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Glycemic control following two regimens of antenatal corticosteroids in mild gestational diabetes: a randomized controlled trial

Sukarna N, Tan PC, Hong JGS, Sulaiman S, Omar SZ

Arch Gynecol Obstet, 2021 08;304(2):345-353.
PMID: 33452923 DOI: 10.1007/s00404-020-05950-3

PURPOSE: To compare 3 consecutive days of hyperglycemic response following antenatal dexamethasone regimens of 12-mg or 6-mg doses 12 hourly in diet-controlled gestational diabetes.
METHODS: A randomized controlled trial was carried out in a university hospital in Malaysia. Women with lifestyle-controlled gestational diabetes scheduled to receive clinically indicated antenatal corticosteroids (dexamethasone) were randomized to 12-mg 12 hourly for one day (2 × 12-mg) or 6-mg 12-hourly for two days (4 × 6-mg). 6-point (pre and 2-h postprandial) daily self-monitoring of capillary blood sugar profile for up to 3 consecutive days was started after the first dexamethasone injection. Hyperglycemia is defined as blood glucose pre-meal ≥ 5.3 or 2 h postprandial ≥ 6.7 mmol/L. The primary outcome was a number of hyperglycemic episodes in Day-1 (first 6 BSP points). A sample size of 30 per group (N = 60) was planned.
RESULTS: Median [interquartile range] hyperglycemic episodes 4 [2.5-5] vs. 4 [3-5] p = 0.3 in the first day, 3 [2-4] vs. 1 [0-3] p = 0.01 on the second day, 0 [0-1] vs. 0 [0-1] p = 0.6 on the third day and over the entire 3 trial days 7 [6-9] vs. 6 [4-8] p = 0.17 for 6-mg vs. 12-mg arms, respectively. 2/30 (7%) in each arm received an anti-glycemic agent during the 3-day trial period (capillary glucose exceeded 11 mmol/L). Mean birth weight (2.89 vs. 2.49 kg p blood loss (300 vs. 400 ml p = 0.02) was lower in the 12-mg arm; all other secondary outcomes were not significantly different.
CONCLUSION: In gestational diabetes, 2 × 12-mg could be preferred over 4 × 6-mg dexamethasone as hyperglycemic episodes were fewer on Day-2, fewer injections were needed and the regimen was completed sooner.
CLINICAL TRIAL REGISTRATION: http://www.isrctn.com/ISRCTN16613220 .

Matched MeSH terms: Blood Glucose/analysis*
Fulltext Bimodality in blood glucose distribution: is it universal?

Lim TO, Bakri R, Morad Z, Hamid MA

Diabetes Care, 2002 Dec;25(12):2212-7.
PMID: 12453963 DOI: 10.2337/diacare.25.12.2212

OBJECTIVE: Bimodality in blood glucose (BG) distribution has been demonstrated in several populations with a high prevalence of diabetes and obesity. However, other population studies had not found bimodality, thus casting doubt on its universality. We address this question in four ethnic populations-namely Malay, Chinese, Indian, and the indigenous people of Borneo.

RESEARCH DESIGN AND METHODS: A national health survey was conducted in Malaysia in 1996. A total of 18,397 subjects aged > or =30 years had post-challenge BG measurements taken. To test whether BG was consistent with a bimodal distribution, we fitted unimodal normal and skewed distribution as well a mixture of two normal distributions to the data by age and ethnic groups.

RESULTS: Age-specific prevalence of diabetes varied from 1.3 to 26.3%. In all ethnic/age groups, the bimodal model fitted the log BG data better (likelihood ratio tests, all P values <0.001).

CONCLUSIONS: Bimodality in BG distribution is demonstrable even in populations with a very low prevalence of diabetes and obesity. Previous studies that found unimodality had failed to detect the second mode because of inadequate sample size, bias due to treatment of subjects with known diabetes, and inclusion of subjects with type 1 diabetes in the sample. Bimodality implies that diabetes is a distinct entity rather than an arbitrarily defined extreme end of a continuously distributed measurement.

Matched MeSH terms: Blood Glucose/metabolism*
Biochemical evaluation of an infant with hypoglycemia resulting from a novel de novo mutation of the GLUD1 gene and hyperinsulinism-hyperammonemia syndrome

Balasubramaniam S, Kapoor R, Yeow JH, Lim PG, Flanagan S, Ellard S, et al.

J Pediatr Endocrinol Metab, 2011;24(7-8):573-7.
PMID: 21932603

Hyperinsulinism-hyperammonemia syndrome (HI/HA) (OMIM 606762), the second most common form of congenital hyperinsulinism (CHI) is associated with activating missense mutations in the GLUD1 gene, which encodes the mitochondrial matrix enzyme, glutamate dehydrogenase (GDH). Patients present with recurrent symptomatic postprandial hypoglycemia following protein-rich meals (leucine-sensitive hypoglycemia) as well as fasting hypoglycemia accompanied by asymptomatic elevations of plasma ammonia. In contrast to other forms of CHI, the phenotype is reported to be milder thus escaping recognition for the first few months of life. Early diagnosis and appropriate management are essential to avoid the neurodevelopmental consequences including epilepsy and learning disabilities which are prevalent in this disorder. We report an infant presenting with afebrile seizures secondary to hyperinsulinemic hypoglycemia resulting from a novel de novo mutation of the GLUD1 gene.

Matched MeSH terms: Blood Glucose/analysis
Fulltext Combined therapy using acupressure therapy, hypnotherapy, and transcendental meditation versus placebo in type 2 diabetes

Bay R, Bay F

J Acupunct Meridian Stud, 2011 Sep;4(3):183-6.
PMID: 21981869 DOI: 10.1016/j.jams.2011.09.006

Type 2 diabetes is one of the most widespread diseases in the world. The main aim of this research was to evaluate the effect of combined therapy using acupressure therapy, hypnotherapy, and transcendental meditation (TM) on the blood sugar (BS) level in comparison with placebo in type 2 diabetic patients. We used "convenience sampling" for selection of patients with type 2 diabetes; 20 patients were recruited. For collection of data, we used an identical quasi-experimental design called "nonequivalent control group." Therapy sessions each lasting 60-90 min were carried out on 10 successive days. We prescribed 2 capsules (containing 3g of wheat flour each) for each member of the placebo group (one for evening and one for morning). Pre-tests, post-tests, and follow-up tests were conducted in a medical laboratory recognized by the Ministry of Health and Medical Education of Iran. Mean BS level in the post-tests and follow-up tests for the experimental group was reduced significantly in comparison with the pre-tests whereas in the placebo group no changes were observed. Combined therapy including acupressure therapy, hypnotherapy, and TM reduced BS of type 2 diabetic patients and was more effective than placebo therapy on this parameter.
Study site: Diabetes clinics, Gorgan Panjomeazar Policlinic, Iran

Matched MeSH terms: Blood Glucose/metabolism*
Arjunolic acid downregulates elevated blood sugar and pro-inflammatory cytokines in streptozotocin (STZ)-nicotinamide induced type 2 diabetic rats

Aamir K, Khan HU, Hossain CF, Afrin MR, Jusuf PR, Waheed I, et al.

Life Sci, 2022 Jan 15;289:120232.
PMID: 34919901 DOI: 10.1016/j.lfs.2021.120232

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a worldwide health issue primarily due to failure of pancreatic β-cells to release sufficient insulin.
PURPOSE: The present work aimed to assess the antidiabetic potential of arjunolic acid (AA) isolated from Terminalia arjuna in type 2 diabetic rats.
STUDY DESIGN: After extraction, isolation and purification, AA was orally administered to type 2 diabetic Sprague Dawley rats to investigate antidiabetic effect of AA.
METHOD: T2DM was induced via single intraperitoneal injection of streptozotocin-nicotinamide (STZ-NIC) in adult male rats. After 10 days, fasting and random blood glucose (FBG and RBG), body weight (BW), food and water intake, serum C-peptide, insulin and glycated hemoglobin (HbA1c) was measured to confirm T2DM development. Dose dependent effects of orally administered AA (25 and 50 mg/kg/day) for 4 weeks was investigated by measuring BW variation, fasting and postprandial hyperglycemia, oral glucose tolerance test (OGTT), and levels of serum HbA1c, serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), serum and pancreatic C-peptide, insulin, growth differentiation factor 15 (GDF-15), serum and pancreatic inflammatory cytokines.
RESULTS: The oral administration of AA in preclinical model of T2DM significantly normalized FBG and RBG, restored BW, controlled polyphagia, polydipsia and glucose tolerance. In addition, AA notably reduced serum HbA1c, TC, TG, LDL with non-significant increase in HDL. On the other hand, significant increase in serum and pancreatic C-peptide and insulin was observed with AA treatment, while serum and pancreatic GDF-15 were non-significantly altered in AA treated diabetic rats. Moreover, AA showed dose dependent reduction in serum and pancreatic proinflammatory cytokines including TNF-α, IL-1β and IL-6.
CONCLUSION: For the first time our findings highlighted AA as a potential candidate in type 2 diabetic conditions.

Matched MeSH terms: Blood Glucose/metabolism*
Fulltext Diet and Pre-Intervention Washout Modifies the Effects of Probiotics on Gestational Diabetes Mellitus: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials

Hasain Z, Che Roos NA, Rahmat F, Mustapa M, Raja Ali RA, Mokhtar NM

Nutrients, 2021 Aug 30;13(9).
PMID: 34578921 DOI: 10.3390/nu13093045

Dynamic interactions among gestational diabetes mellitus (GDM), gut microbiota, inflammation, oxidative stress, and probiotics are increasingly acknowledged. This meta-analysis aimed to summarize the effects of probiotics in GDM, focusing on lifestyle intervention and pre-intervention washout, in addition to metabolic, inflammation, oxidative stress, and pregnancy outcomes. Three electronic databases (i.e., PubMed, Scopus, and CENTRAL) were searched from inception until October 2020. A meta-analysis was performed, and the effect sizes were reported as either mean differences or odds ratios with 95% confidence intervals. Altogether, 10 randomized controlled trials enrolling 594 participants were included. The meta-analysis indicated that probiotics supplementation effectively reduced fasting plasma glucose by 3.10 mg/dL, and subgroup analyses suggested that the duration of intervention, number of species, pre-intervention washout period, and dietary intervention may determine the effects of probiotics. Probiotics also reduced the level of inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-α, and malondialdehyde), incidence of macrosomia, and newborn hospitalization. In conclusion, this meta-analysis suggests that probiotics may have positive effects on metabolic, inflammation, oxidative stress, and neonatal outcomes in women with GDM. Additionally, diet and pre-intervention washout may modify the effects of probiotics. Future studies are warranted on a larger scale to ascertain the clinical significance.

Matched MeSH terms: Blood Glucose/drug effects*
Fulltext Relationship between dyslipidaemia and glycaemic status in patients with Type 2 diabetes mellitus

Thambiah SC, Samsudin IN, George E, Zahari Sham SY, Lee HM, Muhamad MA, et al.

Malays J Pathol, 2016 Aug;38(2):123-30.
PMID: 27568669 MyJurnal

The risk of coronary heart disease (CHD) is dramatically increased in diabetic patients due to their atherogenic lipid profile. The severity of CHD in diabetic patients has been found to be directly associated with glycated haemoglobin (HbA1c). According to the Malaysian Clinical Practice Guidelines on diabetes mellitus (DM), HbA1c level less than 6.5% reduces the risk of microvascular and macrovascular complications. Hence, this study aimed to determine the relationship between dyslipidaemia and glycaemic status in patients with type 2 DM (T2DM) patients in Hospital Putrajaya, a tertiary endocrine centre in Malaysia. This was a cross sectional, retrospective study of 214 T2DM patients with dyslipidaemia who had visited the endocrine clinic between January 2009 and December 2012. Significant correlations were found between fasting blood glucose (FBG) and HbA1c with total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL), non-high density lipoprotein cholesterol (non-HDL), LDL/HDL ratio and TC/HDL ratio; greater correlation being with HbA1c than FBG. In patients with HbA1c ≥ 6.5%, TC, TG, non-HDL and TC/HDL ratio were significantly higher than in patients with HbA1c < 6.5%. Non-HDL, LDL/HDL ratio, TC/HDL ratio and HbA1c were significantly lower in patients on statin treatment than nontreated patients (p<0.05). This significant association between glycaemic status and dyslipidaemia emphasises the additional possible use of HbA1c as a biomarker for dyslipidaemia as well as a potential indirect predictor of cardiovascular disease (CVD) risk in T2DM patients.

Matched MeSH terms: Blood Glucose/analysis*
Fulltext Clinical Utility of Plasma Fructosamine Concentration as a Hypoglycemic Biomarker during Early Lactation in Dairy Cattle

Megahed AA, Hiew MWH, Constable PD

J. Vet. Intern. Med., 2018 Mar;32(2):846-852.
PMID: 29424465 DOI: 10.1111/jvim.15049

BACKGROUND: Plasma fructosamine concentration ([FRA]) is a widely used long term hyperglycemic biomarker in humans and dogs, but its clinical usefulness as a hypoglycemic biomarker in dairy cattle is uncertain.
OBJECTIVES: To evaluate the relationship between plasma [FRA] and glucose concentration ([gluc]) as well as indices of energy balance during early lactation in dairy cattle, and to characterize the influence of plasma total protein concentration ([TP]) and albumin concentration ([albumin]) on [FRA].
ANIMALS: Convenience sample comprising 103 periparturient Holstein-Friesian cattle.
METHODS: Plasma [gluc], [TP], [albumin], and other clinicopathologic indices of energy status were determined periodically from Day 4 postpartum. Body condition score (BCS) was assessed, and backfat thickness (BFT) and longissimus dorsi muscle thickness (LDT) were measured ultrasonographically. Plasma [FRA] was measured at approximately 28 days postpartum. Associations between plasma [FRA] and study variables were evaluated using Spearman's rho and stepwise forward linear regression. Statistical significance was declared at P

Matched MeSH terms: Blood Glucose/analysis
Poor glycaemic control and its metabolic and demographic risk factors in a Malaysian community-based study

Reidpath DD, Soyiri I, Jahan NK, Mohan D, Ahmad B, Ahmad MP, et al.

Int J Public Health, 2018 Mar;63(2):193-202.
PMID: 29372287 DOI: 10.1007/s00038-017-1072-4

OBJECTIVES: The lack of population-based evidence on the risk factors for poor glycaemic control in diabetics, particularly in resource-poor settings, is a challenge for the prevention of long-term complications. This study aimed to identify the metabolic and demographic risk factors for poor glycaemic control among diabetics in a rural community in Malaysia.
METHODS: A total of 1844 (780 males and 1064 females) known diabetics aged ≥ 35 years were identified from the South East Asia Community Observatory (SEACO) health and demographic surveillance site database.
RESULTS: 41.3% of the sample had poor glycaemic control. Poor glycaemic control was associated with age and ethnicity, with older participants (65+) better controlled than younger adults (45-54), and Malaysian Indians most poorly controlled, followed by Malay and then Chinese participants. Metabolic risk factors were also highly associated with poor glycaemic control.
CONCLUSIONS: There is a critical need for evidence for a better understanding of the mechanisms of the associations between risk factors and glycaemic control.

Matched MeSH terms: Blood Glucose/metabolism*
Fulltext The Need to Calculate Target Glucose Levels When Measuring Changes in Insulin Sensitivity During Interventions for Individuals With Type 2 Diabetes

Othman NA, Docherty PD, Krebs JD, Bell DA, Chase JG

J Diabetes Sci Technol, 2018 05;12(3):665-672.
PMID: 29295634 DOI: 10.1177/1932296817750402

BACKGROUND: Physiological models that are used with dynamic test data to assess insulin sensitivity (SI) assume that the metabolic target glucose concentration ( GTARGET) is equal to fasting glucose concentration ( G0). However, recent research has implied that irregularities in G0 in diabetes may cause erroneous SI values. This study quantifies the magnitude of these errors.
METHODS: A clinically validated insulin/glucose model was used to calculate SI with the standard fasting assumption (SFA) G0 = GTARGET. Then GTARGET was treated as a variable in a second analysis (VGT). The outcomes were contrasted across twelve participants with established type 2 diabetes mellitus that were recruited to take part in a 24-week dietary intervention. Participants underwent three insulin-modified intravenous glucose tolerance tests (IM-IVGTT) at 0, 12, and 24 weeks.
RESULTS: SIVGT had a median value of 3.36×10-4 L·mU-1·min-1 (IQR: 2.30 - 4.95×10-4) and were significantly lower ( P < .05) than the median SISFA (6.38×10-4 L·mU-1·min-1, IQR: 4.87 - 9.39×10-4). The VGT approach generally yielded lower SI values in line with expected participant physiology and more effectively tracked changes in participant state over the 24-week trial. Calculated GTARGET values were significantly lower than G0 values (median GTARGET = 5.48 vs G0 = 7.16 mmol·L-1 P < .001) and were notably higher in individuals with longer term diabetes.
CONCLUSIONS: Typical modeling approaches can overestimate SI when GTARGET does not equal G0. Hence, calculating GTARGET may enable more precise SI measurements in individuals with type 2 diabetes, and could imply a dysfunction in diabetic metabolism.

Matched MeSH terms: Blood Glucose/analysis*
Plasma homocysteine reference values of adult Malaysians from three ethnic groups

Lopez JB, Peng CL

Clin Chim Acta, 2004 Feb;340(1-2):235-8.
PMID: 14734218 DOI: 10.1016/j.cccn.2003.11.007
Matched MeSH terms: Blood Glucose/metabolism
Fulltext The Roles of Probiotics in the Gut Microbiota Composition and Metabolic Outcomes in Asymptomatic Post-Gestational Diabetes Women: A Randomized Controlled Trial

Hasain Z, Raja Ali RA, Ahmad HF, Abdul Rauf UF, Oon SF, Mokhtar NM

Nutrients, 2022 Sep 19;14(18).
PMID: 36145254 DOI: 10.3390/nu14183878

Probiotics are widely used as an adjuvant therapy in various diseases. Nonetheless, it is uncertain how they affect the gut microbiota composition and metabolic and inflammatory outcomes in women who have recently experienced gestational diabetes mellitus (post-GDM). A randomized, double-blind, placebo-controlled clinical trial involving 132 asymptomatic post-GDM women was conducted to close this gap (Clinical Trial Registration: NCT05273073). The intervention (probiotics) group received a cocktail of six probiotic strains from Bifidobacterium and Lactobacillus for 12 weeks, while the placebo group received an identical sachet devoid of living microorganisms. Anthropometric measurements, biochemical analyses, and 16S rRNA gene sequencing results were evaluated pre- and post-intervention. After the 12-week intervention, the probiotics group’s fasting blood glucose level significantly decreased (mean difference −0.20 mmol/L; p = 0.0021). The HbA1c, total cholesterol, triglycerides, and high-sensitivity C-reactive protein levels were significantly different between the two groups (p < 0.05). Sequencing data also demonstrated a large rise in the Bifidobacterium adolescentis following probiotic supplementation. Our findings suggest that multi-strain probiotics are beneficial for improved metabolic and inflammatory outcomes in post-GDM women by modulating gut dysbiosis. This study emphasizes the necessity for a comprehensive strategy for postpartum treatment that includes probiotics to protect post-GDM women from developing glucose intolerance.

Matched MeSH terms: Blood Glucose/metabolism
Fulltext Usage of glucometer is associated with improved glycaemic control in type 2 diabetes mellitus patients in Malaysian public primary care clinics: an open-label, randomised controlled trial

Ismail M, Teng CL, Teng CL, Omar M, Ho BK, Kusiar Z, et al.

Singapore Med J, 2013 Jul;54(7):391-5.
PMID: 23900469

INTRODUCTION: Self-monitoring of blood glucose (SMBG) has been underutilised. We conducted an open-label, randomised controlled trial to assess the feasibility of introducing SMBG in primary care clinics in Malaysia.

METHODS: This was an open-label, randomised controlled trial conducted in five public primary care clinics in Malaysia. Patients with type 2 diabetes mellitus (age range 35-65 years) not performing SMBG at the time of the study were randomised to receive either a glucometer for SMBG or usual care. Both groups of patients received similar diabetes care from the clinics.

RESULTS: A total of 105 patients with type 2 diabetes mellitus were enrolled. Of these, 58 and 47 were randomised to intervention and control groups, respectively. After six months, the glycated haemoglobin (HbA1c) level in the intervention group showed a statistically significant improvement of 1.3% (p = 0.001; 95% confidence interval 0.6-2.0), relative to the control group that underwent usual care. The percentages of patients that reached the HbA1c treatment target of ≤ 7% were 14.0% and 32.1% in the control and intervention groups (p = 0.036), respectively.

CONCLUSION: The usage of a glucometer improved glycaemic control, possibly due to the encouragement of greater self-care in the intervention group.

Matched MeSH terms: Blood Glucose Self-Monitoring*
Fulltext Venipuncture versus heel prick for blood glucose monitoring in neonates

Saththasivam P, Umadevan D, Ramli N, Voralu K, Naing NN, Ilias MI, et al.

Singapore Med J, 2009 Oct;50(10):1004-7.
PMID: 19907892

The aim of this study was to determine whether there was a difference in the pain indicators and effectiveness between venipuncture (VP) and heel prick (HP) for blood glucose monitoring in term neonates (recently, venipuncture was shown superior for the Guthrie test).

Matched MeSH terms: Blood Glucose/analysis*
Fulltext Type 2 diabetes mellitus patients with poor glycaemic control have lower quality of life scores as measured by the Short Form-36

Kamarul Imran M, Ismail AA, Naing L, Wan Mohamad WB

Singapore Med J, 2010 Feb;51(2):157-62.
PMID: 20358156

INTRODUCTION: This study aimed to compare the quality of life based on the Short Form-36 (SF-36) between two different groups of type 2 diabetes mellitus patients with glycaemic control: those with a glycosylated haemoglobin (HbA1c) level at or below 7.5 percent and those above 7.5 percent.
METHODS: In this cross-sectional study, a generic SF-36 questionnaire was self-administered to patients with type 2 diabetes mellitus. Based on the HbA1c level, the mean SF-36 scale scores were compared. The analysis of covariance was used to obtain the adjusted mean scores of the SF-36 scales while controlling for age and duration of type 2 diabetes mellitus.
RESULTS: 150 patients with type 2 diabetes mellitus were analysed. There were 63 (42 percent) women and 87 (58 percent) men, and their mean HbA1c level was 8.9 percent (SD 2.4 percent). When comparing the two groups of patients with different HbA1c levels, the adjusted means of four scales: physical health functioning, general health, social functioning and mental health, differed significantly between the two. The SF-36 scale scores in type 2 diabetes mellitus patients were also lower than those of the SF-36 norms for the Malaysian population.
CONCLUSION: Type 2 diabetes mellitus patients with poor glycaemic control had lower mean SF-36 scores in physical functioning, general health, social functioning and mental health, and the SF-36 scores in these patients were also lower than the SF-36 norms of the Malaysian population.

Matched MeSH terms: Blood Glucose/metabolism*
Fulltext Comparison of serum fructosamine and blood glucose concentrations as indices of glycaemic control in non-insulin dependent diabetic out-patients

Lim TO, Selvan T, Suppiah A, Khan N, Ismail F

Singapore Med J, 1992 Jun;33(3):287-9.
PMID: 1631590

The usefulness and validity of blood glucose measurement as an index of diabetic control were assessed with reference to serum fructosamine. Two hundred and twenty-eight non-insulin dependent diabetic out-patients were studied in the usual clinical setting. Fasting blood glucose (FBG) concentration was positively correlated with serum fructosamine (r = 0.42, t = 6.78 p less than 0.01). On the basis of their serum fructosamine concentrations, patients were divided into 3 groups. They were good control (fructosamine less than or equal to 288 umol/l), acceptable control (fructosamine less than or equal to 320 umol/l) and poor control groups (fructosamine greater than 320 umol/l). The mean fasting blood glucose concentration was significantly higher in the latter than the former 2 groups. However, at each level of control, there was a wide range of FBG concentrations. Thus, the value of FBG in predicting glycaemic control is limited. Its positive predictive value was only 32%, and its overall accuracy as an index of diabetic control was only 58% though its negative predictive value was high (93%). In 162 patients with poor diabetic control as indicated by their serum fructosamine concentrations, 81 (50%) of them had FBG less than 10 mmol/l on their clinic visit day. Fasting blood glucose is therefore not a reliable measure of good diabetic control, though it is useful in predicting poor control. FBG is simple to measure, cheap and rapidly available on clinic day, thus ensuring its continuing use. Doctors should be aware of its limitations and should not rely solely on FBG to assess diabetic control.
Study site: Diabetic clinic, Hospital Mentakab, Pahang, Malaysia

Matched MeSH terms: Blood Glucose/analysis*
Fulltext Gestational diabetes: what size the problem?

Wang KW, Balakrishnan V, Liauw PC, Chua EK, Vengadasalam D, Tan YT

Singapore Med J, 1988 Feb;29(1):53-5.
PMID: 3406769

Diabetes mellitus is a common chronic disease in Singapore. Its occurrence in pregnant women was 1.3% in a previous report. In a survey of 145 consecutive pregnant women registered at Alexandra Hospital the incidence of gestational diabetes was 13.1% when a total screen with 75 gm oral glucose challenge was used. The mean age of this sample was 27 years and the mean gestation at screening 33 weeks. There was an excess of Malay and Indian patients. Fifty percent had traditional risk factors tor gestational diabetes. Whether this higher incidence is a result of more stringent screening and/or increased occurrence remains to be confirmed.

Matched MeSH terms: Blood Glucose/analysis*
Revealing metabolic and biochemical variations via 1H NMR metabolomics in streptozotocin-nicotinamide-induced diabetic rats treated with metformin

Zolkeflee NKZ, Wong PL, Maulidiani M, Ramli NS, Azlan A, Mediani A, et al.

Biochem Biophys Res Commun, 2024 May 14;708:149778.
PMID: 38507867 DOI: 10.1016/j.bbrc.2024.149778

The increasing prevalence of lean diabetes has prompted the generation of animal models that mimic metabolic disease in humans. This study aimed to determine the optimum streptozotocin-nicotinamide (STZ-NA) dosage ratio to elicit lean diabetic features in a rat model. It also used a proton nuclear magnetic resonance (1H NMR) urinary metabolomics approach to identify the metabolic effect of metformin treatment on this novel rat model. Three different STZ-NA dosage regimens (by body weight: Group A: 110 mg/kg NA and 45 mg/kg STZ; Group B: 180 mg/kg NA and 65 mg/kg STZ and Group C: 120 mg/kg NA and 60 mg/kg STZ) were administered to Sprague-Dawley rats along with oral metformin. Group A diabetic rats (A-DC) showed favorable serum biochemical analyses and a more positive response toward oral metformin administration relative to the other STZ-NA dosage ratio groups. Orthogonal partial least squares-discriminant analysis (OPLS-DA) revealed that glucose, citrate, pyruvate, hippurate, and methylnicotinamide differentiating the OPLS-DA of A-MTF rats (Group A diabetic rats treated with metformin) and A-DC model rats. Subsequent metabolic pathway analyses revealed that metformin treatment was associated with improvement in dysfunctions caused by STZ-NA induction, including carbohydrate metabolism, cofactor metabolism, and vitamin and amino acid metabolism. In conclusion, our results identify the best STZ-NA dosage ratio for a rat model to exhibit lean type 2 diabetic features with optimum sensitivity to metformin treatment. The data presented here could be informative to improve our understanding of non-obese diabetes in humans through the identification of possible activated metabolic pathways in the STZ-NA-induced diabetic rats model.

Matched MeSH terms: Blood Glucose/analysis
Glycaemic & insulinaemic responses in men at rest following sago meal

Ahmad H, Singh R, Ghosh AK

Indian J Med Res, 2009 Aug;130(2):160-5.
PMID: 19797813

Sago (Metroxylin sagu) is one of the main sources of native starch. In Malaysia sago dishes are commonly eaten with sugar. However, other societies use sago as a staple food item instead of rice or potato. The study was undertaken to investigate the effect of ingestion of different physical forms of sago supplementation on plasma glucose and plasma insulin responses, as compared to the white bread supplementation in man, during resting condition.

Matched MeSH terms: Blood Glucose/metabolism*
Systematic Review of Randomized Controlled Trials in Uses of Nigella Sativa (Black Seed) in Metabolic Syndrome

Elhariri S, Burud I, Zulaimy NA, Tong JA, Ahmed I, Kar Chun SC, et al.

West Afr J Med, 2024 Apr 30;41(4):372-380.
PMID: 39002164

BACKGROUND: Metabolic syndrome as defined by The National Cholesterol Education Panel-Adult Treatment Panel III (NCEPATP III), is the presence of obesity, dyslipidaemia, the elevation of arterial blood pressure, and glucose intolerance. It affects 25% to 40% of the adult population of Malaysia and is associated with other medical conditions, especially cardiovascular disease. In this systematic review, the objective is to assess the effects of Nigella Sativa on parameters that reflect metabolic syndromes, such as lipid profile, blood pressure, blood glucose, and anthropometry indices.
METHODS: This systematic review was conducted by performing searches for relevant publications on two databases (PubMed and Scopus). The publication period was limited from January 2011 to December 2021. Cochrane collaboration tools were used for the risk of bias assessment of each trial.
RESULT: Six out of 8 randomised controlled trials (n:776) demonstrated a significant improvement in lipid profile (p <0.05), 5 out of 7 trials (n:701) showed a significant reduction in glycaemic indices (p <0.05), 1 out of 5 trials (n:551) demonstrated significant improvements in blood pressure (p <0.05), and 2 out of 7 trials (n:705) showed a significant reduction in anthropometric measurements (p <0.05).
CONCLUSION: Nigella Sativa has proved to have a significant positive effect on lipid profile and glycaemic index. The results showed in the parameters of blood pressure and anthropometric indices are less convincing, as results were inconsistent across studies. Nigella Sativa can therefore be recommended as an adjunct therapy for metabolic syndrome.

Matched MeSH terms: Blood Glucose/drug effects

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