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  1. Siti Balkis Budin, Hawa Ismail, Pek LC
    Sains Malaysiana, 2013;42:707-713.
    Abundant natural products with medicinal properties have been used as food and traditional medicine for diabetes mellitus all over the world. Psidium guajava fruit from the family of Myrtaceae has gained attention for its antioxidant potential. This study was conducted to determine the effects of P. guajava fruit peel aqueous extract on oxidative stress of pancreas in streptozotocin-induced (45 mg/kg) diabetic rats. Diabetic rats were administered with 400 mg/kg of aqueous extract of P. guajava fruit peel daily for 28 days duration. The results showed that diabetic rats supplemented with P. guajava extract did not cause significant difference in blood glucose level (p>0.05) as compared with diabetic rats alone. For oxidative stress evaluation, malondialdehyde (MDA) and protein carbonyl level were significantly lower and the activity of superoxide dismutase (SOD) and glutathione (GSH) level were significantly higher (p<0.05) in P. guajava supplemented rats compared with non-supplemented diabetic rats. However, histological observation showed that supplementation of P. guajava extract did not give protective effects towards alterations in pancreas histology in diabetic rats. The findings suggested that aqueous extract of P. guajava fruit peel supplementation has the ability to reduce oxidative stress in pancreas of diabetic rats and may play a role in reducing the development of diabetic complications.
    Matched MeSH terms: Blood Glucose
  2. Hasimah Ismail, Mohd Azahadi Omar, Tahir Aris, Rashidah Ambak, Mohammad Fadhli Mohd Yusoff, Lim, Kuang Kuay, et al.
    Int J Public Health Res, 2016;6(1):677-684.
    MyJurnal
    Introduction The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide
    and many of these affected individuals remain unidentified. Undiagnosed
    T2DM may impose substantial public health implications because these
    individuals remain untreated and at risk for complications. The objective of
    this study was to determine the national prevalence of undiagnosed T2DM
    and to identify the associated risk factors.

    Methods A nationwide cross-sectional study was conducted involving 17,783
    respondents. Two-stage stratified sampling design was used to select a
    representative sample of the Malaysian adult population. Structured
    validated questionnaires with face to face interviews were used to obtain
    data. Respondents, who claimed that they were not having diabetes, were
    then asked to perform a fasting blood glucose finger-prick test by Accutrend
    GC machine.

    Results The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest
    percentage of undiagnosed T2DM was found among males (10.2%), 55-59
    years old (13.4%), highest education attainers of primary school (11.1%),
    Indians (10.3%), married (10.3%), working (8.9%) and living in the urban
    areas (9.2%). Multivariate analyses showed that factors associated with
    undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity
    and hypertension.

    Conclusion This study found an increasing trend of undiagnosed T2DM in Malaysia
    compared to 2006. This finding is alarming as risk factors associated with
    undiagnosed diabetes were related to most of the socio-demographic factors
    studied. Therefore, early diabetic screening is crucial especially among adults
    aged 30 and above to prevent more serious complications of this disease.
    Matched MeSH terms: Blood Glucose
  3. Samat, S., Mohd Nor, N., Hussein, F. N., Eshak, Z., Ismail, W. I. W.
    MyJurnal
    The study was carried out to evaluate short-term administration of Gelam honey. A single oral
    administration of the honey at a dose of 5000 mg/kg body weight on male Sprague Dawley rats
    (test group) for 14 days did not produce any signs of toxicity, behavioral changes, mortality, changes on gross appearance or histopathological changes of internal organs. The examinations
    of signs, animal behavior and health monitoring showed no abnormalities in the test group as
    compared to the rats unfed with the honey (control group). The test group had progressive increased both body weight and in the meal pattern analysis. However, triglycerides level was found significantly decreased in the test group. It suggested that the honey might have a decent effect in controlling the blood triglyceride level. Polyphenol contents in the honey may play the role to reduce the trigyceride level. Biochemical test for aspartate aminotransferase (AST), alanine transaminase (ALT), urea, creatinine, cholesterol and glucose of rats in the test group were in the normal range compared to the control. There were no significant changes in the absolute and relative organ weight between the two groups. As a conclusion, tested dose of Gelam honey is safe and has medical potential. Meanwhile, lethal dose (LD50) of the honey was found to be greater than 5000 mg/kg body weight. Long period of Gelam honey consumption should be conducted to observe and confirm those effects.
    Matched MeSH terms: Glucose
  4. Se KW, Ghoshal SK, Wahab RA, Ibrahim RKR, Lani MN
    Food Res Int, 2018 03;105:453-460.
    PMID: 29433236 DOI: 10.1016/j.foodres.2017.11.012
    In this study, we propose an easy approach by combining the Fourier transform infrared and attenuated total reflectance (FTIR-ATR) spectroscopy together with chemometrics analysis for rapid detection and accurate quantification of five adulterants such as fructose, glucose, sucrose, corn syrup and cane sugar in stingless bees (Heterotrigona itama) honey harvested in Malaysia. Adulterants were classified using principal component analysis and soft independent modeling class analogy, where the first derivative of the spectra in the wavenumber range of 1180-750cm-1 was utilized. The protocol could satisfactorily discriminate the stingless bees honey samples that were adulterated with the concentrations of corn syrup above 8% (w/w) and cane sugar over 2% (w/w). Feasibility of integrating FTIR-ATR with chemometrics for precise quantification of the five adulterants was affirmed using partial least square regression (PLSR) analysis. The study found that optimal PLSR analysis achieved standard error of calibrations and standard error of predictions within an acceptable range of 0.686-1.087% and 0.581-1.489%, respectively, indicating good predictive capability. Hence, the method developed here for detecting and quantifying adulteration in H. itama honey samples is accurate and rapid, requiring only 7-8min to complete as compared to 3h for the standard method, AOAC method 998.12.
    Matched MeSH terms: Glucose
  5. Lee YY, Tang TK, Phuah ET, Karim NAA, Alitheen NBM, Tan CP, et al.
    Food Res Int, 2018 01;103:200-207.
    PMID: 29389606 DOI: 10.1016/j.foodres.2017.10.022
    Medium-and-Long Chain Triacylglycerol (MLCT) is a type of structured lipid that is made up of medium chain, MCFA (C8-C12) and long chain, LCFA (C16-C22) fatty acid. Studies claimed that consumption of MLCT has the potential in reducing visceral fat accumulation as compared to long chain triacylglycerol, LCT. This is mainly attributed to the rapid metabolism of MCFA as compared to LCFA. Our study was designed to compare the anti-obesity effects of a enzymatically interesterified MLCT (E-MLCT) with physical blend of palm kernel and palm oil (B-PKOPO) having similar fatty acid composition and a commercial MLCT (C-MLCT) made of rapeseed/soybean oil on Diet Induced Obesity (DIO) C57BL/6J mice for a period of four months in low fat, LF (7%) and high fat, HF (30%) diet. The main aim was to determine if the anti-obesity effect of MLCT was contributed solely by its triacylglycerol structure alone or its fatty acid composition or both. Out of the three types of MLCT, mice fed with Low Fat, LF (7%) E-MLCT had significantly (P<0.05) lower body weight gain (by ~30%), body fat accumulation (by ~37%) and hormone leptin level as compared to both the LF B-PKOPO and LF C-MLCT. Histological examination further revealed that dietary intake of E-MLCT inhibited hepatic lipid accumulation. Besides, analysis of serum profile also demonstrated that consumption of E-MLCT was better in regulating blood glucose compared to B-PKOPO and C-MLCT. Nevertheless, both B-PKO-PO and E-MLCT which contained higher level of myristic acid was found to be hypercholesterolemic compared to C-MLCT. In summary, our finding showed that triacylglycerol structure, fatty acid composition and fat dosage play a pivotal role in regulating visceral fat accumulation. Consumption of E-MLCT in low fat diet led to a significantly lesser body fat accumulation. It was postulated that the MLM/MLL/LMM/MML/LLM types of triacylglycerol and C8-C12 medium chain fatty acids were the main factors that contributed to the visceral fat suppressing effect of MLCT. Despite being able to reduce body fat, the so called healthful functional oil E-MLCT when taken in high amount do resulted in fat accumulation. In summary, E-MLCT when taken in moderation can be used to manage obesity issue. However, consumption of E-MLCT may lead to higher total cholesterol and LDL level.
    Matched MeSH terms: Blood Glucose
  6. Man F, Choo CY
    J Ethnopharmacol, 2018 Apr 06;215:21-26.
    PMID: 29288829 DOI: 10.1016/j.jep.2017.12.040
    ETHNOPHARMACOLOGICAL RELEVANCE: The seeds of Brucea javanica and its aqueous decoction is a traditional medicine consumed by diabetic patients in Malaysia. The daily consumption of B. javanica seeds and it's aqueous decoction causes much concern as the quassinoids and its glycosides from the seeds exhibited various pharmacological activity at low doses.

    AIMS OF STUDY: The aim of the present study is to evaluate the repeated dose toxicity of the standardized aqueous extract administered daily for 30 days through oral administration at its effective hypoglycemia doses.

    MATERIALS AND METHODS: The seeds were dried, ground and extracted in deionized water. A HPLC-photodiode array method was developed and validated for the standardization of both the hypoglycemia agents, namely bruceine D and E in aqueous extract. Both normoglycemia and streptozotocin (STZ)-induced diabetic rats were fed orally with 15, 30 and 60mg/kg body weight of standardized aqueous extract. The blood glucose was measured at 0-8h. In repeated dose toxicity, similar doses were administered orally to rats for 30 days. At the end of 30 days, the blood was withdrawn and subjected to biochemical and haematology analysis while organs were harvested for histology analysis.

    RESULTS: Oral administration of standardized aqueous extract exhibited a dose-response relationship in both the normoglycemia and STZ-induced diabetic rats. Daily oral administration of 15, 30 and 60mg/kg standardized aqueous extract for 30 days to rats did not show signs to toxicity in its biochemical, haematology and histology analysis.

    CONCLUSION: In conclusion, although the seeds were reported to contain compounds with various pharmacological activity, the daily oral administration to rats for 30 days do not showed signs of toxicity at its effective hypoglycemia doses.

    Matched MeSH terms: Blood Glucose
  7. Nor Hanipah Z, Punchai S, Brethauer SA, Schauer PR, Aminian A
    Obes Surg, 2018 08;28(8):2247-2251.
    PMID: 29524184 DOI: 10.1007/s11695-018-3194-z
    INTRODUCTION: While bariatric surgery leads to significant prevention and improvement of type 2 diabetes, patients may rarely develop diabetes after bariatric surgery. The aim of this study was to determine the incidence and the characteristic of new-onset diabetes after bariatric surgery over a 17-year period at our institution.

    METHODS: Non-diabetic patients who underwent bariatric surgery at a single academic center (1997-2013) and had a postoperative glycated hemoglobin (HbA1c) ≥ 6.5%, fasting blood glucose (FBG) ≥ 126 mg/dl, or positive glucose tolerance test were identified and studied.

    RESULTS: Out of 2263 non-diabetic patients at the time of bariatric surgery, 11 patients had new-onset diabetes in the median follow-up time of 9 years (interquartile range [IQR], 4-12). Bariatric procedures performed were Roux-en-Y gastric bypass (n = 7), adjustable gastric banding (n = 3), and sleeve gastrectomy (n = 1). The median interval between surgery and diagnosis of diabetes was 6 years (IQR, 2-9). At the last follow-up, the median HbA1c and FBG values were 6.3% (IQR, 6.1-6.5) and 95 mg/dl (IQR, 85-122), respectively. Possible etiologic factors leading to diabetes were weight regain to baseline (n = 6, 55%), steroid-induced after renal transplantation (n = 1), pancreatic insufficiency after pancreatitis (n = 1), and unknown (n = 3).

    CONCLUSION: De novo diabetes after bariatric surgery is rare with an incidence of 0.4% based on our cohort. Weight regain was common (> 50%) in patients who developed new-onset diabetes suggesting recurrent severe obesity as a potential etiologic factor. All patients had good glycemic control (HbA1c ≤ 7%) in the long-term postoperative follow-up.

    Matched MeSH terms: Blood Glucose
  8. Kasim S, Malek S, Cheen S, Safiruz MS, Ahmad WAW, Ibrahim KS, et al.
    Sci Rep, 2022 Oct 20;12(1):17592.
    PMID: 36266376 DOI: 10.1038/s41598-022-18839-9
    Limited research has been conducted in Asian elderly patients (aged 65 years and above) for in-hospital mortality prediction after an ST-segment elevation myocardial infarction (STEMI) using Deep Learning (DL) and Machine Learning (ML). We used DL and ML to predict in-hospital mortality in Asian elderly STEMI patients and compared it to a conventional risk score for myocardial infraction outcomes. Malaysia's National Cardiovascular Disease Registry comprises an ethnically diverse Asian elderly population (3991 patients). 50 variables helped in establishing the in-hospital death prediction model. The TIMI score was used to predict mortality using DL and feature selection methods from ML algorithms. The main performance metric was the area under the receiver operating characteristic curve (AUC). The DL and ML model constructed using ML feature selection outperforms the conventional risk scoring score, TIMI (AUC 0.75). DL built from ML features (AUC ranging from 0.93 to 0.95) outscored DL built from all features (AUC 0.93). The TIMI score underestimates mortality in the elderly. TIMI predicts 18.4% higher mortality than the DL algorithm (44.7%). All ML feature selection algorithms identify age, fasting blood glucose, heart rate, Killip class, oral hypoglycemic agent, systolic blood pressure, and total cholesterol as common predictors of mortality in the elderly. In a multi-ethnic population, DL outperformed the TIMI risk score in classifying elderly STEMI patients. ML improves death prediction by identifying separate characteristics in older Asian populations. Continuous testing and validation will improve future risk classification, management, and results.
    Matched MeSH terms: Blood Glucose
  9. Satyam SM, Bairy LK, Shetty P, Sainath P, Bharati S, Ahmed AZ, et al.
    Cardiovasc Toxicol, 2023 Feb;23(2):107-119.
    PMID: 36790727 DOI: 10.1007/s12012-023-09784-8
    Doxorubicin is a widely used anticancer drug whose efficacy is limited due to its cardiotoxicity. There is no ideal cardioprotection available against doxorubicin-induced cardiotoxicity. This study aimed to investigate the anticipated cardioprotective potential of metformin and dapagliflozin against doxorubicin-induced acute cardiotoxicity in Wistar rats. At the beginning of the experiment, cardiac screening of experimental animals was done by recording an electrocardiogram (ECG) before allocating them into the groups. Thereafter, a total of thirty healthy adult Wistar rats (150-200 g) were randomly divided into five groups (n = 6) and treated for eight days as follows: group I (normal control), group II (doxorubicin control), group III (metformin 250 mg/kg/day), group IV (metformin 180 mg/kg/day), and group V (dapagliflozin 0.9 mg/kg/day). On the 7th day of the treatment phase, doxorubicin 20 mg/kg was administered intraperitoneal to groups II, III, IV, and V. On the 9th day (immediately after 48 h of doxorubicin administration), blood was collected from anesthetized animals for glucose, lipid profile, CK-MB & AST estimation, and ECG was recorded. Later, animals were sacrificed, and the heart was dissected for histopathological examination. We found that compared to normal control rats, CK-MB, AST, and glucose were significantly increased in doxorubicin control rats. There was a significant reversal of doxorubicin-induced hyperglycemia in the rats treated with metformin 250 mg/kg compared to doxorubicin control rats. Both metformin (180 mg/kg and 250 mg/kg) and dapagliflozin (0.9 mg/kg) significantly altered doxorubicin-induced ECG changes and reduced the levels of cardiac injury biomarkers CK-MB and AST compared to doxorubicin control rats. Metformin and dapagliflozin protected the cellular architecture of the myocardium from doxorubicin-induced myocardial injury. Current study revealed that both metformin and dapagliflozin at the FDA-recommended antidiabetic doses mitigated doxorubicin-induced acute cardiotoxicity in Wistar rats. The obtained data have opened the perspective to perform chronic studies and then to clinical studies to precisely consider metformin and dapagliflozin as potential chemoprotection in the combination of chemotherapy with doxorubicin to limit its cardiotoxicity, especially in patients with comorbid conditions like type II diabetes mellitus.
    Matched MeSH terms: Glucose
  10. Harraqui K, Oudghiri DE, Mrabti HN, Hannoun Z, Lee LH, Assaggaf H, et al.
    PMID: 36767104 DOI: 10.3390/ijerph20031739
    This study aimed to examine the association between physical activity (PA), body composition, and metabolic disorders in a population of Moroccan women classified by menopausal status. This cross-sectional study comprised 373 peri- and postmenopausal women aged 45-64 years old. PA levels were assessed using the short version of the International Physical Activity Questionnaire (IPAQ-SF). Body composition and metabolic disorders were assessed by measurements of anthropometric and biological parameters: weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), WC/HC ratio, percent body fat, systolic and diastolic blood pressure, fasting blood glucose, and serum lipids (total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C). Metabolic syndrome (MetS) was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Pearson correlations were used to test for associations. The mean total PA score of perimenopausal women was 1683.51 ± 805.36 MET-min/week, and of postmenopausal women was 1450.81 ± 780.67 MET-min/week. In all participants, peri- and postmenopausal women, PA was significantly and inversely associated with BMI, weight, percent body fat, HC, WC, and number of MetS components (p < 0.01), and with fasting blood glucose, TC, TG, and LDL-C (p < 0.05). The frequencies of metabolic disorders, obesity, abdominal obesity, type 2 diabetes, dyslipidemia, and MetS were significantly lower at moderate and intense levels of PA (p < 0.05), in also all participants. In middle-aged women, particularly those who are peri-menopausal, PA at moderate and intense levels is associated with more favorable body composition and less frequent metabolic disorders. However, in this particular study, PA does not appear to be associated with blood pressure and HDL-C concentrations. Future studies may be needed to further clarify these findings.
    Matched MeSH terms: Blood Glucose
  11. Widyawati T, Yusoff NA, Bello I, Asmawi MZ, Ahmad M
    Molecules, 2022 Oct 12;27(20).
    PMID: 36296407 DOI: 10.3390/molecules27206814
    (1) Background: An earlier study on the hypoglycemic activity of S. polyanthum (Wight.) leaf methanol extract identified squalene as the major chemical compound. The present study was conducted to assess the hypoglycemic effect of fractions and subfractions of the methanol extract of S. polyanthum compared to the squalene using a bioassay-guided in vivo study. (2) Methods: The methanol extract was fractionated using the liquid−liquid fractionation method. Streptozotocin-induced type 1 diabetic rat was used to study the hypoglycemic effect. (3) Results: The findings showed that chloroform fraction significantly (p < 0.05) lowered blood glucose levels of diabetic rats as compared to the control. Further fractionation of chloroform fraction yielded subfraction-1 and -2, whereby subfraction-1 exhibited a higher blood-glucose-lowering effect. The lipid profile test showed that the total cholesterol level of subfraction-1 and squalene-treated groups decreased significantly (p < 0.05). An immunohistochemistry study revealed that none of the treatments regenerated pancreatic β-cells. Gas chromatography−mass spectrophotometer analysis identified the presence of squalene in the active methanol extract, chloroform fraction, and subfraction-1. In silico analysis revealed a higher affinity of squalene against protein receptors that control lipid metabolism than metformin. (4) Conclusions: Data obtained from the present work suggested the crude methanol extract exerted the highest hypoglycemic effect compared to fraction, subfraction, and squalene, confirming synergistic effect may be responsible for the hypoglycemic activity of S. polyanthum.
    Matched MeSH terms: Blood Glucose
  12. Lloyd-Jones DM, Ning H, Labarthe D, Brewer L, Sharma G, Rosamond W, et al.
    Circulation, 2022 Sep 13;146(11):822-835.
    PMID: 35766033 DOI: 10.1161/CIRCULATIONAHA.122.060911
    BACKGROUND: The American Heart Association recently published an updated algorithm for quantifying cardiovascular health (CVH)-the Life's Essential 8 score. We quantified US levels of CVH using the new score.

    METHODS: We included individuals ages 2 through 79 years (not pregnant or institutionalized) who were free of cardiovascular disease from the National Health and Nutrition Examination Surveys in 2013 through 2018. For all participants, we calculated the overall CVH score (range, 0 [lowest] to 100 [highest]), as well as the score for each component of diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure, using published American Heart Association definitions. Sample weights and design were incorporated in calculating prevalence estimates and standard errors using standard survey procedures. CVH scores were assessed across strata of age, sex, race and ethnicity, family income, and depression.

    RESULTS: There were 23 409 participants, representing 201 728 000 adults and 74 435 000 children. The overall mean CVH score was 64.7 (95% CI, 63.9-65.6) among adults using all 8 metrics and 65.5 (95% CI, 64.4-66.6) for the 3 metrics available (diet, physical activity, and body mass index) among children and adolescents ages 2 through 19 years. For adults, there were significant differences in mean overall CVH scores by sex (women, 67.0; men, 62.5), age (range of mean values, 62.2-68.7), and racial and ethnic group (range, 59.7-68.5). Mean scores were lowest for diet, physical activity, and body mass index metrics. There were large differences in mean scores across demographic groups for diet (range, 23.8-47.7), nicotine exposure (range, 63.1-85.0), blood glucose (range, 65.7-88.1), and blood pressure (range, 49.5-84.0). In children, diet scores were low (mean 40.6) and were progressively lower in higher age groups (from 61.1 at ages 2 through 5 to 28.5 at ages 12 through 19); large differences were also noted in mean physical activity (range, 63.1-88.3) and body mass index (range, 74.4-89.4) scores by sociodemographic group.

    CONCLUSIONS: The new Life's Essential 8 score helps identify large group and individual differences in CVH. Overall CVH in the US population remains well below optimal levels and there are both broad and targeted opportunities to monitor, preserve, and improve CVH across the life course in individuals and the population.

    Matched MeSH terms: Blood Glucose
  13. Ismail A, Suddin LS, Sulong S, Ahmed Z, Kamaruddin NA, Sukor N
    Indian J Community Med, 2016 7 8;41(3):208-12.
    PMID: 27385874 DOI: 10.4103/0970-0218.183590
    CONTEXT: Diabetes mellitus is a growing health problem in most countries. In Malaysia, there was an increase in prevalence over the years. This makes diabetes also a growing concern in Malaysia, which warrants strengthening of the prevention and control programme.

    AIMS: This paper aims to describe the profiles of diabetes mellitus type 2 in tertiary setting and to identify the risk factors for high level of HbA1c among the study population. The findings will give a glimpse on current status of diabetes in our country and may reflect the achievement of the country in combating this disease.

    SETTINGS AND DESIGN: A cross-sectional study was conducted in UKM Medical Centre.

    METHODS AND MATERIAL: Medical records of patient with E11 ICD-10 code were collected using Case Report Form.

    STATISTICAL ANALYSIS USED: Descriptive analysis done of mean and median while test of association were done using Spearman correlation and logistic regression.

    RESULTS: The results showed that majority of inpatients of DMT2 showed mean age of 58.8 + 12.6 years and most were males (56.7%) with secondary level of education (41.7%). Median duration of disease was 12.0 + 11.0 years with median HbA1c level of 8.9 ± 4.4%. Only small proportion of patients achieved the desired level of HbA1c <6.5% (21.3%) and significant association was found with tertiary level of education [AOR = 0.10, 95%CI = 0.01-0.96] and with type of anti-diabetic therapy [AOR = 15.90, 95%CI=1;2.03-124.30].

    CONCLUSIONS: In conclusion, diabetes mellitus type 2 inpatients still showed unsatisfactory glycemic control and holistic approach using health education should be advocated continuously in the future in view of education being one of the predictors for the good HbA1c outcome.

    Matched MeSH terms: Blood Glucose
  14. Perak AM, Ning H, Khan SS, Van Horn LV, Grobman WA, Lloyd-Jones DM
    J Am Heart Assoc, 2020 Feb 18;9(4):e015123.
    PMID: 32063122 DOI: 10.1161/JAHA.119.015123
    Background Pregnancy is a cardiometabolic stressor and thus a critical period to address women's lifetime cardiovascular health (CVH). However, CVH among US pregnant women has not been characterized. Methods and Results We analyzed cross-sectional data from National Health and Nutrition Examination Surveys 1999 to 2014 for 1117 pregnant and 8200 nonpregnant women, aged 20 to 44 years. We assessed 7 CVH metrics using American Heart Association definitions modified for pregnancy; categorized metrics as ideal, intermediate, or poor; assigned these categories 2, 1, or 0 points, respectively; and summed across the 7 metrics for a total score of 0 to 14 points. Total scores 12 to 14 indicated high CVH; 8 to 11, moderate CVH; and 0 to 7, low CVH. We applied survey weights to generate US population-level estimates of CVH levels and compared pregnant and nonpregnant women using demographic-adjusted polytomous logistic and linear regression. Among pregnant women, the prevalences (95% CIs) of ideal levels of CVH metrics were 0.1% (0%-0.3%) for diet, 27.3% (22.2%-32.3%) for physical activity, 38.9% (33.7%-44.0%) for total cholesterol, 51.1% (46.0%-56.2%) for body mass index, 77.7% (73.3%-82.2%) for smoking, 90.4% (87.5%-93.3%) for blood pressure, and 91.6% (88.3%-94.9%) for fasting glucose. The mean total CVH score was 8.3 (95% CI, 8.0-8.7) of 14, with high CVH in 4.6% (95% CI, 0.5%-8.8%), moderate CVH in 60.6% (95% CI, 52.3%-68.9%), and low CVH in 34.8% (95% CI, 26.4%-43.2%). CVH levels were significantly lower among pregnant versus nonpregnant women; for example, 13.0% (95% CI, 11.0%-15.0%) of nonpregnant women had high CVH (adjusted, comparison P=0.01). Conclusions From 1999 to 2014, <1 in 10 US pregnant women, aged 20 to 44 years, had high CVH.
    Matched MeSH terms: Blood Glucose
  15. Jamaludin UK, Docherty PD, Geoffrey Chase J, Shaw GM
    J Med Biol Eng, 2015 02 03;35(1):125-133.
    PMID: 25750607
    Critically ill patients are occasionally associated with an abrupt decline in renal function secondary to their primary diagnosis. The effect and impact of haemodialysis (HD) on insulin kinetics and endogenous insulin secretion in critically ill patients remains unclear. This study investigates the insulin kinetics of patients with severe acute kidney injury (AKI) who required HD treatment and glycaemic control (GC). Evidence shows that tight GC benefits the onset and progression of renal involvement in precocious phases of diabetic nephropathy for type 2 diabetes. The main objective of GC is to reduce hyperglycaemia while determining insulin sensitivity. Insulin sensitivity (S
    I
    ) is defined as the body response to the effects of insulin by lowering blood glucose levels. Particularly, this study used S
    I
    to track changes in insulin levels during HD therapy. Model-based insulin sensitivity profiles were identified for 51 critically ill patients with severe AKI on specialized relative insulin nutrition titration GC during intervals on HD (OFF/ON) and after HD (ON/OFF). The metabolic effects of HD were observed through changes in S
    I
    over the ON/OFF and OFF/ON transitions. Changes in model-based S
    I
    at the OFF/ON and ON/OFF transitions indicate changes in endogenous insulin secretion and/or changes in effective insulin clearance. Patients exhibited a median reduction of -29 % (interquartile range (IQR): [-58, 6 %], p = 0.02) in measured S
    I
    after the OFF/ON dialysis transition, and a median increase of +9 % (IQR -15 to 28 %, p = 0.7) after the ON/OFF transition. Almost 90 % of patients exhibited decreased S
    I
    at the OFF/ON transition, and 55 % exhibited increased S
    I
    at the ON/OFF transition. Results indicate that HD commencement has a significant effect on insulin pharmacokinetics at a cohort and per-patient level. These changes in metabolic behaviour are most likely caused by changes in insulin clearance or/and endogenous insulin secretion.
    Matched MeSH terms: Blood Glucose
  16. Tan SC, Rajendran R, Bhattamisra SK, Krishnappa P, Davamani F, Chitra E, et al.
    J Pharm Pharmacol, 2023 Aug 01;75(8):1034-1045.
    PMID: 37402616 DOI: 10.1093/jpp/rgad063
    OBJECTIVES: Madecassoside (MAD) is a triterpenoid constituent of Centella asiatica (L.) Urb., an ethnomedical tropical plant, extracts of which were shown to reduce blood glucose in experimental diabetes. This study examines MAD for its anti-hyperglycaemic effects and tests the hypothesis that it reduces the blood glucose in experimentally induced diabetic rats by protecting the β-cells.

    METHODS: Diabetes was induced using streptozotocin (60 mg/kg, i.v.) followed by nicotinamide (210 mg/kg, intraperitoneal (i.p.)). MAD (50 mg/kg) was administered orally for 4 weeks, commencing 15 days after induction of diabetes; resveratrol (10 mg/kg) was used as a positive control. Fasting blood glucose, plasma insulin, HbA1c, liver and lipid parameters were measured, along with antioxidant enzymes and malondialdehyde as an index of lipid peroxidation; histological and immunohistochemical studies were also undertaken.

    KEY FINDINGS: MAD normalized the elevated fasting blood glucose levels. This was associated with increased plasma insulin concentrations. MAD alleviated oxidative stress by improving enzymatic antioxidants and reducing lipid peroxidation. Histopathological examination showed significant recovery of islet structural degeneration and an increased area of islets. Immunohistochemical staining showed increased insulin content in islets of MAD-treated rats.

    CONCLUSIONS: The results demonstrate an antidiabetic effect of MAD associated with preservation of β-cell structure and function.

    Matched MeSH terms: Blood Glucose
  17. David SR, Lai PPN, Chellian J, Chakravarthi S, Rajabalaya R
    Sci Rep, 2023 Aug 01;13(1):12423.
    PMID: 37528147 DOI: 10.1038/s41598-023-39442-6
    The present work examined the effect of oral administration of rutin and its combination with metformin, an antidiabetic drug on blood glucose, total cholesterol and triglycerides level and vascular function in streptozotocin (STZ) -induced diabetic rats. Male Sprague Dawley rats were rendered diabetic by a single intraperitoneal injection of STZ (50 mg/kg). Rutin and metformin were orally administered to diabetic rats at a dose of 100 mg/kg and 300 mg/kg body weight/day, respectively, for 4 weeks. Plasma analysis was conducted to determine changes in the plasma glucose and lipid levels. Rat aortic ring reactivity in response to endothelium-dependent (acetylcholine, ACh) and endothelium-independent (sodium nitroprusside, SNP) relaxants, and to the α1-adrenergic agonist phenylephrine (PE) were recorded. Histology of pancreas, liver and kidney were evaluated. In results, rutin and metformin alone and in combination has led to significant improvements in blood glucose, cholesterol and triglyceride levels compared to diabetic group. Diabetic aortic rings showed significantly greater contraction in response to PE, and less relaxation in response to ACh and SNP. Treatment with rutin and metformin in combination significantly reduced PE-induced contraction and increased ACh-induced and SNP-induced relaxation in diabetes when compared to rutin or metformin alone. Significant histological improvements were seen with combination therapy. In conclusion, rutin and metformin combination therapy has the most potentiality for restoring blood glucose and lipid level as well as vascular function.
    Matched MeSH terms: Blood Glucose
  18. Arumugam B, Palanisamy UD, Chua KH, Kuppusamy UR
    Mol Vis, 2019;25:47-59.
    PMID: 30820141
    Purpose: Oxidative stress is implicated in the etiology of diabetes and its debilitating complications, such as diabetic retinopathy (DR). Various flavonoids have been reported to be useful in reducing DR progression. Myricetin derivatives (F2) isolated from leaf extract of Syzygium malaccense have the potential to serve as functional food as reported previously. The present study was performed with the aim of determining the antioxidant potential and protective effect of myricetin derivatives (F2) isolated from leaf extract of S. malaccense against glucose oxidase (GO)-induced hydrogen peroxide (H2O2) production that causes oxidative stress in ARPE-19 (RPE) cells.

    Methods: Antioxidant properties were assessed through various radical (DPPH, ABTS, and nitric oxide) scavenging assays and determination of total phenolic content and ferric reducing antioxidant power level. ARPE-19 cells were preincubated with samples before the addition of GO (to generate H2O2). Cell viability, change in intracellular reactive oxygen species (ROS), H2O2 levels in cell culture supernatant, and gene expression were assessed.

    Results: F2 showed higher antioxidant levels than the extract when assessed for radical scavenging activities and ferric reducing antioxidant power. F2 protected the ARPE-19 cells against GO-H2O2-induced oxidative stress by reducing the production of H2O2 and intracellular reactive oxygen species. This was achieved by the activation of nuclear factor erythroid 2-related factor 2 (Nrf2/NFE2L2) and superoxide dismutase (SOD2), as well as downregulation of nitric oxide producer (NOS2) at the transcriptional level.

    Conclusions: The results showed that myricetin derivatives from S. malaccense have the capacity to exert considerable exogenous antioxidant activities and stimulate endogenous antioxidant activities. Therefore, these derivatives have excellent potential to be developed as therapeutic agents for managing DR.

    Matched MeSH terms: Glucose Oxidase/antagonists & inhibitors; Glucose Oxidase/pharmacology; Glucose Oxidase/chemistry
  19. Chai JW, Lim SL, Kanthimathi MS, Kuppusamy UR
    Genes Nutr, 2011 May;6(2):181-8.
    PMID: 21484150 DOI: 10.1007/s12263-010-0196-4
    The nutraceutical benefits of β-sitosterol (SIT) are well documented. The present study investigated the in vitro effects of SIT on adipogenesis, glucose transport, and lipid mobilization in rat adipocytes. Primary cultures of rat preadipocytes and differentiated adipocytes were used in this study. Glucose uptake was measured by the uptake of radio-labeled glucose. Adipogenesis and lipolysis were measured by oil-red-O and glycerol quantification methods, respectively. The expression of protein kinase B (Akt), glucose transporter 4 (GLUT4), hormone sensitive lipase (HSL), and phosphatidylinositol-3-kinase (PI3 K) genes in SIT-treated adipocytes were assessed by real-time reverse transcription polymerase chain reaction (RT-PCR). The data showed that SIT induced glucose uptake in adipocytes. It also stimulated adipogenesis in differentiating preadipocytes. Interestingly, although SIT displayed general insulin-mimetic activity by stimulating glucose uptake and adipogenesis, it also induced lipolysis in adipocytes. Furthermore, the SIT-induced lipolysis was not attenuated by insulin and co-incubation of SIT with epinephrine improved epinephrine-induced lipolysis. GLUT4 gene expression was highly down-regulated in SIT-treated adipocytes, compared to insulin-treated adipocytes, which was up-regulated. Insulin- and SIT-treated adipocytes showed similar levels of Akt, HSL, and PI3 K gene down-regulation. These observations suggest that the elevation of glucose uptake in SIT-treated adipocytes was unrelated to de novo synthesis of GLUT4 and the SIT-induced lipolysis is associated with the down-regulation of Akt and PI3K genes. The unique effects of SIT on the regulation of glucose uptake, adipogenesis, and lipolysis in adipocytes show that it has potential to be utilized in diabetes and weight management.
    Matched MeSH terms: Glucose
  20. Mirasol R, Thai AC, Salahuddin AA, Tan K, Deerochanawong C, Mohamed M, et al.
    J ASEAN Fed Endocr Soc, 2017;32(1):6-12.
    PMID: 33442078 DOI: 10.15605/jafes.032.01.02
    The Asia-Pacific region carries a high disease burden, with over half of the global diabetic population residing in this region. Increasing evidence shows that without targeted intervention, the progression from impaired glucose tolerance (IGT) to type 2 diabetes occurs more frequently in Asians compared with Caucasians. Furthermore, IGT is independently associated with an increased risk of cardiovascular disease, and should be managed as early as possible. Because diabetes is now a major public health issue, strategies aimed at prevention and treatment are urgently required. Lifestyle modification, including weight loss, dietary changes and increased physical activity, play a major role in controlling the disease. Significant evidence also supports the effectiveness of a combination of lifestyle modification and pharmacologic therapy, such as metformin, in delaying the onset of diabetes. Although the importance of lifestyle interventions is well recognized throughout Asia, many countries do not have formal recommendations to guide the diagnosis and management of individuals at risk of progression to diabetes. At a recent regional meeting, experts from the Asian region convened to develop consensus recommendations to guide clinicians in the management of Asian patients with pre-diabetes. These consensus recommendations provide a clear and concise approach to the management of individuals with IGT based on the available evidence and current best clinical practice.
    Matched MeSH terms: Glucose Intolerance
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