these findings, over-expression of insulin-like growth factor-1 in heart only lengthened life. From a completely new direction, type 5 adenylyl cyclase knockout mice were observed to live more than 30% longer than controls. Finally, a new program for evaluating potential pharmaceutical interventions in aging and longevity made its appearance, and is notable at this point chiefly for the excellence of its experimental design. A similar program for the disinterested evaluation of reported longevity mutations in mice would be a service to the community of vertebrate aging researchers. [source] Blood leucocyte cytokine production after LPS stimulation at different concentrations of glucose and/or insulinACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2009S. BEITLAND Background: Previous studies have indicated that alterations in blood glucose and/or insulin levels modify the inflammatory response. The purpose of this study was to elucidate whether increased levels of glucose and/or insulin influence the activation pattern of blood leucocytes and their production of cytokines in vitro. Methods: Venous blood was obtained from eight healthy male volunteers after an overnight fast. Glucose and/or insulin were added to aliquots of whole blood to increase the blood glucose concentration by 5 or 20 mmol/l and/or the insulin concentration by 6 or 30 nmol/l, respectively, before stimulation with E. coli lipopolysaccharide (LPS) at concentrations of 10, 100 or 1000 ng/ml. The samples were subsequently incubated at 37 °C for 6 h before cytokine measurements. After centrifugation the levels of interleukins (IL)-1,, IL-6, IL-8, IL-10 and tumour necrosis factor (TNF)-, were measured in plasma using enzyme-linked immuno-sorbent assays. The results were compared with cytokine levels in parallel control samples to which only identical amounts of LPS were added. Results: The LPS-stimulated production of IL-1, was significantly reduced by on average 26% in samples to which glucose 20 mmol/l was added; addition of insulin and/or glucose 5 mmol/l had no apparent effect on the IL-1, production at any LPS concentration. The levels of IL-6, IL-8, IL-10 and TNF-, were not manifestly altered by addition of glucose and/or insulin at any LPS concentration. Conclusion: A substantial increase in blood glucose concentration changed the IL-1, production, but not the production of other cytokines, in response to LPS stimulation. [source] Impaired Glucose Tolerance in the R6/1 Transgenic Mouse Model of Huntington's DiseaseJOURNAL OF NEUROENDOCRINOLOGY, Issue 2 2008K. Josefsen Previous reports have highlighted a possible link between Huntington's disease (HD) and diabetes mellitus (DM), but the association has not been characterised in detail. A transgenic mouse model for HD, the R6/2 mouse, also develops diabetes. In the present study, we examined the R6/1 mouse, which carries a shorter CAG repeat than the R6/2 mouse, and found that, although not diabetic, the mice showed several signs of impaired glucose tolerance. First, following i.p. glucose injection, the blood glucose concentration was approximately 30% higher in young R6/1 mice (10 weeks) compared to wild-type mice (P = 0.004). In older mice (38 weeks), glucose tolerance was further impaired in both R6/1 and wild-type animals. Second, during glucose challenge, the R6/1 mice reached higher plasma insulin levels than wild-type mice, but the peripheral insulin sensitivity was normal as measured by injection of human or mouse insulin or when evaluated by the quantitative insulin sensitivity check index (QUICKI). Third, the beta cell volume was 17% and 39% smaller at 10 and 38 weeks of age, respectively, compared to age-matched wild-type littermates and the reduction was not caused by apoptosis at either age. Finally, we demonstrated the presence of the HD gene product, huntingtin (htt), in both alpha- and beta-cells in R6/1 islets of Langerhans. Since pancreatic beta cells and neurons share several common traits, clarification of the mechanism associating neurodegenerative diseases with diabetes might improve our understanding of the pathogenic events leading to both groups of diseases. [source] Evaluation of a score designed to predict sepsis in foalsJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2003DACVECC, DACVIM, Kevin T. T. Corley BSc, MRCVS Abstract Objective: To evaluate the accuracy of a published score designed to predict sepsis in foals in a clinical setting and to evaluate the association of clinical and clinicopathological variables with sepsis. Design: Observational study. Retrospective for data from 1998. Prospective in 1999,2001. Setting: Foal intensive care unit of a university hospital. Animals: Client-owned foals of less than 10 days of age, presenting from 1998 to 2001. Interventions: None. Measurements and main results: Data from the history and physical examination, together with admission hematology, biochemistry and arterial blood gas analysis were used to generate the published sepsis scores. The same data were investigated for their statistical relationship with sepsis. The presence or absence of sepsis was determined from blood culture, culture of sites of suspected local infection, clinical course and/or post-mortem examination. The modified sepsis score was calculated for 168 foals, which were classified as septic (86), non-septic (45) or not possible to classify (37). The modified sepsis score correctly predicted sepsis in 58 out of 86 foals and non-sepsis in 34 out of 45 foals, resulting in a sensitivity of 67%, a specificity of 76%, a positive predictive value of 84% and a negative predictive value of 55%. Abnormal neutrophil cytology, an immunoglobulin concentration of less than 400 mg/dl, and low blood glucose concentration had the strongest association with sepsis. Conclusions: The low negative predictive value of the sepsis score limited its clinical utility. The sepsis score should not be used to define sepsis in clinical studies, unless previously validated in the study center. [source] Field Safety and Efficacy of Protamine Zinc Recombinant Human Insulin for Treatment of Diabetes Mellitus in CatsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 4 2009R.W. Nelson Background: This study describes the efficacy of a new protamine zinc recombinant human insulin (PZIR) preparation for treating diabetic cats. Objective: To evaluate effects of PZIR on control of glycemia in cats with newly diagnosed or poorly controlled diabetes mellitus. Animals: One hundred and thirty-three diabetic cats 120 newly diagnosed and 13 previously treated. Methods: Prospective, uncontrolled clinical trial. Cats were treated with PZIR twice daily for 45 days. Control of glycemia was assessed on days 7, 14, 30, and 45 by evaluation of change in water consumption, frequency of urination, appetite, and body weight, serum fructosamine concentration, and blood glucose concentrations determined 1, 3, 5, 7, and 9 hours after administration of PZIR. Adjustments in dosage of PZIR were made as needed to control glycemia. Results: PZIR administration resulted in a significant decrease in 9-hour mean blood glucose (199 ± 114 versus 417 ± 83 mg/dL, X± SD, P < .001) and serum fructosamine (375 ± 117 versus 505 ± 96 ,mol/L, P < .001) concentration and a significant increase in mean body weight (5.9 ± 1.4 versus 5.4 ± 1.5 kg, P= .017) in 133 diabetic cats at day 45 compared with day 0, respectively. By day 45, polyuria and polydipsia had improved in 79% (105 of 133), 89% (118 of 133) had a good body condition, and 9-hour mean blood glucose concentration, serum fructosamine concentration, or both had improved in 84% (112 of 133) of the cats compared with day 0. Hypoglycemia (<80 mg/dL) was identified in 151 of 678, 9-hour serial blood glucose determinations and in 85 of 133 diabetic cats. Hypoglycemia causing clinical signs was confirmed in 2 diabetic cats. Conclusions and Clinical Relevance: PZIR is effective for controlling glycemia in diabetic cats and can be used as an initial treatment or as an alternative treatment in diabetic cats that do not respond to treatment with other insulin preparations. [source] Incidence and Clinical Relevance of Hyperglycemia in Critically Ill DogsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2007Danna M. Torre Background: Hyperglycemia associated with critical illness in nondiabetic human patients is a common occurrence in the intensive care unit (ICU), with a reported incidence as high as 71%. Hypothesis: Hyperglycemia in critically ill dogs increases the risk of morbidity and mortality. Animals: Two hundred forty-five dogs hospitalized in the ICU over a 2-month period were evaluated. Methods: Prospective observational study was conducted over a 2-month period. All dogs in the ICU had their highest daily blood glucose concentration recorded. All dogs with diabetes were excluded from the study. Hyperglycemia was defined as a blood glucose concentration >120 mg/dL. Dogs with hyperglycemia were monitored for persistence and resolution of hyperglycemia. Results: During the study period, 245 dogs were evaluated, of which 38 (16%) were hyperglycemic. Twenty-six percent (10/ 38) developed hyperglycemia during hospitalization, whereas 74% (28/38) were hyperglycemic at presentation. Length of hospitalization (LOH) was shorter in dogs that presented with hyperglycemia compared with those that developed hyperglycemia during hospitalization (P= .001). Seventy-one percent (27/38) of dogs were discharged from the hospital, whereas the remaining 29% (11/38) died or were euthanatized. Nonsurvivors had significantly higher median glucose concentration (median, 176 mg/dL; range 122,310 mg/dL) than did survivors (median, 139 mg/dL; 121,191 mg/dL; P= .021). Conclusions and Clinical Importance: The incidence of hyperglycemia in this population of dogs was 16%. Dogs that developed hyperglycemia had longer LOH and nonsurvivors had more pronounced hyperglycemia than did survivors. [source] Monitoring of blood proteins glycation by refractive index and spectral measurementsLASER PHYSICS LETTERS, Issue 6 2008O.S. Zhernovaya Abstract Monitoring of blood glucose and glycated proteins level is an urgent requirement for diabetic patients. The amount of glycated hemoglobin and glycated albumin depends on blood glucose concentration and reflects the mean glycemia. The purpose of this study is to investigate the effect of presence of glucose and glycation of proteins on optical properties of water solutions of hemoglobin and albumin with different glucose concentrations. We present the results of feasibility study of the refractive index measurements for water solutions of hemoglobin and albumin with glucose by Abbe refractometer. In addition, absorbance spectrum of water solutions of hemoglobin and albumin with different glucose concentrations has been studied. The experimental results show that the changes of optical properties caused by glycation of proteins can be observed by refractive index and spectral measurements. The refractive index measurements can be potentially applied for evaluation of glycated hemoglobin and glycated albumin amount in blood. (© 2008 by Astro Ltd., Published exclusively by WILEY-VCH Verlag GmbH & Co. KGaA) [source] Effect of the motilin agonist KC 11458 on gastric emptying in diabetic gastroparesisALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2004A. Russo Summary Background :,KC 11458, a motilin agonist without antibiotic properties, accelerates gastric emptying in animals and healthy humans. Aim :,To evaluate the acute effects of KC 11458 on gastric emptying in diabetic gastroparesis. Methods :,Twenty-nine patients (6 type 1 and 23 type 2) with gastroparesis underwent assessments of: (i) gastric emptying of a solid/liquid meal using scintigraphy, (ii) glycaemic control (blood glucose at 0, 30, 60, 90 and 120 min during the gastric emptying measurement) and (iii) upper gastrointestinal and ,meal-related' symptoms (questionnaire), at baseline and after treatment with KC 11458 in a dose of 8 mg t.d.s., or placebo for 8 days. Results :,KC 11458 had no statistically significant or clinically relevant effect on gastric emptying of either the solid intragastric retention at 100 min (T100) (P = 0.87) or liquid 50% emptying time (T50) (P = 0.17) components of the meal. KC 11458 slightly worsened (P = 0.04) upper gastrointestinal symptoms when compared with placebo. The magnitude of the change in solid gastric emptying correlated with the change in the blood glucose concentration (r = 0.49; P < 0.05). Conclusions :,KC 11458, in a dose of 8 mg t.d.s. for 8 days, does not accelerate gastric emptying in patients with diabetic gastroparesis. The absence of efficacy may relate to an effect of hyperglycaemia. [source] An exploratory comparative study of volatile compounds in exhaled breath and emitted by skin using selected ion flow tube mass spectrometryRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 4 2008Claire Turner Selected ion flow tube mass spectrometry (SIFT-MS) has been used to carry out a pilot parallel study on five volunteers to determine changes occurring in several trace compounds present in exhaled breath and emitted from skin into a collection bag surrounding part of the arm, before and after ingesting 75,g of glucose in the fasting state. SIFT-MS enabled real-time quantification of ammonia, methanol, ethanol, propanol, formaldehyde, acetaldehyde, isoprene and acetone. Following glucose ingestion, blood glucose and trace compound levels were measured every 30,min for 2,h. All the above compounds, except formaldehyde, were detected at the expected levels in exhaled breath of all volunteers; all the above compounds, except isoprene, were detected in the collection bag. Ammonia, methanol and ethanol were present at lower levels in the bag than in the breath. The aldehydes were present at higher levels in the bag than in breath. The blood glucose increased to a peak about 1,h post-ingestion, but this change was not obviously correlated with temporal changes in any of the compounds in breath or emitted by skin, except for acetone. The decrease in breath acetone was closely mirrored by skin-emitted acetone in three volunteers. Breath and skin acetone also clearly change with blood glucose and further work may ultimately enable inferences to be drawn of the blood glucose concentration from skin or breath measurements in type 1 diabetes. Copyright © 2008 John Wiley & Sons, Ltd. [source] Influence of Sirolimus on Cyclosporine-Induced Pancreas Islet Dysfunction in RatsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2009H. K. Song This study was performed to investigate the effect of sirolimus (SRL) on cyclosporine (CsA)-induced pancreatic islet dysfunction in rats. Three separate studies were performed. First, diabetogenic effect of SRL was evaluated with three different doses (0.15, 0.3 and 0.6 mg/kg). Second, rats were treated with SRL (0.3 mg/kg) with or without CsA (15 mg/kg) for 4 weeks. Third, rats were treated with CsA for 4 weeks, and then switched to SRL for 4 weeks. The effect of SRL on CsA-induced pancreatic islet dysfunction was evaluated by an intraperitoneal glucose tolerance test, plasma insulin concentration, HbA1c level, HOMA-R index, immunohistochemistry of insulin and pancreatic beta islet cell mass. The SRL treatment increased blood glucose concentration in a dose-dependent manner. The combined treatment with SRL and CsA increased blood glucose concentration, Hemoglobin A1c (HbA1c) level, HOMA-R [fasting insulin (mU/mL) x fasting glucose (mmol/L)]/22.5] index and decreased plasma insulin concentration, immunoreactivity of insulin and pancreatic beta islet cell mass compared with rats treated with CsA. CsA withdrawal for 4 weeks improved pancreatic beta-cell function and structure. However, conversion from CsA to SRL further increased blood glucose levels compared with the rats converted from vehicle to SRL. The results of our study demonstrate that SRL is diabetogenic and aggravates CsA-induced pancreatic islet dysfunction. [source] Neonatal blood glucose concentrations in caesarean and vaginally delivered term infantsACTA PAEDIATRICA, Issue 10 2010Ronella Marom Abstract Background:, Little is known about the glucose concentrations at and after birth of infants delivered by caesarean section (CS), when compared with infants born vaginally (VD). Aim:, To compare venous cord blood glucose concentrations of term infants born after elective CS to infants born by VD. We studied the null hypothesis that mode of delivery does not affect neonatal blood glucose values. Methods:, We compared cord blood glucose concentrations in healthy term infants born after VD (n = 16) or by elective CS (n = 21). Glucose concentrations were obtained immediately at birth from the umbilical cord. Kruskal,Wallis was used to compare glucose concentrations and demographic variables between the groups. Results:, Gestational age was 39.6 ± 0.8 weeks in VD group vs. 38.7 ± 0.9 weeks in CS group, and birthweight was 3359 ± 494 vs. 3500 ± 528 g. Cord blood glucose concentration was higher in VD (81.3 ± 16.9 mg/dL) than CS infants (70.3 ± 9.7 mg/dL, p = 0.039). The change in blood glucose concentration over the first 2-h of life differed significantly between the two groups, being an increase in CS versus a decrease in VD infants (,3.5 ± 15.2 vs. ,15.4 ± 24.6 mg/dL, p = 0.013). Conclusions:, Glucose concentrations in VD infants are higher than in infants born by elective CS without labour. [source] Comparison of EML 105 and Advantage analysers measuring capillary versus venous whole blood glucose in neonatesACTA PAEDIATRICA, Issue 9 2001PJ McNamara Aim: Near-patient blood glucose monitoring is an essential component of neonatal intensive care but the analysers currently used are unreliable and inaccurate. The aim of this study was to compare a new glucose electrode-based analyser (EML 105) and a non-wipe reflectance photometry method (Advantage) as opposed to a recognized laboratory reference method (Hexokinase). We also investigated the effect of sample route and haematocrit on the accuracy of the glucose readings obtained by each method of analysis. Methods: Whole blood glucose concentrations ranging from 0 to 3.5mmol/l were carefully prepared in a laboratory setting and blood samples from each respective solution were then measured by EML 105 and Advantage analysers. The results obtained were then compared with the corresponding plasma glucose reading obtained by the Hexokinase method, using linear regression analysis. An in vivo study was subsequently performed on 103 neonates, over a 1-y period, using capillary and venous whole blood samples. Whole blood glucose concentration was estimated from each sample using both analysers and compared with the corresponding plasma glucose concentration estimated by the Hexokinase method. Venous blood was centrifuged and haematocrit was estimated using standardized curves. The effect of haematocrit on the agreement between whole blood and plasma glucose was investigated, estimating the degree of correlation on a scatterplot of the results and linear regression analysis. Results: Both the EML 105 and Hexokinase methods were highly accurate, in vitro, with small proportional biases of 2% and 5%, respectively. However, in vivo, both study analysers overestimated neonatal plasma glucose, ranging from at best 0.45 mmol/l (EML 105 venous) to 0.69 mmol/l (EML capillary). There was no significant difference in the agreement of capillary (GD = 0.12, 95% CI. {-0.32,0.08}, p= 0.2) or venous samples (GD = 0.05, 95% CI. {0.09, 0.19}, p= 0.49) with plasma glucose when analysed by either study method (GD = glucose difference between study analyser and reference method) However, the venous samples analysed by EML 105 estimated plasma glucose significantly better than capillary samples using the same method of analysis (GD = 0.24, 95% CI. {0.09, 0.38}, p < 0.01). The relationship between haematocrit and the resultant glucose differences was non-linear with correlation coefficients of r= -0.057 (EML 105 capillary), r= 0.145 (EML 105 venous), r= -0.127 (Advantage capillary) and r= -0.275 (Advantage venous). There was no significant difference in the effect of haematocrit on the performance of EML 105 versus Advantage, regardless of the sample route. Conclusion: Both EML 105 and Advantage overestimated plasma glucose, with no significant difference in the performance of either analyser, regardless of the route of analysis. Agreement with plasma glucose was better for venous samples but this was only statistically significant when EML 105 capillary and venous results were compared. Haematocrit is not a significant confounding factor towards the performance of either EML 105 or Advantage in neonates, regardless of the route of sampling. The margin of overestimation of blood glucose prohibits the recommendation of both EML 105 and Advantage for routine neonatal glucose screening. The consequences include failure accurately to diagnose hypoglycaemia and delays in the instigation of therapeutic measures, both of which may potentially result in an adverse, long-term, neurodevelopmental outcome. [source] Pregnancy and lactation have anti-obesity and anti-diabetic effects in Ay/a miceACTA PHYSIOLOGICA, Issue 2 2010E. N. Makarova Abstract Aim:, Dominant ,yellow' mutation at the mouse agouti locus (Ay) results in obesity. Pregnancy and lactation are characterized by large energy demand. The aim of this study was to investigate whether obesity would develop in pregnant and suckling Ay mice. Methods:, Body weight and food intake in pregnancy, lactation, and after weaning, plasma leptin, insulin, corticosterone and blood glucose concentrations on days 7, 13 and 18 of pregnancy, days 1, 10, 21 and 80 postpartum, glucose and insulin tolerance on pregnancy days 7 and 18 were measured in C57Bl/6J mice of a/a (normal metabolism) and Ay/a genotypes. The same parameters were also measured in age-matched virgin females. Results:, Virgin Ay/a females exhibited hyperphagia, enhanced body weight, glucose intolerance and normal blood parameters at the mating age. With age, they developed obesity, hyperleptinaemia, hyperinsulinaemia and hyperglycaemia. Obesity did not develop in mated Ay/a mice; during suckling, they had equal food intake and body weight as a/a mice. During pregnancy, glucose tolerance was enhanced in Ay/a mice and became equal in both genotypes. In both genotypes, concentrations of hormones increased, and glucose decreased from pregnancy day 7 to day 18 and returned to normal values after parturition. Ay/a mice did not differ from a/a in corticosterone, insulin and glucose levels during pregnancy and lactation, in leptin levels during suckling; however, Ay/a mice had two times higher leptin levels than a/a during pregnancy. After weaning, Ay/a mice began to eat and weigh more than a/a exhibiting normal metabolic parameters for 50 days. Conclusion:, Pregnancy and lactation retard obesity and diabetes development in Ay mice. [source] Active immunization against (Pro3)GIP improves metabolic status in high-fat-fed miceDIABETES OBESITY & METABOLISM, Issue 9 2010I. A. Montgomery Aim: Ablation of gastric inhibitory polypeptide (GIP) receptor signalling can prevent many of the metabolic abnormalities associated with dietary-induced obesity-diabetes. The present study was designed to assess the ability of active immunization against (Pro3)GIP to counter metabolic dysfunction associated with diet-induced obesity in high-fat-fed mice. Methods: Normal male Swiss NIH mice were injected (s.c.) once every 14 days for 98 days with complexed (Pro3)GIP peptide, with transfer to a high-fat diet on day 21. Results: Active immunization against (Pro3)GIP resulted in circulating GIP antibody production and significantly (p < 0.05 p < 0.01) reduced circulating blood glucose concentrations compared to high-fat control mice from day 84 onwards. Glucose levels were not significantly different from lean controls. The glycaemic response to i.p. glucose was correspondingly improved (p < 0.01) in (Pro3)GIP-immunized mice. Furthermore, circulating and glucose-stimulated plasma insulin levels were significantly (p < 0.01 to p < 0.001) depressed compared to high-fat control mice. Liver triglyceride, pancreatic insulin and circulating LDL-cholesterol levels were also significantly reduced in (Pro3)GIP-immunized mice. These changes were independent of any effects on food intake or body weight. The glucose-lowering effect of native GIP was annulled in (Pro3)GIP-immunized mice consistent with the induction of biologically effective GIP-specific neutralizing antibodies. Conclusion: These results suggest that immunoneutralization of GIP represents an effective means of countering the disruption of metabolic processes induced by high-fat feeding. [source] A method for assessing quality of control from glucose profilesDIABETIC MEDICINE, Issue 7 2007N. R. Hill Abstract Aim As the practice of multiple assessments of glucose concentration throughout the day increases for people with diabetes, there is a need for an assessment of glycaemic control weighted for the clinical risks of both hypoglycaemia and hyperglycaemia. Methods We have developed a methodology to report the degree of risk which a glycaemic profile represents. Fifty diabetes professionals assigned risk values to a range of 40 blood glucose concentrations. Their responses were summarised and a generic function of glycaemic risk was derived. This function was applied to patient glucose profiles to generate an integrated risk score termed the Glycaemic Risk Assessment Diabetes Equation (GRADE). The GRADE score was then reported by use of the mean value and the relative percent contribution to the weighted risk score from the hypoglycaemic, euglycaemic, hyperglycaemic range, respectively, e.g. GRADE (hypoglycaemia%, euglycaemia%, hyperglycaemia%). Results The GRADE scores of indicative glucose profiles were as follows: continuous glucose monitoring profile non-diabetic subjects GRADE = 1.1, Type 1 diabetes continuous glucose monitoring GRADE = 8.09 (20%, 8%, 72%), Type 2 diabetes home blood glucose monitoring GRADE = 9.97 (2%, 7%, 91%). Conclusions The GRADE score of a glucose profile summarises the degree of risk associated with a glucose profile. Values < 5 correspond to euglycaemia. The GRADE score is simple to generate from any blood glucose profile and can be used as an adjunct to HbA1c to report the degree of risk associated with glycaemic variability. [source] Relationship of glucose concentrations with PAI-1 and t-PA in subjects with normal glucose toleranceDIABETIC MEDICINE, Issue 8 2006P. E. Heldgaard Abstract Aims To study metabolic risk factors for the development of cardiovascular disease (CVD), including markers of the fibrinolytic system in relation to blood glucose levels in subjects with normal glucose tolerance and fasting blood glucose levels below 5.6 mmol/l. Methods Cross-sectional, community-based study from a primary health-care centre of adult subjects with normal glucose tolerance. Analysis of fasting and 2-h post-load blood glucose concentrations were centralized and related to anthropometric characteristics, metabolic variables, inflammatory markers, and coagulation and fibrinolytic variables. Results Increasing fasting blood glucose concentrations within the normal range in subjects with normal glucose tolerance were associated with increasing age, body mass index, and waist circumference, and with increasing concentrations of metabolic risk factors for development of CVD. After adjustment for gender, age, body mass index (BMI), and fasting insulin, levels of plasmin activator inhibitor (PAI-1) and tissue type plasminogen activator (t-PA) increased significantly with increasing levels of fasting glucose within the normal range (P = 0.012 and P < 0.0001, respectively). Conclusions We found risk factors for CVD, specifically key components of the fibrinolytic system, PAI-1 and t-PA, increased with increasing fasting glucose levels even in subjects with normal glucose tolerance. This observation may help to explain the increased risk of CVD with increasing values of fasting glucose in the normal range. [source] Potential use of insulin as an anti-inflammatory drugDRUG DEVELOPMENT RESEARCH, Issue 3 2008Paresh Dandona Abstract Acute hyperglycemia worsens morbidity and mortality in critically ill patients. The control of hyperglycemia with insulin improves clinical outcomes in patients with a stay of more than 3,5 days in the intensive care unit (ICU) and in coronary artery bypass graft (CABG) patients. However, clinical benefits of insulin infusion have not been seen consistently in patients with acute coronary syndromes. Since all previous studies in the ICU have centered on the normalization of glycemia, we still do not know whether insulin exerts beneficial effects over and above those observed with reduction of blood glucose concentrations. The regimens used in acute coronary syndromes infuse fixed doses of insulin with high rates of glucose and are usually associated with hyperglycemia; this may neutralize the beneficial effects of insulin. In this article, we discuss data demonstrating an anti-inflammatory effect of insulin and a pro-inflammatory effect of glucose. We provide a mechanistic justification for the benefits of maintaining euglycemia with insulin infusions in the hospitalized patients. To investigate the clinical benefits of the anti-inflammatory effects of insulin, we also suggest further investigations directed toward optimization of insulin infusion regimens to determine whether restoration of glucose levels toward normal with higher infusion rates and concentrations of insulin will lead to further improvement in outcomes in the critical care and acute coronary syndromes. Drug Dev Res 69:101,110, 2008 © 2008 Wiley-Liss, Inc. [source] ORIGINAL ARTICLE: Many patients with Type 1 diabetes estimate their prandial insulin need inappropriatelyJOURNAL OF DIABETES, Issue 3 2010Aila J. AHOLA Abstract Background:, Many factors contribute to the need for prandial insulin in Type 1 diabetes. However, patients' success in achieving normal postprandial glucose concentration is understudied. The aim of the present study was to determine how often patients with Type 1 diabetes achieve normal postprandial glucose concentrations and to evaluate factors associated with postprandial hypo- and hyperglycemia. Methods:, Data on food intake, physical activity, insulin administration, and blood glucose concentration were collected using a self-administered questionnaire from 331 patients with Type 1 diabetes (43% men; mean age 49 ± 12 years; mean diabetes duration 32 ± 13 years). Of these, 179 provided data on blood glucose concentrations measured 110,150 min postprandially. One such meal per patient was randomized for analyses. Results:, Hypoglycemia (<4.0 mmol/L), normoglycemia (4.0,7.9 mmol/L), and hyperglycemia (,8.0 mmol/L) were observed after 23%, 36%, and 41% of meals, respectively. The three postprandial glycemia groups did not differ with respect to the meal composition or the timing of the postprandial blood glucose measurement. In women, postprandial hyperglycemia was associated with shorter diabetes duration and higher preprandial blood glucose concentration, whereas postprandial hypoglycemia was associated with higher physical activity. No single factor explained the postprandial glycemic state in men. Conclusions:, A total of 64% of patients estimated their prandial insulin need inappropriately, suggesting that estimation of the optimal prandial insulin dose is not easy, even after a long duration of diabetes. [source] Hydroxypropylated Tapioca Starch Retards the Development of Insulin Resistance in KKAy Mice, a Type 2 Diabetes Model, Fed a High-Fat DietJOURNAL OF FOOD SCIENCE, Issue 7 2009Makoto Tachibe ABSTRACT:, The hypoglycemic and antidiabetic effect of hydroxypropyl tapioca starch (HPTS, degree of substitution = 0.180) was investigated in male KKAy mice. Mice were fed a purified high-fat (20%) diet without or with HPTS (5% or 10%) for 33 d. Gelatinized tapioca starch (TS) was used as a reference. Fasting blood glucose concentrations, days 14 and 28, were significantly lower in the 10% HPTS group compared with the reference. In an oral glucose tolerance test (OGTT), day 28, blood glucose concentrations in the 5% HPTS group, at 60, 90, and 120 min, and in the 10% HPTS group, at 30, 60, and 90 min after oral administration of glucose, were significantly lower compared with the reference. The area under the glucose curve (AUC) for glucose in both HPTS groups was significantly lower compared with the reference. Energy intake was significantly lower in the 10% HPTS group compared with the reference. At the end of the experiment, adiponectin concentrations were significantly higher in the 10% HPTS group compared with the reference. A homeostasis model assessment of insulin resistance (HOMA-IR) tended to be lower in the 10% HPTS group compared with the reference, whereas a quantitative insulin sensitivity check index (QUICKI) was significantly higher in both HPTS groups compared with the reference. These results show that HPTS retards the development of insulin resistance in KKAy mice fed a high-fat diet. [source] Hyperglycaemia and cardiovascular diseaseJOURNAL OF INTERNAL MEDICINE, Issue 2 2007M. Bartnik Abstract. Coronary artery disease and type 2 diabetes are chronic diseases of substantial and growing prevalence. Their coincidence is common, markedly enhancing mortality and morbidity. The risk for cardiovascular disease increases along a spectrum of blood glucose concentrations already apparent at levels regarded as normal. Accordingly, strategies for the early detection of glucometabolic disturbances are needed to find ways to prevent the occurrence of cardiovascular complications or to treat them already at an early stage. More specifically, abnormal glucose tolerance is almost twice as common amongst patients with a myocardial infarction as in population-based controls and a normal glucose regulation is indeed less common than abnormal glucose metabolism also amongst patients with stable coronary artery disease. Already an abnormal glucose tolerance is a strong risk factor for future cardiovascular events after an acute myocardial infarction. An oral glucose tolerance test should, therefore, be a part of the evaluation of total risk in all patients with coronary artery disease. As glucose disturbances are common and easy to detect, they may be suitable targets for novel secondary preventive efforts. [source] Model predictive control with learning-type set-point: Application to artificial pancreatic ,-cellAICHE JOURNAL, Issue 6 2010Youqing Wang Abstract A novel combination of model predictive control (MPC) and iterative learning control (ILC), referred to learning-type MPC (L-MPC), is proposed for closed-loop control in an artificial pancreatic ,-cell. The main motivation for L-MPC is the repetitive nature of glucose-meal-insulin dynamics over a 24-h period. L-MPC learns from an individual's lifestyle, inducing the control performance to improve from day to day. The proposed method is first tested on the Adult Average subject presented in the UVa/Padova diabetes simulator. After 20 days, the blood glucose concentrations can be kept within 68,145 mg/dl when the meals are repetitive. L-MPC can produce superior control performance compared with that achieved under MPC. In addition, L-MPC is robust to random variations in meal sizes within ±75% of the nominal value or meal timings within ±60 min. Furthermore, the robustness of L-MPC to subject variability is validated on Adults 1,10 in the UVa/Padova simulator. © 2009 American Institute of Chemical Engineers AIChE J, 2010 [source] | |||||||||||||||||||||||||||||||||||||