Search

The risk of hypoglycaemia is still a limiting factor for achieving near-normoglycaemia in subjects with Type 1 Diabetes. From the metabolic perspective, counterregulation has a significant influence in plasma glucose concentration during hypoglycaemia. In Type 1 Diabetes, adrenaline is the first line of counterregulatory hormone response to hypoglycaemia due to the early impairment of glucagon secretion. In a previous work, an adrenaline secretion model was developed. Here, adrenaline counterregulatory action is addressed by means of an extension of the well-known Bergman Minimal Model. The added terms were based on both adrenaline concentration after counterregulatory response begins and the influence of hypoglycaemic levels of glucose in blood. Individual parameters were estimated using data from a eu-hypoglycaemic clamp study by means of global optimization algorithms, in particular CMA-ES. Analysis of plasma glucose prediction accuracy demonstrated the importance of considering counterregulation in predictive algorithms when hypoglycaemic events occur.

To determine the effectiveness of hemoglobin A1c (HbA1c) ≥ 6.5% in diagnosing diabetes compared to fasting plasma glucose (FPG) ≥ 126 mg/dL and 2-hour plasma glucose (2hPG) ≥ 200 mg/dL in a previously undiagnosed diabetic cohort, we included 5,764 adult subjects without established diabetes for whom HbA1c, FPG, 2hPG, and BMI measurements were collected. Compared to the FPG criterion, the sensitivity of HbA1c ≥ 6.5% was only 43.3% (106 subjects). Compared to the 2hPG criterion, the sensitivity of HbA1c ≥ 6.5% was only 28.1% (110 subjects). Patients who were diabetic using 2hPG criterion but had HbA1c < 6.5% were more likely to be older (64±15versus60±15years old,P=0.01, mean ± STD), female (53.2% versus 38.2%,P=0.008), leaner (29.7±6.1versus33.0±6.6 kg/m2,P=0.000005), and less likely to be current smokers (18.1% versus 29.1%,P=0.02) as compared to those with HbA1c ≥ 6.5%. The diagnostic agreement in the clinical setting revealed the current HbA1c ≥ 6.5% is less likely to detect diabetes than those defined by FPG and 2hPG. HbA1c ≥ 6.5% detects less than 50% of diabetic patients defined by FPG and less than 30% of diabetic patients defined by 2hPG. When the diagnosis of diabetes is in doubt by HbA1c, FPG and/or 2hPG should be obtained.

We hypothesized that poor quality of life may lead to the development of post-operative hyperglycemia, as it is more likely to be associated with stress-induced impairment of glucose control. A correlation between the components of quality of life, and blood glucose changes after Coronary Artery Bypass Surgery (CABG) was examined. In a cross-sectional study, 268 consecutive patients undergoing CABG at Tehran Heart Center were recruited. Postoperative blood glucose were measured every 2 to 4 h for 24 h following surgery. Quality of life was assessed using the SF-36 questionnaire, and the physical and mental component summary scores were used to analyze data. An adverse relationship was found between mental summary score and the mean of plasma glucose concentrations during 24 h after surgery (β = −0.152, SE = 0.076, P = 0.046). No significant association was found between physical summary score and mean of plasma glucose concentration during this time. Postoperative blood glucose changes may be independently associated with patients’ mental status preoperative, as reflected by mental component of quality of life.

Considering old GDM diagnostic criteria, alterations in insulin secretion and action are present in women with GDM as well as in women with one abnormal value (OAV) during OGTT. Our aim is to assess if changes in insulin action and secretion during pregnancy are related to 1-hour plasma glucose concentration during OGTT. We evaluated 3 h/100 g OGTT in 4,053 pregnant women, dividing our population on the basis of 20 mg/dL increment of plasma glucose concentration at 1 h OGTT generating 5 groups (n=661; 120–139 mg/dL,n=710; 140–159 mg/dL,n=912; 160–179 mg/dL,n=885; and ≥180 mg/dL,n=996). We calculated incremental area under glucose (AUCgluc) and insulin curves (AUCins), indexes of insulin secretion (HOMA-B), and insulin sensitivity (HOMA-R), AUCins/AUCgluc. AUCglucand AUCinsprogressively increased according to 1-hour plasma glucose concentrations (bothP<0.0001for trend). HOMA-B progressively declined (P<0.001), and HOMA-R progressively increased across the five groups. AUCins/AUCglucdecreased in a linear manner across the 5 groups (P<0.001). Analysing the groups with 1-hour value P<0.001). Progressive increase in 1-hour OGTT is associated with deterioration of glucose tolerance and alterations in indexes of insulin action and secretion.

Hypoglycemia is characterized by a reduction in plasma glucose concentration to a level that may induce symptoms or signs such as altered mental status or sympathetic nervous system stimulation. Glucose levels

Type 2 diabetes mellitus (DM2) is one of the most widely prevalent diseases worldwide and is currently screened by invasive techniques based on enzymatic assays that measure plasma glucose concentration in a laboratory setting. A promising plan of action for screening DM2 is to identify molecular signatures in a non-invasive fashion. This work describes the application of portable Raman spectroscopy coupled with several supervised machine-learning techniques, to discern between diabetic patients and healthy controls (Ctrl), with a high degree of accuracy. Using artificial neural networks (ANN), we accurately discriminated between DM2 and Ctrl groups with 88.9–90.9% accuracy, depending on the sampling site. In order to compare the ANN performance to more traditional methods used in spectroscopy, principal component analysis (PCA) was carried out. A subset of features from PCA was used to generate a support vector machine (SVM) model, albeit with decreased accuracy (76.0–82.5%). The 10-fold cross-validation model was performed to validate both classifiers. This technique is relatively low-cost, harmless, simple and comfortable for the patient, yielding rapid diagnosis. Furthermore, the performance of the ANN-based method was better than the typical performance of the invasive measurement of capillary blood glucose. These characteristics make our method a promising screening tool for identifying DM2 in a non-invasive and automated fashion.

Diabetes mellitus is often accompanied to schizophrenia patient. This condition probably related to genetic, antipsychotic drugs and the development of schizophrenia that can lead to an unhealthy lifestyle, such as sedentary lifestyle and the increased of dietary intake. Cross-sectional study was held in Psychiatry Department Cipto Mangunkusumo Hospital during May to June 2014 to determine the correlation between fasting plasma glucose concentration in schizophrenia patient to their nutritional status indicator and physical activity level. Forty-seven subjects finished the study protocol. The result showed that the fasting plasma glucose concentration in schizophrenia patient has no correlation with nutritional status indicator and physical activity level, in which 91.5% subject had normal fasting plasma glucose. However, there is a need for further investigation because 31.9% subject was overweight, 48.9% subject was obesity and 74.5% subject had central obesity.

This study was carried out to evaluate the inclusion of two rice co-products in pig feed during the starter phase in terms of the nutritional value and digestibility of the co-products, and the effect on plasma parameters, growth performance and economic viability. In Experiment I, a digestibility assay was performed using 30 barrows (14.4 ± 2.4 kg body weight), which were distributed in a completely randomised design. The co-products studied were broken rice (BR) and hominy rice 3/4 (HR) to replace the reference diet (300 g/kg). The estimated digestible energy (DE) and metabolisable energy (ME) were 3,476 and 3,360 kcal/kg for BR and 3,487 and 3,362 kcal/kg for HR, respectively. In Experiment II, 108 pigs (15.5 ± 1.0 to 30.1 ± 1.3 kg body weight) were used, distributed in a randomised block design with a factorial analysis scheme (2 × 4), using two types of rice and four inclusion levels (160, 320, 480, and 640 g/kg), with six replicates and two pigs per experimental unit. Additionally, a control diet was used with no inclusion of the co-product. The daily weight gain increased and the feed:gain (F:G) ratio decreased as HR content of feed increased. An effect of both types of rice on plasma glucose concentration was obtained, in which the pigs fed with BR showed the highest values. The cost of diet per kilogram of body weight gain increased as BR levels in the diet increased. It was observed that inclusion levels of 480 and 640 g/kg of BR differed from the control diet, showing the highest costs. HR and BR can be used in pig feed in the starter phase at up to 640 g/kg without impairing performance. Este estudo foi realizado para avaliar a inclusão de dois coprodutos do arroz na alimentação de suínos durante a fase inicial sobre o valor nutricional e a digestibilidade dos coprodutos, parâmetros plasmáticos, desempenho zootécnico e a viabilidade econômica. No experimento I, realizou-se um ensaio de digestibilidade, utilizando 30 suínos machos castrados (14.4 ± 2.4 kg de peso corporal), distribuídos em um delineamento inteiramente casualizado. Os coprodutos estudados foram a quirera de arroz (QA) e o arroz canjica 3/4 (AC) em substituição à ração referência (300 g/kg). Os valores estimados de energia digestível (ED) e energia metabolizável (EM) foram de 3.476 e 3.360 kcal/kg para QA e 3.487 e 3.362 kcal/kg para AC, respectivamente. No experimento II, foram utilizados 108 suínos (15.5 ± 1.0 a 30.1 ± 1.3 kg de peso corporal), distribuídos em um delineamento em blocos casualizados, em esquema de análise fatorial (2 x 4), com dois tipos de arroz e quatro níveis de inclusão (160, 320, 480 e 640 g/kg), com seis repetições e dois suínos por unidade experimental. Adicionalmente, foi utilizada uma ração controle, sem inclusão dos coprodutos. O ganho diário de peso aumentou e a conversão alimentar reduziu quando aumentou AC nas rações. Foi obtido efeito dos tipos de arroz sobre a concentração de glicose plasmática, em que os suínos alimentados com QA apresentaram os maiores valores. O custo de ração (CR) por quilograma de ganho de peso corporal aumentou em função dos níveis de QA. Observou-se que os níveis de 480 e 640 g/kg de inclusão de QA diferiram da ração controle, apresentando os maiores custos. O AC e o QA podem ser utilizados, em dietas para suínos na fase inicial, em até o nível de 640 g/kg sem prejudicar o desempenho.

Summary The aim of the present study was to evaluate the capacity of the horse, during low intensity exercise, to increase the contribution of fat oxidation to energy production as a result of a pre-exercise elevation of triglyceride derived plasma FFA. Seven Thoroughbred horses were exercised for 91 min (3.2 m/s for 60 min, 13.4 ± 2.9% VO2max) during 2 randomised experimental sessions (test, T and control, C). Prior to the test session, plasma FFA were elevated using a combination of a heparinoid type substance (pentosan polysulphate, 1.3 mg/kg bwt) and a triglyceride emulsion (Iverlip 20; 0.4 g/kg bwt). Mean pre-exercise plasma FFA and triglyceride concentrations were 903.9 ± 275.0 and 810.2 ± 169.6 μmol/l for the test session and 465.5 ± 266.0 and 158.4 ± 64.5 μmol/l for the control session, respectively. Total lipase activity was significantly increased at rest after pentosan polysulphate and Iverlip administration and throughout exercise during the test session. Respiratory exchange ratio (RER) was lower in 5 out of 7 horses and plasma glucose concentration was higher in 4 of these 5 horses during the test exercise session. These results suggest that an elevation of plasma FFA concentration prior to exercise results in an increase in the utilisation of fat, during subsequent low intensity exercise, in a proportion of horses. This effect, however, is probably influenced by individual biological and metabolic variation in the response to exercise and may depend upon the individual's inherent ability to utilise fat.

OBJECTIVE To assess the relative contribution of increased fasting and postload plasma glucose concentrations to the incidence of type 2 diabetes in subjects with a normal 2-h plasma glucose concentration. RESEARCH DESIGN AND METHODS A total of 3,450 subjects with 2-h plasma glucose concentration RESULTS In subjects with 2-h plasma glucose CONCLUSIONS An increase in postload glycemia in the normal range is associated with an increase in the incidence of type 2 diabetes. After controlling for 1-h plasma glucose concentration, the increase in FPG concentration is not associated with an increase in the incidence of type 2 diabetes.

Zusammenfassung Plasma-Glucose-Konzentration und Glucose-Umsatz bei Milchkuhen wahrend der spaten Trachtigkeit und zu Beginn der Laktation Es wurden der Zusammenhang zwischen der Glucose-Konzentration im Plasma und dem Glucose-Umsatz am Ende der Trachtigkeit und zu Beginn der Laktation untersucht und die Ergebnisse hinsichtlich der Gluconeogenese und der Nutzung durch das Euter diskutiert. Die Messungen wurden an sechs Kuhen bei einer Leistung von 10,7–35,8 kg/Tag einmal am Ende der Trachtigkeit und zweimal zu Beginn der Laktation durchgefuhrt. Die Glucose-Konzentration wurde jeweils uber 24 Stunden gemessen. Mit Ausnahme der Kuh mit der niedrigsten Leistung wurde ein Abfall der Plasma-Glucose-Konzentration vom Ende der Graviditat bis zu den ersten Laktationstagen gemessen. Dabei stieg der Glucose-Umsatz um das 2–3-fache. Zwischen Plasma-Glucose und Glucose-Umsatz konnte keine Beziehung ermittelt werden. Die Untersuchungen zeigten, das die Verfugbarkeit der Glucose in den peripheren Geweben mit Ausnahme des Euters vom spaten Laktationsstadium bis zum Beginn der Laktation abfallt. Relativ hohe Glucose-Konzentrationen im Plasma verbunden mit hohem Glucose-Umsatz bei hoher Milchleistung schliesen niedrige Plasma-Glucose-Konzentrationen als wichtigen Faktor zur Stimulation der Gluconeogenese und Bevorzugung des Euters bei der Nahrstoffausnutzung im fruhen Laktationsstadium aus. Als wichtigstes Regulativ scheint der Hormonstatus der Tiere einzugreifen.

Exact computations of glucose accumulation (GA, mM) and Na anions deficit (ΔNa, mEq) can be obtained in hypo-osmolar hyponatremic hyperglycaemia (HHH), where plasma osmolality (POsm) is lower than normal. In this condition, GA − ΔNa = ∆POsm × TBW (total body water). GA is given by plasma glucose concentration (PG1) times extra-cellular volume (ECV), calculated as TBW − ICV (the known intra-cellular volume). The changes in solute content can then be computed from their concentrations. This model was verified on computer-simulated patients to whom GA was added in variable amounts, lower than those of ΔNa subtracted, generating known ICV, ECV, PNa1, and PG1. True computer-generated values were identical (the correlation coefficient R 2 = 1, p

OBJECTIVE—The purpose of this study was to assess the efficacy of the postload plasma glucose concentration in predicting future risk of type 2 diabetes, compared with prediction models based on measurement of the fasting plasma glucose (FPG) concentration. RESEARCH DESIGN AND METHODS—A total of 2,442 subjects from the Botnia Study, who were free of type 2 diabetes at baseline, received an oral glucose tolerance test (OGTT) at baseline and after 7–8 years of follow-up. Future risk for type 2 diabetes was assessed with area under the receiver-operating characteristic curve for prediction models based up measurement of the FPG concentration 1) with or without a 1-h plasma glucose concentration during the OGTT and 2) with or without the metabolic syndrome. RESULTS—Prediction models based on measurement of the FPG concentration were weak predictors for the risk of future type 2 diabetes. Addition of a 1-h plasma glucose concentration markedly enhanced prediction of the risk of future type 2 diabetes. A cut point of 155 mg/dl for the 1-h plasma glucose concentration during the OGTT and presence of the metabolic syndrome were used to stratify subjects in each glucose tolerance group into low, intermediate, and high risk for future type 2 diabetes. CONCLUSIONS—The plasma glucose concentration at 1 h during the OGTT is a strong predictor of future risk for type 2 diabetes and adds to the prediction power of models based on measurements made during the fasting state. A plasma glucose cut point of 155 mg/dl plus the Adult Treatment Panel III criteria for the metabolic syndrome can be used to stratify nondiabetic subjects into low-, intermediate-, and high-risk groups.

OBJECTIVE—To assess the efficacy of 1-h plasma glucose concentration and the metabolic syndrome in predicting future risk of type 2 diabetes. RESEARCH DESIGN AND METHODS—A total of 1,611 subjects from the San Antonio Heart Study, who were free of type 2 diabetes at baseline; who had plasma glucose and insulin concentrations measured at time 0, 30, 60, and 120 min during the oral glucose tolerance test (OGTT); and who had their diabetes status determined with an OGTT after 7–8 years of follow-up, were evaluated. Two models, based on glucose tolerance status, 1-h plasma glucose concentration, and presence of the metabolic syndrome, were tested in predicting the risk for type 2 diabetes at 7–8 years of follow-up. RESULTS—A cutoff point of 155 mg/dl for the 1-h plasma glucose concentration during the OGTT was used to stratify subjects in each glucose tolerance group into low, intermediate, and high risk for future type 2 diabetes. A model based upon 1-h plasma glucose concentration, Adult Treatment Panel (ATP) III criteria for the metabolic syndrome, and fasting plasma glucose, independent of 2-h plasma glucose, performed equally well in stratifying nondiabetic subjects into low, intermediate, and high risk for future type 2 diabetes and identified a group of normal glucose-tolerant subjects who were at very high risk for future type 2 diabetes. CONCLUSIONS—The plasma glucose concentration at 1 h during the OGTT is a strong predictor of future risk for type 2 diabetes. A plasma glucose cutoff point of 155 mg/dl and the ATP III criteria for the metabolic syndrome can be used to stratify nondiabetic subjects into three risk groups: low, intermediate, and high risk.

Summary Objective To measure glucose kinetics and the influence of age, nutritional status and fasting duration in children with uncomplicated falciparum malaria (UFM) under the age of 5 years. Methods Plasma glucose concentration, endogenous glucose production (EGP) and gluconeogenesis (GNG) were measured using [6,6-2H2]glucose and 2H2O in 17 very young (

6 Abstract: Studies were conducted on the effects of aqueous extract of Triplochiton scleroxylon on white blood cell differentials in alloxan-induced diabetic rabbits. At least 100 mL of the aqueous extract was administered orally to test rabbits of New Zealand strain weighing between 1200 to 1680g for a period of 28 days. Clean drinking troughs were used in the administration of water and aqueous extract to the control and test rabbits respectively. Blood was collected for analyses intravenously through the larger vein at the back of the ear of rabbits. Hematological Swelab autocounter 920 (UK) was used in the determination of white blood cell E+ differentials; neutrophils, lymphocytes, basophils and eosinophils. Analyses of results showed that the aqueous extract of the bark of Triplochiton scleroxylon did not have significant effects (p>0.05) on white blood cell differentials in alloxan-induc ed diabetic rabbits studied. Plasma glucose concentration decreased significantly (p

We investigated the effects of high-monounsaturated fatty acid (MUFA) versus high-carbohydrate enteral formula on post-prandial plasma glucose concentration and insulin response in Japanese patients with type 2 diabetes mellitus and healthy Japanese volunteers. Ten healthy volunteers aged 20.8 ± 1.2 years and 12 diabetic patients with good glycaemic control (glycosylated haemoglobulin < 7%) aged 58.6 ± 7.7 years were randomly assigned to take high-MUFA or high-carbohydrate formula after a 12-h overnight fast. The patients switched to the other formula after 7 days. Post-prandial plasma glucose and insulin response were significantly lower in all subjects after taking high-MUFA formula compared with high-carbohydrate formula. No differences were observed in free fatty acids, triglycerides and plasma glucagon between the two diet groups. In conclusion, a high-MUFA enteral formula suppresses post-prandial hyperglycaemia without exaggerated insulin secretion compared with a high-carbohydrate enteral diet in patients with type 2 diabetes and healthy subjects.

Continuous glucose monitoring (CGM) sensors measure glucose concentration in the interstitial fluid (ISF). Equilibration between plasma and ISF glucose is not instantaneous. Therefore, ISF and plasma glucose concentrations exhibit different dynamic patterns, particularly during rapid changes. The purpose of this work was to investigate how well plasma glucose can be reconstructed from ISF CGM data.Six diabetic volunteers were monitored for 2 days using the TheraSense FreeStyle Navigator (Abbott Diabetes Care, Alameda, CA), a minimally invasive device that, on the basis of an initial calibration procedure (hereafter referred to as standard calibration), returns ISF glucose concentration. Simultaneously, plasma glucose concentration was also measured every 15 minutes. First we identified, in each subject, the linear time-invariant (LTI) two-compartment model of plasma-interstitium kinetics. Then, a nonparametric regularization deconvolution method was used to reconstruct plasma from ISF glucose.Deconvoluted profiles were always closer to plasma glucose than ISF ones. However, the quality of the reconstruction is unsatisfactory. Some visible discrepancies between average plasma and ISF time series suggest problems either in the applicability of the LTI model of plasma-interstitium kinetics to normal life conditions or in the standard calibration with which ISF glucose is determined from the sensor internal readings. Assuming that the LTI model of plasma-interstitium kinetics is correct, we focused on the influence of calibration and we employed a recently proposed method to recalibrate ISF data.After the recalibration step, the relative error in reconstructing plasma glucose was reduced significantly. Results also demonstrate that further margins of improvement of plasma glucose reconstruction are possible by developing more sophisticated recalibration procedures.

Objective. The aim of this study was to investigate the effects of spinal cord stimulation (SCS) on peripheral circulation in rats with streptozotocin (STZ)-induced diabetes. Materials and Methods. Four weeks after streptozotocin or vehicle was injected (i.p.) in male Sprague-Dawley rats, SCS-induced vasodilation was examined. Results. Plasma glucose concentration was significantly higher in diabetic rats than in the control animals. Motor threshold (MT) was significantly higher in diabetic rats than in control rats. SCS-induced vasodilation was attenuated at 90% of the MT, but not at 30% and 60% of MT in diabetic rats when compared to control rats (p

This study was designed to determine the effects of ingesting a carbohydrate (CHO) solution on affective states and rating of perceived exertion (RPE) during prolonged intermittent high-intensity exercise. Seventeen male soccer players completed a prolonged intermittent high-intensity exercise protocol for 90 min on two occasions, separated by at least 7 days. Participants consumed either a 6.4% CHO (0.6 g/kg body mass (BM)/h) or an artificially sweetened placebo (PLA) solution immediately before (8 mL/kg BM) and every 15 min (3 mL/kg BM) during exercise in a double-blind, counterbalanced design. Pleasure-displeasure, perceived activation, RPE and plasma glucose concentration was assessed. The results showed that compared with the CHO trial, perceived activation were lower in the placebo trial during the last 30 min of exercise and this was accompanied by lowered plasma glucose concentrations. In the CHO trial, RPE was maintained in the last 30 min of exercise but carried on increasing in the PLA trial. Therefore, CHO ingestion during prolonged high-intensity exercise appears to elicit an enhanced perceived activation profile that may impact upon task persistence and performance. This finding is in addition to the physiological and metabolic benefits of the exogenous energy supply.

Naturally, the presence of electromagnetic waves in our living environment affects all components of organisms, particularly humans and animals, as the large part of their body consists of water. In the present study, we tried to investigate the relation between exposure to the extremely low-frequency electromagnetic field (ELF-EMF) and common behaviors such as body weight, food and water intake, anorexia (poor appetite), plasma glucose concentration, movement, rearing and sniffing in rats. For this purpose, rats were exposed to 40 Hz ELF-EMF once a day for 21 days, then at days 1, 3, 7, 14 and 21 after exposure, any changes in the above-mentioned items were assessed in the exposed rats and compared to the non-exposed group as control. Body weight of irradiated rats significantly increased only a week after exposure and decreased after that. No significant change was observed in food and water intake of irradiated rats compared to the control, and the anorexia parameter in the group exposed to ELF-EMF was significantly decreased at one and two weeks after irradiation. A week after exposure, the level of glucose was significantly increased but at other days these changes were not significant. Movements, rearing and sniffing of rats at day 1 after exposure were significantly decreased and other days these changes did not follow any particular pattern. However, the result of this study demonstrated that exposure to ELF-EMF can alter the normal condition of animals and may represent a harmful impact on behavior.

In addition to impaired physical activity, adult GH deficiency (GHD) can decrease quality of life (QOL). Hence, assessment of QOL is important to evaluate the efficacy of GH replacement therapy. This study aimed to identify factors that may be predictive of long-term improvement in QOL among clinical/laboratory variables during GH replacement therapy. The analysis included 83 Japanese adults with GHD who participated in the Hypopituitary Control and Complications Study (HypoCCS). Correlations between the change from baseline in clinical/laboratory variables at 6 months and the change from baseline in Quality of life (Short-Form 36 [SF-36] component scores) at 12 months were examined. Unexpectedly, all component scores were negatively correlated with the change in fasting plasma glucose concentration (FPG) (physical component summary [PCS], r = -0.456; mental component summary [MCS], r = -0.523; role/social component summary [RCS], r = -0.433). The change in MCS was positively correlated with the change in insulin-like growth factor-1 standard deviation score (IGF-1 SDS) (r = 0.417). The change in PCS was positively correlated with the change in body fat (r = 0.551). The change in RCS was positively correlated with the change in waist circumference (r = 0.528). Short-term changes in several clinical/laboratory variables, most notably FPG and IGF-1 SDS, were correlated with long-term changes in QOL. The clinical importance of these correlations for predicting GH replacement treatment efficacy warrants further investigation.

We present a clinical case that we did not find described in literature and yet is quite common in primary care. The patient described is female with a diagnosis of diabetes mellitus treated with insulin and poor clinical response according to glycated haemoglobin measurements. In addition to the main diagnosis, she also shows excessive sweating in palms and feet, which explains why her blood sugar levels were wrong. This also led to treatment adjustments that were carried out with disregard to her true plasma glucose concentration. To conclude, this case report highlights the importance of treating subjects in lieu of separate conditions, as well as the need of a team approach to patients in care.Se da cuenta de un caso clínico que puede presentarse con frecuencia en atención primaria, aunque no se registran casos similares en la literatura. Se trata de una mujer con diagnóstico de diabetes mellitus en tratamiento con insulina y con mala evolución según las hemoglobinas glicosiladas. Además del diagnóstico principal, también presenta hiperhidrosis palmo-plantar, lo que conducía a error en los controles glucémicos. Ello es de gran importancia, dado que se ajustaba tratamiento sin considerar que el control no se realizaba de forma adecuada. De este reporte se concluye la relevancia de tratar al paciente como tal y no como patologías individuales, así como la importancia del trabajo en equipo.

application/pdf, D‐Psicose in one of rare sugars present in small quantities in commercial carbohydrates and agricultural products. In this study, we investigate the effects of D‐psicose on the activities of α‐amylases and α‐glucosidases in vitro, and evaluate the effects of D‐psicose on postprandial glycemic response using rats in vivo. In vitro study, D‐psicose potently inhibited intestinal sucrase and maltase. however, slightly inhibited intestinal and salivary α‐amylase activities. Male Wistar rats (6 months old) were administrated 2 g/kg of sucrose, maltose or soluble starch together with 0.2 g/kg of D‐psicose or D‐fructose. D‐Psicose significantly inhibited the increment of plasma glucose concentration induced by sucrose or maltose. Starch‐induced glycemic response tended to be suppressed by D‐psicose, however the suppression was not significant. These results suggest that D‐psicose inhibits intestinal sucrase and maltase activities in an uncompetitive manner and suppresses the plasma glucose increase after sucrose and maltose ingestion. Thus, D‐psicose may be useful in proventing postprandial hyperglycemia in diabetic patients when foods containing sucrose and maltose are ingested., D‐プシコースは市販炭水化物食品や農生産物にわずかに含まれる希少糖類の一つである。本研究では、D‐プシコースがアミラーゼおよびα‐グリコシダーゼ活性に及ぼす影響（In viro試験）および炭水化物摂取後の血糖値上昇反応に及ぼす影響（ラット、In vivo試験）について検討した。In viro試験において、D‐プシコースは小腸スクラーゼおよびマルターゼを強く抑制したが、小腸アミラーゼおよび唾液アミラーゼに対する抑制効果はわずかであった。ラットIn vivo試験において、6ヶ月齢のウイスター系雄ラットに2g/kgのスクロース、マルトースおよび可溶性デンプンと共に0.2g/kgのD‐プシコースあるいはD‐フルクトースを経ロ投与した。D‐プシコースはスクロースおよびマルトースによる血糖値上昇を有意に抑制した。一方、可溶性デンプンによる血糖値上昇は、D‐プシコースによって抑制傾向を示したが、有意ではなかった。以上の結果から、D‐プシコースは小腸スクラーゼおよびマルターゼを阻害することで、炭水化物摂取後の血糖上昇反応を抑制することが示唆された。D‐プシコースは糖尿病患者の食事療法に有益である可能性が示された。

BackgroundHbA1c is recommended for monitoring glycaemic control in people with cystic fibrosis-related diabetes (CFRD). However the relationship between HbA1c and mean plasma glucose concentration (MPG) has not been established in CFRD, as in other forms of diabetes mellitus.Methods20 people (13 male, 29.7±8.8 years, 10 CFRD) with cystic fibrosis (CF) underwent HbA1c measurement and 48 h continuous glucose monitoring for estimation of MPG. The relationship between HbA1c and MPG was established and compared to the reported relationship for type 1 diabetes.ResultsHbA1c was strongly correlated with MPG (R2=0.888, p

The positron emission tomography (PET) clinical utility of the sensitivity (gamma) of uptake (Q) to a change in plasma glucose concentration (C) is investigated.Gamma is obtained from data as [ln(Q (2)/Q (1))] / [ln(C(2)/C(1))], using previously published intrapatient studies varying C within a single patient and some interpatient ones. It can be theoretically related to the half-saturation constant in the Michaelis-Menten quantification of competitive uptake. One of its uses is making uptake corrections for desired vs. actual C using Q(2) = Q(1) (C(2)/C(1))(gamma).Intrapatient studies proved to be preferable to interpatient ones, and a 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-PET survey with analyses for gamma yielded the following result: usually the gamma values of tumors and brain tissues were near -1, whereas those of other noncerebral tissues were near 0. Regarding correcting uptakes for C, instead of a universally assumed and applied gamma = -1, corrections should be for a single tissue using its known gamma. An advantageous use of gamma is predicting how C affects image contrast, including where glucose loading is sometimes preferable to fasting.A potentially useful quantifier of uptake sensitivity to plasma glucose has been defined and values obtained. Correcting uptakes to some standard C requires special care. gamma can help PET clinicians select fasting or loading to achieve glucose levels for optimum contrast.

Objective: To determine whether systematic evaluation of cognitive function by the Mini-Mental State Examination (MMSE) allows the objective detection and documentation of cognitive deterioration in patients referred for evaluation of suspected hypoglycaemic disorders by the 72-h fast. Design: Prospective case series. Methods: In 50 patients referred for evaluation of suspected hypoglycaemic disorders, the MMSE score (maximum 30 points) was assessed at the start and at the end of the fast. Results: The fast was terminated before 72 h in 14 patients because they developed neuroglycopenic symptoms due to hypoglycaemic disorders. Their MMSE score fell from a median of 29 points (range 20–30) at the beginning to 17 points (range 0–24) at the termination of the fast. The score dropped by ≥6 points in all patients with hypoglycaemic disorders. Median (range) plasma glucose concentration at the end of the fast was 2.1 (1.1–2.5) mmol/l. Thirty-six individuals developed no neuroglycopenic symptoms throughout the 72-h fast, their MMSE score remained between 27 and 30 throughout the fast and their median plasma glucose concentration dropped to 2.9 (2–3.6) mmol/l. Conclusions: Systematic evaluation of cognitive function by the MMSE at the beginning and at the termination of the fast allows objective determination and documentation of the deterioration of the cognitive state in patients with hypoglycaemic disorders. A decline in the cognitive performance by ≥6 points in the MMSE score rather than a distinct plasma glucose concentration should be used as the criterion to terminate the prolonged fast before 72 h.

Many animals including cattle can synthesize vitamin C from glucose. The objective of this study was to investigate plasma vitamin C concentration in ketotic cows during the early lactation period because glucose supply for vitamin C synthesis might be limited in these cows. We measured plasma beta-hydroxybutyrate (BHBA) concentration in 118 cows within 2 months after parturition. Subclinical/clinical ketosis was quantitatively determined using a plasma BHBA threshold of 1,200 microM. Plasma glucose concentration was lower in the ketotic cows than in the control cows but plasma vitamin C concentration did not differ between the control and the ketotic cows. Then we measured plasma vitamin C, BHBA and glucose levels in 7 cows during the periparturient period. Plasma BHBA increased and plasma glucose decreased after parturition but plasma vitamin C did not change. These results indicate that plasma vitamin C is not related to the incidence of ketosis in the early lactation period. We suggest that ketotic cows have the ability to produce vitamin C to meet its requirement in the early lactation period although glucose supply is not sufficient for milk production. Vitamin C synthesis is possibly given a high metabolic-priority for glucose in lactating cows.

Previously, glucose concentration has been presumed to be similar in seroma, lymph, and plasma. However, there are few studies actually measuring glucose concentration in seroma. The aim of this pilot study was to determine if the glucose concentration in seroma is similar to that in plasma, as it has previously been presumed. Biochemical analysis of seroma was performed on 11 patients that had undergone plastic surgery. Fluid was taken from the drains between postoperative day 3 and 6. The median glucose concentration was 3.09 millimolar (mM) (range 2.25-3.89 mM). Glucose concentration in seroma does not seem to be similar to that of plasma and lymph that has previously been presumed. The result of this pilot study warrants further investigation to determine the span of normal glucose concentration, its development over time, its relation to plasma glucose concentration, and how it is affected by infection.

The aim of our present study was to establish if there are any changes in core temperature and plasma glucose concentration during exposure to bright (5000 lx) and dim (100 lx) light. Ten healthy women (age: 19.6 ± 1.66 years) were studied in climatic chamber in which ambient temperature and relative humidity were maintained at 26°C and 60% RH, respectively. Rectal temperature was measured every 5 min and blood samples for determination of glucose were collected every 2 h. Each participant took part in both sessions in bright light and dim light conditions on different days with an interval of at least 1 day. Our results have shown that glucose concentration increases in bright light conditions as compared to dim light conditions but it remains within the normal range values for healthy subjects. On the other hand, there is a slight but significant decrease in rectal temperature in bright light in comparison to dim light conditions. The findings showing the decreased rectal temperature with concomitant increase in glucose concentration observed in bright light conditions might be explained by the mechanism involving melatonin action as shown previously by Aizawa and Tokura (1999).