Displaying publications 481 - 500 of 740 in total

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  1. Azizan NA, Majid HA, Nahar Mohamed A, Su TT
    SAGE Open Med, 2020;8:2050312120960563.
    PMID: 33014371 DOI: 10.1177/2050312120960563
    Objective: To ascertain the effect of dietary practice modification and a peer-support home blood pressure monitoring program on the nutritional intake (macronutrients and micronutrients), blood pressure and biochemical profiles of hypertension patients in a low-income community setting.

    Methods: This is a pre- and post-measurement intervention study conducted in low-income community housing projects in Kuala Lumpur, Malaysia. A total of 90 participants aged 18 years and above with hypertension received intervention. The participants were divided into small groups and received instructions on the use of home blood pressure measurement. They also attended a series of talks on dietary intake modification and exercise demonstration for the first six months (active phase). In another 6 months (maintenance phase), they received only pamphlet and SMS reminders. Their anthropometry, blood pressure, dietary, and biochemical parameter changes were measured at baseline, 6 months, and 12 months of intervention.

    Results: Macronutrients and micronutrients showed a significant improvement at the end of 12-month dietary intervention. The energy, carbohydrate, protein, total fat, sodium, and potassium are showing significant reduction from baseline to end of the 12-month intervention. There is no significant reduction in blood pressure. Fasting blood glucose, renal sodium, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol showed a significant improvement, after controlling for age and reported physical activity.

    Conclusion: The intervention improved the nutritional intake and biochemical profiles of the low-income urban population with hypertension. This promising result should be replicated in a larger scale study.

    Matched MeSH terms: Blood Glucose
  2. Chin KY, Chan CY, Subramaniam S, Muhammad N, Fairus A, Ng PY, et al.
    Int J Med Sci, 2020;17(16):2585-2593.
    PMID: 33029101 DOI: 10.7150/ijms.49030
    Objectives: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that elevates the individual risk of cardiovascular diseases. These abnormalities are also known to alter bone remodelling. Therefore, MetS may be associated with osteoporosis. This study aims to determine the association between MetS and its components and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DXA) among Malaysians. Methods: 400 Malaysians aged ≥ 40 years (52.5% women) residing in Klang Valley, Malaysia, were recruited. Subjects' demographic and lifestyle details were collected using a questionnaire, and blood pressure and body anthropometry were measured. Subjects' lumbar spine and total hip BMD were measured by DXA. Their fasting blood was collected for blood glucose level and lipid profile analysis. Regression analysis was used to analyze the relationship between MetS or its components and BMD. Results: Subjects with MetS had higher BMD compared to subjects without MetS in models unadjusted for BMI (spine p=0.008; hip p<0.001). This difference was attenuated with BMI adjustment (spine p=0.625; hip p=0.478). Waist circumference was associated positively with BMD in models unadjusted for BMI (spine p=0.012; hip p<0.001), but the association became negative with BMI adjustment (spine p=0.044; hip p=0.021). Systolic blood pressure was associated positively with total hip BMD (p=0.019) but BMI adjustment attenuated the relationship (p=0.080). Triglyceride level was associated with osteoporosis in a fully adjusted model (p=0.001). Overall, MetS was associated with osteoporosis (p=0.019) but lifestyle (p=0.188) and BMI adjustment attenuated the relationship (p=0.904). Conclusion: MetS is positively associated with BMD, and this relationship is predominantly mediated by BMI. Although MetS is not a significant risk factor for osteoporosis, the inverse relationship between waist circumference, a marker of central obesity, and BMD highlights the need to prevent adiposity to improve metabolic and skeletal health.
    Matched MeSH terms: Blood Glucose
  3. Etminani R, Manaf ZA, Shahar S, Azadbakht L, Adibi P
    Int J Prev Med, 2020;11:113.
    PMID: 33088441 DOI: 10.4103/ijpvm.IJPVM_274_19
    Background: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. Therefore, we sought to determine the most important predictors of NAFLD among middle-aged men and women in Isfahan, Iran.

    Methods: A total of 413 individuals (163 men and 250 women) aged 30-60 years were selected by stratified random sampling. The participants had safe alcohol consumption habits (<2 drinks/day) and no symptoms of hepatitis B and C. NAFLD was diagnosed through ultrasound. Blood pressure, anthropometric, and body composition measurements were made and liver function tests were conducted. Biochemical assessments, including the measurement of fasting blood sugar (FBS) and ferritin levels, as well as lipid profile tests were also performed. Metabolic syndrome was evaluated according to the International Diabetes Federation (IDF) criteria.

    Results: The overall prevalence of ultrasound-diagnosed NAFLD was 39.3%. The results indicated a significantly higher prevalence of NAFLD in men than in women (42.3% vs 30.4%; P < 0.05). Binary logistic regression analysis was performed to determine the significant variables as NAFLD predictors. Overall, male gender, high body mass index (BMI), high alanine aminotransferase (ALT), high FBS, and high ferritin were identified as the predictors of NAFLD. The only significant predictors of NAFLD among men were high BMI and high FBS. These predictors were high BMI, high FBS, and high ferritin in women (P < 0.05 for all variables).

    Conclusions: The metabolic profile can be used for predicting NAFLD among men and women. BMI, FBS, ALT, and ferritin are the efficient predictors of NAFLD and can be used for NAFLD screening before liver biopsy.

    Matched MeSH terms: Blood Glucose
  4. Mediani A, Abas F, Maulidiani M, Abu Bakar Sajak A, Khatib A, Tan CP, et al.
    J Physiol Biochem, 2018 May 15.
    PMID: 29766441 DOI: 10.1007/s13105-018-0631-3
    Diabetes mellitus (DM) is a chronic disease that can affect metabolism of glucose and other metabolites. In this study, the normal- and obese-diabetic rats were compared to understand the diabetes disorders of type 1 and 2 diabetes mellitus. This was done by evaluating their urine metabolites using proton nuclear magnetic resonance (1H NMR)-based metabolomics and comparing with controls at different time points, considering the induction periods of obesity and diabetes. The biochemical parameters of the serum were also investigated. The obese-diabetic model was developed by feeding the rats a high-fat diet and inducing diabetic conditions with a low dose of streptozotocin (STZ) (25 mg/kg bw). However, the normal rats were induced by a high dose of STZ (55 mg/kg bw). A partial least squares discriminant analysis (PLS-DA) model showed the biomarkers of both DM types compared to control. The synthesis and degradation of ketone bodies, tricarboxylic (TCA) cycles, and amino acid pathways were the ones most involved in the variation with the highest impact. The diabetic groups also exhibited a noticeable increase in the plasma glucose level and lipid profile disorders compared to the control. There was also an increase in the plasma cholesterol and low-density lipoprotein (LDL) levels and a decline in the high-density lipoprotein (HDL) of diabetic rats. The normal-diabetic rats exhibited the highest effect of all parameters compared to the obese-diabetic rats in the advancement of the DM period. This finding can build a platform to understand the metabolic and biochemical complications of both types of DM and can generate ideas for finding targeted drugs.
    Matched MeSH terms: Blood Glucose
  5. Mustapha Umar Imam, Sasikala M. Chinnappan, Maznah Ismail
    Sains Malaysiana, 2017;46:589-595.
    There is growing interest in the use of plant bioresources for managing type 2 diabetes. In this study, Rhodamnia cinerea, which is used traditionally to manage diseases in Malaysia, was explored for its antidiabetic effects. Type 2 diabetic rats were managed for 4 weeks using aqueous extract of R. cinerea or quercetin. Weights and fasting glucose were measured weekly, while serum lipid profiles, insulin, antioxidant status, urea, creatinine and liver enzymes were assayed at the end. Sorbitol contents, antioxidant capacities and aldose reductase activities of the kidney, lens and sciatic nerve were also assessed. The results showed that the aqueous extract of R. Cinerea mainly contained Myricitrin and it reduced glycemia (p>0.05), lipid profiles (p<0.05), F2-isoprostanes (p<0.05) and overall metabolic condition of type 2 diabetic rats. R. cinerea also attenuated sorbitol contents of the nerve (p<0.05) and kidney (p<0.05), partly through regulating the activity of aldose reductase (p<0.05 for nerve) and sorbitol dehydrogenase (p<0.05 for kidney) in comparison with diabetic untreated group. Quercetin is a known aldose reductase inhibitor and can improve several metabolic indices related to Type 2 diabetes. In this study, the results of R. cinerea were comparable to or better than those of quercetin, suggesting that R. cinerea extract can be a good candidate for managing Type 2 diabetes and its complications related to sorbitol accumulation.
    Matched MeSH terms: Blood Glucose
  6. Mudassir J, Darwis Y, Muhamad S, Khan AA
    Int J Nanomedicine, 2019;14:4895-4909.
    PMID: 31456636 DOI: 10.2147/IJN.S199507
    Introduction: Insulin is given by injection, because when administered orally, it would be destroyed by enzymes in the digestive system, hence only about 0.1% reaches blood circulation. The purpose of the present study was to use pH sensitive polyelectrolyte methyl methacrylate (MMA)/itaconic acid (IA) nanogels as carriers in an attempt to improve absorption of insulin administered orally. Methods: Insulin (Ins) was incorporated into the MMA/IA nanogels (NGs) using the polyelectrolyte complexation (PEC) method to form Ins/NGs-PEC. Several parameters, including Ins:NGs ratio, pH, incubation time and stirring rate were optimized during preparation of InsNGs-PEC. The prepared formulations were characterized in terms of particle size (PS), polydispersity index (PdI), zeta potential (ZP) and percent entrapment efficiency (% EE). Results: The optimized InF12 nanogels had a PS, PdI, ZP and %EE of 190.43 nm, 0.186, -16.70 mV and 85.20%, respectively. The InF12 nanogels were lyophilized in the presence of different concentrations of trehalose as cryoprotectant. The lyophilized InF12 containing 2%w/v trahalose (InF12-Tre2 nanogels) was chosen as final formulation which had a PS, PdI, ZP and %EE of 430.50 nm, 0.588, -16.50 mv and 82.10, respectively. The in vitro release of insulin from InF12-Tre2 nanogels in the SGF and SIF were 28.71% and 96.53%, respectively. The stability study conducted at 5±3°C for 3 months showed that lnF12-Tre2 nanogels were stable. The SDS-PAGE assay indicated that the primary structure of insulin in the lnF12-Tre2 nanogels was intact. The in-vivo study in the diabetic rats following oral administration of InF12-Tre2 nanogels at a dose of 100 IU/kg body weight reduced blood glucose level significantly to 51.10% after 6 hours compared to the control groups. Conclusions: The pH sensitive MMA/IA nanogels are potential carriers for oral delivery of insulin as they enhanced the absorption of the drug.
    Matched MeSH terms: Blood Glucose
  7. Ng AWR, Loh KK, Gupta N, Narayanan K
    Clin Nutr ESPEN, 2019 10;33:39-41.
    PMID: 31451273 DOI: 10.1016/j.clnesp.2019.07.014
    BACKGROUND & AIMS: Consumption of sugars in food and beverages has increased at an alarming rate. While excessive daily sugar intake has been well-associated as the onset of medical complications, additional sugars are still used in manufactured food products just to satisfy the consumers' needs. Hence, there is a need to develop sugar replacers that have low glycemic response without compromising the organoleptic characteristics of food products. This study aimed to determine if SUITENA™, a novel sweetener containing erythritol, xylitol, and Stevia, has low glycemic response upon consumption by human subjects.

    METHODS: Six human subjects were randomly chosen and were healthy at the point of experimentation. Capillary blood was collected via finger-prick method to monitor the glycemic response of every individual for 90 min after ingestion of sugar solution.

    RESULTS: It was found that the mean area under the curve (AUC) of the dextrose standard was 11.8-fold higher (p blood glucose level for up to 90 min while a spike in blood glucose level was observed from 15 min post-consumption of dextrose solution. We found that SUITENA™ has elicited a glycemic response 8% relative to the standard. Such low glycemic response has been reported by studies on other novel sugars.

    CONCLUSION: This preliminary finding suggested that SUITENA™ is a healthier alternative to fast sugars due to its low glycemic response. A larger sampling size is required to confirm the results.

    Matched MeSH terms: Blood Glucose
  8. Ng YL, Teoh SH, Mohd Radzniwan AR, Syahnaz MH
    J Taibah Univ Med Sci, 2019 Feb;14(1):88-94.
    PMID: 31435395 DOI: 10.1016/j.jtumed.2018.12.002
    Objectives: Undiagnosed glycaemic disorders remain a major health concern as in such cases the opportunity for early interventions that can potentially prevent complications is missed. Erectile dysfunction (ED) has been suggested as a predictor for glycaemic disorders in men. However, data on men with ED having undiagnosed glycaemic disorders is limited, especially in the Malaysian context. This study aimed to identify prevalence and associated factors of undiagnosed glycaemic disorders in men with ED.
    Methods: We applied a cross-sectional purposive sampling technique on a group of 114 men with ED without underlying glycaemic disorders. They underwent a 2-h oral glucose tolerance test and the cases were then classified into two groups: normal and undiagnosed glycaemic disorders groups. The glycaemic disorders group consisted of patients with diabetes mellitus (DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG). The patients were interviewed, and their medical records were reviewed for their sociodemographic and clinical profiles.
    Results: Prevalence of undiagnosed glycaemic disorders in men with ED was 41.2%. Higher age (adjusted OR = 1.10, 95% CI: 1.03, 1.17, p = 0.002) and BMI (adjusted OR = 1.16, 95% CI: 1.05, 1.29, p = 0.003) were found to be significantly associated with undiagnosed glycaemic disorders.
    Conclusion: This study found that men with ED had a high prevalence of undiagnosed glycaemic disorders. ED was associated with advancing age and higher BMI. Further research to validate the findings of this study is needed to increase the prevalence of DM screening among men with ED.
    Study site: Klinik Kesihatan Kajang, Selangor, Malaysia
    Matched MeSH terms: Blood Glucose
  9. Huan, Nai Chien, Wan Awatif Wan Mohd Zohdi
    MyJurnal
    High anion gap metabolic acidosis (HAGMA) is a hallmark of Diabetic Ketoacidosis (DKA). Occasionally, a Normal Anion Gap Metabolic Acidosis (NAGMA) can be seen, especially during the treatment phase. In this case report, a 55-year-old lady with diabetes mellitus who presented with a 2-day history of fever, lethargy and multiple episodes of vomiting and diarrhoea. Initial laboratory investigations revealed: capillary blood glucose as 27 mmol/L, urine ketone as 3+, blood ketone as 3.5 mmol/L, serum bicarbonate as 14 mmol/L, and serum chloride as 95 mmol/L. She was treated with intravenous normal saline fluid resuscitation and constant rate insulin infusion which was fortunately accompanied by stabilization of blood glucose and normalization of blood ketone to 0.2 mmol/L. However, despite normalization of her anion gap (25 to 14), she remained unwell with acidotic breathing due to refractory hyperchloraemic NAGMA with bicarbonate at 11 mol/L and chloride of 112 mmol/L. It was then decided to administer 100 mL of 8.4% Sodium Bicarbonate solution. The next day, she was no longer tachypneic as her bicarbonate and carbon dioxide improved to 21 mmol/L and 32 mmHg respectively. The presence of NAGMA in DKA should prompt clinicians to conduct a thorough search for possible underlying causes, such as gastrointestinal fluid loss, sepsis and chloride load from aggressive fluid resuscitation with normal saline. Sodium bicarbonate should only be considered in intractable cases to correct a NAGMA and not routinely used in the treatment of DKA.
    Matched MeSH terms: Blood Glucose
  10. Sang C, Yan H, Chan WK, Zhu X, Sun T, Chang X, et al.
    Front Med (Lausanne), 2021;8:637652.
    PMID: 33708783 DOI: 10.3389/fmed.2021.637652
    Non-alcoholic fatty liver disease (NAFLD) is one of the main causes of fibrosis. Liver biopsy remains the gold standard for the confirmation of fibrosis in NAFLD patients. Effective and non-invasive diagnosis of advanced fibrosis is essential to disease surveillance and treatment decisions. Herein we used routine medical test markers and logistic regression to differentiate early and advanced fibrosis in NAFLD patients from China, Malaysia, and India (n1 = 540, n2 = 147, and n3 = 97) who were confirmed by liver biopsy. Nine parameters, including age, body mass index, fasting blood glucose, presence of diabetes or impaired fasting glycemia, alanine aminotransferase, γ-glutamyl transferase, triglyceride, and aspartate transaminase/platelet count ratio, were selected by stepwise logistic regression, receiver operating characteristic curve (ROC), and hypothesis testing and were used for model construction. The area under the ROC curve (auROC) of the model was 0.82 for differentiating early and advanced fibrosis (sensitivity = 0.69, when specificity = 0.80) in the discovery set. Its diagnostic ability remained good in the two independent validation sets (auROC = 0.89 and 0.71) and was consistently superior to existing panels such as the FIB-4 and NAFLD fibrosis score. A web-based tool, LiveFbr, was developed for fast access to our model. The new model may serve as an attractive tool for fibrosis classification in NAFLD patients.
    Matched MeSH terms: Blood Glucose
  11. Nurul Salwana Abu Bakar, Jabrullah Abdul Hamid, Sharifah Zawani Syed Ahmad Yunus, Nurul Syarbani Eliana Musa, Roslinda Abu Sapian, Nur Hidayati Abdul Halim, et al.
    MyJurnal
    Introduction: Electronic medical records from hospital information system (HIS) offer a major potential for secondary data analysis which can improve the efficiency of healthcare delivery. This study describes an initiative to use HIS data to explore the level of diabetic care in patients with T2DM in a hospital-based outpatient clinic, the advantages and challenges in utilising HIS data. Methods: Patients age of 18 and above who received any diabetes medication in 2013 were retrospectively identified from HIS of Serdang Hospital. Demographic characteristics, anti-diabetic agent (ADA) dispensed, and glycaemic measures were quantified. Data was extracted using structured query lan- guage (SQL) and descriptive statistical analyses were conducted using Stata Version 12. Results: Prevalence of T2DM patients in the hospital was 7.5%. Male had slightly higher prevalence and patient at age of 61-70 years old. About 62% of patients were prescribed with metformin and 5% of newer combination of oral hypoglycemic agent. In pre- scribing pattern, stratification by age group, showed that patient age 41 to 70 years received mostly monotherapy, whilst 61.1% continue their regime for the year. Only 18% obtained good glycaemic control. Conclusion: Hospital Information system is a critical instrument in providing data as a platform in diabetic care in an outpatient care. Moving forward, steps to improve HIS should be taken to seize its potential as a tool to increase the efficiency of healthcare delivery.
    Matched MeSH terms: Blood Glucose
  12. Syukri Y, Taher M, Martien R, Lukitaningsih E, Nugroho AE, Zakaria ZA
    Adv Pharm Bull, 2021 Jan;11(1):171-180.
    PMID: 33747864 DOI: 10.34172/apb.2021.018
    Purpose:
    Insulin resistance is a characteristic of non-insulin-dependent diabetes mellitus associated with obesity and caused by the failure of pancreatic beta cells to secrete sufficient amount of insulin. Andrographolide (AND) improves beta-cell reconstruction and inhibits fat-cell formation. This research aimed to improve the delivery of water-insoluble AND in self-nanoemulsifying (ASNE) formulation, tested in streptozotocin (STZ)-induced diabetic rats and 3T3-L1 preadipocyte cells.
    Methods:
    A conventional formulation of AND in suspension was used as a control. The experimental rats were orally administered with self-nanoemulsifying (SNE) and suspension of AND for 8 days. Measurements were performed to evaluate blood glucose levels in preprandial and postprandial conditions. Immunohistochemistry was used to assess the process of islet beta cell reconstruction. In vitro study was performed using cell viability and adipocyte differentiation assay to determine the delivery of AND in the formulation.
    Results:
    ASNE lowered blood glucose levels (day 4) faster than AND suspension (day 6). The histological testing showed that ASNE could regenerate pancreatic beta cells. Therefore, ASNE ameliorated pancreatic beta cells. The in vitro evaluation indicated the inhibition of adipocyte differentiation by both AND and ASNE, which occurred in a time-dependent manner. ASNE formulation had better delivery than AND.
    Conclusion:
    ASNE could improve the antidiabetic activity by lowering blood glucose levels, enhancing pancreatic beta cells, and inhibiting lipid formation in adipocyte cells.
    Matched MeSH terms: Blood Glucose
  13. Nawaz MS, Nawaz MS, Shah KU, Mustafa ZU, Ahmed A, Sajjad Ahmed H, et al.
    Diabetes Metab Syndr, 2021 Feb 13;15(2):525-528.
    PMID: 33668002 DOI: 10.1016/j.dsx.2021.02.013
    BACKGROUND AND AIMS: Restless legs syndromes (RLS) are intrinsic sleeping disorder and its prevalence rate is 10-15% in general population but it is observed that prevalence rate is different in diabetes patients. Current study aims to find prevalence and determinants of RLS in people living with type 2 diabetes mellitus in Pakistan.

    METHOD: A multicenter cross-sectional observational study was conducted in 388 diabetes patients attending daily diabetes clinics and teaching hospitals in Pakistan's twin city between August 2019 and February 2020. The chi-square test and linear regression were used to detect RLS-related factors in type 2 diabetes mellitus.

    RESULTS: The prevalence of RLS found was; 3.1% patients with diabetes were suffering from very severe RLS, 23.5% from severe RLS, 34% from moderate RLS, 21.1% from mild RLS and 18.3% from non-RLS. Gender, age, education, blood glucose fasting (BSF), blood glucose random (BSR) and HBA1c were found to be significant predictors of RLS in patients with diabetes.

    CONCLUSION: Policy makers can develop local interventions to curb the growing RLS prevalence by keeping in control the risk factors of RLS in people living with type 2 diabetes.

    Matched MeSH terms: Blood Glucose
  14. Linoby, Adam, Muhammad Alif Nazrin Jumat, Ahmad Safwanudin Nordin, Nur Hidayah Asilah Za’don, Jamiaton Kusrin, Sharifah Maimunah Syed Mud Puad
    MyJurnal
    High-intensity exercise acutely improves suppression of appetite in populations with normal body mass index (BMI). However, whether moderate intensity exercise (MIE) and high-intensity exercise (HIE) can elicit similar (or greater) appetite suppression effects for obese populations are still relatively unknown. The main aim is to investigate the acute effects of MIE and HIE on the appetite score, eating behaviour and blood glucose regulation among the obese population. Twelve obese participants (age: 20.8 ± 1 yr, BMI: 34.1 ± 3 kg·m-2, V̇o2max: 30.7 ± 3 ml·kg·min-1) were randomly allocated, in a crossover manner, with a 7-day interval in between (1) MIE (cycling at 60-75% HRmax), (2) HIE (cycling at 80-95% HRmax, 8-sec sprint x 12 sec rest) and (3) control (CON) condition after a 10-hr overnight fast. Physiological (fasting blood [glucose] and 24-hr calorie intake) and psychological responses (Three Factor Eating Questionnaire-R18, TFEQ-R18, and appetite score using Visual Analog Scale, VAS) were recorded prior to and after exercise interventions. Both MIE and HIE significantly reduced the calorie intake compared to CON (P0.05). A difference was found in fasting blood [glucose] level between trials in MIE (P0.05). In response to acute intervention, both MIE and HIE improved some psychological appetite score and attenuated daily energy consumption; these positive effects could benefit obese and diabetic populations.
    Matched MeSH terms: Blood Glucose
  15. Haliza, A.M., Roslan Johari, M.G., Badrulnizam, M., Rosidah, S.S., Teng, S.C., Saiful Safuan, M.S., et al.
    MyJurnal
    Diabetes mellitus is a chronic disorder with many vascular complications, leading to significant morbidity and mortality. The prevalence of Type 2 diabetes mellitus in Malaysia has risen dramatically from 6.3% (NHMS 1 in 1986); to 8.3% (NHMS 2 in 1996); and to 14.9% (NHMS 3 in 2006). An audit was conducted on patient's medical records from selected MOH health facilities to assess the control of diabetes using HbA1c. The response rate was 69.6% and the control of diabetes was poor. Only 18.4% of patients with valid HbA1c had value less than 6.5%. This is notably worst amongst patients from younger age groups. Many recommended investigations such as fundoscopy and urine microalbumin had not been done regularly. Efforts to look for various vascular complications were under-reported. About 45% of patients had been treated with 2 oral antidiabetic agents; mainly the sulphonylureas and the biguanides. Only 13.3% of patients were on insulin despite having poorly controlled disease. There is an urgent need to improve the management of diabetes mellitus in these areas:- (i) improving the glycemic control status (particularly among younger diabetic patients) with early and optimal use of oral diabetic drugs and insulin; (ii) stringent monitoring of glycemic control with adequate funds for regular performance of HbA1c (at least every 6 monthly for all diabetic patients) (iii) organizing regular updates or interactive programme for diabetes healthcare providers from primary, secondary and tertiary care; (iv) ensuring regular and prompt review of diabetic complications so that the complications can be dealt with early; (v) producing more diabetes educators to strengthen and standardize the diabetes education programme; and promote patients adherence to non-pharmacological and pharmacological interventions.
    Matched MeSH terms: Blood Glucose
  16. Kochuieva M, Psarova V, Ruban L, Kyrychenko N, Alypova O, Matlai O, et al.
    Wiad Lek, 2019 Aug 31;72(8):1484-1498.
    PMID: 32003208
    Introduction: The metabolic syndrome is one of the most discussed cross-disciplinary problems of modern medicine. Now there are various definitions and criteria of diagnostics of metabolic syndrome. The abdominal obesity is considered the main component of the metabolic syndrome, as a reflection of visceral obesity which degree is offered to be estimated on an indirect indicator – a waist circumference. Alongside with abdominal obesity, a number of classifications distinguish insulin resistance (IR) as a diagnostic criterion of metabolic syndrome. It is proved that IR is one of the pathophysiological mechanisms influencing the development and the course of arterial hypertension (AH), type 2 DM and obesity. There are two components in the development of IR: genetic (hereditary) and acquired. In spite of the fact that IR has the accurate genetic predisposition, exact genetic disorders of its appearance have not been identified yet, thus demonstrating its polygenic nature.

    The aim: To establish possible associations of the insulin receptor substrate-1 (IRS-1) gene polymorphism with the severity of the metabolic syndrome components in patients with arterial hypertension (AH).

    Material and methods: 187 patients with AH aged 45-55 years and 30 healthy individuals. Methods: anthropometry, reactive hyperemia, color Doppler mapping, biochemical blood analysis, HOMA-insulin resistance (IR), glucose tolerance test, enzyme immunoassay, molecular genetic method.

    Results: Among hypertensive patients, 103 had abdominal obesity, 43 - type 2 diabetes, 131 - increased blood triglycerides, 19 - decreased high density lipoproteins, 59 - prediabetes (33 - fasting hyperglycemia and 26 - impaired glucose tolerance), 126 had IR. At the same time, hypertensive patients had the following distribution of IRS-1 genotypes: Gly/Gly - 47.9%, Gly/Arg - 42.2% and Arg/Arg - 10.7%, whereas in healthy individuals the distribution of genotypes was significantly different: Gly/Gly - 86.8% (p <0.01), Gly/ Arg - 9.9% (p <0.01) and Arg/Arg - 3.3% (p <0.05). Hypertensive patients with Arg/Arg and Gly/Arg genotypes had significantly higher HOMA-IR (p <0.01), glucose, insulin and triglycerides levels (p <0.05), than in Gly/Gly genotype. At the same time, body mass index, waist circumference, blood pressure, adiponectin, HDL, interleukin-6, C-reactive protein, degree of endothelium-dependent vasodilation, as well as the frequency of occurrence of impaired glucose tolerance did not significantly differ in IRS-1 genotypes.

    Conclusions: In hypertensive patients, the genetic polymorphism of IRS-1 gene is associated with such components of the metabolic syndrome as hypertriglyceridemia and fasting hyperglycemia; it is not associated with proinflammatory state, endothelial dysfunction, dysglycemia, an increase in waist circumference and decrease in HDL.

    Matched MeSH terms: Blood Glucose
  17. Nurul-Alia Samiun, Barakatun-Nisak Mohd Yusof, Irmi Zarina Ismail, Norfarhana Mohd Anuar, Winnie Chee Siew Swee
    MyJurnal
    Introduction: Optimal nutritional status is of utmost importance not only for foetal
    development but also to maintain normoglycemia in women with gestational diabetes mellitus
    (GDM). This cross-sectional study described the nutritional status of women with GDM and
    explored whether self-reported nutrition education (NEd) exposure before a GDM diagnosis
    would be able to promote better nutrition status. Methods: GDM women (n= 60; age= 31.6 ±
    5.0 years) diagnosed between 13th and 28th week of gestation participated in the study. We
    assessed nutritional status that included anthropometric and blood pressure assessments,
    biochemical data, and dietary intake. The respondents self-reported their NEd exposure before
    a GDM diagnosis was made. Results: The pre-pregnancy BMI of the participants was 27.9 ±
    6.8 kg/m2
    , which was categorised as overweight. Total (4.3 ± 5.6 kg) and rate (0.2 ± 0.3
    kg/week) of gestational weight gain were within the recommendations. Glycemic parameters
    and blood pressure were also within the normal range. Nevertheless, they had high intakes of
    fat (35.5%) and sugar (14.4%) proportionate to their energy intake. They did not meet the
    recommended nutrient intakes for fibre, calcium, and iron. Only 28.3% of women had prior
    NEd exposure. Among them, almost all (94.1%) had recurrent GDM. Those with NEd
    exposure had lower pre-prandial blood glucose profiles, systolic blood pressure, and
    proportion of protein intake from energy than those without (p< 0.05). Conclusions:
    Suboptimal maternal nutritional status and low exposure to NEd are evident in women with
    GDM. Those with self-reported NEd exposure had better parameters of nutritional status. The
    findings recognised the need of having proper nutrition education for women who are at high
    risk of GDM since at early pregnancy.
    Matched MeSH terms: Blood Glucose
  18. Cao W, Chen X, Chin Y, Zheng J, Lim PE, Xue C, et al.
    J Food Biochem, 2021 Apr 04.
    PMID: 33817806 DOI: 10.1111/jfbc.13686
    Natural compounds have tremendous potential to regulate glucose metabolism, but conventional methods for studying their bioactivities are usually labor intensive. Here, hypoglycemic properties in 22 selected food-derived compounds were examined using molecular docking. The results indicated that curcumin is an inhibitor of both α-glucosidase and dipeptidyl-peptidase 4 (DPP-4), which are important for glycemic control. These effects of curcumin were also confirmed by enzymatic determination in vitro. Furthermore, curcumin significantly improved diet-induced hyperglycemia (e.g., fasting plasma glucose levels and glycogen storage in muscle or liver) in mice. This might be attributed to its inhibitory effects on the activities of α-glucosidase and DPP-4 in vivo. Curcumin also upregulated the expression of genes (e.g., glucagon-like peptide 1) related to DPP-4 activity in the small intestine. In conclusion, curcumin is a potential ingredient of functional foods used for diet-induced hyperglycemia management. PRACTICAL APPLICATIONS: Curcumin has been widely used as a colorant in the food industry. Moreover, a growing number of studies have described its diverse biological functions, such as anti-inflammatory, anti-oxidant, and anti-angiogenic activities. Thus, curcumin is regarded as a potential ingredient in functional foods. Our results highlighted the hyperglycemic effect of curcumin, suggesting that curcumin may be included in food products for hyperglycemic patients.
    Matched MeSH terms: Blood Glucose
  19. Ibraheem ZO, Farhan SS, Al Sumaidaee A, Al Sufi L, Bashir A, Balwa A, et al.
    Toxicol Res, 2021 Apr;37(2):221-235.
    PMID: 33868979 DOI: 10.1007/s43188-020-00059-w
    Metabolic syndrome is one of the major risk factors that lead to various serious complications like cardiovascular abnormalities, hyperlipidemia and diabetes. Its co-incidence with other organs dysfunction results in further deterioration of the condition or precipitation of other dysfunctions. This study aimed at studying the changes in the hepatic functions after the co-incidence of the high fat or fructose diets induced metabolic syndrome along with the gentamicin induced nephrotoxicity. Briefly, six groups of male Sprague Daley rats (n = 10-12) were fed with different feeding protocols; viz; standard rodent's chow, an experimental high fat or high fructose diets feedings. For each, two groups were allocated that one of them was injected with normal saline and the other with 80 mg/kg/day I.P gentamicin during the last 24 days of the feeding period. The rats were monitored for changes in the metabolic data, glycemic control, lipid profile, renal and hepatic functions, oxidative stress and the inflammatory response. The study revealed stronger hepatic changes in the renal failure groups fed with the high fat diet rather than that in the groups fed with the high fructose diet. Although, the latter experienced a stronger deterioration in the glycemic control. The study suggests that the incidence of the hepatic changes is more linked to the incidence of the deterioration in the lipids profile that was observed after the high fat diet feeding. Overall, the co-incidence of the high fat diet induced metabolic syndrome along with the renal failure constitutes a risk factor for the hepatic dysfunction.
    Matched MeSH terms: Blood Glucose
  20. Abu NA, Lim CB, Nor NSM
    Clin Pediatr Endocrinol, 2021;30(2):93-97.
    PMID: 33867669 DOI: 10.1297/cpe.30.93
    Mauriac syndrome is a rare and underdiagnosed complication of type 1 diabetes mellitus (T1DM). It is characterized by growth retardation, delayed puberty, Cushingoid features, hepatomegaly, and increased transaminase levels. The term glycogenic hepatopathy has been used to describe patients with poorly controlled T1DM and glycogen overload in the hepatocytes but without all the features of Mauriac syndrome. Although rare, glycogenic hepatopathy is reported to be the main cause of hepatomegaly in young patients with T1DM. We report two cases of glycogenic hepatopathy in children with poorly controlled T1DM. Both children had hepatomegaly, elevated liver enzyme levels, and elevated lactate levels. A liver biopsy confirmed the diagnosis of glycogenic hepatopathy in both patients. In conclusion, hepatomegaly with elevated liver enzymes, negative infective and metabolic screenings and persistently elevated plasma lactate levels should raise the suspicion of glycogenic hepatopathy in poorly controlled T1DM. Early diagnosis and improvement in glycemic control are the mainstays of treatment, which can prevent long-term complications.
    Matched MeSH terms: Blood Glucose
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