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The current research was conducted during May-October, 2023 aimed to assess the haemato-biochemical parameters in cattle affected with S. aureus affected subclinical mastitis. Mastitis in dairy cattle is the persistent, inflammatory reaction of the udder tissue. Financial losses due to mastitis occur in the case of both sub-clinically and clinically affected animals. Subclinical mastitis exhibits no clinical signs and mostly remains unnoticed by the farmer and can be detected if specific tests are performed in milk samples. Sub-clinical mastitis has an erosive effect on the economy of dairy farmers as it effect directly on the milk quality and quantity. In India prevalence of sub-clinical mastitis was found to be more in cows when compared to clinical mastitis. Blood samples were collected from the jugular vein of 10 healthy and 10 subclinical mastitis affected cattle. Blood samples were analyzed for Hb, PCV, TEC, TLC, while serum samples were examined for ALT, AST, ALP, Glucose, Total protein, Albumin, Cholesterol and Calcium. Haematology report showed significantly (p<0.01) decrease in Hb, PCV and TEC in subclinical affected cattle when compared to healthy animals. TLC was significantly increased in (p<0.01) subclinical affected animal than healthy animal. Biochemical estimate revealed significantly (p<0.05) higher average values of AST, ALP and Ca in subclinical mastitis affected animals compared to healthy animals. Glucose, total protein, albumin, cholesterol and ALT levels are significantly (p<0.05) decrease in subclinical mastitis affected animals when compared to healthy cows. Haemato-biochemical parameters can be used as important for pathological state of subclinical mastitis animals. [ABSTRACT FROM AUTHOR]

Alectra parasitica subsp. chitrakutensis (M.A. Rau) K.K. Khanna & An. Kumar (Orobanchaceae) is a parasitic plant indigenous to India. Locally, the plant is known as 'Midaki and Nirgundikand'. It is used to treat fever, piles, cardiovascular disorders, and blood-borne non-infectious diseases by ethnic communities. The phytochemical investigation of A. parasitica subsp. chitrakutensis rhizome led to the isolation of azafrin (1), rehmaionoside-C (2), and mussaenoside (3). Compounds (2) and (3) are being reported for the first time from this plant. Compounds were evaluated for their intercellular glucose uptake activity in basal and insulin-TNF-α-stimulated L6 muscle cells. In particular, rehmaionoside C exhibited activity comparative to metformin, increasing uptake by basal- and insulin-TNF-α-stimulated cells by 4.88- and 3.90-fold and 5.04- and 4.04-fold. While azafrin and mussaenoside have produced 3.03- and 2.36-fold; 4.03- and 3.22-fold increase in intercellular glucose uptake. Compounds did not show toxicities in rat L6 myoblast cells. The study suggests that rehmaionoside-C from A. parasitica subsp. chitrakutensis might activate glucose uptake by insulin mimics and could be a nontoxic anti-diabetes lead for drug discovery. [ABSTRACT FROM AUTHOR]

Keeping up with the global scenario, diabetes prevalence is on rise in India. Inadequate glycemic control is a major cause of diabetes-related morbidity and mortality. The conventional standards of care (SOC) in diabetes, including self-monitoring of blood glucose and measurement of glycated hemoglobin, have supported achievement of glycemic control, yet there are a few limitations. With the use of current technologies and metrics, such as continuous glucose monitoring (CGM) and standardized CGM data reporting, the continuous real-time glucose levels can be measured, and importantly, the percentage of time above, below, and within the target glucose range can be calculated, which facilitates patient-centric care, a current goal in diabetes management. International consensus recommendations endorse the incorporation of CGM and CGM data reporting in SOC for diabetes management. The guidelines provide time in range (TIR) thresholds for different patient populations and different types of diabetes. However, extrapolation of these global guidelines does not aptly cover the Indian population, which has diverse diet, culture, and religious practices. In this context, a consensus meeting was held in India in 2021 with experts in the field of diabetes care. The purpose of the meeting was to develop consensus recommendations for TIR thresholds for different patient profiles in India. Those expert recommendations, together with an evidence-based review, are reported here. The aim of this agreement is to aid clinicians across India to routinely use CGM and CGM data reports for optimizing individualized diabetes care, by implementing clinical targets for TIR. [ABSTRACT FROM AUTHOR]

Autonomic imbalance is attributed as key mechanism altering metabolic regulation in diabetes mellitus. In view of controversial reports on autonomic function in FDRD and prediabetes, we aimed to assess and compare the autonomic function across the complete glycaemic spectrum in Indian population. Short term heart rate variability and cardiac autonomic reactivity tests – blood pressure and heart rate response to orthostatic tolerance and deep breathing exercise, and diastolic response to isometric handgrip exercise were recorded in normoglycemic apparently healthy individual, normoglycemic first degree relatives of diabetes, prediabetes and diabetes individuals. Resting heart rate is significantly higher in FDRD, prediabetes and diabetes as compared to controls (control < FDRD = prediabetes = diabetes). Total power, LF power (control < FDRD < prediabetes = diabetes) and HF power (control < FDRD < prediabetes < diabetes) decreased along the glycaemic spectrum. Time-domain variables of HRV (SDNN, RMSSD, NN50, pNN50) were reduced as we move along the glycaemic spectrum (control < FDRD < prediabetes = diabetes). Cardiac autonomic function reactivity parameters such as 30:15 ratio and E:I ratio are decreased in prediabetes and diabetes group as compared to control and FDRD group (control = FDRD < prediabetes = diabetes). Diastolic response to isometric hand grip increases along the glycaemic spectrum starting from FDRD (control < FDRD < prediabetes = diabetes). Autonomic dysfunction is observed even in first degree relatives of diabetes. Autonomic dysfunction increases as we move along the glycaemic spectrum (control < FDRD < prediabetes < diabetes). [ABSTRACT FROM AUTHOR]

Extracts of mulberry have been shown to reduce post-prandial glucose (PPG) and insulin (PPI) responses, but reliability of these effects and required doses and specifications are unclear. We previously found that 1·5 g of a specified mulberry fruit extract (MFE) significantly reduced PPG and PPI responses to 50 g carbohydrate as rice porridge, with no indications of intolerance. The trials reported here aimed to replicate that work and assess the efficacy of lower MFE doses, using boiled rice as the carbohydrate source. Two separate randomised controlled intervention studies were carried out with healthy Indian males and females aged 20–50 years (n 84 per trial), with PPG area under the curve over 2 h as the primary outcome. Trial 1 used doses of 0, 0·37, 0·75, 1·12 and 1·5 g MFE in boiled rice and 0 or 1·5 g MFE in rice porridge. Trial 2 used doses of 0, 0·04, 0·12, 0·37 g MFE in boiled rice. In trial 1, relative to control, all MFE doses significantly decreased PPG (–27·2 to −22·9 %; all P ≤ 0·02) and PPI (–34·6 to −14·0 %, all P < 0·01). Breath hydrogen was significantly increased only at 1·5 g MFE (in rice porridge), and self-reported gastrointestinal symptoms were uniformly low. In trial 2, only 0·37 g MFE significantly affected PPG (–20·4 %, P = 0·002) and PPI (–17·0 %, P < 0·001). Together, these trials show that MFE in doses as low as 0·37 g can reliably reduce PPG and PPI responses to a carbohydrate-rich meal, with no apparent adverse effects. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Hypoglycemia occurs in 5% to 15% of neonates in the first few days. A significant proportion requires admission for intravenous fluids. Dextrose gel may reduce admissions and mother-infant separation. We aimed to study the utility of dextrose gel in reducing the need for intravenous fluids. METHODS: This stratified randomized control trial included at-risk infants with asymptomatic hypoglycemia. Study populations were stratified into 3 categories: small for gestational age (SGA) and intrauterine growth-restriction (IUGR), infants of diabetic mothers (IDM) and large for gestational age (LGA), and late preterm (LPT) neonates. Intervention group received dextrose gel followed by breastfeeding, and the control group (CG) received only breastfeeding. RESULTS: Among 629 at-risk infants, 291 (46%) developed asymptomatic hypoglycemia; 147 (50.4%) in the dextrose gel group (DGG) and 144 (49.6%) in CG. There were 97, 98, and 96 infants in SGA/IUGR, IDM/LGA, and LPT categories, respectively. Treatment failure in the DGG was 17 (11.5%) compared to 58 (40.2%) in CG, with a risk ratio of 0.28 (95% confidence interval [CI]: 0.17-0.46; P < .001). Treatment failure was significantly less in DGG in all 3 categories: SGA/IUGR, IDM/LGA, and LPT with a risk ratio of 0.29 (95% CI:0.13-0.67), 0.31 (95% CI:0.14-0.66) and 0.24 (95% CI:0.09-0.66), respectively. CONCLUSIONS: Dextrose gel reduces the need for intravenous fluids in at-risk neonates with asymptomatic hypoglycemia in the first 48 hours of life. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To compare the efficacy of 25% dextrose with 24% sucrose for heel-lance analgesia in preterm infants admitted to the NICU. METHODS: In this noninferiority, double-blind, randomized controlled trial, preterm infants born at 28 weeks and 0 days to 35 weeks and 6 days of gestation who were due for a scheduled heel-lance procedure were enrolled. Infants randomly assigned to the intervention arm received 0.5 mL 25% dextrose, whereas infants in the active control group received 0.5 mL 24% sucrose orally just 2 minutes before the heel-lance procedure. The primary outcome was Premature Infant Pain Profile (PIPP) score 30 seconds after the procedure. Secondary outcomes included PIPP scores at 60 and 120 seconds, PIPP-Revised scores at 30, 60, and 120 seconds, and any adverse events. RESULTS: Sixty-four infants were enrolled (32 in each group). The mean (SD) PIPP score at 30 seconds was 6.41 (2.56) in the dextrose group and 7.03 (2.23) in the sucrose group (mean difference, -0.63 (95% confidence interval, -1.85 to 0.60; P = .31). The upper margin of the confidence interval did not cross the predefined noninferiority margin of 2. The mean PIPP scores at 60 (5.03 [2.18] vs 5.39 [1.48]) and 120 (4.75 [1.97] vs 4.94 [1.46]) seconds were also similar. The PIPP-Revised scores between the 2 groups at all time intervals were comparable. One infant in the intervention group had a transient coughing episode. CONCLUSIONS: In preterm infants under intensive care, 25% dextrose is noninferior to 24% sucrose for heel-lance analgesia as assessed by PIPP score. [ABSTRACT FROM AUTHOR]

Aims: The International Association for Diabetes in Pregnancy Study Group (IADPSG) criteria recommend a single-step diagnostic oral glucose tolerance test (OGTT) for diagnosis of gestational diabetes mellitus (GDM). The aim of this study was to examine the association between the number of abnormal glucose values and levels of FPG with pregnancy outcomes. Methods: Pregnant women (n=1,044) were screened for GDM at maternity centers in South India using IADPSG criteria. OGTTs were classified based on the number of abnormal glucose values (any one value or more than one value high) and fasting plasma glucose (FPG) values (<92mg/dl,92-100mg/dl,>100mg/dl) and correlated with pregnancy outcomes. Odds ratio were adjusted for age, BMI, gestational week at diagnosis, family history of diabetes, previous history of GDM, gestational week at delivery and birth weight. For macrosomia and large for gestation age, birth weight was excluded from the model. Results: Risk of caesarean section was significantly higher in women with any one abnormal glucose value (OR: 1.49; 95%CI: 1.07–2.09). This further increased in those with >1 value (OR: 1.35; 95%CI: 0.87–2.10), when compared to women with all values normal. Risk of large for gestation age (LGA) was higher in women with FPG 92–100mg/dl (OR: 1.37; 95%CI: 0.80–2.35) and in those with FPG >100mg/dl (OR: 1.87; 95%CI: 1.04–3.35), compared to those with FPG <92mg/dl. Conclusions: The risk for poor pregnancy outcomes starts in those with one abnormal value in the OGTT or with FPG >92mg/dl but becomes significantly higher in those with higher abnormal values. [ABSTRACT FROM AUTHOR]

Aim: To report on glycated haemoglobin (HbA1c) values among individuals with normal glucose tolerance (NGT) at different age groups, using data acquired from a large national survey in India. Materials and methods: Data on glycaemic parameters at different age groups were obtained from the Indian Council of Medical Research–INdia DIABetes (ICMR–INDIAB) study, in adults aged ≥ 20 years representing all parts of India. Age-wise distribution of HbA1c was assessed among individuals with NGT (n = 14,222) confirmed by an oral glucose tolerance test using the World Health Organization (WHO) criteria. Results were validated in another large epidemiological study (n = 1077) conducted in Chennai, India. Results: Among NGT individuals, HbA1c increased gradually with age from 5.16 ± 0.71% (33 mmol/mol) in the age group of 20–29 years to 5.49 ± 0.69% (37 mmol/mol) in those aged 70 + years. In the validation study, conducted in another study population, HbA1c was 5.35 ± 0.43% (35 mmol/mol) in age group of 20–29 years and 5.74 ± 0.50% (39 mmol/mol) in those aged 70 and above. In the INDIAB study, for every decadal increase in age, there is a 0.08% increase in HbA1c and this increase was more significant in females (females: 0.10% vs. males: 0.06%) and in urban (urban: 0.10% vs. rural: 0.08%) population. Conclusions: HbA1c levels increase steadily with age. This suggests that age-specific cutoffs be used while utilizing HbA1c to diagnose diabetes and prediabetes, so as to minimize the risk of overdiagnosis and unnecessary initiation of treatment in elderly people who could have physiological increase in HbA1c levels. [ABSTRACT FROM AUTHOR]

Objective: India is a double world capital of early-life undernutrition and type 2 diabetes. We aimed to characterize life course growth and metabolic trajectories in those developing glucose intolerance as young adults in the Pune Maternal Nutrition Study (PMNS).Research Design and Methods: PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood, and adolescence. We compared normal glucose-tolerant and glucose-intolerant participants for serial growth, estimates of insulin sensitivity and secretion (HOMA and dynamic indices), and β-cell compensation accounting for prevailing insulin sensitivity.Results: At 18 years (N = 619), 37% of men and 20% of women were glucose intolerant (prediabetes n = 184; diabetes n = 1) despite 48% being underweight (BMI <18.5 kg/m2). Glucose-intolerant participants had higher fasting glucose from childhood. Mothers of glucose-intolerant participants had higher glycemia in pregnancy. Glucose-intolerant participants were shorter at birth. Insulin sensitivity decreased with age in all participants, and those with glucose intolerance had consistently lower compensatory insulin secretion from childhood. Participants in the highest quintile of fasting glucose at 6 and 12 years had 2.5- and 4.0-fold higher risks, respectively, of 18-year glucose intolerance; this finding was replicated in two other cohorts.Conclusions: Inadequate compensatory insulin secretory response to decreasing insulin sensitivity in early life is the major pathophysiology underlying glucose intolerance in thin rural Indians. Smaller birth size, maternal pregnancy hyperglycemia, and higher glycemia from childhood herald future glucose intolerance, mandating a strategy for diabetes prevention from early life, preferably intergenerationally. [ABSTRACT FROM AUTHOR]

Increasing evidence suggests that vitamin D (Vit-D) could be pivotal in maintaining normal glucose homeostasis. Low levels of Vit-D in early pregnancy are associated with a higher risk of gestational diabetes mellitus (GDM). Though several reports have highlighted the prevalence of vit-D deficiency among pregnant women, its underlying cause has not yet been fully elucidated. In this connection, a few studies have found the development of resistance to Vit-D, including the levels of Vitamin D receptor (VDR) and transcription regulators that modify VDR action, as well as the bioavailability of Vit-D. We aimed to determine the levels of Vit-D resistance genes such as 25-HydroxyVit-D-24-hydroxylase (CYP24A1), VDR repressor genes (SNAIL and SMRT) and their association between Vit-D concentrations in early pregnancy, and the risk of gestational diabetes mellitus (GDM). A prospective observational study was conducted on healthy pregnant women (NGDM; n = 50) and GDM (n = 50) attending routine antenatal care at SRM Medical College Hospital, Chennai, recruited at 12 weeks of gestation. We found that the serum levels of Vit-D were low in GDM subjects and negatively correlated with the fasting glucose levels. Further, increased expressions of Vit-D resistance genes such as CYP24A1, SNAIL, and SMRT were observed in GDM subjects and negatively correlated with the serum levels of Vit-D. Furthermore, we have validated the data using the trophoblast cell line, BeWo, exposed to calcitriol under a hyperglycemic environment. Our finding showed that increased expression of Vit-D resistance genes in pregnancy may be associated with a greater risk of adverse pregnancy outcomes, including GDM., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Diabetes mellitus type 2 refers to a group of metabolic disorder that is characterized by hyperglycemia. Diabetes mellitus type 2 is caused by either deficiency in production of insulin by the pancreas or insulin resistance. In India, this increase is estimated to be 58%, from 51 million people in 2010 to 87 million in 2030. An in vitro a-amylase enzyme inhibition test of Vidangadi Kvatha was performed. The results show that the IC50 value of Vidangadi Kvatha and Acarbose was 70.39 ± .0890 µg/ml and 40.89 ± 7.162 µg/ml. The a-glucosidase inhibitory activity of the Vidangadi Kvatha was evaluated in triplicate using standard method. The % inhibition and IC50 value of Vidangadi Kvatha and Acarbose were calculated from the graph plotted between % inhibition and concentration of Vidangadi Kvatha. The IC50 value of Vidangadi Kvatha and Acarbose was found 321 µg/ml and 175 µg/ml. In glucose diffusion inhibitory assay percent glucose diffusion retardation index (% GDRI) was calculated and the result shows the % GDRI was found maximum in Vidangadi Kvatha i.e. 45% at 30 min time interval and 83% at 60 min time interval in comparison to other drugs. The present study focus on antidiabetic property of Vidangadi Kvatha and trying to established the mechanism of action through different experimental models like inhibition of amylase activity, glucosidase enzyme activity, glucose diffusion inhibitory activity. [ABSTRACT FROM AUTHOR]

Background: Hyperglycemia (>180 mg/dL or >10.0 mmol/L) has serious health implications in intensive care unit (ICU) patients. The aim of the present study was to explore the effectiveness of SavenG (Sanjith's Very Easy Nurse managed glucose control) protocol in the maintenance of glucose concentration in ICU patients. Materials and Methods: In this observational study, a total of 108 patients admitted to the ICU unit of SL Raheja hospital, a tertiary care institute in Mumbai, were enrolled. The patients received insulin therapy as proposed in SavenG protocol. The glucose in serum was measured using a glucometer and was categorized into three levels: <150 mg/dL, 150-200 mg/dL, and >200 mg/dL. The collected data were statistically analyzed by using SPSS version 24.0. Results: Patients were primarily male (69%), with an average age of 63.96 ± 13.14 years, reporting at least two complications (1.49 ± 1.03), and with a greater risk of hypertension (60%). Higher doses of insulin (~59.9 units) were administered on the first two days of protocol. By day 5, the requirement of insulin dose was gradually decreased to 36.8 units. The insulin was administered for totally seven days. The insulin dosing that was administered was sufficient to maintain the glucose level of 150-200 mg/dL for 12 h (F = 79.35, P < 0.01) and this sugar level showed a comparatively lower level of variation within a day (F = 13.123, P < 0.01). Further, the sugar level was not influenced by demographic characteristics such as age, gender and concomitant complications such as hypertension, ischemic heart disease, coronary artery bypass grafting, and kidney disease. Conclusion: The proposed SavenG protocol validates the effectiveness of insulin doses to regulate and maintain the glucose level at 150-200 mg/dL for 12 h within a day in ICU patients. [ABSTRACT FROM AUTHOR]

Present investigation was carried out to study the influence of blood metabolites, viz., glucose and NEFA on ovarian rebound in postpartum Sahiwal cows. Advance pregnant Sahiwal cows (n=14) maintained at Bull Mother Experimental Farm at Anjora, Durg (CG), India were selected and divided into two Groups, Group I comprised of animals (n=7) with BCS = 2.75 and that of Group II comprised of animals (n=7) with average BCS < 2.75 at one week before parturition. Trans-rectal ultrasound scanning of ovaries was accomplished in animals of both groups on alternate days from 21 to 51 days postpartum to record the development of dominant follicles (DF). Animals of Group-I without DF recorded higher pre-partum BCS than those with DF (n=3). Non-significant differences were recorded in mean serum glucose concentration between animals of Group-I and Group-II during all days of observation. Significant differences were (p<0.01) observed in mean serum glucose concentration between animals with and without DF of Group-I on day 20 postpartum (39.79±0.56 vs 43.53±0.29 mg/dl). Animals (n=3) with DF of Group-I showed significantly increasing trend of mean serum glucose level from 20 to 50 days of postpartum, whereas the animals (n=4) without DF recorded similar serum glucose levels between 10 and 40 days postpartum. Significantly (p < 0.05) higher mean serum NEFA concentrations were recorded in animals without DF than in animals with DF of Group-I on all days from the day of calving to 50 days postpartum, except on day 10. It may be concluded that higher serum NEFA concentration influenced the development of dominant follicle in postpartum Sahiwal cows. [ABSTRACT FROM AUTHOR]

Background: More than 250 loci have been identified by genome-wide scans for type 2 diabetes in different populations. South Asians have a very different manifestation of the diseases and hence role of these loci need to be investigated among Indians with huge burden of cardio-metabolic disorders. Thus the present study aims to validate the recently identified GWAS loci in an endogamous caste population in North India., Methods: 219 T2D cases and 184 controls were recruited from hospitals and genotyped for 15 GWAS loci of T2D. Regression models adjusted for covariates were run to examine the association for T2D and fasting glucose levels., Results: We validated three variants for T2D namely, rs11634397 at ZFAND6 (OR = 3.05, 95%CI = 1.02-9.19, p = 0.047) and rs8042680 at PRC1 (OR = 3.67, 95%CI = 1.13-11.93, p = 0.031) showing higher risk and rs6813195 at TMEM154 (OR = 0.28, 95%CI = 0.09-0.90, p = 0.033) showing protective effect. The combined risk of 9 directionally consistent variants was also found to be significantly associated with T2D (OR = 1.91, 95%CI = 1.18-3.08, p = 0.008). One variant rs10842994 at KLHDC5 was validated for 9.15mg/dl decreased fasting glucose levels (SE = -17.25-1.05, p = 0.027)., Conclusion: We confirm the role of ZFAND6, PRC1 and TMEM154 in the pathophysiology of type 2 diabetes among Indians. More efforts are needed with larger sample sizes to validate the diabetes GWAS loci in South Asian populations for wider applicability., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Walia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background and Aims: There has been a lot of confusion in management of apparently healthy individuals whose post prandial plasma glucose levels were lower than fasting levels. It has been observed that many clinicians do send for repeat tests to rule out analytical error since there is common knowledge that post prandial glucose should be higher than fasting glucose level. Blood glucose level is regulated by a fully integrated mechanism with complex interplay of hormones and enzymes on metabolic pathways. Increase or decrease of thyroid hormones can break this equilibrium leading to alterations of carbohydrate metabolism. The objective for this study was to look for subclinical hypothyroidism (SCH) and insulin resistance (IR) in Idiopathic Post prandial glucose lowering and the correlation between thyroid stimulating hormone (TSH) with IR in them. Methods: A cross-sectional study with subgroup analysis, 34 cases and 34 controls. Cases comprises of otherwise healthy individuals whose post prandial glucose is lower than fasting glucose and controls as those healthy individual whose post prandial glucose is higher than fasting. Thyroid hormones and insulin were measured in fasting serum samples. Homeostasis model assessment for IR was calculated as per formula. Results: Among the 34 cases with idiopathic post prandial glucose lowering, 76% (n = 26) had subclinical hypothyroidism and 61% (n = 21) had insulin resistance. A positive correlation (r = 0.55) was observed between Thyroid-Stimulating hormone (TSH) and Index of insulin resistance and homeostatic model assessment (HOMA-IR) and was statistically significant with P < 0.1. Conclusions: The study highlights the importance of evaluating glycoregulatory hormones like thyroid hormones and insulin in cases with idiopathic post prandial glucose lowering for early diagnosis and prevention of overt clinical diseases like Hypothyroidism and Diabetes Mellitus. [ABSTRACT FROM AUTHOR]

Background: The distribution of body fat and its variation is of great importance in determining the pathogenesis of insulin resistance. Central obesity has been recognized as an independent risk factor for diabetes. The objective of the study was to evaluate the predictive accuracy of various anthropometric measures of body fat in determining impaired glucose tolerance (IGT) or prediabetes among South Indian population. Methodology: This was a community-based comparative cross-sectional study where the anthropometric measures of a representative sample of 171 individuals with glycosylated hemoglobin (HbA1c) in the range for IGT were compared with age- and gender-matched controls with HbA1c in the normal range. The predictive accuracy of the various anthropometric measures of obesity to identify individuals with IGT was estimated using the area under the receiver operating characteristic (ROC) curve. Results: Patients with IGT in both genders had significantly higher BMI, waist circumference (WC), neck circumference (NC), and waist-to-height ratio (WHtR). ROC analysis revealed WHtR in females and NC among males to have the largest area under the curve for predicting IGT. In both genders, WC, WHtR, and NC had better predictive accuracy for prediabetes as compared to BMI and waist-to-hip ratio (WHR). Conclusion: It is suggested that the WHtR and WC are better screening tools for prediabetes in comparison to BMI and WHR among the South Indian population. [ABSTRACT FROM AUTHOR]

This study measures in situ microbial glucose uptake rate in two different hot springs in Ladakh, J&K, India with distinct temperatures >74°C and pH > 7.4. For this purpose, the slurry samples from each hot spring were incubated up to 4 h with 13C-labelled glucose in gas-tight incubation bottles at the respective hot-spring sites. The natural d 13C particulate varies from -9.1? in Panamik hot spring to -11.7? in Puga hot spring. After incubation with 13C-labelled glucose, the d 13C particulate reached a maximum 2472? in Panamik and 4365? in Puga hot-spring samples. The glucose uptake rate calculated from the final d 13C particulate in the incubation bottles varied from 28 to 147 ng C g-1 h-1 in the Panamik and from 168 to 1196 ng C g-1 h-1 in the Puga samples. This reveals that even at >74°C temperature, thermophiles are capable of running their metabolic machinery, perhaps faster than the heterotrophic microbes/cells under normal temperature condition. [ABSTRACT FROM AUTHOR]

Background: Plateletpheresis procedures are generally safe and associated with low adverse reactions. Although donor reactions and injuries are self-limited events, they may discourage donors from future platelet donations. Aim: The purpose of this study was to determine the prevalence and predictors of adverse donor reactions in plateletpheresis donors, which could serve as targets for interventions to reduce reactions. Materials and Methods: The study included 106 platelet donors over a period of 2 years. The demographic, biometric, and clinical parameters were noted. The data were analyzed for predictors of adverse donor reactions. Statistical Analysis Used: The data were analyzed using independent sample t-test to correlate donor variables such as gender. To correlate other variables such as age, weight, and whole blood processed, Chi-square test was used. Results: A total of 106 plateletpheresis donations were performed and 13.2% of vasovagal reactions were observed. The significant predictive factors for reactions were young female donors with low body weight in which more than 2.5 L volume of whole blood was processed and more than 250 ml of acid, citrate, and dextrose-A was infused and with single venous access procedures. Conclusions: The results of this study are encouraging and helpful in identifying donors at risk for developing adverse reactions during plateletpheresis so that proper and close observation during and after donation as well as timely intervention can prevent most of the unpleasant events of plateletpheresis donors. [ABSTRACT FROM AUTHOR]

Background: Eye examination is a painful procedure. Neonates exposed to painful stimuli have short- and long-term behavioral and sensory problems. To determine an analgesic for alleviating pain during this mandatory painful, medical procedure is of utmost importance, to have optimal outcomes in these vulnerable preterm babies. We analyzed the effectiveness of 25% dextrose solution as analgesic for retinopathy of prematurity (ROP) screening. Objective: The objective was to study the feasibility of conducting a Phase III randomized controlled trial, for oral analgesic during ROP screening in neonates and to utilize this pilot data for calculating sample size for Phase III trial. Place of the Study: The study was conducted in a tertiary care neonatal unit, Southern India. Type of Study: This was a randomized parallel group masked Phase I/2 external pilot study. Methods: Feasibility was defined a priori; the study population was inpatient babies undergoing ROP screening procedure for the first time as per unit protocol. All subsequent babies, after a written consent from parents/legal guardian, were randomized to oral glucose (25% dextrose solution) or placebo group (distilled water). Premature infant pain profile (PIPP) scores were assessed at basal and post procedure. Babies were observed for 24 h for predefined adverse events. Statistical analysis was done using Stata 11.2. Continuous data were expressed as median based on the skewness, and Mann–Whitney U-test was used for hypothesis testing. Results: Twenty-six inpatient neonates were randomized. The median pain scores (PIPP) at 1 min post procedure for the placebo group were 7 IQ (6, 8), and median pain scores of the oral glucose group were 4 IQ (3–5). Eighty-six percent of the eligible babies were randomized for the study. Eighty-five percent of the randomized babies where available for total observation period of 24 h. Inter-rater variability was assessed by interclass correlation (ICC) coefficient. No adverse events (predefined) were recorded in both groups. Conclusion: This randomized pilot trial is feasible to deliver. Oral glucose (25% dextrose) solution has a significant pain alleviation compared to placebo, in our pilot population. Pain scores assessed were validated by independent reviewer with high ICC of 0.89. [ABSTRACT FROM AUTHOR]

Aims: Guidelines recommend hemoglobin A1c (HbA1c) as a diagnostic test for type 2 diabetes, but its accuracy may differ in certain ethnic groups.Methods: The prevalence of type 2 diabetes by HbA1c, fasting glucose, and 2 h glucose was compared in 3016 participants from Chennai and Delhi, India from the CARRS-2 Study to 757 Indians in the U.S. from the MASALA Study. Type 2 diabetes was defined as fasting glucose ≥ 7.0 mmol/L, 2-h glucose ≥ 11.1 mmol/L, or HbA1c ≥ 6.5%. Isolated HbA1c diabetes was defined as HbA1c ≥ 6.5% with fasting glucose < 7.0 mmol/L and 2 h glucose < 11.1 mmol/L.Results: The age, sex, and BMI adjusted prevalence of diabetes by isolated HbA1c was 2.9% (95% CI: 2.2-4.0), 3.1% (95% CI: 2.3-4.1), and 0.8% (95% CI: 0.4-1.8) in CARRS-Chennai, CARRS-Delhi, and MASALA, respectively. The proportion of diabetes diagnosed by isolated HbA1c was 19.4%, 26.8%, and 10.8% in CARRS-Chennai, CARRS-Delhi, and MASALA respectively. In CARRS-2, individuals with type 2 diabetes by isolated HbA1c milder cardio-metabolic risk than those diagnosed by fasting or 2-h measures.Conclusions: In Asian Indians, the use of HbA1c for type 2 diabetes diagnosis could result in a higher prevalence. HbA1c may identify a subset of individuals with milder glucose intolerance. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) occurs during pregnancy which affects mother, fetus, and outcome of pregnancy, hence early detection is necessary. The objective of this study was to ascertain the validity of glucometer over standard biochemical testing for detection of GDM and to estimate prevalence of GDM and its associated risk factors. Materials and Methods: A hospital-based study was conducted at Antenatal clinics of Obstetrics Department, tertiary care hospital, based on the "National Guidelines for Diagnosis and Management of GDM." Totally 357 pregnant women between 21 and 28 weeks of gestational age agreed were included in the study from January to March 2016. After obtaining written consent, one step procedure was offered to pregnant women by giving 75 g of anhydrous glucose dissolving in 200-250 ml of water. After 2 h, glucose level was estimated by capillary testing with glucometer and venous glucose by glucose oxidase test. Results: GDM was found in 20.4% pregnant women with capillary testing done by glucometer compare to 11.5% with venous blood testing. GDM was found higher among literates, homemakers, Hindus, people living in nuclear family, belongs to middle class, residing in urban area, primigravidae, obese and with gestational age between 21 and 24 weeks. Intermediate agreement (Kappa = 0.42) was found between two methods with sensitivity of 70.7%, specificity of 86.1%, positive predictive value 39.7%, and negative predictive value 95.8%. Conclusion: Intermediate agreement between two methods indicates glucometer testing can be used to screen pregnant women at an early gestational age (21 weeks), at the community level by health-care workers. [ABSTRACT FROM AUTHOR]

Introduction: Neoplastic involvement of cerebrospinal fluid (CSF) secondary to known or unknown primaries elsewhere is a poor prognostic factor and is equivalent to stage IV disease. Aim: The aim of the study is to analyse the cytological features of neoplastic meningitis in a tertiary care center. Materials and Methods: A retrospective study of 400 consecutive CSF samples was done in the cytology laboratory of our hospital. The fluid obtained by spinal tap was sent for microbiological, biochemical and cytological evaluation. Smears that showed the presence of malignant cells were included in this study. Results: Out of 400 cases, 36 (9%) showed neoplastic meningitis. Of which, 13 cases (36%) revealed leukemic infiltration, 2 (6%) lymphomatous infiltration and 21 (58%) carcinomatous meningitis. The leukemia cases included seven cases of acute lymphoblastic leukemia and six cases of acute myeloid leukemia. Among the carcinomatous meningitis cases, eight were metastasis from carcinoma breast, six from lung carcinoma and one each from malignancies of gallbladder, stomach and retinoblastoma. Four cases were metastatic adenocarcinoma from unknown primary. Pleocytosis was a significant finding seen in 58% cases (n = 21). Elevated protein and hypoglychorrhachia was noted in 68% cases (n = 18). Conclusion: A combined diagnostic approach including biochemical, microbiological and pathological evaluation was useful in eliminating infectious meningitis and confirming neoplastic meningitis in these cases. Cytology should be performed on cerebrospinal specimens from all patients with known or suspected malignancy with meningismus. Detection of malignant cells on cytological examination of CSF is the diagnostic gold standard for neoplastic meningitis. [ABSTRACT FROM AUTHOR]

Abstract: Aim: This study aimed to determine the association between periodontal disease and gestational diabetes mellitus (GDM) and the effect of this association on pregnancy outcome in North Indian population. Materials and Methods: A total of 584 primigravidae were recruited at 12–14 weeks of gestation. Their periodontal examination was carried out along with 75 g oral glucose load test at the time of recruitment. GDM was diagnosed as per the DIPSI (The Diabetes in Pregnancy Study group India) guidelines (≥140 mg/dl). Women with normal plasma glucose values underwent a repeat 75 g oral glucose load test at 24–28 weeks of gestation. All patients were followed up for pregnancy outcomes. Results: Of 584 primigravida, 184 (31.5%) had gingivitis and 148 (25.3%) had periodontitis. Overall, 332 (56.8%) pregnant women had periodontal disease. It was associated with GDM with adjusted hazard ratio (aHR) of 2.85 (95%CI = 1.47–5.53). The occurrence of pre‐eclampsia was associated with periodontal disease with aHR of 2.20 (95%CI = 0.86–5.60). If primigravidae had periodontal disease along with GDM, the risk of pre‐eclampsia had shown increased aHR of 18.79 (95% CI = 7.45–47.40). Conclusions: The study shows a significant association of periodontal disease with GDM and an increased risk of developing pre‐eclampsia due to this association. [ABSTRACT FROM AUTHOR]

Introduction: Ficus racemosa is widely used in ayurvedic medicine in India, mostly as fruits and bark decoction to treat uncontrolled diabetes, the objective of this study is to study the uptake of glucose in L6 myotubes by Ficus racemosa. Background: Diabetes is a common metabolic disease characterized by abnormally high plasma glucose levels, leasing to major complications, such as diabetic neuropathy, retinopathy and cardiovascular disease. Presently available oral hypoglycaemic agents exhibit several side effects. Therefore, there is a need for more effective oral antihyperglycemic agent, particularly those that normalize both insulin and glucose levels. Method: Cell culture: L6, a mono layer myoblast culture (obtained from NCCS, Pune-Passageno-19) was cultured in the DMEM. In vitro glucose uptake activity: Glucose uptake assay was followed by the methodology of (Gupta et al) Result: It was observed from the results that Ficus racemosa extract at different concentrations exhibited substantial degree of glucose uptake in skeletal muscle cells, which was compared with that of Standard Metformin. A maximum glucose uptake of 53% was observed for ficus 30mg/ml, whereas metformin exhibited 61% of glucose uptake. The IC50 of ficus extract and metformin was found to be 2.57mg/ml and 1.79mg/ml respectively. Conclusion: From the study that was conducted above it can be concluded that Ficus racemosa had a better glucose uptake compared to the with that of Standard Metformin used by diabetic patients. [ABSTRACT FROM AUTHOR]

With type 2 diabetes presenting at younger ages, there is a growing need to identify biomarkers of future glucose intolerance. A high (20%) prevalence of glucose intolerance at 18 years was seen in women from the Pune Maternal Nutrition Study (PMNS) birth cohort. We investigated the potential of circulating microRNAs in risk stratification for future pre-diabetes in these women. Here, we provide preliminary longitudinal analyses of circulating microRNAs in normal glucose tolerant (NGT@18y, N = 10) and glucose intolerant ( N = 8) women (ADA criteria) at 6, 12 and 17 years of their age using discovery analysis (OpenArray™ platform). Machine-learning workflows involving Lasso with bootstrapping/leave-one-out cross-validation identified microRNAs associated with glucose intolerance at 18 years of age. Several microRNAs, including miR-212-3p, miR-30e-3p and miR-638, stratified glucose-intolerant women from NGT at childhood. Our results suggest that circulating microRNAs, longitudinally assessed over 17 years of life, are dynamic biomarkers associated with and predictive of pre-diabetes at 18 years of age. Validation of these findings in males and remaining participants from the PMNS birth cohort will provide a unique opportunity to study novel epigenetic mechanisms in the life-course progression of glucose intolerance and enhance current clinical risk prediction of pre-diabetes and progression to type 2 diabetes.

Purpose: A limited number of studies have compared the glycaemic index (GI) and glycaemic responses (GR) to solid foods between Caucasians and Asians. These studies have demonstrated that Asians have greater GI and GR values for solid foods than Caucasians. However, no study has compared the GI and GR to liquids among various Asian ethnic groups. Methods: A total of forty-eight males and females (16 Chinese, 16 Indians, and 16 Malay) took part in this randomised, crossover study. Glycaemic response to the reference food (glucose beverage) was measured on three occasions, and GR to three liquids were measured on one occasion each. Liquids with different macronutrient ratio's and carbohydrate types were chosen to be able to evaluate the response to products with different GIs. Blood glucose concentrations were measured in duplicate at baseline (−5 and 0 min) and once at 15, 30, 45, 60, 90, and 120 min after the commencement of beverage consumption. Results: There were statistically significant differences in GI and GR between the three liquids ( P < 0.01 in all cases). However, there were no statistically significant differences in GI and GR for the liquids between the ethnic groups (Chinese vs. Indian vs. Malay). Conclusion: The GR for three different types of liquid nutritional supplements did not differ between the three main ethnic groups in Asia. It appears that the GI of liquid food derived from one Asian ethnicity can be applicable to other Asian populations. [ABSTRACT FROM AUTHOR]

Objective: Legume consumption is associated with lower fasting glucose (FG) and insulin levels in nutrition trials and lower CVD mortality in large-scale epidemiological studies. In India, legumes are widely consumed in various preparations, yet no epidemiological study has evaluated the association of legumes with FG levels, insulin resistance and diabetes risk. The present study aimed to fill this gap.Design: Fasting blood samples, in-person interviews to obtain information on demographic/socio-economic factors, physical activity, alcohol and tobacco use, and anthropometric measurements were collected. Dietary intakes were assessed by an interviewer-administered, validated, semi-quantitative FFQ.Setting: Lucknow, Nagpur, Hyderabad and Bangalore, India.Subjects: Men and women (n 6367) aged 15-76 years - urban residents, urban migrants and their rural siblings.Results: In multivariate random-effects models adjusted for age, BMI, total energy intake, macronutrients, physical activity and rural/migration status, daily legume consumption was not associated with FG (P-for-trend=0·78), insulin resistance (homeostasis model assessment score; P-for-trend=0·73) or the prevalence of type 2 diabetes mellitus (P-for-trend=0·41). Stratified analyses by vegetarian diet and migration status did not change the findings. Inverse associations between legumes and FG emerged for participants with lower BMI and higher carbohydrate, protein, fat and sugar intakes.Conclusions: Although legumes are essential in traditional Indian diets, as well as in prudent and Mediterranean diets in the West, we did not find an association between legumes and markers of glycaemic control, insulin resistance or diabetes, except for subgroups based on BMI and macronutrient intake. The ubiquitous presence and complexity of legume preparations in Indian diets may contribute to these findings. [ABSTRACT FROM AUTHOR]

Objective: According to the thrifty phenotype hypothesis, intrauterine malnutrition has a role in the etiology of type 2 diabetes. This study was planned to determine the early alterations in indices of glucose homeostasis (glucose, insulin, and cortisol) in term and preterm newborns and the correlations of glucose, insulin, and cortisol levels with insulin resistance indices. Methods: A descriptive study comprising 35 term and 35 preterm newborns was carried out from December 2013 to June 2015. Venous cord blood was collected and plasma glucose was analyzed by the glucose oxidase-peroxidase method in an auto analyzer. Serum insulin and cortisol levels were assessed by the enzymelinked immunosorbent assay. Homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index and glucose insulin ratio were calculated to assess insulin resistance. The data on physical and metabolic parameters were analyzed using standard tests for statistical significance. Results: In term newborns, mean glucose and cortisol levels (83.6±17.4 mg/dL and 11.88±5.78 μg/dL, respectively) were significantly higher than those in preterm infants (70.4±15.8 mg/dL and 8.9±4.6 μg/dL, respectively). Insulin and HOMA-IR levels were found higher in preterm newborns (10.8±4.8 μIU/mL and 1.52±0.66, respectively) than in term newborns (7.9±2.7 μIU/mL and 1.19±0.29, respectively). Insulin was found to positively correlate with HOMA-IR, whereas cortisol was negatively correlated with HOMA-IR in both term and preterm newborns. Conclusion: Higher insulin levels and HOMA-IR values in the cord blood of preterm newborns support the theory of intrauterine origin of metabolic diseases. [ABSTRACT FROM AUTHOR]

Background: In India, the prevalence of overweight among adolescents is on the rise, setting the stage for an increase in metabolic syndrome (MS). This paper presents the national prevalence of MS in adolescents in India., Methods: A nationally representative data of adolescents (10-19 years) from the Comprehensive National Nutrition Survey was used. MS was defined based on the NCEP-ATP III criteria for adolescents. Bivariate analysis was used to report socio-demographic differentials in prevalence and to assess interstate variability. Multivariate logistic regression model was constructed to measure the association between socio-demographic characteristics and prevalence of MS. Census data from 2011 was projected to 2017 to calculate burden., Results: The prevalence of MS was 5.2% among adolescents. 11.9%, 15.4%, 26.0%, 31.9% and 3.7% had central obesity, high blood pressure, hypertriglyceridemia, low HDL-cholesterol and high fasting glucose, respectively. The prevalence was higher among males (5.7% vs. 4.7%, adjusted odds ratio (AOR): 1.3, 95% confidence interval [CI]: 1.0, 1.6), those residing in urban areas (7.9% vs 4.2%, AOR: 1.4, 95% CI: 1.1, 1.8), and from wealthier households as compared to their counterparts (8.3% vs. 2.4%, AOR: 3.4, 95% CI: 2.1, 5.5). There was wide interstate variability in the prevalence of MS (0.5% - 16.5%). In 2017, 14.2 million adolescents had MS in India., Conclusions: The prevalence of MS among adolescents in India is low and clustered in urban areas and richer households. Early prevention interventions promoting a healthy lifestyle, especially in high prevalence areas, are needed to keep MS from becoming a public health issue., (© 2022. The Author(s).)

In India, Kumaryasava, a popular Aloe barbadensis Mill. gel preparation has therapeutic value in treatment of female reproductive disorders like menstrual disturbances and menopausal problems. Despite their widespread use, only a limited number of studies have probed into the scientific evidence for their varied bioactivities. In this regard, studies have demonstrated that Aloe vera gel has the potential to modulate steroidogenic activity in letrozole induced polycystic ovary syndrome (PCOS) rat. However, isolation and identification of the bioactive molecule/s from Aloe vera gel and studying their molecular targets will underpin the treatment regime for PCOS. The Partially Purified Non-Polar Phytocomponents (PPNPP)- LP1 and LP3 were isolated from the petroleum ether extract of Aloe vera gel by column chromatography. Based upon the GC-MS analysis, LP1 and LP3 comprised of n-Hexadecanoic acid and Campesterol acetate with an abundance of 97.07%, and 96.07% respectively. For evaluation of their bioactivities, eighty 3–4 months female Balb/c mice were classified as 10 groups with 8 animals in each group. Groups were control (C), PCOS (0.5 mg/kg/day Letrozole orally for 21days), PCOS treated orally for 60 days with Aloe vera gel (AVG) (10 mg/kg/day) (PCOS + AVG), PCOS treated orally for 60 days with petroleum ether extract (PE) of Aloe vera gel (25 μg/kg/day) (PCOS + PE), PCOS treated orally for 60 days with LP1 (0.5 μg/kg/day) (PCOS + LP1), PCOS treated orally for 60 days with commercially available pure compound-n-Hexadecanoic acid (HA) (0.5 μg/kg/day) (PCOS + HA), PCOS treated orally for 60 days with LP3 (0.01 μg/kg/day) (PCOS + LP3), PCOS treated orally for 60 days with commercially available pure compound- Campesterol acetate (CA) (0.01 μg/kg/day) (PCOS + CA), PCOS treated orally for 60 days with Metformin (100 mg/kg/day) (PCOS + Metformin) and PCOS treated orally for 60 days with DMSO (Vehicle) (PCOS + DMSO). Body weight, Oral glucose tolerance test, lipid profile, fasting glucose, insulin, estrus cycle, hormonal profile, gene expression of gonadotropin receptors (Fshr and Lhr), steroid receptors (Ar, Esr1, Esr2 and Pgr) and steroidogenic markers (Star , Hsd3b1 , Cyp19a1 and Amh) were analysed in the ovaries. Polycystic ovarian morphology was assessed through histopathological changes of ovary. Toxicity markers- SGOT, SGPT and creatinine were also measured at the end of the study. Mice treated with letrozole demonstrated significant increase in body weight, glucose intolerance, fasting insulin levels, HOMA-IR, triglycerides levels as well as testosterone levels, and a significant decline in the progesterone levels as compared to the control animals. PCOS animals also exhibited arrested estrus cyclicity, disrupted ovarian histopathology with the presence of multiple peripheral cysts and abnormal gene expression of gonadotropin receptor, steroid receptor and steroid markers. Oral administration of AVG, PE extract of AVG, LP3 and metformin greatly alleviated these complications in PCOS animals. The above findings indicate the effectiveness of LP3, isolated from Aloe vera gel against letrozole induced PCOS in mice and may be used in the treatment of PCOS as an alternative to metformin. [Display omitted] [ABSTRACT FROM AUTHOR]

A low-glycaemic-index (GI) breakfast has been shown to lower blood glucose levels throughout the day. A wide variety of breakfast foods are consumed, but their GI values are largely unknown, hence limiting consumers’ ability to select healthier options. This study investigated the GI values of ten common breakfast (five Asian and five Western) foods in this region using a randomised, cross-over study design. Participants arrived after an overnight fast, and fasting blood sample was taken before participants consumed test foods. Next, blood samples were taken at fixed intervals for 180 min. Glycaemic and insulinaemic responses to test foods were calculated as incremental AUC over 120 min, which were subsequently reported as glycaemic and insulinaemic indices. In all, nineteen healthy men (nine Chinese and ten Indians) aged 24·7 (sem 0·4) years with a BMI of 21·7 (sem 0·4) kg/m2 completed the study. Asian breakfast foods were of medium (white bun filled with red bean paste=58 (sem 4); Chinese steamed white bun=58 (sem 3)) to high GI (rice idli=85 (sem 4); rice dosa=76 (sem 5); upma=71 (sem 6)), whereas Western breakfast foods were all of low GI (whole-grain biscuit=54 (sem 5); whole-grain biscuit filled with peanut butter=44 (sem 3); whole-grain oat muesli=55 (sem 4); whole-grain oat protein granola=51 (sem 4); whole-grain protein cereal=49 (sem 3)). The GI of test foods negatively correlated with protein (rs−0·366), fat (rs−0·268) and dietary fibre (rs−0·422) (all P<0·001). GI values from this study contribute to the worldwide GI database, and may assist healthcare professionals in recommending low-GI breakfast to assist in lower daily glycaemia among Asians who are susceptible to type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objectives: Hypoglycemia unawareness (HUA) in patients with FCPD is common with an unclear etiology. We evaluated the prevalence, characteristics of HUA, glycemic variability (GV), its possible association with pancreatic glucagon secretion & cardiac autonomic function in patients with FCPD., Methods: A two-week ambulatory glucose profile (AGP) and cardiac autonomic function test was done in patients with FCPD (n = 60), and categorized into UNAWARE (n = 44) and AWARE (n = 16) groups based on the Hypoglycemia Unawareness Index (HUI) score. Glycaemic variability was assessed from the AGP data using Easy GV 9.0.2 software. A subset of patients from both the groups (n = 11) underwent a mixed-meal challenge test and were compared with healthy individuals (controls; n = 11)., Results: HUA was evidenced in 73% (44/60) of patients with FCPD. Significant hypoglycemia, nocturnal hypoglycemia, duration of hypoglycemia and poor cardiac autonomic functions (p = 0.01) were prominent in the UNAWARE group. The overall GV was greater in the UNAWARE group. In the UNAWARE group, significantly reduced fasting and post prandial glucagon levels negatively correlated with HUI (r = -0.74, p < 0.05) and GV-hypoglycemia indices (p < 0.05) In contrast, significantly higher post prandial glucagon levels in the AWARE group positively correlated with post prandial hyperglycemia (r = 0.61, p < 0.05)., Conclusion: Heterogeneity in patterns of glucagon secretion were significantly associated with HUA and GV. Reduced glucagon levels contribute to greater risks of HUA, nocturnal hypoglycemia and greater GV, while hyperglucagonemia predisposes to postprandial hyperglycemia and hypoglycemia awareness in patients with FCPD., Competing Interests: The authors have declared that no competing interests exist

Background: The early detection of diabetes, and subsequent lifestyle intervention, may reduce the burden of diabetes and its complications. Several studies have identified a link between sudomotor dysfunction, insulin resistance, and pre-diabetes. The aim of this study was to evaluate the ability of a new non-invasive device EZSCAN evaluating sudomotor function to detect pre-diabetes in a German population at risk for diabetes. Methods and findings: 200 German subjects at risk for diabetes (mean age 56 ± 14 years, BMI 28.4 ± 5.4 kg/m2) were measured for anthropo-metric data on inflammatory parameters, including high sensitivity C reactive protein (hs-CRP). The subjects also underwent an oral glucose tolerance test with measurements of plasma glucose, insulin, proinsulin, C-peptide and free fatty acids during 2 h following glucose challenge. Indexes for sensitivity to insulin were calculated: S I using minimal model, HOMA-IR and Matsuda index. Based on the measurement of electro-chemical sweat conductance, subjects were classified as no risk, moderate risk or high risk. According to this risk model classification, a significant difference was observed between OGTT-1 h (p = 0.004), AUC glucose (p = 0.011), AUC C-peptide (p < 0.001), HOMA-IR (p = 0.009), Matsuda (p = 0.002), S I (p < 0.001) and hs-CRP (p = 0.025) after adjustment for age. Among the 54 subjects with impaired fasting glucose or impaired glucose tolerance according to WHO classification, 37 had a moderate risk and 15 a high risk according to the EZSCAN risk model classification. Among the 12 subjects with newly diagnosed diabetes, 2 had a moderate risk and 10 a high risk according to the risk model classification. No adverse event was reported during or after the study. Conclusions: These results, in accordance with a previous study performed in India, show that EZSCAN could be developed as a screening tool for diabetes risk, and could help to improve diabetes screening strategies. Results obtained from an at-risk population would have to be confirmed in a larger population. [ABSTRACT FROM AUTHOR]

To assess the burden of type 2 diabetes (T2D) and its genetic profile in endogamous populations of India given the paucity of data, we aimed to determine the prevalence of T2D and estimate its heritability using family-based cohorts from three distinct Endogamous Ethnic Groups (EEGs) representing Northern (Rajasthan [Agarwals: AG]) and Southern (Tamil Nadu [Chettiars: CH] and Andhra Pradesh [Reddys: RE]) states of India. For comparison, family-based data collected previously from another North Indian Punjabi Sikh (SI) EEG was used. In addition, we examined various T2D-related cardiometabolic traits and determined their heritabilities. These studies were conducted as part of the Indian Diabetes Genetic Studies in collaboration with US (INDIGENIUS) Consortium. The pedigree, demographic, phenotypic, covariate data and samples were collected from the CH, AG, and RE EEGs. The status of T2D was defined by ADA guidelines (fasting glucose ≥ 126 mg/dl or HbA1c ≥ 6.5% and/or use of diabetes medication/history). The prevalence of T2D in CH (N = 517, families = 21, mean age = 47y, mean BMI = 27), AG (N = 530, Families = 25, mean age = 43y, mean BMI = 27), and RE (N = 500, Families = 22, mean age = 46y, mean BMI = 27) was found to be 33%, 37%, and 36%, respectively, Also, the study participants from these EEGs were found to be at increased cardiometabolic risk (e.g., obesity and prediabetes). Similar characteristics for the SI EEG (N = 1,260, Families = 324, Age = 51y, BMI = 27, T2D = 75%) were obtained previously. We used the variance components approach to carry out genetic analyses after adjusting for covariate effects. The heritability (h 2 ) estimates of T2D in the CH, RE, SI, and AG were found to be 30%, 46%, 54%, and 82% respectively, and statistically significant (P ≤ 0.05). Other T2D related traits (e.g., BMI, lipids, blood pressure) in AG, CH, and RE EEGs exhibited strong additive genetic influences (h 2 range: 17% [triglycerides/AG and hs-CRP/RE] - 86% [glucose/non-T2D/AG]). Our findings highlight the high burden of T2D in Indian EEGs with significant and differential additive genetic influences on T2D and related traits., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Venkatesan, Lopez-Alvarenga, Arya, Ramu, Koshy, Ravichandran, Ponnala, Sharma, Lodha, Sharma, Shaik, Resendez, Venugopal, R, Saju, Ezeilo, Bejar, Wander, Ralhan, Singh, Mehra, Vadlamudi, Almeida, Mummidi, Natesan, Blangero, Medicherla, Thanikachalam, Panchatcharam, Kandregula, Gupta, Sanghera, Duggirala and Paul.)

Air pollution exposure have been shown to adversely impact health through a number of biological pathways, and is also associated with glucose metabolism. There are few studies that evaluated the associations between air pollution and fasting blood sugar and HbA1C levels. But no such study occurred in Indian population. Hence to address this knowledge gap, we investigated the associations between air borne fine particulate matter (PM10, PM2.5), nitrogen di-oxide and glucose metabolism in a tertiary care center in north western rajasthan., Material: We performed cross-sectional analysis in 3457 participants between 30 to 70 years of age group from five different urban and rural areas of Bikaner district. Air pollution concentration of multiple air pollutants (PM10, PM2.5andNitogen dioxide) were estimated by ambient air quality standard method by respiratory dust sampler. Diabetes was defined based on self reported diagnosis, medication prescription, oral glucose tolerance test and HbA1C. We adjusted for potential confounders including socio-economic status, smoking habits, alcohol consumtion, physical activity and Body Mass Index (BMI) by using logistic regression method., Observation: After adjustment for potential confounders, air pollutants PM10, NO2, except PM2.5 were associated with diabetes prevalence. The prevalence of diabetes was 8.93% and the mean HbA1C was 8.67±1.16, where as the concentration of PM10 was 156.12 mcg/m3, NO2 was 5.43 mcg/m3 and PM2.5 was 25.36 mcg/m3. The prevalence of IFG, IGT and diabetes increases with increased concentration of air pollutants. By applying Pearson's co-relation for air pollutants the 'r' value of PM10was 0.163, p value &lt; 0.001, for PM2.5 'r' value was 0.001 and p value 0.965, for NO2 'r' value was 0.149 and p value was 0.001 respectively. By applying step wise logistic regression analysis, air pollutants PM10 (Odd Ratio 0.002, 95% CI 0.002;0.003) and by adding duration of exposure to air pollutants (Odd ratio 0.003,95%CI 0.001,0.005) by adding PM2.5 air pollutant (odd ratio 0.028,95%CI -0.042,-0.015) and by adding NO2 (odd ratio 0.140,95% CI 0.104,0.175)., Conclusion: long term air pollution exposure was associated with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and prevalence of diabetes mellitus (DM). This study can be used as a good evidence that air pollution is an important and manageable risk factor for diabetes hence awareness about air pollution in the society and at government level is much needed., (© Journal of the Association of Physicians of India 2011.)

Diarrhoea and pneumonia account for most deaths in children aged < 5 years. However, most diarrhoeal deaths are preventable with appropriate hygienic measures and timely initiation of rehydration therapy. A cross-sectional study was conducted on 280 mothers with children aged 2-59 months with acute watery diarrhoea at a tertiary hospital. One-fifth of respondents were illiterate and only one-third of mothers pre-treated water to make it drinkable. Mean knowledge scores for hand washing, diarrhoea prevention and complications of diarrhoea were poor, though higher in educated mothers ( P < 0.05). Scores were similar for the first episode or repeat episodes of diarrhoea. Only 50.4% and 55.2% mothers knew the correct method of Oral Rehydration Solution (ORS) preparation and administration, respectively. Lack of adequate maternal knowledge and practices concerning childhood diarrhoea highlights the need for patient counselling and education, especially among the illiterate in India. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes is a serious public health concern in India, even the indigenous tribal populations are not left unaffected. The present study aims to understand the association of major risk factors i.e. obesity, hypertension, dyslipidemia, ACE I/D polymorphism with impaired fasting glucose (IFG) and type 2 diabetes (T2D) among two different Mendelian populations of North East India., Methods: Demographic, somatometric, physiological variables along with fasting blood samples were collected from 609 individuals. The participants were screened for ACE I/D polymorphism., Results: ACE I/D polymorphism was found to follow HWE among Liangmai tribe but not among Mizo tribe. Distribution of DD genotype/D allele was found to be significantly higher for T2D among Mizo tribe. Significant association were observed between DD genotype/D allele of ACE I/D polymorphism and TC as well as LDL with both IFG and T2D only in Mizo tribe., Conclusions: The present study is an example of gene-environment interaction where DD genotype or D allele and dyslipidemia (high TC and high LDL) are posing risk for IFG and T2D both independently and in combination only among Mizo tribe with relatively less physical activity attributed to their residence in less hilly terrain however Liangmai tribe which resides in high hilly terrain shows no such association., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Acacia farnesiana is a medicinal plant that grows throughout tropical parts of Indian subcontinent, particularly in sandy soils of river beds in Northern India. The objective of the present study was to evaluate the anti-hyperglycemic activity of the extracts using glucose tolerance test. Isolation of an active fraction (AF) from the active extract (water extract) using alcohol precipitation and to get insight to the mechanism of action of the AF of A. farnesiana. Materials and Methods: Glucose uptake by isolated rat diaphragm of the AF was performed. Further the effect of release of Insulin from isolated and cultured pancreatic β-cell was determined. Besides, effect of oral administration of the AF was compared with that of intraperitonial administration. The effect of AF on serum glucose levels in orally glucose loaded rats was compared with that of intraperitoneal glucose loaded rats. Results: The water extract significantly lowered the blood glucose level. When precipitated with alcohol, the activity was found in the soluble fraction. Glucose uptake in the isolated rat hemidiaphragm, was increased by the AF at 40 μg/ml concentration, the AF did not significantly influence insulin release from cultured islets. The AF was found to be effective in orally glucose loaded in contrast to intraperitonial route. Conclusion: Our findings suggest that this plant is promising for further studies leading to the development of valuable medicine for diabetes. [ABSTRACT FROM AUTHOR]

The article discusses research which investigated effectiveness of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) guidelines on oral glucose tolerance testing (OGTT) for diagnosing gestational diabetes (GDM) in pregnant women in India. Topics explored include the prevalence of GDM among Indian women, the compliance of participating pregnant women to the OGTT process, and the IADPSG criteria for recording GDM incidence.

Abstract: Peganum harmala Linn, commonly known as ‘harmal’ belonging to the family Zygophyllaceae, is one of the most important medicinal plants of India. In continuation of our drug development program on Indian medicinal plants we discovered antihyperglycemic activity in 4-hydroxypipecolic acid (4-HPA), isolated from the seed of P. harmala. Effect of 4-HPA on glucose uptake and glucose transporter-4 (GLUT-4) translocation was investigated in L6 skeletal muscle cell lines. Treatment with 4-HPA stimulated both glucose uptake and GLUT4 translocation from intracellular to cell surface in skeletal muscle cells in a concentration-dependent manner, which might be leading to antihyperglycemic effect. [Copyright &y& Elsevier]

Context: The risk of cardiovascular disease was assessed among officer grade bank employees of Gulbarga city, as they face a large of amount of work related stress. Aims: (1) To assess the risk of cardiovascular disease among the study group. (2) To propose a similar population based heart disease screening strategy for other groups. Settings and Design: Out of the 242 officers in 26 banks in Gulbarga city (nationalized and private), 59 officers were willing to be a part of the study. This population was initially screened by a self-assessment scale, consisting of 10 questions relating to past history, family history, and lifestyle practices. Scoring system was used for the analysis. Materials and Methods: The initial part of this cross-sectional study was conducted during April 2006. Forty nine officers who scored ≥3 were recruited for preliminary assessment, which consists of physical examination, Electrocardiogram (ECG) and some invasive investigations (fasting blood sugar and cholesterol). Those found at further risk, were recruited for detailed assessment. 15 officers who qualified were screened for specific cardiac markers using advanced investigations Lipoprotein (Lp) a, homocysteine, C reactive protein (CRP), lipid profile measurements, Treadmill test (TMT) / Echocardiogram (ECHO), and Glucose tolerance test (GTT). All the five officers who were found at the highest level of risk were referred to the tertiary health care centre. Statistical Analysis: Microsoft excel was used to compute the frequencies and percentages. Results: Among the 59 employees examined in the study, 49 were found to be at risk for cardiovascular diseases (comprising ~83% of the assessed population) and thus qualified to the second round of assessment. Only 31 officers underwent the second round of assessment, out of whom 15 (48.4%) were found to be at higher risk and thus were subjected to the third round. Only five officers (of the 15) underwent the third round of assessment and all were found to be utmost at risk for CVDs and were duly referred to a tertiary health care centre. Conclusions: The study shows the application of a risk assessment model, towards predicting the risk for cardiovascular diseases among a group ofhigh risk population. Similar models could be used for the risk assessment of other population groups. [ABSTRACT FROM AUTHOR]

Background: India has the largest number of patients with diabetes in the world, accounting for more than 50 million subjects. There are limited studies on diabetes awareness, attitude, and prevalence in rural communities, especially in the northeastern part of India. Materials and Methods: A community-based survey using the STEPS questionnaire with recording of blood pressure, fasting blood glucose, postprandial blood glucose, waist circumference, and height was conducted among the residents of Kameng district of Arunachal Pradesh. A door-to-door survey was conducted in each village, and members above the age of 25 years from each household were considered eligible to participate. Results and Conclusion: The awareness of diabetes in the study population was found to be as low as 21%. Majority of subjects (58%) had a normal BMI and adequate physical activity (88%). The prevalence of smoking (72%) and alcohol consumption (49%) was found to be very high amongst the study population. Blood glucose screening revealed that 13% had impaired fasting glucose and 6% had impaired glucose tolerance. [ABSTRACT FROM AUTHOR]

Two thraustochytrid protists of the genus Thraustochytrium isolated from coastal and mangrove habitats of Goa, India were studied for extracellular alkaline lipase production. Maximum lipase production was supported by a combination of peptone and yeast extract in the growth medium while strong inhibition of enzyme production was observed in presence of glucose. The inducible nature of the enzyme production was evidenced by the requirement of olive oil in the medium. Lipase production was salt-dependent and optimum production required 3.4% (w/v) crude sea salt. Ideal conditions for maximum production of lipases were therefore adopted as incubation at 30 ± 2°C for 168 h at an initial pH of 6.0 in a medium consisting of 0.5% peptone, 0.01% yeast extract, 0.5% olive oil and 3.4% crude salt. Extracellular lipase production by the two thraustochytrid isolates [designated TZ (ATCC #PRA-295) and AH-2 (ATCC #PRA-296)] was increased threefold under these optimized culture conditions. This appears to be the first report on optimization of cultivation conditions for the production of alkaline lipases by thraustochytrids. [ABSTRACT FROM AUTHOR]

The prevalence of diabetes in India has grown over the past decade. Diabetic patients develop complications due to poor awareness regarding the disease and inadequate glycemic control. Patient education is the most effective way to lessen the complications of diabetes and its management. A total of 207 (85 males and 122 females) type 2 diabetes mellitus patients were enrolled and randomized into test and control groups. Patients in the test group received counseling at each visit and information leaflets from the pharmacist; the control group patients received counseling and information leaflets only at the end of the study. A validated knowledge, attitude, and practice (KAP) questionnaire was administered to both test and control group patients at baseline and at final follow-up to assess awareness regarding disease management. Glucose and lipid levels were also evaluated at baseline and final follow-up in both the groups. At the end of the study, the KAP score of test group patients improved significantly (P<0.0001), whereas no significant changes were observed in control group patients. The postprandial blood glucose (PPBG) levels decreased significantly in the test group. Total cholesterol (TC), triglycerides (TGL), and low density lipoprotein levels (LDL) also showed a decrease in the test group. Thus, our study reveals that pharmacist counseling might be an important element in diabetes management programs. [ABSTRACT FROM AUTHOR]

naerobic growth of a newly isolated Pseudomonas putida strain WB from an arsenic-contaminated soil in West Bengal, India on glucose, l-lactate, and acetate required the presence of arsenate, which was reduced to arsenite. During aerobic growth in the presence of arsenite arsenate was formed. Anaerobic growth of P. putida WB on glucose was made possible presumably by the non-energy-conserving arsenate reductase ArsC with energy derived only from substrate level phosphorylation. Two moles of acetate were generated intermediarily and the reducing equivalents of glycolysis and pyruvate decarboxylation served for arsenate reduction or were released as H. Anaerobic growth on acetate and lactate was apparently made possible by arsenate reductase ArrA coupled to respiratory electron chain energy conservation. In the presence of arsenate, both substrates were totally oxidized to CO and H with part of the H serving for respiratory arsenate reduction to deliver energy for growth. The growth yield for anaerobic glucose degradation to acetate was Y = 20 g/mol, leading to an energy coefficient of Y = 10 g/mol adenosine-5'-triphosphate (ATP), if the Emden-Meyerhof-Parnas pathway with generation of 2 mol ATP/mol glucose was used. During growth on lactate and acetate no substrate chain phosphorylation was possible. The energy gain by reduction of arsenate was Y = 6.9 g/mol, which would be little less than one ATP/mol of arsenate. [ABSTRACT FROM AUTHOR]