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Aims: The study targeted to evaluate the antihyperglycemic activity of Salvia hispanica. Background: Salvia hispanica L. (Lamiaceae) is a medicinal plant with many beneficial properties on human health. Objective: This objective of the study was to investigate the antihyperglycemic effect of the aqueous extract of Salvia hispanica (S. hispanica) seeds and its capacity to improve lipid profile in normal and STZ-induced diabetic rats. Material and Methods: The seed aqueous extract of S. hispanica (SHSAE) at a dose of 100 mg/kg was administered orally in normal and diabetic rats. The effect of oral SHSAE treatment on blood glucose and lipid levels during 15 days was assessed in normal and streptozotocin-induced diabetic rats. The oral glucose tolerance test (OGTT) was carried out. The antioxidant activity of SHSAE was also examined. Results: The decrease of glycemia in rats following the administration of the plant extract suggested that the studied extract possesses antidiabetic effect. The extract of S. hispanica produced hypolipidemic effect with a significant lowering effect on plasma total cholesterol levels and increased on HDL-cholesterol levels. SHSAE was also able to enhance glucose tolerance using OGTT. Moreover, SHSAE possesses a potential antioxidant effect in vitro. Conclusion: In conclusion, this study demonstrates the antihyperglycemic and antilipidemic effects of SHSAE in rats.

This study examined the effect of moderate intensity stair stepping exercise on the glycemic response, and antioxidant capacity (TAC) during an oral glucose tolerance test (OGTT).Thirty participants (women = 12) completed 4 OGTTs during rest or stair walking bouts of 1, 3, and 10 min in a randomized order. Blood was collected at baseline and 30 min during the OGTTs and analyzed for glucose, insulin, TAC, and lactate. Glucose concentrations were decreased following the 10 min (-22.69 (-34.66 to -10.72) mg/dL, p 0.002) and 3 min (-15.37 (-25.05 to -5.69) mg/dL, p 0.004) bouts but not the 1 min bout (-6.18 (-19.54 to 7.18) mg/dL, p = 0.352). Insulin concentrations were decreased following the 10 min (-6.11 (-8.86 to -3.36 μIU/dL), p 0.001) and 3 min (-2.589 (-4.54 to -0.63) μIU/dL, p 0.012) bouts but not the 1 min bout (-0.37 (-1.87 to 1.13) μIU/dL, p = 0.616). Insulin sensitivity index values showed a significant increase in the 10-min trial (1.81 (0.03-3.58), p 0.048), but not during the 3 min (0.65 (-0.66 to 1.96) p = 0.317) or 1 min trial (0.13 (-1.58 to 1.84) p = 0.878). There was no omnibus effect for trial in TAC (p = 0.132, ηThis study provides evidence bouts as short as 3 min decrease postprandial blood glucose and insulin levels but longer bouts are needed to affect insulin sensitivity.

Background/Purpose: Hypertension is a risk factor of incident diabetes. In 2017, the ACC/AHA updated the definition of hypertension to above 130/80 mmHg, while the 2018 ESC/ESH guideline and the JNC7 criteria remained the cutoff of 140/90 mmHg. This study was aimed to investigate how different cutoffs of hypertension affect the association of hypertension to incident diabetes and the progression of insulin resistance. Methods: A total of 1177 subjects without diabetes at baseline were followed for 4.5 years. Diabetes was diagnosed by the results of oral glucose tolerance tests and hemoglobin A1c, or if anti-diabetic agents were used. Results: Hypertension by both criteria was associated with incident diabetes. Change of HOMA2-IR every 5 years (ΔHOMA2-IR/5 yr) was higher in subjects with hypertension than those without (adjusted p = 0.044). Subjects with treated hypertension had the highest risk of diabetes (HR 2.98, p

AIMS To improve perinatal outcomes, screening for hyperglycaemia using 75 g oral glucose tolerance test (OGTT) is recommended for all pregnant women at 24-28 weeks gestation (routine), and earlier if high-risk. Screening coverage for remote and Aboriginal Australian women is less than ideal. This study examined OGTT completion (early and routine) by women from rural and remote Western Australia compared with early glycated haemoglobin (HbA1c). METHODS In 2015-2018, 27 primary health care sites recruited 600 (233 Aboriginal) women aged ≥16-years, without pre-existing diabetes, who delivered >30-weeks gestation. All women presenting

In this descriptive cross-sectional study, the data on the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients at the Urban Directly Observed Treatment Centers in the Kathmandu, Bhaktapur, and Lalitpur districts of Nepal were collected. The prevalence of DM was assessed in 67 previously treated TB (PTTB) and 214 new TB patients. DM was diagnosed in 8 PTTB and 20 new TB patients. Clinical interviews identified 14 patients with DM, rapid blood glucose test was used to diagnose DM in 4 patients, and oral glucose tolerance test was used to diagnose DM in another 4 patients. Impaired glucose tolerance and impaired fasting glycemia were observed in 8 and 5 patients, respectively. The 18-24-year age group had the largest number of new TB patients (82, 38.3%). However, the incidence of DM among TB patients was higher in the >35-year age group. Moreover, DM was diagnosed in 24.2% of PTTB patients and in 23.1% of new TB patients. To determine the impact of DM screening in TB patients, a larger number of samples should be analyzed. DM screening for patients with TB is expected to start in developing countries. This should be initiated by conducting clinical interviews about DM and glucose tests using rapid kits.

Diabetes mellitus (DM) is a problem that deserves attention because of its increasing prevalence every year. The prevalence of DM based on WHO in 2030 is predicted to reach 366 patients. Epidemiologically, it is estimated that in 2030 the prevalence of DM in Indonesia reaches 21.3 million people. The purpose of this study was to determine the effectiveness of glycosides from noni fruit on reducing blood sugar levels in normal rats induced by diabetes by the method of glucose tolerance and induction of streptozotocin (STZ). Antidiabetic effect testing was divided into 8 groups namely 4 groups for oral glucose tolerance test in male mice (positive control group, negative control group, glycoside control group, and normal group), 4 other groups for testing with STZ induction (positive control group, positive control group, negative control, glycoside control group, and normal group). Oral glucose tolerance test results on normal mice showed that glycosides from noni fruit (Morinda citrifolia L.) gave significantly different results with negative controls at minute 30 is 0.036 (p 0.05) with the positive group on day 1 (0.056), day 3 (0.168), and day 7(0.141) so that it could be concluded that the glycosides from Noni fruit with a dose of 150mg/kg body weight provides antidiabetic activity.

El déficit de hormona del crecimiento (DGH) en la infancia se asocia a factores que aceleran la aterosclerosis. Objetivo: describir las alteraciones metabólicas en niños con deficiencia de hormona de crecimiento. Método: se realizó un estudio observacional, descriptivo y transversal que incluyó 53 pacientes con DGH a los cuales se les realizó un interrogatorio, examen físico y los estudios complementarios: prueba de tolerancia a la glucosa oral (PTG-O), lipidograma e insulinemia en ayunas. Resultados: predominó la hipertrigliceridemia en el sexo femenino, mientras las elevaciones de las LDL fueron más frecuentes en los menores de 5 años. Los valores de tensión arterial (TA), circunferencia de la cintura (CC) y el índice de masa corporal (IMC) se incrementan significativamente con la edad. Conclusiones: en los niños predominaron las alteraciones corporales, mientras que en las niñas fueron las alteraciones del lipidograma.

BACKGROUND Women with gestational diabetes mellitus (GDM) are at a seven-fold higher risk of developing type 2 diabetes (T2D) within 7-10 years after childbirth, compared with those with normoglycemic pregnancy. Although raised fasting blood glucose (FBG) levels has been said to be the main significant predictor of postpartum progression to T2D, it is difficult to predict who among the women with GDM would develop T2D. Therefore, we conducted a cross-sectional retrospective study to examine the glycemic indices that can predict postnatal T2D in Emirati Arab women with a history of GDM. AIM To assess how oral glucose tolerance test (OGTT) can identify the distinct GDM pathophysiology and predict possible distinct postnatal T2D subtypes. METHODS The glycemic status of a cohort of 4603 pregnant Emirati Arab women, who delivered in 2007 at both Latifa Women and Children Hospital and at Dubai Hospital, United Arab Emirates, was assessed retrospectively, using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Of the total, 1231 women were followed up and assessed in 2016. The FBG and/or the 2-h blood glucose (2hrBG) levels after a 75-g glucose load were measured to assess the prevalence of GDM and T2D, according to the IADPSG and American Diabetes Association (ADA) criteria, respectively. The receiver operating characteristic curve for the OGTT was plotted and sensitivity, specificity, and predictive values of FBG and 2hrBG for T2D were determined. RESULTS Considering both FBG and 2hrBG levels, according to the IADPSG criteria, the prevalence of GDM in pregnant Emirati women in 2007 was 1057/4603 (23%), while the prevalence of pre-pregnancy T2D among them, based on ADA criteria, was 230/4603 (5%). In the subset of women (n = 1231) followed up in 2016, the prevalence of GDM in 2007 was 362/1231 (29.6%), while the prevalence of pre-pregnancy T2D was 36/1231 (2.9%). Of the 362 pregnant women with GDM in 2007, 96/362 (26.5%) developed T2D; 142/362 (39.2%) developed impaired fasting glucose; 29/362 (8.0%) developed impaired glucose tolerance, and the remaining 95/362 (26.2%) had normal glycemia in 2016. The prevalence of T2D, based on ADA criteria, stemmed from the prevalence of 36/1231 (2.9%) in 2007 to 141/1231 (11.5%), in 2016. The positive predictive value (PPV) for FBG suggests that if a woman tested positive for GDM in 2007, the probability of developing T2D in 2016 was approximately 24%. The opposite was observed when 2hrBG was used for diagnosis. The PPV value for 2hrBG suggests that if a woman was positive for GDM in 2007 then the probability of developing T2D in 2016 was only 3%. CONCLUSION FBG and 2hrBG could predict postpartum T2D, following antenatal GDM. However, each test reflects different pathophysiology and possible T2D subtype and could be matched with a relevant T2D prevention program.

Background Gestational diabetes mellitus (GDM) incidence is increasing worldwide. It represents a major risk factor for adverse foetal-maternal outcomes. Awareness among women in regard to GDM-related risks (in particular foetus ones) has been proven to have an impact on compliance with recommendations. Therefore we aimed to evaluate the efficacy of our post-diagnosis counselling, that informs affected women of the GDM related risks for complications, in determining an adequate level of understanding. Method This is a cohort study involving 400 women undergoing the 24-28 weeks 75 g oral glucose tolerance test. Two hundred women diagnosed with GDM received the post-diagnosis counselling (treatment group) and two hundred women diagnosed without did not receive any counselling (control group). Both populations were surveyed with a 5 question questionnaire regarding their awareness about GDM foetal-maternal related risks. Their level of education about GDM foetal-maternal related risks, estimated according to the number of correct answers, was scored as: primary (score 0-1), secondary (score 2-3) or tertiary (score 4-5). Results Most of the women in the treatment group after receiving the post-diagnosis counselling have demonstrated a secondary level of education 132/200 (66%). Their mean level of awareness was higher in comparison to the control group 2.6 ± 1.8 (SD) versus 2.14 ± 1.8 (SD) p value = 0.012. In particular, they’ve demonstrated to be more aware of the risks for the foetus to become macrosomic (p = 0.004) or to die in utero (p = 0.0001). A high level of education and to have had previous pregnancies positively affected correct answers. Conclusions Our post-diagnosis counselling has played a role in improving women awareness about GDM foetal-maternal related risks. Future study will explore the impact of women’s level of awareness on glycaemic control.

This study aimed to investigate whether persistently high 1-h postchallenge glucose (PG) levels in a 75 g oral glucose tolerance test (75 g OGTT), as well as persistently low 1-h PG levels, are a risk factor for reclassification from normal glucose tolerance (NGT) into impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) among participants continually observed for 11 years. This single-center retrospective study used the electronic records of all participants undergoing Ningen Dock (health checkup) at Kiryu Kosei General Hospital between 2008 and 2018. In 2008, 361 of 523 participants who received Ningen Dock had NGT. Of the 361 participants, 109 received 75 g OGTT yearly for 11 years (2008–2018), and 72 of these 109 participants showed either persistently high 1-h PG (> 155 mg/dL) or persistently low 1-h PG (

Background: Diabetes mellitus (DM) is a dangerous disease with prevalence in Indonesia, including South Sulawesi, until now it has reached 3.4% of the total population. Prediabetes is an early condition for diabetes where blood glucose levels are above normal levels. One of the factors that are most closely related to the incidence of prediabetes is obesity which is also a problem currently faced at the age of children and adolescents. One way to detect a disturbance in glucose metabolism is the Oral Glucose Tolerance Test (TTGO).Objective: This study aims to determine the incidence of prediabetes in obese students. Methods: The study design was analytical descriptive, analyzing the test variables of OGTT as a prediabetes screening in the obese. The population was all active students of Megarezky University who were obese obtained by purposive sampling technique. Results: Based on the research result of 40 respondents, after the measured levels of GDP and two-hour glucose levels after oral glucose administration (postprandial), obtained a mean grade of respondents OGTT was 120,45 mg/dl and 8 (20%) of whom had an abnormal OGTT level ( 140-199 mg/dl). Conclusion: It reveals that the eight respondents experienced impaired glucose tolerance (IGT) and prediabetes. Obese people should begin to keep a balance between intake and energy expended to avoid Diabetes Mellitus.

Flavonoids are a class of natural chemicals with variable phenolic structures that have long been recognized for their health advantages, they have recently attracted researchers’ attention for treating diabetes and hyperglycemia. The goal of this research is to develop a novel antihyperglycemic formulation using a combination of three plant flavonoids: Linum usitatissimum L. seeds (FLU), Coriandrum sativum L. seeds (FCS), and Olea europaea var. sylvestris leaves (FOE) based on a mixture design experiment approach which generates the most effective ratio of each component in a mixture instead of the trial-and-error method. Prior to the test, sub-acute toxicity research was conducted to establish a safe and effective dosage. The Oral Glucose Tolerance Test (OGTT) was used to assess the antihyperglycemic impact of these extracts and their combinations in Swiss albino mice. The dose that showed efficacy and safety was 25 mg/kg, which was utilized in all formulations. According to the results, the binary and ternary combinations showed the most significant synergetic effects. The optimum combination with the most potent effect was 37% FLU, 20% FCS, and 43% FOE. This study’s mixture design and prediction model for glycemic variation (GV) may be utilized at an industrial level to develop a novel antidiabetic and antihyperglycemic formulation that is safe and effective.

The occurrence of gestational diabetes has increased recently. This condition, which can have extremely negative consequences for both mother and baby, can be detected by using an oral glucose tolerance test, and remedial action can be taken to prevent or reduce complications based on the results of the test. However, information about the oral glucose tolerance test (the OGTT) from different sources can negatively affect pregnant women and their families, resulting in their not taking the test. The aim of this study is to determine the knowledge and attitudes of women in the third trimester of pregnancy in relation to the OGTT. This descriptive cross-sectional study was conducted at two university hospitals between October 2017 and June 2018. The voluntary participants comprised 303 pregnant women in the third trimester of pregnancy. The research data were collected using "Demographic Data Collection Form and Determination Form for the OGTT Screening Status of Pregnant Women." The relationship between categorical variables was analyzed using chi-square tests. The percentage of pregnant women who did not have the OGTT monitoring was 32.7%. The main reasons for this were media exposure (28.6%), lack of knowledge (19.4%), and doctor's recommendation (19.4%). Forty-three percent of the pregnant women who did not have the OGTT were not aware of why the test done and 73.3% thought that the OGTT was dangerous for the baby. Of these, 58.8% of pregnant women received the information about the OGTT from doctors and 41.2% from midwives and nurses. A significant difference was found between the OGTT status of women according to their place of residence, number of pregnancies, knowledge about why the OGTT is performed, information sources, and the belief that the test is dangerous to the health of mother and baby (p < 0.05). Not having OGTT screening during pregnancy can lead to irremediable negative complications for the health of both mother and baby.

Telah dilakukan penelitian tentang pengaruh infusa batang gelagah (Saccharum spontaneum L.) terhadap kadar glukosa darah mencit putih (Mus musculus L.) jantan yang diinduksi glukosa. Penelitian ini bertujuan untuk melihat pengaruh infusa batang gelagah (Saccharum spontaneum L.) terhadap kadar glukosa darah mencit putih (Mus musculus L.) jantan yang diinduksi glukosa 2g/KgBB. Penelitian ini menggunakan metode Tes Toleransi Glukosa Oral (TTGO). Hewan percobaan dibagi menjadi 6 kelompok. Kelompok kontrol negatif hanya diberikan akuades, kelompok kontrol pembanding hanya diberikan larutan glukosa 2g/KgBB, kelompok positif diberi Metfromin dengan dosis 65mg/KgBB, kelompok perlakuan diberi sediaan infusa batang gelagah (Saccharum spontaneum L.) dengan konsentrasi 10%, 20% dan 30%. Setelah masing-masing hewan uji diberi perlakuan 30 menit kemudian diberi glukosa 2g/KgBB secara oral. Kemudian dilakukan pengukuran kadar glukosa darah mencit pada menit 30-180. Berdasarkan hasil pengujian infusa batang gelagah (Saccharum spontaneum L.) menunjukkan bahwa konsentrasi 10%, 20% dan 30% memiliki penurunan kadar glukosa darah mencit putih (Mus musculus L). Hasil yang diperoleh dari hasil uji ANOVA dua arah dilanjutkan dengan uji Post Hoc Tukey juga menunjukkan bahwa lama pemberian dapat mempengaruhi penurunan kadar glukosa darah mencit (p

OBJECTIVE To develop twin-specific outcome-based oral glucose tolerance test (OGTT) diagnostic thresholds for GDM based on the risk of future maternal type-2 diabetes. DESIGN A population-based retrospective cohort study (2007-2017). SETTING Ontario, Canada. METHODS Nulliparous women with a live singleton (n = 55 361) or twin (n = 1308) birth who underwent testing for gestational diabetes mellitus (GDM) using a 75-g OGTT in Ontario, Canada (2007-2017). We identified the 75-g OGTT thresholds in twin pregnancies that were associated with similar incidence rates of future type-2 diabetes to those associated with the standard OGTT thresholds in singleton pregnancies. RESULTS For any given 75-g OGTT value, the incidence rate of future maternal type-2 diabetes was lower for women with a twin than women with a singleton pregnancy. Using women with a negative OGTT as reference, the risk of future maternal type-2 diabetes in twin pregnancies with a positive OGTT based on the standard OGTT thresholds (9.86 per 1000 person years, adjusted hazard ratio (aHR) 4.79, 95% CI 2.69-8.51) was lower than for singleton pregnancies with a positive OGTT (18.74 per 1000 person years, aHR 8.22, 95% CI 7.38-9.16). The twin-specific OGTT fasting, 1-hour and 2-hour thresholds identified in the current study based on correlation with future maternal type-2 diabetes were 5.8 mmol/l (104 mg/dl), 11.8 mmol/l (213 mg/dl) and 10.4 mmol/l (187 mg/dl), respectively. CONCLUSIONS We identified potential twin-specific OGTT thresholds for GDM that are associated with a similar risk of future type-2 diabetes to that observed in women diagnosed with GDM in singleton pregnancies based on standard OGTT thresholds. TWEETABLE ABSTRACT Potential twin-specific OGTT thresholds for GDM were identified.

The oral glucose tolerance test (OGTT) has been widely used both in clinics and in basic research for a long time. It is applied to diagnose impaired glucose tolerance and/or type 2 diabetes mellitus in individuals. Additionally, it has been employed in research to investigate glucose utilization and insulin sensitivity in animals. The main aim of each was quite different, and the details are also somewhat varied. However, the time or duration of the OGTT was the same, using the 2-h post-glucose load glycemia in both, following the suggestions of the American Diabetes Association. Recently, the use of 30-min or 1-h post-glucose load glycemia in clinical practice has been recommended by several studies. In this review article, we describe this new view and suggest perspectives for the OGTT. Additionally, quantification of the glucose curve in basic research is also discussed. Unlike in clinical practice, the incremental area under the curve is not suitable for use in the studies involving animals receiving repeated treatments or chronic treatment. We discuss the potential mechanisms in detail. Moreover, variations between bench and bedside in the application of the OGTT are introduced. Finally, the newly identified method for the OGTT must achieve a recommendation from the American Diabetes Association or another official unit soon. In conclusion, we summarize the recent reports regarding the OGTT and add some of our own perspectives, including machine learning and others.

Introduction: In view of the alarmingly increasing incidence of Gestational Diabetes Mellitus (GDM), worldwide, as well as in India, a consensus to bring about standardization for diagnosis of GDM is needed. Internationally, the WHO 2013 criteria is being widely used, while (Diabetes In Pregnancy Study Group of India) DIPSI non fasting criteria is popularly used in India. There still remains many missed cases of GDM in India, which is a cause of concern. This study was done to compare the DIPSI non fasting, with WHO 2013 criteria for diagnosis of GDM. Methods: this cross-sectional study included 530 pregnant women, attending antenatal clinic of a tertiary care center, of North India, from Feb. 2018 to March 2019 and fulfilling inclusion criteria. All women attending antenatal clinic, during the study period, were subjected to capillary glucose evaluation, 2 hours after 75g oral glucose load, irrespective of the timing of last meal (DIPSI), as part of routine antenatal checkup. After 7 days, only those 530 women, who turned up in fasting state, and fulfilled inclusion criteria, were enrolled in the study and subjected to fasting 75g, oral glucose tolerance test (OGTT) (WHO 2013). Accuracy of DIPSI test was compared, to the fasting WHO 2013 criteria. Capillary glucose was measured using regular, well calibrated, point of care, “Optium Free Style” glucometer. Results: Out of 107 women diagnosed to have GDM by WHO 2013 criteria, only 89 were diagnosed by the DIPSI criteria. DIPSI had a low sensitivity (83.18%) when compared to the WHO 2013 criteria, Conclusion: This study showed that when non fasting DIPSI criteria was used as diagnostic criteria, 10.58% women with GDM, missed the diagnosis. Considering the adverse maternal and perinatal outcome of GDM, implication of missed diagnosis would be grave, especially in a developing country, like India. Hence, use of DIPSI criteria for diagnosing GDM should be reconsidered. Key words: GDM, DIPSI, OGTT, Diabetes in Pregnancy.

Objectives To estimate the metformin failure rate in women with gestational diabetes. Methods The study was designed as a retrospective cohort of women diagnosed with gestational diabetes by the 75 g 2 h oral glucose tolerance test. Women were placed into two groups: metformin success (107 patients not requiring insulin therapy) or metformin failure (15 patients requiring the addition of, or, transition to insulin). Primary outcome: rate of metformin failure. Secondary outcomes: maternal and neonatal factors. Results The failure rate of metformin was 15% (19/122 women) in the study. The failure group was more likely to have 3 abnormal values on a 2-h 75 g oral glucose tolerance test (37% (n=7/19) vs. 15% (n=15/103), p=0.02). Patients who failed had higher average fasting blood glucose levels on the glucose tolerance test as well as on pretreatment fasting finger stick values. Those who failed metformin were diagnosed with gestational diabetes and started on metformin earlier in gestation. Conclusions Overall low rate of metformin failure in treatment of gestational diabetes.

Objective: Characteristics of the glucose response during oral glucose tolerance test (OGTT) may reflect differences in insulin secretion and action. The aim was to examine whether timing of the glucose peak, shape of the glucose curve and their combination could be indicators of beta-cell dysfunction in obese/severely obese adolescents with normal glucose tolerance (NGT). Methods: Data from 246 obese/severely obese adolescents who completed OGTT were reviewed. Out of 184 adolescents with NGT, 174 could be further classified into groups based on timing of the glucose peak (early/30 minutes vs late/ ≥60 minutes) and shape of the glucose curve (monophasic vs biphasic). Groups were compared with respect to insulin sensitivity (whole body insulin sensitivity index - WBISI), early-phase insulin secretion (insulinogenic index - IGI) and beta- cell function relative to insulin sensitivity (oral disposition index - oDI). Results: Late glucose peak (p=0.004) and monophasic glucose curve (p=0.001) were both associated with lower oDI after adjustment for age, sex, puberty stage and body mass index z- score. Among obese/severely obese adolescents with NGT, those with coexistent late glucose peak and monophasic glucose curve had lower oDI than those with early glucose peak and biphasic glucose curve (p=0.002). Moreover, a combination of late glucose peak and monophasic glucose curve was the most powerful predictor of the lowest oDI quartile [odds ratio (OR): 11.68, 95% confidence interval: 3.048-44.755, p

Background: the pathogeneses of type 2 diabetes (T2DM) are impaired insulin action and secretion, including the second phase insulin secretion (SPIS). However, SPIS is difcult to be measured. The study aimed to validate the SPIS derived from the simpler oral glucose tolerance test (OGTT) against the SPIS derived from the more complicated gold standard test, i.e. low dose graded glucose infusion test (LDGGI). Methods: Fourteen participants (3 with normal glucose tolerance, 8 with pre-diabetes and 3 with T2DM) were enrolled. They received both a standard LDGGI and an OGTT. The mathematical method which is called deconvolution was applied in both tests. The slope of the insulin secretion rate (ISR) against glucose levels during the LDGGI was obtained and regarded as the gold standard (SPIS-L). At the same time, the SPIS calculated from OGTT with minimal model was also obtained (SPIS-O). Results: Pearson correlation was used to assess the correlation between SPIS-L and SPIS-O. There was a signicant correlation between SPIS-L and SPIS-O (r = 0.843, p = 0.000). At the same time, a good agreement between the SPIS-L and SPIS-O was also found from the Bland-Altman plot. Conclusion: SPIS-O is highly correlated with the gold standard, i.e., the SPIS-L. Since it is easier to be performed, future researches focusing on SPIS by using OGTT might be expedited.

Objectives:Fruit intake may influence gestational diabetes mellitus (GDM) risk. However, prospective evidence remains controversial and limited. The current study aimed to investigate whether total fruit and specific fruit intake influence GDM risk.Design:A prospective cohort study was conducted. Dietary information was collected by a 3-d 24-h dietary recall. All participants underwent a standard 75-g oral glucose tolerance test at 24–28 gestational weeks. Log-binomial models were used to estimate the association between fruit intake and GDM risk, and the results are presented as relative risks (RR) and 95 % CI.Setting:Southwest China.Participants:Totally, 1453 healthy pregnant women in 2017.Results:Total fruit intake was not associated with lower GDM risk (RR of 1·03 (95 % CI 0·83, 1·27) (Ptrend = 0·789)). The RR of GDM risk was 0·73 for the highest anthocyanin-rich fruit intake quartile compared with the lowest quartile (95 % CI 0·56, 0·93; Ptrend = 0·015). A higher grape intake had a linear inverse association with GDM risk (Q4 v. Q1: RR = 0·65; 95 % CI 0·43, 0·98; Ptrend = 0·044), and after further adjustment for anthocyanin intake, the inverse association tended to be non-linear (Q4 v. Q1: RR = 0·65; 95 % CI 0·44, 0·98; Ptrend = 0·079). However, we did not find an association between glycaemic index-grouped fruit, glycaemic load-grouped fruit or other fruit subtype intake and GDM risk.Conclusions:In conclusion, specific fruit intake (particularly anthocyanin-rich fruit and grapes) but not total fruit intake was inversely associated with GDM risk.

To clarify whether mild first trimester hyperglycaemia (characteristic of early-onset GDM) is associated with higher incidence of congenital malformations and other adverse fetomaternal outcomes compared to women with second trimester hyperglycaemia (later-onset GDM). We analyzed the Portuguese National GDM database, containing data collected between 2011 and 2017. Two study groups were defined: Group 1—Women with GDM diagnosed during the first trimester (with fasting glycemia ≥ 92 and

Aims/Introduction We aimed to determine whether glucokinase is required for β‐cell mass expansion induced by high‐starch diet (HSTD)‐feeding, as has been shown in its high‐fat diet‐induced expansion. Materials and Methods Eight‐week‐old male wild‐type (Gck+/+ ) or glucokinase haploinsufficient (Gck+/− ) mice were fed either a normal chow (NC) or an HSTD for 15 weeks. The bodyweight, glucose tolerance, insulin sensitivity, insulin secretion and β‐cell mass were assessed. Results Both HSTD‐fed Gck+/+ and Gck+/− mice had significantly higher bodyweight than NC‐fed mice. Insulin and oral glucose tolerance tests revealed that HSTD feeding did not affect insulin sensitivity nor glucose tolerance in either the Gck+/+ or Gck+/− mice. However, during the oral glucose tolerance test, the 15‐min plasma insulin concentration after glucose loading was significantly higher in the HSTD group than that in the NC group for Gck+/+ , but not for Gck+/− mice. β‐Cell mass was significantly larger in HSTD‐fed Gck+/+ mice than that in NC‐fed Gck+/+ mice. In contrast, the β‐cell mass of the HSTD‐fed Gck+/− mice was not different from that of the NC‐fed Gck+/− mice. Conclusions The results showed that HSTD feeding would increase pancreatic β‐cell mass and insulin secretion in Gck+/+ , but not Gck+/− mice. This observation implies that glucokinase in β‐cells would be required for the increase in β‐cell mass induced by HSTD feeding., Our results indicated that high‐starch diet feeding augmented insulin secretion and increased pancreatic beta‐cell mass in wild‐type mice, but not in the beta cell‐specific glucokinase haploinsufficient mice. These findings demonstrated that glucokinase in beta cells is required for increasing beta cell mass induced by high‐starch diet feeding.

Made available in DSpace on 2021-06-25T10:56:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Animal models are widely used for studying diabetes in translational research. However, methods for induction of diabetes are conflicting with regards to their efficacy, reproducibility and cost. A comparison of outcomes between the diabetic models is still unknown, especially full-term pregnancy.To understand the comparison, we analyzed the streptozotocin (STZ)-induced diabetes at three life-different moments during the neonatal period in Sprague–Dawley female rats: at the first (D1), second (D2) and fifth (D5) day of postnatal life. At adulthood (90 days; D90), the animals were submitted to an oral glucose tolerance test (OGTT) for diabetic status confirmation. The diabetic and control rats were mated and sacrificed at full-term pregnancy for different analyses. Group D1 presented a higher mortality percentage after STZ administration than groups D2 and D5. All diabetic groups presented higher blood glucose levels as compared to those of the control group, while group D5 had higher levels of glycemia compared with other groups during OGTT. The diabetic groups showed impaired reproductive outcomes compared with the control group. Group D1 had lower percentages of mated rats and D5 showed a lower percentage of a full-term pregnancy. Besides that, these two groups also showed the highest percentages of inadequate fetal weight. In summary, although all groups fulfill the diagnosis criteria for diabetes in adult life, in our investigation diabetes induced on D5 presents lower costs and higher efficacy and reproducibility for studies involving diabetes-complicated pregnancy. Laboratory of Experimental Research on Gynecology and Obstetrics São Paulo State University (UNESP) DNA Repair Laboratory University of São Paulo (USP) Joslin Diabetes Center Harvard Medical School Department of Physiology Charles University Laboratory of System Physiology and Reproductive Toxicology Federal University of Mato Grosso (UFMT) Laboratory of Experimental Research on Gynecology and Obstetrics São Paulo State University (UNESP)

Objective:Measures of glycaemic impact (e.g. postprandial glucose (PPG), oral glucose tolerance test (OGTT) and glycaemic index (GI)) are used by government health and regulatory agencies and public health associations around the world. The objective of this global review was to identify similarities and differences in the use of glycaemic impact measures for potential considerations for harmonisation.Design:A literature and internet search was conducted to identify country government agencies and health associations that provide guidance or recommendations for PPG, OGTT, GI and glycaemic load.Results:Based on this global review, the use of GI for food labelling (e.g. low GI) is limited and its use is voluntary. The application of OGTT as a diagnostic measurement of diabetes and gestational diabetes is widely used and in a consistent manner among the different regions of the world. Time-specific (e.g. 2 h) PPG is commonly used as a target not to exceed in individuals with diabetes and gestational diabetes. PPG is used by regulatory agencies for the substantiation of food labelling. There are differences, however, among regulatory agencies in the specific measure of PPG (i.e. PPG AUC v. peak PPG). Maximum targets for 2-h PPG for individuals with diabetes and gestational diabetes, ranging between 6 and 10 mmol/l, across countries suggest a potential consideration to harmonise PPG targets.Conclusions:There is general consistency in the use and/or target levels of glycaemic impact measures; however, there is a potential need to investigate harmonisation strategies on certain aspects of glycaemic impact measures.

The goal of this study was to examine associations of measures of maternal glucose metabolism and blood pressure during pregnancy with blood pressure at follow-up in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. The HAPO Follow-Up Study included 4747 women who had a 75-g oral glucose tolerance test (OGTT) at ~28 weeks' gestation. Of these, 4572 women who did not have chronic hypertension during their pregnancy or other excluding factors, had blood pressure evaluation 10-14 years after the birth of their HAPO child. Primary outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (SBP ≥ 140 and/or DBP ≥ 90 or treatment for hypertension) at follow-up. Blood pressure during pregnancy was associated with all blood pressure outcomes at follow-up independent of glucose and insulin sensitivity during pregnancy. The sum of glucose z-scores was associated with blood pressure outcomes at follow-up but associations were attenuated in models that included pregnancy blood pressure measures. Associations with SBP were significant in adjusted models, while associations with DBP and hypertension were not. Insulin sensitivity during pregnancy was associated with all blood pressure outcomes at follow-up, and although attenuated after adjustments, remained statistically significant (hypertension OR 0.79, 95%CI 0.68-0.92; SBP beta -0.91, 95% CI -1.34 to -0.49; DBP beta -0.50, 95% CI -0.81 to -0.19). In conclusion, maternal glucose values at the pregnancy OGTT were not independently associated with maternal blood pressure outcomes 10-14 years postpartum; however, insulin sensitivity during pregnancy was associated independently of blood pressure, BMI, and other covariates measured during pregnancy.

Objective: To determine the frequency of normoglycemia (NG), prediabetes and diabetes mellitus (DM) among patients having impaired random glucose (IRG) and establish the optimum cutoff of impaired random glucose for the diagnosis of diabetes and prediabetes. Study Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Pathology Rawalpindi and Combined Military Hospital Quetta, from Nov 2016 to Nov 2018. Methodology: Healthy individuals of both genders undergoing investigation for diabetes mellitus were enrolled through non probability consecutive sampling while patients with diabetes, pregnant, hospitalized, using con-comitant medications (corticosteroids, immunosuppressive, chemotherapy) and those unable to complete oral glucose tolerance test (OGTT) were excluded. Random plasma glucose (RPG) was determined and patients having impaired random glucose underwent oral glucose tolerance test, analysis being done on ADVIA1800® using hexokinase methodology. Results: Among the 280 study participants, majority were female {156 (57.5%) vs 124 (44.3%) male}. Mean age in male and female patients was 33.625 ± 3.34 years vs 35.150 ± 2.79 years with p-value 0.50 while mean IRG was 7.12 ± 1.47 vs 6.90 ± 1.17 mmol/L respectively with p-value 0.16 (statistically insignificant). Oral glucose tolerance test results showed NG in 61.8% (173), prediabetes in 24.6% (69) while diabetes was found in 38 (13.6%) patients. Optimal impaired random glucose cutoff value for diagnosis of diabetes was found 7.45 mmol/L (AUC 0.956 [CI 0.927-0.984], p

Aim To investigate the glucose profile of women with and without gestational diabetes mellitus (GDM) by simultaneously analyzing several factors of continuous glucose monitoring (CGM) data. Methods CGM was conducted for 2 weeks in the second trimester of pregnant women whose random blood glucose level was ≥100 mg/dl. A 75-g oral glucose tolerance test was performed around day 7, and the index of hyperglycemia, relative hypoglycemia, and indices of glucose variability were extracted from CGM data. Unsupervised hierarchical clustering was performed to categorize glucose profiles of the participants. Results CGM data were obtained from 29 women. Glucose profiles were categorized into three clusters: low glucose levels with less glucose variability group (L group, n = 7); moderate glucose levels with moderate-to-high glucose variability group (M group, n = 18); and high glucose levels with high glucose variability group (H group, n = 4). The waveforms of the glucose profiles were very different among the three groups. Women with GDM tended to be more frequent in the H group than in the M and L groups (75.0%, 16.7%, and 14.3%, respectively; p = 0.053). Maternal age was significantly higher and the proportion of multiparous women was significantly larger in the H group compared to L group (p = 0.002 and 0.015, respectively). Conclusions A comprehensive analysis of CGM data could help us extract a subgroup of women with characteristics of GDM.

Background: Dipeptidyl peptidase IV has been reported to be an important target for the development and discovery of new therapies for diabetes mellitus type II. Objective: The main aim of this study was to discover chemical entities that target the inhibition of DPP IV and feature potent hypoglycemic action. Methods: A structure-based virtual screening was applied to discover new hypoglycemic agents. Molecular docking was performed to compute the binding free energies. Molecular dynamics simulations were done to evaluate the binding stability of resulted hits. Results: Seven small non-peptide potential inhibitors of Dipeptidyl peptidase IV with 3-imino-4-(4- substituted phenyl)-1, 2, 5-thiadiazolidine-1,1-dioxide scaffold were discovered. The binding free energies ranged from -24.50 to -36.06 kJ/mol. Molecular dynamics simulations revealed high stability of all protein-ligand complexes with low root mean square deviation over 10 ns simulation time. The tested compounds expressed a significant reduction in blood glucose level up to 90% with excellent oral glucose tolerance test after 120 minutes of injection in a diabetes mellitus type II animal model. A promising release of insulin was observed with a potential hypoglycemic activity for all compounds. Conclusion: The virtual screening was successful to discover potent hypoglycemic agents with drug-like properties that may need more consideration for future studies and development.

To investigate differences in heart rate variability (HRV) during oral glucose tolerance tests (OGTTs) in response to the rate of change in glucose and to different glycaemic ranges in individuals with type 1 diabetes. This was a single‐centre, prospective, secondary outcome analysis in 17 individuals with type 1 diabetes (glycated haemoglobin 53 ± 6.3 mmol/L), who underwent two OGTTs (after 12 and 36 hours of fasting) investigating differences in HRV in response to rapid glucose increases/decreases and different glycaemic ranges during OGTT. Based on the rate of change in glucose level, the variables heart rate (P 50 ms difference (P

Hyperglycaemia can alter placental resistance to blood flow and hyperglycaemia has adverse perinatal outcomes. Oral glucose tolerance testing (OGTT) increases the maternal plasma glucose levels temporarily and mimics metabolic hyperglycaemia. The blood flow of the uterine artery (UtA), umbilical artery (UA), middle cerebral artery (MCA) were assessed before, 1 and 2 h following the OGTT by using Doppler ultrasonography. Z-score of cerebroplacental ratio (CPR), pulsatility index (PI) for three vessels were evaluated separately. All measurements of the MCA, UA, UtA Doppler parameters were not statistically different for fasting, and 1 and 2 h following the 75 g OGTT in the 53 pregnant women with a singleton gestation in the low-risk group. This study results show that acute hyperglycaemia induced by OGTT has no effect on maternal and foetal Doppler parameters in healthy pregnancies.IMPACT STATEMENT

BACKGROUND AND AIMS: Gestational diabetes mellitus (GDM) has high prevalence worldwide. This study aimed to evaluate the fasting plasma glucose (FPG) cutoffs at first prenatal visit and at 24–28th of gestational weeks to avoid obtaining full oral glucose-tolerance test (OGTT) in the diagnosis of GDM. METHODS: This study was a cross-sectional study conducted in Tehran, Iran during October 2016 and November 2017. All pregnant women reporting for the first routine prenatal visit before 20th week of gestational age were included in this study. Participants without overt diabetes mellitus at first prenatal visit, underwent OGTT at 24–28th of gestational weeks. RESULTS: Totally 952 pregnant women with mean age of 26.4 ± 14.1 years took part in this study. The prevalence of GDM was 12.7% (mostly diagnosed based on the FPG alone). FPG cutoffs 75 and 80 mg/dL at first prenatal visit and at 24–28th of gestational weeks can rule out the GDM with high sensitivity and negative predictive value, respectively. FPG cutoffs 85 and 90 mg/dL at first prenatal visit and at 24–28th of gestational weeks had high capacity, excellent specificity and positive predictive value in diagnosing GDM, respectively. CONCLUSIONS: Performing only the FPG and considering FPG cutoffs 75 and 80 mg/dL at first prenatal visit and at 24–28th of gestational weeks can be a useful tool predicting the incidence of GDM, respectively, and had similar diagnostic power.

Objective: The present study aimed to assess the results of pregnant women who have been applied a 50 g oral glucose tolerance test (OGTT) in the first and second trimesters and investigate this method’s role in the diagnosis of gestational diabetes mellitus (GDM) and risk factors associated with this disease. Material and Methods: This retrospective study was performed on 153 pregnant women who were admitted to our hospital’s antenatal clinics between March 2011 and August 2011. Fifty grams OGTT was applied to the same pregnant women both in the 1st trimester (between 8th and 14th weeks) and second trimester (between 24th and 28th weeks); values of the test results were then compared. A 100 g OGTT di- agnostic test was performed on those with a 50 g OGTT value of ≥140 mg/dl in both trimesters. The study patients were divided into two groups as non-GDM and GDM based on venous plasma glucose values measured 1 h after 50 g of oral glucose load given. The non-GDM group consisted of those with plasma glucose levels

Background: In the absence of international or national guidelines for the diagnosis and treatment of gestational diabetes mellitus (GDM), physicians’ current practice varies a great deal. This is particularly true for most developing countries, including Bangladesh. We have conducted a study to register the current practices related to the diagnosis and management of GDM in Bangladesh. Materials and Methods: A cross-sectional survey was conducted to obtain details regarding diagnostic criteria used, screening methods, management strategies, and postpartum follow-up of GDM using a structured questionnaire. A total of 756 physicians from 30 centers of the Diabetic Association of Bangladesh, Government and Private Hospitals located in both the capital Dhaka city and outside Dhaka participated. Results: The study found that diabetologists look after 42.5% of the GDM patients. Among the physicians participated, 44.4% preferred first antenatal care visit for the GDM screening, and 55.2% preferred two samples oral glucose tolerance test (OGTT) for screening. About 47.6% of the physicians followed the American Diabetic Association (ADA) guidelines for diagnosis. Half of the participated physicians preferred short-acting insulin and four-times home monitoring of blood glucose per day. Around 66.3% of the physicians advised OGTT 6 weeks after delivery. Conclusion: The majority of the participating physicians do not follow the recommendations for the diagnosis and management of GDM. This emphasizes the need for developing an evidence-based national guideline for GDM and necessary training to halt the rise of diabetes and safe mother and child health in Bangladesh.

Objectives: To compare the reliability of non-fasting oral glucose tolerance test (OGTT) versus fasting OGTT for screening of hyperglycaemia in pregnancy (HIP). Methods: This cross sectional analytic study was conducted by the Department of Obstetrics & Gynaecology, Isra University Karachi Campus from October 2016 to April 2017. A total of 225 pregnant women irrespective of gestational age were included in the study. They underwent non fasting 75 grams OGTT. Venous plasma glucose was done 02 hours after the glucose load. Same women were advised to come again within three to seven days for fasting OGTT. Venous plasma glucose (VPG) was estimated in fasting and 2 hours post glucose load. Results: Using the non-fasting OGTT, out of 204 women, 32 were diagnosed with hyperglycemia. All these 204 women were again called for fasting OGTT three to seven days after the initial non-fasting OGTT. Only nine were diagnosed with hyperglycemia, out of these nine women, seven women who were screen positive on non-fasting OGTT were found to be screen positive on fasting OGTT as well. However, only two women were additionally diagnosed with hyperglycemia who were initially screen negative on non-fasting OGTT. The non-fasting OGTT has diagnosed HIP with sensitivity of 77.7%, specificity of 87.1%, positive predictive value of 21.8% and negative predictive value of 98.8%. Conclusion: The use of the non-fasting OGTT at first antenatal visit may be a practical approach to detect the HIP as screening and diagnostic tool in the resource constrained settings. doi: https://doi.org/10.12669/pjms.37.4.3979 How to cite this:Masood SN, Lakho N, Saeed S, Masood Y. Non-fasting OGTT versus Fasting OGTT for screening of Hyperglycaemia in Pregnancy (HIP). Pak J Med Sci. 2021;37(4):1008-1013. doi: https://doi.org/10.12669/pjms.37.4.3979 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background/Aim. Insulin resistance occurs in approximately 60?80% of women with polycystic ovary syndrome (PCOS) and in 95% of obese women with PCOS. Previous studies have shown that the shape of the glucose curve obtained during an oral glucose tolerance test (OGTT) may be useful as a metabolic screening parameter and could give in-sight into the future risk of diabetes mellitus type II. The aim of this study was to determine the frequency of insulin resistance according to the Homeostasis model assessment of insulin resistance (HOMA-IR) and indirect assessment method of insulin resistance based on insulinemias during the oral glucose tolerance test (OGTT) (here in after ?insulinemias during the OGTT?), as well as, frequency of glucose curve shapes (monophasic, biphasic, triphasic) in patients with PCOS. Also, the aim of research was testing the correlation between glucose curve shape and peak time of glucose during the OGTT with presence of insulin resistance in patients with PCOS. Methods. Patients were observed according to the following parameters: presence of insulin resistance, glucose curve shape and peak time of glucose and insulin during the OGTT. Results. The observed prevalence of insulin resistance in the PCOS group according to the HOMA-IR > 2.5 was 66.19% and according to insulinemias during the OGTT was 78.42%. The shape of the glucose curve was monophasic in 293 (70.26%), biphasic in 56 (13.43%) and triphasic in 68 (16.31%) of patients. There was statistically significant difference in the frequency of insulin resistance, according to glucose curve shape, only when it was defined by insulinemias during the OGTT (p = 0.005). Conclusion. According to results of the study, the most patients with PCOS have a monophasic shape of glucose curve. When we take frequency of insulin resistance in account, we notice approximately the same frequency in all types of curves, when it is defined by the HOMA-IR. On the other hand, when insulin resistance is defined by insulinemias during the OGTT, resistant patients with PCOS mostly have triphasic glucose curve shape.

Aim: There are limited data on the management of gestational diabetes mellitus (GDM) during the coronavirus disease 2019 (COVID-19) pandemic. This survey was carried out in India to understand the practice patterns of diabetologists and obstetricians (OBs) during the pandemic. Materials and Methods: An online questionnaire was designed, and the link to the survey was shared with doctors through email. Questions were related to the diagnosis and management of GDM both before and during the COVID-19 pandemic. Results: A total of 117 diabetologists and 90 OBs from different parts of India participated in the survey. During the COVID-19 pandemic, diabetologists carried out higher random glucose and HbA1c tests and lower numbers of oral glucose tolerance tests (OGTTs), but differences compared with before COVID-19 were nonsignificant. The OBs reported doing a significantly lower number of OGTTs (85.6% vs. 95.6%, P = 0.02) and significantly more HbA1c tests (16.7% vs. 5.6%, P = 0.03) and self-monitoring of blood glucose (59.4% vs. 37.1%, P < 0.0001) during the pandemic, than earlier. Although 97% of all the doctors surveyed reported using some form of telemedicine, several challenges were identified. Conclusion: The COVID-19 pandemic has resulted in changes in the management of women with GDM. The use of digital technologies could help improve the care of women with GDM during such pandemics.

Background To estimate the ability of fasting, 1-h, and 2-h post-load glucose to predict cardiovascular outcomes. Methods We examined a population-based study consisting of 977 middle-aged subjects who underwent an oral glucose tolerance test with glucose values measured at 0, 60, and 120 min. Participants were followed up to 24 years, and cardiovascular outcomes were collected from national registers. Predictive abilities of fasting, 1-h, and 2-h glucose were evaluated alone and in the prediction models with traditional cardiovascular risk factors using Cox proportional hazard models, the likelihood-ratio test, Harrell's concordance index and integrated discrimination improvement. Results Cardiovascular endpoint occurred in 222 (22.7%) participants during a median follow-up of 19.8 years. In the prognostic models, 1-h glucose (HR 1.67, 95%CI 1.10–2.53), but not fasting or 2-h glucose, predicted cardiovascular events statistically significantly. In addition, when adding glucose parameters into the model including traditional cardiovascular risk factors, only 1-h glucose improved the predictive ability (LR-test p=.046). Finally, 1-h glucose found slightly over 50% more cardiovascular endpoints that were not recognized by fasting or 2-h glucose levels. Conclusions Our findings support the earlier ones suggesting that 1-h glucose would be a better long-term predictor of cardiovascular morbidity and mortality than fasting or 2-h glucose.KEY MESSAGESIn addition to conventional CV risk factors,1-h but not fasting or 2-h post-load glucoses seems to be an independent predictor of cardiovascular events and seems to improve the predictive ability of the traditional cardiovascular risk model.Elevated 1-hpost-load glucose finds a large number (slightly over 50%)of cardiovascular endpoints that were not recognized by fasting or 2-h post-load glucose levels.One-hour glucose seems to be a better long-term predictor of cardiovascular morbidity and mortality than fasting or 2-h post-load glucose.

Background. Gestational diabetes mellitus (GDM) remains a significant concern within the medical community due to its high risk, as well as its serious side effects on both the mothers and the fetuses. This study aims to assess the prevalence and the risk factors of gestational diabetes mellitus in pregnant women at Da Nang Hospital for Women and Children. Methods. A cross-sectional study was conducted on 706 pregnant women at 2428 weeks of gestation at Da Nang hospital to determine the prevalence of gestational diabetes. Multivariate regression analysis was used to clarify the independent risk factors associated with gestational diabetes. All participants were interviewed and tested for the oral glucose tolerance test (OGTT) to identify the number of gestational diabetes, which was diagnosed according to the American Diabetes Association (ADA) diagnostic criteria in 2014. Results. Gestational diabetes prevalence was 10.2%; categorized by the number of matched diagnostic criteria: 1 criterion: 7.1%; 2 criteria: 2.1%; 3 criteria: 1.0%. There are four independent risk factors for gestational diabetes determined through multivariate regression analysis: maternal age > 30 years (OR = 2.376), a history of gestational diabetes (OR = 12.211), pre-pregnancy BMI ≥ 23 kg/m2 (OR = 10.775), a history of fetal macrosomia > 3800 g (OR = 4.655). The risk of gestational diabetes in the group with risk factors was 6.21 times higher than that in the group with no risk factors. Conclusion. More attention should be paid to the risk factors for gestational diabetes, such as maternal age > 30 years, a history of gestational diabetes, pre-pregnancy BMI ≥ 23 kg/m2, a history of fetal macrosomia > 3800 g in all pregnant women.

Introduction: Diabetes is considered primary risk factor for heart disease and comorbidities in older people and in children. Due to escalating epidemic, diabetes is concerned high profile public health problem. Materials and Methods: Swiss albino rats weighing around 150-200gms of either sex were randomly selected from the central animal facility. Animals were randomly divided into 2 groups, six animals in each group. A group of 3 rats were kept in individual cages. The control was given 0.5 ml 1% Gum acacia, test group was given Telmisartan at the dose of 7.2mg/kg/day. All the drugs were given orally and for the period of 5 days. All rats were fasted overnight before the 5th day. On the 5th day glucose (0.6gm/kg body weight) was given orally using oral feeding tube and oral glucose tolerance test (OGTT) was performed. Blood was collected by tail snipping method and capillary blood glucose was assessed at 0, 60, and 150 minutes using a glucometer. Results: Fall in capillary blood glucose level was seen in Telmisartan group at all-time intervals when compared to control group. Conclusion:Telmisartan when given orally for 5 days showed fall in blood glucose level in swiss albino rats. Keywords: Adipokines, Capillary blood glucose, Diabetes, Euglycemic

To explore the impact of ferritin level on the disassociation of glycated hemoglobin A1c (HbA1c) and mean plasma glucose (MPG).We used a 2012-2013 cross-sectional survey conducted in Pinggu district, Beijing including 3095 Chinese participants aged 25-75 years. We categorized their glycemic status by interviewing for diagnosed diabetes and by measuring HbA1c, fasting plasma glucose (FPG), and 2-hours post-load plasma glucose (2-hours PPG). We fitted a multivariable regression model to explore the impact of ferritin on the association of HbA1c or glycated albumin (GA) and mean plasma glucose.A total of 5.65% of participants were diagnosed as diabetes using HbA1c criteria, and 9.79% using oral glucose tolerance test criteria. Compared with males, females had significantly lower hemoglobin levels (159.82 ± 11.56 vs 135.93 ± 12.62) and lower ferritin levels (113.00 [68.55, 185.50] vs 33.40 [12.40, 70.13]). Linear regression analysis performed in different groups classified by different diagnose criterion indicated that the correlation between MPG and HbA1c differs in different tertiles of ferritin (lowest vs middle vs highest: RFerritin level might affect the association between glucose and HbA1c, which should be taken into account when using HbA1c as a diagnosis criterion for diabetes and prediabetes.目的: 探讨铁蛋白水平如何影响糖化血红蛋白(HbA1c)与平均血糖的关系 研究设计与方法: 我们使用了2012-2013年在北京市平谷区进行的横断面调查; 这项调查纳入了3095名年龄在25-75岁的中国受试者。根据了解既往确诊糖尿病史和测量HbA1c、空腹血糖与负荷后两小时血糖对受试者的血糖状况进行分类。通过拟合的多变量回顾模型; 分析铁蛋白水平如何影响平均血糖与HbA1c、糖化白蛋白的关系。 结果: 根据HbA1c标准; 共有5.65%的受试者被诊断为糖尿病; 而根据口服糖耐量试验标准则有9.79%被诊断为糖尿病。相比于男性; 女性受试者的血红蛋白水平显著更低(159.82±11.56 vs. 135.93±12.62 g/L); 铁蛋白水平也更低(113.00 [68.55, 185.50] vs. 33.40 μg/L [12.40, 70.13])。在根据不同诊断标准划分的不同组别中进行的线性回归显示; 平均血糖值和HbA1c之间的相关性在铁蛋白值三分位组中有所不同(最低、中间与最高:女性R

We surveyed US transplant centers to assess practices regarding the evaluation and selection of living kidney donors based on metabolic, cardiovascular, and substance use risk factors. Our companion article describes renal aspects of the evaluation. Response rate was 31%. Compared with 2005, programs have become more accepting of hypertensive candidates: 65% in 2017% vs 41% in 2005 consider candidates with hypertension well controlled with 1 medication. One notable exception is black hypertensive candidates, who are frequently excluded regardless of severity. The most common body mass index (BMI) cutoff remains 35 kg/m2 , and fewer programs now consider candidates with BMI >40 kg/m2 . A 2-hour oral glucose tolerance test of ≥140 mg/dL remains the most common criterion for exclusion of prediabetic candidates. One quarter to one third of programs exclude based on isolated cardiac abnormalities, such as mild aortic stenosis; a similar proportion consider these candidates only if older than 50 years. Cigarette or marijuana smoking are infrequently criteria for exclusion, although 45% and 37% programs, respectively, require cessation 4 weeks prior to surgery. In addition to providing an overview of current practices in living kidney donor evaluation, our study highlights the importance of research evaluating outcomes with various comorbidities to guide practice.

Diabetes mellitus is an important social and medical problem as it causes the development of dangerous complications leading to disability and mortality. This disease is characterized by a multi-vector pathogenesis that requires a comprehensive approach to the treatment. Due to the use of mixtures of medicinal plants in the treatment of diabetes it is possible to cover all aspects of the development of this disease and its complications.Aim. To study the hypoglycemic activity of herbal mixtures used in folk medicine for the prevention and treatment of diabetes mellitus type 2, and determine their conditional therapeutic dose.Materials and methods. The study was performed on male albino rats weighing 180-200 g. For the preventive treatment within 20 days they received orally the aqueous extracts (1:10) of the herbal mixtures studied in the doses of 6 mL/kg/day, 9 mL/kg/day and 12 mL/kg/day and the reference drugs – the official herbal mixture “Arfazetin” in the dose of 9 mL/kg/day and metformin tablets in the dose of 60 mg/kg/day. The study of hypoglycemic properties and determination of the conditional therapeutic dose of the mixtures studied were performed using glucose loading tests (oral glucose tolerance test – OGTT and intraperitoneal glucose tolerance test– IPGTT). All experiments were performed in accordance with general ethical principles with the recommendations of the EEC Council Directive 2010/63/EU about the protection of animals used for scientific purposes.Results and discussion. The results of the study showed that the 20-day preventive treatment with the herbal mixtures reduced alimentary hyperglycemia 30 minutes after OGTT and regulated carbohydrate tolerance disorders by reducing hyperglycemia 15 minutes after IPGTT. The herbal mixture No. 13 in the dose of 12 mL/kg/day showed the highest hypoglycemic activity, which was almost similar with the reference drug – metformin tablets, but exceeded the official herbal mixture “Arfazetin” by its efficiency. In addition, the dose-dependence of the effectiveness of all five herbal mixtures studied was determined.Conclusions. For the first time, the screening study of the hypoglycemic activity of herbal mixtures used in folk medicine for the prevention and treatment of diabetes mellitus type 2 has been conducted. It has been determined that the herbal mixture No. 13 containing Cichorii radices, Elymi repens rhizomata, Helichrysi arenarii flores, Rosae fructus, Maydis style cum stigmatis shows the highest effectiveness by the ability to reduce alimentary hyperglycemia during OGTT and reduce impaired carbohydrate tolerance during IPGTT. Its conditional therapeutic dose, which is 12 mL/kg/day, has been determined.

The aim of this study was to evaluate the effect of an acute bout of cycling immediately after oral glucose intake on glucose metabolism in pregnant women at risk for gestational diabetes mellitus (GDM). Fifteen pregnant women with BMI ≥ 27 kg/m2 were enrolled in a randomized crossover controlled study and underwent two oral glucose tolerance tests (OGTTs) ingesting 75 g of glucose followed by either 20 min of stationary cycling at moderate intensity (65%–75% maximal heart rate) or rest. Using continuous glucose monitors, glucose was measured up to 48 h after the OGTT. Glucose, insulin, and C-peptide were determined at baseline and after 1 and 2 h. One hour after glucose intake, mean blood glucose was significantly lower after cycling compared with rest (p = 0.002). Similarly, mean glucose peak level was significantly lower after cycling compared with after rest (p = 0.039). Lower levels of insulin and C-peptide were observed after 1 h (p < 0.01). Differences in glucose measurements after 2 h and up to 48 h were not statistically different. We found that 20 min of cycling at moderate intensity after glucose intake reduced blood glucose excursions in pregnant women at risk for GDM. ClinicalTrials.gov Identifier: NCT03644238. Novelty Bullets In pregnant women, we found that cycling after glucose intake resulted in significantly lower glucose levels compared with rest. The exercise intervention studied is feasible for pregnant women and could be readily used to reduce glucose excursions.

For over 100 years, the oral glucose tolerance test (OGTT) has been the cornerstone for detecting prediabetes and type 2 diabetes (T2DM). In recent decades, controversies have arisen identifying internationally acceptable cut points using fasting plasma glucose (FPG), 2-h post-load glucose (2-h PG), and/or HbA1c for defining intermediate hyperglycemia (prediabetes). Despite this, there has been a steadfast global consensus of the 2-h PG for defining dysglycemic states during the OGTT. This article reviews the history of the OGTT and recent advances in its application, including the glucose challenge test and mathematical modeling for determining the shape of the glucose curve. Pitfalls of the FPG, 2-h PG during the OGTT, and HbA1c are considered as well. Finally, the associations between the 30-minute and 1-hour plasma glucose (1-h PG) levels derived from the OGTT and incidence of diabetes and its complications will be reviewed. The considerable evidence base supports modifying current screening and diagnostic recommendations with the use of the 1-h PG. Measurement of the 1-h PG level could increase the likelihood of identifying high-risk individuals when the pancreatic s-cell function is substantially more intact with the added practical advantage of potentially replacing the conventional 2-h OGTT making it more acceptable in the clinical setting.

Postprandial blood glucose (PBG) is an independent predictor of disease and mortality risk. To date, the shortest, single, moderate-intensity exercise intervention to reduce PBG is a 1 min bout of stair stepping during an oral glucose tolerance test. Whether this effect translates to real meal consumption is unknown.Subjects (N = 30) participated in a randomized controlled crossover trial performing 0 min (seated control), 1 min, 3 min or 10 min of stair climbing and descending bouts (SCD) at a self-selected pace after consumption of a mixed meal on four separate visits. Compared to control, all SCD reduced PBG at least one timepoint: at 30-min the 3 min (-10.8 (-18.7 to -2.8) mg/dL, p = 0.010) and 10 min (-36.3 (-46.4 to -26.3) mg/dL), p .001), and at 45-min the 1 min (-7.3 (-13.9 to -0.7) mg/dL, p = 0.030, 3 min (-8.7 (-13.9 to -3.6) mg/dL, p = 0.002 and 10 min SCD (-12.2 (-18.2 to -6.1)mg/dL, p 0.000) reduced PBG. The area under the curve (AUC) for PBG was lower following the 3 min (-4.4% (-7.5 to -1.4%), p = 0.006) and 10 min (-8.9% (-12.4 to -5.3%), p 0.001), while the incremental AUC (iAUC) was reduced only following the 10 min (-38.0% (-63.7 to -12.3%), p = 0.005) SCD. All SCD were rated by subjects as very light to light intensity.Single, subjectively "light" intensity stair climbing and descending bouts as short as 1 min in duration attenuate the postprandial glucose response in normal weight individuals following consumption of a mixed meal. More pronounced effects require longer bouts in a dose-dependent manner.

PURPOSE Arterial stiffness is considered a predictor of cardiovascular disease. Females have higher values of arterial stiffness than males, suggesting a greater risk of heart-related complications. Although a low-calorie diet (LCD) reduces fasting arterial stiffness, in part through weight loss, it is unknown if interval exercise (INT) adds to the benefit of LCD on fasting and postprandial arterial stiffness in females with obesity. METHODS Twenty-five females (47 ± 2.6 yr, 37.6 ± 1.3 kg·m-2) were randomized to 13 d of LCD (n = 12; mixed meals of ~1200 kcal·d-1) or LCD + INT (n = 13; 60 min·d-1 of supervised 3-min intervals at 90% HRpeak and 50% HRpeak). Arterial stiffness (augmentation index [AIx] and carotid-femoral pulse wave velocity [cfPWV]) and blood biochemistries were measured during a 75-g oral glucose tolerance test before and after the intervention to determine fasting and postprandial arterial stiffness as well as insulin sensitivity (simple index of insulin sensitivity [SIIS]) and inflammation (C-reactive protein, interleukin 8, and tumor necrosis factor alpha). RESULTS Although LCD + INT increased V˙O2peak and HDL compared with LCD (P = 0.04 and P < 0.01, respectively), both interventions decreased body fat, LDL, total cholesterol, and triglycerides (all P < 0.01) and increased SIIS (P = 0.03). Despite no effect on fasting AIx (P = 0.27), LCD and LCD + INT decreased AIx60min (-7.4% ± 4.3% vs -7.0% ± 5.0%, P = 0.04) and tAUC120min (-663 ± 263 vs -457 ± 406, P = 0.03). There were no changes in fasting cfPWV (P = 0.91) or cfPWV120min (P = 0.62). Increased SIIS and decreased interleukin 8 were associated with reduced fasting AIx (r = -0.44, P = 0.03, and r = 0.40, P = 0.055), whereas decreased C-reactive protein correlated with reduced postprandial AIx60min (r = 0.43, P = 0.04). CONCLUSION Independent of exercise, 13 d of LCD reduces postprandial AIx in females with obesity. Insulin sensitivity and inflammation correlated with improved arterial stiffness, suggesting unique mechanisms regulate fasted versus postprandial arterial stiffness.

Diabetes has emerged as a major co-morbidity in cystic fibrosis (CF). The 75 g oral glucose tolerance test (OGTT) is used to screen for CF-related diabetes (CFRD) but is inconvenient, and adherence to screening is poor. The 50 g glucose challenge test (GCT) is shorter, performed non-fasting, and may serve to pre-screen the subset of individuals requiring confirmatory OGTT. We performed a pilot study in twenty-seven CF individuals across the glucose tolerance spectrum to test whether the GCT could identify subjects with abnormal glucose tolerance defined as 2-h OGTT glucose ≥7.8 mmol/L (2 h-AGT) or 1-h defined as 1-hr OGTT glucose ≥11.1 mmol/L (1 h-AGT). A GCT threshold of 8.1 mmol/L was 73% sensitive and 63% specific for 2hr-AGT and 80% sensitive and 65% specific for 1hr-AGT. Therefore, a screening GCT may reduce need for confirmatory OGTT for identifying AGT but a larger study is warranted to identify a robust cutoff for CFRD.

Introduction: The free iron and haemosiderosis-induced damage of the endocrine glands cause endocrinopathies such as abnormal glucose tolerance and hypothyroidism in transfusion - dependent beta-thalassemia major patients. Our objective was to study the association of serum ferritin level with thyroid dysfunctions; abnormal blood glucose tolerance and to see if they appear in the earlier period of life. Methods: This cross-sectional study was done among thalassemia major children of two to 12 years in a tertiary care hospital, Kolkata, India. A pre-designed proforma was filled. Serum ferritin, fT4, TSH level, and oral glucose tolerance test (OGTT) were measured at presentation and noted in proforma. Results: A total of 80 thalassemic children were studied. Fiftieth percentile cut off value (1414 ng/ml) of serum ferritin was found to be significant with associated variables like normal fT4, TSH, and OGTT. Out of all study subjects, 39 (51.3%) of normal fT4, 39 (54.9%) of normal TSH and 39 (52.0%) of normal OGTT had ferritin < 50th percentile (P < 0.05). Nine (11.3%) children had abnormal thyroid profiles and five (6.3%) children had abnormal OGTT having ferritin > 2000 ng/ml. At a cut off value of ferritin level > 1414 ng/ml, fT4, TSH and OGTT showed significant abnormality (p < 0.05 with df 1). Conclusions: Ferritin is a good indirect marker to assess the risk of endocrine abnormality in thalassemic children. Frequent monitoring should be done once ferritin level crosses 1000 ng/ml. This will help in early detection and timely management of thalassemia related endocrinopathies.