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Background. Forms of glucose metabolism disorders are one of the key processes in the course of cystic fibrosis (CF) and can be variable, starting with impaired glucose tolerance (IGT) and ending with cystic fibrosis-related diabetes (CFRD), which is the most dangerous complication, worsening the prognosis and outcome of disease. Decreased lung function and poor nutritional status are the leading causes of morbidity and mortality in patients with carbohydrate metabolism disorders (CMD). Materials and methods. The study included 85 children with CF. Patients underwent measurement of anthropometric parameters (height, weight) to assess nutritional status (NS), and spirometry test was used to assess pulmonary function (PF). Of these, 78 patients were assessed with an oral glucose tolerance test (OGTT) at 5 points (0 minutes, 30 minutes, 60 minutes, 90 minutes, 120 minutes) assessing the concentration of venous plasma glucose in mmol/l. The results of the OGTT were assessed in accordance with the diagnostic criteria for CFRD. Results. According to the Kruskal–Wallis test, the maximum volumetric flow rate during exhalation of 75% FVC (FEF 75) differed between different forms of carbohydrate metabolism (p=0.031). Other indicators of respiratory function didn’t have any significant differences. Using the Mann–Whitney test, pairwise comparisons were performed, so the FEF 75 indicator was statistically significantly lower in the group of children with CFRD than in other groups. There were no statistically significant differences when assessing Z-scores weight/age (WAZ) and height/age (HAZ) depending on the forms of carbohydrate metabolism. However, BMI/age Z-scores (BAZ) were statistically significantly lower in groups of children with CFRD than in other forms of carbohydrate metabolism. Conclusion. Children with CF in the period of prediabetes don’t have significant impairments in lung function and NS. These disorders are typical for children with CFRD.

Today, diabetes mellitus (DM) represents a problem on which the attention of endocrinologists, general practitioners, and dentists is focused. Early pathological changes, which manifest themselves in the oral cavity, determine the relevance and social significance of this pathology, because dentists are usually the first to diagnose disorders of carbohydrate metabolism based on the results of the analysis of specific complaints and typical clinical symptoms of damage to the mucous membrane and periodontal tissues. The aim of the work is to find out the pathogenetic characteristics of the reparative component of the post-extraction alveolar socket depending on the time after tooth extraction in experimental diabetes. Materials and methods. In total, 120 sexually mature (age 8–10 months) male Wistar rats, divided into 8 groups of 15 animals each, were used for research. Complex immunohistological, radiographic and biochemical studies were used for the purpose of detailed analysis of the features of the course and mechanisms of development of complications after tooth extraction against the background of DM. In order to assess the state of the innate link of local immunity, the specifics of the course of repair processes at different times of the post-extraction period, the levels of cell proliferation (by expression of Ki-67) and the concentration and content of CD68-positive macrophages in the mucous membrane were determined immunohistochemically. In order to determine the state of the bone tissue of the dental and jaw apparatus and the levels of mineralization of the hard tissues of the molars in the animals of the experimental groups, radiovisiographic images of the right half-mandible were analyzed with determination of the radiographic density. Results. Analysis of proliferative-reparative relationships showed almost no macrophages and very low proliferative activity in the intact periodontium, on the other hand, in DM, initial significant diffuse infiltration by CD68-immunopositive cells with high levels of Ki-67 expression was found. Analysis of X-ray images of the half-mandible revealed that induced DM in rats, even without prior surgical intervention, led to the intensification of resorption processes in bone tissue, which was evidenced by a decrease in radiographic density in the root region of the 1st molar and intraalveolar bone membranes of all three lower molars. Conclusions. In the intact periodontium, there are almost no CD68-immunopositive macrophages and very low proliferation activity in the periodontal soft tissues. In experimental diabetes, on the contrary, initial significant diffuse infiltration by CD68- immunopositive macrophages with high proliferative activity of most fibroblasts is determined. Induced diabetes in rats, even without prior surgical intervention, leads to increased resorption processes in the bone tissue of the mandible and long-term prolongation of the inflammatory process after tooth extraction. [ABSTRACT FROM AUTHOR]

Carbohydrate metabolism disorders are a serious problem during pregnancy. They are a complication in approximately 15-20% of pregnancies. The body has difficulty processing and using carbohydrates, leading to abnormal levels of glucose (sugar) in the blood. Two common pregnancy-related disorders are gestational diabetes mellitus (GDM) and pre-existing diabetes. Hypoglycemia and insulin resistance are also very common problems during pregnancy. Complications affect both the mother and the child, so it is important to know them and be able to prevent their occurrence and complications. The purpose of this literature review is to evaluate the influence of carbohydrate metabolism disorders during pregnancy and diet and physical exercise in the light of most up to date research.

Aim. To establish the prevalence of masked uncontrolled hypertension (HTN) (MUH) in patients with diabetes or impaired glucose tolerance (IGT) and determine its clinical and hemodynamic characteristics.Material and methods. The study involved 87 patients who received regular antihypertensive therapy for hypertension and had established diabetes or IGT. The mean age of patients was 62,6±9,9 years, of which 51,7% were women, 48,3% — men. Type 2 diabetes was revealed in 77,7%, IGT — 22,8% of patients. For 24-hour blood pressure monitoring, BpLAB system (OOO Petr Telegin) was used; blood pressure (BP) was determined in the brachial artery, central blood pressure — in the aorta. We analyzed risk factors and target organ damage. The results were processed using the Excel Microsoft Office 2007 package and the Statistica 6.0 and 10.0 package from StatSoft, Inc (USA).Results. Uncontrolled hypertension was revealed in 59,8%, MUH — in 18,4%, controlled HTN — 21,8% of patients. Mean daytime and mean nighttime systolic BP in patients with MUH and uncontrolled HTN were comparable. Patients with controlled hypertension compared with MUH had lower mean day- and nighttime aortic BP by 27,1% (p

The prevalence of diabetes mellitus in acromegaly is significantly higher than that in the general population. Carbohydrate metabolism abnormalities often precede other phenotypic manifestations of acromegaly. The review presents data on the prevalence of carbohydrate metabolism disorders in acromegaly and describes their pathophysiological characteristics and approaches to treatment. Growth hormone (GH) excess is recognized as a key factor of glucose homeostasis abnormalities due to decreased insulin sensitivity (resulting from active lipolysis) and direct stimulation of insulin secretion. Insulin-like growth factor 1 (IGF1) improves insulin sensitivity; however, the GH diabetogenic effects prevail over the insulin-sensitizing impact of IGF1. Surgical and radiation treatment for somatotropinoma may indirectly improve carbohydrate metabolism, because they decrease the GH levels. Treatment with first generation somatostatin analogues can both improve glycemic control due to decreased GH levels and worsen it due to deterioration of postprandial insulin release, especially in patients with already manifest carbohydrate metabolism disorders. The GH receptor antagonist pegvisomant blocks the effects of excess GH on the target tissues without suppressing insulin secretion, which results in better glucose control; treatment with this agent can be preferred in patients with acromegaly and diabetes mellitus. Management of carbohydrate metabolism disorders in acromegaly is done in accordance with general treatment principles for type 2 diabetes mellitus.

Introduction: Affective disorders and carbohydrate metabolism disorders are problems of increasing importance in the population of children, teenagers and young adults. Much evidence indicates that these problems may co-occur with increased frequency and have much more serious consequences than on their own. Material and methods: Inclusion criteria were established for the review of studies and comprised participants under 25 years of age diagnosed with carbohydrate metabolism disorders, psychometric measurements of symptoms of affective disorders and self-aggressive tendencies. Review of the MEDLINE database was conducted. Discussion: The results of 10 out of 12 studies included in the review indicated significantly increased risk of depression and suicidal tendencies in patients with diabetes. In the described publications, the frequency of affective disorders in a specific population ranged from 1.2% to 47.6% and up to 60.4% for unspecified affective disorder, sub-threshold and fully symptomatic, and the HR ranged from 1.33 to 2.0 for fully symptomatic affective disorders and up to 6.49 for unspecified affective disorder, sub-threshold and fully symptomatic. Descriptions of the incidence of self-injurious behavior and suicidal tendencies estimate them in the range from 0.8% to 35.7%, and in the studies comparing to a control group, the risk for a suicide attempt was between HR: 1.7 and 3.25. Conclusions: The occurrence of affective disorders in children and young adults is significantly more frequent in patients with diabetes compared to patients without carbohydrate metabolism disorders. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the effect of carbohydrate metabolism disorders and insulin resistance indices on the immediate results of coronary artery bypass grafting (CABG). Method. Patients with coronary artery disease who underwent CABG (n = 383) were examined to determine glycemic status, free fatty acid and fasting insulin levels, and insulin resistance indices (Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), McAuley index, Quantitative Insulin Sensitivity Check Index (QUICKI), Revised-QUICKI). Patients were assessed for the development of perioperative complications and their length of stay in the hospital. Two groups were formed: group 1, patients with a combined endpoint (CEP, any complication and/or duration of hospital stay >10 days), n = 291; and group 2 (n = 92) without a CEP. Perioperative characteristics were analyzed, and predictors of hospital complications and prolonged hospital stay were evaluated. Results. Patients in the CEP group were older, and there were more women among them (p = 0.003). Additionally, in this group, there were more patients with diabetes mellitus (37.5% vs 17.4%, p < 0.001), obesity (p < 0.001), and a higher percentage of combined operations (p = 0.007). In the group with a CEP, the levels of glucose (p = 0.031), glycated hemoglobin (p = 0.009), and free fatty acids (p = 0.007) and the Revised-QUICKI (p = 0.020) were higher than in the group without complications. In a regression analysis, the independent predictors of complications were combined operations (p = 0.016) and the predictors of a long hospital stay (>14 days) were female gender, the left atrium size, and diabetes mellitus (p < 0.001). The predictors of a composite endpoint included female gender, age, the left atrium size, and free fatty acid levels (p < 0.001). Conclusions: In the group with in-hospital complications after CABG, not only was the presence of diabetes mellitus more often detected, but there were also higher levels of free fatty acids and a higher Revised-QUICKI. Therefore, additional assessments of insulin resistance and free fatty acid levels are advisable in patients before CABG. [ABSTRACT FROM AUTHOR]

Given the availability of molecular tools, population studies increasingly include the gen-diet interactions in their considerations. The use of these interactions allows for the obtaining of more uniform research groups. In practice, this translates into the possibility of reducing the size of the research group while maintaining the precision of the research. The research results obtained in this way can be used to select certain ingredients and foods in a dietary intervention with a higher degree of personalisation. In both prophylaxis and dietary therapy of overweight and obesity, the proper selection of bioactive ingredients best suited to the given group of consumers is of key importance. Hence, the aim of the presented study was to assess the effectiveness of a dietary intervention with the use of lactoferrin (LF)-fortified yoghurt, in terms of the ability to regulate body weight and carbohydrate metabolism in individuals whose genomes contained single nucleotide polymorphisms that predisposed them to increased accumulation of fatty tissue and consequently overweight or obesity. A group of 137 participants (98 women and 37 men) of Polish origin were screened for the presence of four single nucleotide polymorphisms (rs993960—FTO gene, rs7903146—TCF7L2 gene, rs10830963—MTNR1B gene, and rs1121980—FTO gene). Subsequently, a group of 19 participants diagnosed with the presence of risk factors within said SNPs underwent a 21-day dietary intervention (crossover study) with the use of yoghurt fortified with lactoferrin (200 mg/day). The results of the study revealed a genetic difference between the Polish population and the European average, in terms of the SNPs analysed. The dietary intervention showed a statistically significantly higher efficiency in terms of body mass reduction (p = 0.000) and lowering the glycated haemoglobin ratio (HbA1c) (p = 0.000) when consuming specially prepared yoghurt containing lactoferrin, as compared to results registered for unfortified yoghurt. Given the above, yoghurt fortified with LF should be considered as a viable element of diet therapy in overweight and obese patients diagnosed with risk factors within the analysed polymorphisms. [ABSTRACT FROM AUTHOR]

The object of the study is the indigenous population of the North and the Arctic of the Russian Federation. The subject of the study is changes in nutrition during transition from the traditional to modernized lifestyle. The purpose of the study is to consider the risk to the health of the northerners in the quantitative and qualitative changes in the consumption of flour and starch-containing products. The consumption of bread products and starch by the population of the northern regions of the Russian Federation in the 19th – 20th centuries and in the 2010s – 2020s was estimated. Estimates of the frequencies of the amylase genes AMY1, AMY2B, AMY2A in the populations that differ in geographic localization and type of management are systemized. In the 20th century, percapita consumption of bread in Russia decreased from 700 to 260 g/day, among the indeginous northerners — from 300 to 250 g/day. The inclusion of pasta products and potato in the diet of the northerners changed the volume and structure of the consumed carbohydrate foods. The intake of high glycemic load starch increased from 100 to 250 g/day. Replacing the dried crusts with pasta and potato meals eased mastication of food, thus inducing a reflectory rise in serum glucose at ingestion and increasing the risk of developing chronic carbohydrate metabolism disorders. High-latitude populations are distinct in the prevalence of the genotypes that determine low activity of the polysaccharidase enzymes necessary for starch digestion. The ample production of amylase and less prominent blood glucose upswing in response to the consumption of starchy foods are determined by the number of successive copies of the amylase genes on the AMY locus. For the AMY1 gene, a negative correlation was found between the gene copy number and the geographical latitude of the population area (rSp = -0.19), for the AMY2A gene rSp = -0.33 (p < 0.001 in both cases). In addition, in the Arctic groups there is a high frequency of deletions of the AMY2A gene, which also lead to insufficient synthesis of pancreatic amylase. In the European populations, AMY2A deletions occur in 10–11 %; among the Khanty, Mansi, and Selkups — in 28 %; among the indigenous population of Chukotka — in 52 %. Changes in the “Arctic diet” in the 20th century led to a sharp increase in the starch consumption. With the traditional way of life, the northerners did not form adaptations to the nutrient intake of large volumes of starchy foods. In modern conditions, accumulation of nutritional, physiological and genetic factors increases the risk of metabolic disorders related to the consumption of high-starch food.

BACKGROUND: Russia is one of the most multinational states in the world. Identification of ethnic groups with a higher risk of developing DM2, analysis of risk factors for the development of DM2 will allow developing personalized approaches to the prevention and treatment of DM2.AIMS: To reveal ethnic features of the prevalence of carbohydrate metabolism disorders and risk factors for the development of DM2 in the adult population of the Russian Federation.MATERIALS AND METHODS. A retrospective analysis of the database of the national epidemiological cross-sectional study NATION was carried out. Depending on the self-specified nationality, on the basis of anthropological characteristics, the following ethnic groups were identified: “Mongoloid population”, “Peoples of the Volga region”, “Peoples of the North Caucasus”, “Peoples of Transcaucasia”, “Russians”. The analysis consisted of several stages and included: analysis of the anthropometric features of the selected groups, taking into account the presence of carbohydrate metabolism disorders (MO); study of the prevalence of violations of the MA in the selected ethnic groups; analysis of ethnic characteristics of risk factors for the development of type 2 diabetes; analysis of the frequency of violations of the MA in various ethnic groups, taking into account the territory of residence. MR disorders were defined as the presence of DM and/or prediabetes. In accordance with the WHO criteria, HbA1c≥6.5% corresponded to the diagnosis of DM, HbA1c values in the range of 5.7%≤HbA1c

Patients with type 2 diabetes make up 25 to 40% of those referred for coronary bypass surgery, and the impact of diabetes on the results of the operation is studied in various aspects. To assess the state of carbohydrate metabolism before any surgical interventions, including CABG, daily glycemic control, and the determination of glycated hemoglobin (HbA1c) is recommended. Glycated hemoglobin reflects the glucose concentration for the 3 months prior to the measurement, but alternative markers that reflect glycemic fluctuations over a shorter period of time may be useful in preoperative preparation. The aim of this study was to study the relationship between the concentration of alternative markers of carbohydrate metabolism (fructosamine and 1,5-anhydroglucitol) with patients' clinical characteristics and the rate of hospital complications after coronary artery bypass grafting (CABG). Method. In the cohort of 383 patients, besides the routine examination, additional markers of carbohydrate metabolism were determined before and on days 7–8 after CABG: glycated hemoglobin (HbA1c), fructosamine, and 1,5-anhydroglucitol. We evaluated the dynamics of these parameters in groups of patients with diabetes mellitus, prediabetes, and normoglycemia, as well as the association of these parameters with clinical parameters. Additionally, we assessed the incidence of postoperative complications and factors associated with their development. Results. In all groups of patients (diabetes mellitus, prediabetes, normoglycemia), there was a significant decrease in the level of fructosamine on the 7th day after CABG compared with baseline (p1st–2nd point 0.030, 0.001, and 0.038 in groups 1, 2, and 3, respectively), whereas the level of 1,5-anhydroglucitol did not change significantly. The preoperative level of fructosamine was associated with the risk of surgery according to the EuroSCORE II scale (p = 0.002), as were the number of bypasses (p = 0.012), body mass index and overweightness (p < 0.001 in both cases), triglyceride (p < 0.001) and fibrinogen levels (p = 0.002), preoperative and postoperative glucose and HbA1c levels (p < 0.001 in all cases), left atrium size (p = 0.028), multiplicity of cardioplegia, cardiopulmonary bypass duration and aortic clamp time (p < 0.001 in all cases). The preoperative level of 1,5-anhydroglucitol showed an inverse correlation with fasting glucose and fructosamine levels before surgery (p < 0.001 in all cases), intima media thickness (p = 0.016), and a direct correlation with LV end-diastolic volume (p = 0.020). The combined endpoint (presence of significant perioperative complications + extended hospital stay after surgery >10 days) was identified in 291 patients. In binary logistic regression analysis patient age (p = 0.005) and fructosamine level (p = 0.022) were independently associated with the development of this composite endpoint (presence of significant perioperative complications + extended hospital stay after surgery >10 days). Conclusions: This study demonstrated that in patients after CABG there was the significant decrease in the level of fructosamine compared with baseline, whereas the level of 1,5-anhydroglucitol did not change. Preoperative fructosamine levels were one of the independent predictors of the combined endpoint. The prognostic value of preoperative assessment of alternative markers of carbohydrate metabolism in cardiac surgery deserves further study. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the effect of carbohydrate metabolism disorders and insulin resistance indices on the immediate results of coronary artery bypass grafting (CABG). Method. Patients with coronary artery disease who underwent CABG (n = 383) were examined to determine glycemic status, free fatty acid and fasting insulin levels, and insulin resistance indices (Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), McAuley index, Quantitative Insulin Sensitivity Check Index (QUICKI), Revised-QUICKI). Patients were assessed for the development of perioperative complications and their length of stay in the hospital. Two groups were formed: group 1, patients with a combined endpoint (CEP, any complication and/or duration of hospital stay >10 days), n = 291; and group 2 (n = 92) without a CEP. Perioperative characteristics were analyzed, and predictors of hospital complications and prolonged hospital stay were evaluated. Results. Patients in the CEP group were older, and there were more women among them (p = 0.003). Additionally, in this group, there were more patients with diabetes mellitus (37.5% vs 17.4%, p < 0.001), obesity (p < 0.001), and a higher percentage of combined operations (p = 0.007). In the group with a CEP, the levels of glucose (p = 0.031), glycated hemoglobin (p = 0.009), and free fatty acids (p = 0.007) and the Revised-QUICKI (p = 0.020) were higher than in the group without complications. In a regression analysis, the independent predictors of complications were combined operations (p = 0.016) and the predictors of a long hospital stay (>14 days) were female gender, the left atrium size, and diabetes mellitus (p < 0.001). The predictors of a composite endpoint included female gender, age, the left atrium size, and free fatty acid levels (p < 0.001). Conclusions: In the group with in-hospital complications after CABG, not only was the presence of diabetes mellitus more often detected, but there were also higher levels of free fatty acids and a higher Revised-QUICKI. Therefore, additional assessments of insulin resistance and free fatty acid levels are advisable in patients before CABG.

BACKGROUND: Depending on the polymorphism of genes that that are involved in metabolism, the response of patients to different types of therapy may differ. Despite the potential effect of rs7903146 TCF7L2 and rs1042712 ADRB2 on changes in body composition in different types of therapy of early carbohydrate metabolism disorders, these associations haven’t been studied yet. AIM: To study the influence of rs7903146 TCF7L2, rs1042714 ADRB2 on changes in body fat composition in different types of therapy of early carbohydrate metabolism disorders.MATERIALS AND METHODS: The study involved patients with overweight or obesity and risk factors for Type 2 Diabetes development. All patients underwent genotyping with the real-time polymerase chain reaction, oral glucose tolerance test and bioimpedancemetry. Further, the patients were divided into two groups. First group kept a diet with the exclusion of simple and limitation of complex carbohydrates and fats. Second group took metformin in addition to the diet. Three months after bioimpedancemetry was performed again.RESULTS: The research involved 73 patients (the mean age 48±12 y.o., the mean BMI 34,27±6,18 kg/m2 ). The diet therapy group consisted of 47 people. Other 26 patients took metformin in addition to the diet. In group of diet, T allele carriers of rs7903146 TCF7L2 were characterized with more decrease in fat mass compared with CC homozygotes (- 7.90 ± 9.46% vs. -1.54 ± 8.98%, p = 0.027). CC genotype carriers of rs7903146 TCF7L2 in group of metformin and the diet had a tendency for more decrease in hip circumference compared with T allele carriers (-4.95 ± 3.34% vs. — 2.5 ± 2.96%, p = 0.064). Carriers of C allele in homozygous state of rs1042714 ADRB2, who took metformin with the diet, demonstrated more decrease in hip circumference (- 5.81 ± 3.00% vs. -2.50 ± 2.7%, p = 0.009), the tendency for decrease in fat mass (-8.28 ± 8.86% vs. — 3.20 ± 5.09%, p = 0.068) and waist circumference (-5.91 ± 4.29% vs. -3.03 ± 4.01 %, p = 0.091) compared with G allele carriers. The association of rs7903146 TCF7L2 and rs1042714 ADRB2 with changes in total body weight was not observed (p> 0.05).CONCLUSION: Single nucleotide polymorphisms rs7903146 TCF7L2 and rs1042714 ADRB2 influence on body fat composition in patients with early carbohydrate metabolism disorders in various types of treatment.

Introduction. Cystic fibrosis associated (related) diabetes mellitus (CFDM) is one of the most common severe complications of cystic fibrosis. Today, the issue of the goodness of a single measurement of fasting blood glucose, glycated hemoglobin and fructosamine to assess the degree of carbohydrate metabolism disorders in children with cystic fibrosis is a subject of debate. The gold standard for diagnosing carbohydrate metabolism disorders (impaired fasting glycemia, various pre-diabetic conditions, diabetes mellitus) is the oral glucose tolerance test. Data about the diagnostic value of fructosamine for predicting CFDM aren’t dispositive. No credible studies of fructosamine in children with cystic fibrosis have been found in the Russian medical literature.Aim. To determine the diagnostic informative value of the blood fructosamine and other single-measured glycemic marker levels in the early diagnosis of carbohydrate metabolism disorders at the pre-diabetes stage in children with cystic fibrosis.Materials and methods. The results of laboratory tests and instrumental examinations of 87 children with cystic fibrosis aged 5–18 years were reviewed. A cross-sectional study of fructosamine, fasting blood sugar and glycated hemoglobin level (some patients underwent an oral glucose tolerance test), and liver fibroelastometry were also performed.Results and discussion. An increase in the fructosamine level was observed, which indicates a possible CFDM in children (p = 0.049): CFDM is highly likely, if the level of fructosamine is ≥255.5 µmol/l (reference ranges for children are 272–285 µmol/l; sensitivity = 57.1%, specificity = 85.2%). It has been found that children with cystic fibrosis and liver cirrhosis have increased fructosamine levels: cut-off = 253.0 µmol/l (Sn – 70.0%, Sp – 85.2%).Conclusion. The fructosamine level, a single determination of fasting blood glucose and glycated hemoglobin are not informative markers for the diagnosis of pre-diabetic conditions in cystic fibrosis in children. It is important to bear in mind that concomitant liver cirrhosis can affect the fructosamine levels. CFDM can be diagnosed at the lower fructosamine level, despite the generally accepted ranges.

Objective: To study the effect of the rs1801282 PPARG polymorphism on changes in the body composition of patients with early carbohydrate metabolism disorders in groups with different variants of treatment.Materials and Methods: The study involved 64 patients (8 men and 56 women) with early carbohydrate metabolism disorders. At baseline, all patients underwent genotyping for the rs1801282 PPARG polymorphism and body composition determination with bioelectrical impedance analysis (BIA). Then, the patients were divided into two groups depending on the type of therapy. The patients from Group 1 (40 subjects, mean age 45.2±15.4 years) kept a generally accepted diet with the exclusion of simple carbohydrates and limitation of complex carbohydrates and fats. The patients from Group 2 (24 subjects, mean age 51.2±14.5 years) took metformin in addition to the diet therapy. The effects of different types of treatment on body composition changes were assessed with follow-up BIA 3 months after the start of treatment.Results: Carriers of the mutant G allele of rs1801282 PPARG in the metformin and diet therapy group showed a significant increase in the content of body cell mass (1.28±0.51% vs 0.36±0.37%; P = 0.021) compared with CC homozygotes in the absence of differences in body weight changes (P > 0.05).Conclusions: The presence of the mutant allele G of rs1801282 PPARG promotes the increase in body cell mass in case of adding metformin to the diet therapy in patients with early carbohydrate metabolism disorders.

A retrospective analysis of the database of the NATION nation-wide epidemiological cross-sectional study was carried out. Depending on the self-declared ethnicity and anthropological characteristics, the following ethnic groups were identified: “Mongoloid population”, “Peoples of the Volga region”, “Peoples of the North Caucasus”, “Peoples of Transcaucasia”, “Russians”. The analysis consisted of several stages and included: analysis of the selected groups’ anthropometrics, analysis of the prevalence of carbohydrate metabolism disorders in the selected ethnic groups, analysis of ethnic-specific T2D risk factors, and analysis of region-specific factors affecting the prevalence of carbohydrate metabolism disorders in various ethnic groups. We defined carbohydrate metabolism disorders as diabetes and/or a prediabetes condition. In accordance with the WHO criteria, HbA1c≥6.5% was interpreted as diabetes, whereas values ​​in the range of 5.7%≤HbA1c

Introductions: Relevance of the study is due to the unrecognized effect of carbohydrate metabolism disorders on bone tissue metabolism in patients with acute otitis media (AOM). Aim: to determine the peculiarities of bone tissue metabolism in patients with AOM caused by disorders of carbohydrate metabolism. Materials and methods: Our study included 73 patients aged 18 to 79 (29 males and 44 females) who were randomized into 4 groups according to the aim of the research: Group 1 - 17 patients with AOM, Group 2 - 15 patients with AOM combined with paranasal sinus pathology, Group 3 - 20 patients with AOM on the background of type 2 diabetes mellitus, Group 4 - 21 patients with AOM combined with transitory disorders of glucose metabolism. On the basis of clinical examination all patients were tested for glycosylated hemoglobin (HbA1c), blood calcium level and parathormone as a marker of bone resorption and osteocalcin as a marker of bone remodeling. Results of the study and discussion: The statistical evaluation of the indicators identified a reliable difference between groups 1-2 and groups 3-4, while between groups 1 and 2, 3 and 4 reliable difference in metabolic parameters of bone tissue has not been established. The level of glucosylated hemoglobin was significantly elevated even for transitory signs of carbohydrate metabolism disorders (5,17±0,17%, 4,95±0,17%, 9,8±0,46% and 7,78±0,19% in groups 1,2, 3 and 4 respectively).The value of parathormone was within the reference values, but it proved to be significantly (p<0,001) higher in glucose metabolism disorders (56.8±3.02pg/ml and 52.56±2.7pg/ml in groups 3 and 4, respectively).The amount of osteocalcin and calcium tended to decrease in type 2 diabetes mellitus (group 3) and in transitory disorders (group 4), but without a significant difference (p>0.05). Correlation analysis revealed a strong correlation between glucose and glucosylated hemoglobin levels in patients in group 3 and the average strength in patients in group 4 (r=0.832 and r=0.44, respectively). The increase of parathormone level on the basis of carbohydrate metabolism disorders was due to the presence of correlation with the level of glucosylated haemoglobin in groups 3 and 4 (r=0.705 and r=0.81 respectively). Calcium correlations of r=-0.77 and r=-0.56 with parathormone level and r=-0.79 and r=-0.44 with glucosylated haemoglobin level were found in patients of groups 3 and 4 accordingly. In the absence of glucose metabolism disorders in groups 1 and 2, no significant correlations were found, except for physiologically determined correlations of parathormone and calcium levels in group 1 (r=-0.489). Conclusions: Disorders of carbohydrate metabolism negatively affect metabolism of bone tissue due to activation of bone resorption processes. This is manifested by correlated with the level of glycosylated hemoglobin by an increase in the amount of parathormone with pathogenetic significance of both type 2 diabetes mellitus and transitory disorders of carbohydrate metabolism. In this category of patients, the level of parathormone and its dynamics, as well as the determination of glucosylated hemoglobin are informative even in transitory disorders of carbohydrate metabolism. [ABSTRACT FROM AUTHOR]

The article presents study results of the effect of humic nature biologically active additive «Humilid» on carbohydrate metabolism, namely on glucose, insulin and C-peptide in alloxan-induced diabetes mellitus in rats. The purpose of the experiment was to investigate how “Humilid” affects carbohydrate metabolism in rats; to study and analyze the effect of the humic nature biologically active substance «Humilid» on metabolic processes. In the work we used biochemical methods for studying the blood of experimental rats. Adult male white rats were taken for the experiment, from which four groups were formed. The experiment lasted three weeks, during which the animals from the first experimental group received daily in addition to the main feed an aqueous solution of feed additive «Humilid» at dose 5 mg / kg of body weight of the active substance, and had free access to water. Rats of the second and third groups were injected with alloxan as a single intraperitoneal injection. The rats of the third group additionally received an aqueous solution of feed additive «Humilid». It was identified that “Humilid” has an antioxidant activity, which may be one of the mechanisms of its antidiabetic action, as it is known that alloxan causes free radical damage to β-cells with weak antioxidant protection. The use of a biologically active feed additive of humic nature was found to have a hypoglycemic effect in both healthy animals as well as in rats with alloxan-induced diabetes mellitus. It was found that the use of “Humilid” in rats enhances energy processes in their bodies of experimental animals. There was a decrease in glucose content in rats from second group by 11.9% (P ≤ 0.001) compared with the control one. At the same time, the glucose content in animals from third and fourth groups was higher by 35.9% (P ≤ 0.001) and 20% (P ≤ 0.001) higher than in animals from the control one. The insulin concentration in the blood of rats from the second group was 7.4% higher (P ≤ 0.05) compared to the animals from first group. The concentration of C-peptide was within the reference values. The levels of insulin and C-peptide concentration in animals of the third and groups were lower by 47.8% (P ≤ 0.001) and 32.4% (P ≤ 0.001) and 55.5% (P ≤ 0.001) and 37.5% (P ≤ 0.001) in comparison with animals of first group. A pronounced hypoglycemic effect, which was due to an increase in the sensitivity of tissues to glucoregulatory hormones and an increase in the body’s tolerance to excessive intake of carbohydrates. The obtained results of the study indicate the regulatory effect of humic feed additive «Humilid» on key links in the regulation of carbohydrate metabolism, which is characterized by the decrease in blood glucose level due to activation of the synthesis and secretion of insulin and C-peptide.

Aim. To study the prevalence of carbohydrate metabolism disorders in a repre - sentative sample of the working-age population of the Krasnoyarsk Krai aged 25-64 years and to identify the association of these disorders with cardiovascular pathology.Material and methods. A random representative sample within the all-Russian epidemiological study ESSE-RF included 1603 residents of the Krasnoyarsk Krai aged 25 to 64 years. The gradation of carbohydrate metabolism disorders was carried out on the basis of fasting plasma glucose level in accordance with the criteria of the American Diabetes Association (ADA). Hypertension (HTN) was defined as office BP ≥140/90 mm Hg or an indication of previous use of antihypertensive drugs. The presence of myocardial infarction (MI), stroke, coronary artery disease (CAD) was detected by anamnesis collection. Statistical processing was carried out using IBM SPSS v 22 and Microsoft Excel 2021 programs. When comparing differences by sex, age, level of education, and type of residence, differences was assessed by chi-squared test and considered significant at p≤0,05.Results. In total representative sample of Krasnoyarsk Krai population, 3,6% of participants indicated prior diabetes, while its prevalence naturally increased with age. The detection rate of fasting glucose of 5,6-6,9 mmol/l among individuals without prior diabetes (impaired fasting glycemia (IFG), as one of the criteria for prediabetes, according to ADA guidelines) was 22,5% of the general population. Fasting hyperglycemia (HG) ≥7,0 mmol/l without prior diabetes was registered in 3,8%. This figure can be roughly considered as the proportion of people with newly diagnosed diabetes. IFG and HG were significantly more common among men, as well as among those with primary and secondary education compared with higher education. In rural residents, all types of carbohydrate metabolism disorders were more common than in urban ones. Compared with the normoglycemic group, the presence of prior diabetes, IFG and GH was associated with a significantly higher prevalence of hypertension, CAD and stroke.Conclusion. The prevalence of IFG, fasting HG ≥7,0 mmol/l and diagnosed diabetes in a representative sample of the Krasnoyarsk Krai aged 25-64 years exceeds the national average, although it is consistent with the data of a number of other Siberian regions. The prevalence of both carbohydrate metabolism disorders in general and the percentage of possible undiagnosed diabetes increases with age. At the same time, there are more such individuals among those with primary and secondary education, as well as among rural residents. The approximate proportion of undiagnosed diabetes in the study population reaches 50%. Timely detection of carbohydrate metabolism disorders can contribute to the earlier implementation of active preventive measures and reduce the risk of cardiovascular events.

Patients with type 2 diabetes make up 25 to 40% of those referred for coronary bypass surgery, and the impact of diabetes on the results of the operation is studied in various aspects. To assess the state of carbohydrate metabolism before any surgical interventions, including CABG, daily glycemic control, and the determination of glycated hemoglobin (HbA1c) is recommended. Glycated hemoglobin reflects the glucose concentration for the 3 months prior to the measurement, but alternative markers that reflect glycemic fluctuations over a shorter period of time may be useful in preoperative preparation. The aim of this study was to study the relationship between the concentration of alternative markers of carbohydrate metabolism (fructosamine and 1,5-anhydroglucitol) with patients’ clinical characteristics and the rate of hospital complications after coronary artery bypass grafting (CABG). Method. In the cohort of 383 patients, besides the routine examination, additional markers of carbohydrate metabolism were determined before and on days 7–8 after CABG: glycated hemoglobin (HbA1c), fructosamine, and 1,5-anhydroglucitol. We evaluated the dynamics of these parameters in groups of patients with diabetes mellitus, prediabetes, and normoglycemia, as well as the association of these parameters with clinical parameters. Additionally, we assessed the incidence of postoperative complications and factors associated with their development. Results. In all groups of patients (diabetes mellitus, prediabetes, normoglycemia), there was a significant decrease in the level of fructosamine on the 7th day after CABG compared with baseline (p1st–2nd point 0.030, 0.001, and 0.038 in groups 1, 2, and 3, respectively), whereas the level of 1,5-anhydroglucitol did not change significantly. The preoperative level of fructosamine was associated with the risk of surgery according to the EuroSCORE II scale (p = 0.002), as were the number of bypasses (p = 0.012), body mass index and overweightness (p < 0.001 in both cases), triglyceride (p < 0.001) and fibrinogen levels (p = 0.002), preoperative and postoperative glucose and HbA1c levels (p < 0.001 in all cases), left atrium size (p = 0.028), multiplicity of cardioplegia, cardiopulmonary bypass duration and aortic clamp time (p < 0.001 in all cases). The preoperative level of 1,5-anhydroglucitol showed an inverse correlation with fasting glucose and fructosamine levels before surgery (p < 0.001 in all cases), intima media thickness (p = 0.016), and a direct correlation with LV end-diastolic volume (p = 0.020). The combined endpoint (presence of significant perioperative complications + extended hospital stay after surgery >10 days) was identified in 291 patients. In binary logistic regression analysis patient age (p = 0.005) and fructosamine level (p = 0.022) were independently associated with the development of this composite endpoint (presence of significant perioperative complications + extended hospital stay after surgery >10 days). Conclusions: This study demonstrated that in patients after CABG there was the significant decrease in the level of fructosamine compared with baseline, whereas the level of 1,5-anhydroglucitol did not change. Preoperative fructosamine levels were one of the independent predictors of the combined endpoint. The prognostic value of preoperative assessment of alternative markers of carbohydrate metabolism in cardiac surgery deserves further study.

Copyright of Pediatric Endocrinology, Diabetes & Metabolism is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Carbohydrate metabolism disorders, obesity and a severe course of gastroesophageal reflux correlate with more frequent development of esophageal complications. The aim of this study was to assess the influence of obesity and carbohydrate disorders on the characteristics of gastroesophageal reflux disease (GERD). Methods: The study included 58 patients with excess weight. Anthropometric parameters (including the body mass index, BMI), data regarding GERD (severity of symptoms, gastroscopy and esophageal pH monitoring results) were included in the study. Correlations between obesity and GERD parameters were analyzed. Subjects were divided into a diabetic and a control group and the severity of GERD was compared. Results: GERD was diagnosed in 40 patients and occurred more frequently in the obese group (73%) than in the overweight group (57%). Increased GERD severity was associated with increased BMI only for postprandial parameters. GERD was diagnosed in most of the group with carbohydrate disorders (78% vs 63% in the non-diabetic group). No differences in the severity of GERD were observed between groups depending on carbohydrate disorders. Conclusions: In our study, GERD was common in obesity and in diabetic disorders. Increased severity of postprandial reflux was associated with an increased BMI. Diabetic disorders were not associated with more severe GERD. [ABSTRACT FROM AUTHOR]

The International Diabetes Federation estimates that approximately 10 % of the adult population in Ukraine has prediabetes. According to many studies, prediabetes is observed in every second obese patient, and later prediabetes can progress to type 2 diabetes mellitus. Therefore, timely detection of early disorders of carbohydrate metabolism is very important, as well as implementation of recommendations for lifestyle changes, the use of modern drugs to prevent type 2 diabetes and cardiovascular diseases. In recent years, increasing attention is drawn to dietary fibers as an integral part of a healthy diet. They help prevent obesity, metabolic syndrome and adverse changes in the gut, and also help increase the population of beneficial bacteria in the gut. That is why nutritionists recommend that obese people include dietary fibers in their diet. One of the most famous dietary fibers is psyllium, which comes from the husk of plantain seeds (Plantago ovata). Numerous studies show that psyllium has a positive effect on the functioning of many organs and systems, including the pancreas, intestines and heart muscle. Psyllium also lowers glucose and cholesterol and is an effective way to lose weight for people who are overweight. Fibolex® plant complex contains dietary fibers (psyllium and natural wheat fibers) and green tea extract. Due to the combined herbal composition, Fibolex® can be used in obese people, patients with prediabetes, metabolic syndrome, type 2 diabetes and other metabolic disorders for the correction of eating habits in order to improve carbohydrate and lipid metabolism. [ABSTRACT FROM AUTHOR]

The article is a literature review devoted to issues of planned percutaneous coronary intervention for patients with type 2 diabetes mellitus. Pathogenetic base of poor prognosis and new ways to pharmacological risk correction are described. The article highlights the trends in the incidence of carbohydrate metabolism disorders, their role in the development of complications of myocardial revascularization. The results of studies comparing different tactics of revascularization and their results in patients with different status of carbohydrate metabolism are presented. The article discusses the methods of risk management within percutaneous coronary revascularization, the role of glycemic metabolism in the risk of an poor prognosis of myocardial revascularization, describes the results of clinical trials of new drugs that can have a positive effect on the prognosis of revascularization in patients with carbohydrate metabolism disorders.

The review deals with the problem of carbohydrate metabolism disorders in patients undergoing corticosteroid therapy, relevant for specialists in various fields. The article describes the epidemiology and risk factors for the development of carbohydrate metabolism disorders when using glucocorticosteroids. Contemporary information is provided about the diagnostics, prevalence and pathogenesis of steroid-induced hyperglycemia. A particular attention is paid to current data on various disorders of carbohydrate metabolism in patients with a therapeutic profile. Main approaches to the correction of glycemia in the steroid-induced disorders of carbohydrate metabolism using modern therapy are considered elucidated.Conclusion. The widespread use of glucocorticosteroids, significant prevalence of the steroid-induced disorders of carbohydrate metabolism, features of the pathogenetic mechanisms of steroid-induced diabetes mellitus determine the need to create algorithms for the diagnosis and treatment of these conditions. A conclusion is made that rational glucose-lowering therapy that takes into account the pathogenetic and clinical aspects of the steroid-induced disorders of carbohydrate metabolism, can reduce the rate of macro- and microvascular complications.Conflict of interest: the authors declare no conflict of interest.

Aim. To study the role of soluble ST2 (sST2) in patients with coronary artery disease (CAD) and chronic heart failure (CHF) associated with carbohydrate metabolism disorders (impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) in risk stratification of adverse cardiovascular events (ACE) for 12 months of follow-up. Materials and methods. We enrolled 118 patients with CAD and CHF I-III FC (NYHA) with the ejection fraction of left ventricular of 60 [46; 64] % aged 62.5 [57; 68] years. Serum sST2 levels were measured by enzyme immunoassay. Results. Depending on the presence of carbohydrate metabolism disorders (CMD), the patients were divided into 3 groups: group 1 (n=65) included patients without CDM, group 2 (n=30) included with IGT, and group 3 (n=23) included with type 2 DM. Serum levels of sST2 in patients with CMD were significantly (p=0.011) higher than in patients without CMD, but in subgroups of patients with IGT and type 2 DM, the concentrations of sST2 did not differ. In group 1 sST2 levels were 30.51 [26.38; 37.06] ng/ml, and in group 2 and 3 - 37.97 [33.18; 47.48] and 41.45 [35.27; 50.37] ng/ml, respectively. There were statistically significant differences in the rate of adverse ACE in relation to sST2 levels: in spite of CMD, in subgroups with biomarker overexpression adverse CCC occurred more often (p

Aim. To study the prevalence of carbohydrate metabolism disorders in patients with heart failure (HF) hospitalized in the city HF center.Material and methods. According to the local registry, the study sequentially included 183 patients (99 men and 84 women) hospitalized in the Nizhny Novgorod city HF center from September 1, 2019. The examination and treatment were carried out in accordance with the current clinical guidelines. In the first 48 hours after hospitalization, the concentration of the N-terminal pro-brain natriuretic peptide, soluble stimulating growth factor 2 (sST2), neutrophil gelatinase-associated lipocalin, cystatin C, blood creatinine was determined. The glomerular filtration rate was calculated using the СKDEPI equation. To assess the carbohydrate metabolism disorders, all patients were studied for fasting plasma glucose, glycated hemoglobin (HbA1c) and fructosamine. Statistical data processing was carried out using the R statistics package (R Core Team (2019)).Results. The incidence of carbohydrate metabolism disorders among patients withdecompensated HF was 75,89%, including previously diagnosed type 2 diabetes in 31,25%, newly diagnosed dysglycemia in 44,64% of patients. Less than one fourth of patients had normal parameters of carbohydrate metabolism according to HbA1c, fructosamine and fasting plasma glucose. The severity of carbohydrate metabolism disorders was significantly correlated with the severity of HF according to the following criteria: 6-minute walk test, HF functional class, sST2 level, and some parameters of cardiac remodeling. Among the criteria used for carbohydrate metabolism disorders, the HbA1c level was most closely associated with the criteria for HF severity.Conclusion. Carbohydrate metabolism disorders in HF patients are widespread and underdiagnosed during routine examination. The interrelation of carbohydrate metabolism parameters and indicators of HF severity is rationale for active detection of dysglycemia in these patients in order to potentially influence the prognosis.

The paper presents evidence that the individuals with different blood groups and glucose levels exhibit individual IgE reagin responses to insulin. Thus, the persons with 0 (I) blood group showed the highest values of anti-insulin-specific IgE (124.83±67.9 kE/L) when their glucose level was under 4 mmol/l. Such values are characteristic to the patients with A (II) and B (III) blood groups with normal glucose levels. Among subjects with B (III) blood group showing decreased glucose values (< 4 mmol/L), the lowest insulin induction (0.85±0.05 mkE/ml) was observed, and the IgE production to insulin increased 80-fold, reaching 113.0±56.0 kE/L. At the first ("borderline") stage of carbohydrate metabolism disorders (glucose levels 6.0 to 7.6 mmol/L), the insulin production is increased 3-fold in 0 (I) and A (II) blood groups, whereas insulin levels in persons with B(III) blood group are near-normal (12.3±3.7), and IgE antibodies to insulin show lowest levels (27.2±9.08 kE/L), thus being 5 times lower when compared to the persons with B (III) blood group. However, carriers of all three group antigens and patients with expressed type 2 diabetes respond to increased glucose and insulin levels in blood by decreased production of specific IgE antibodies to insulin.

Glycogen storage disease type I, also known von Gierke's disease, is a rare, severe autosomal recessive disorder due to a defect in liver, kidney, and intestinal mucosa. The existence of delayed development of the dentition, increased incidence of dental caries, taurodontism, and prolonged bleeding following dental procedures should lead clinicians to consider type I glycogen storage disease. A 10-year-old boy with glycogen storage disease type I whose condition was first diagnosed when he was 4 years of age, was referred to the clinic for multiple caries and evaluation of delayed tooth eruption. On physical examination, the patient was cooperative, with short stature, protuberant abdomen, and growth retardation. Laboratory findings indicated that blood levels of pyruvate, triglycerate, uric acid, and cholesterol were elevated. lntraorally delayed mixed dentition was evident, and approximal caries were found in teeth 55, 54, 52, 51, 61, 62, 65, 74, 84, and 85. The most significant radiographic finding was consistent with taurodontism of the molar teeth. Lateral and posteroanterior cephalometric films showed that dimensions of the craniofacial complex were strongly reduced. Evaluation of the patient's dental age was approximately 6 years. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate Cardio-Ankle Vascular Index (CAVI) and increased arterial stiffness predictors in patients with carbohydrate metabolism disorders (CMD) in the population sample of Russian Federation. Methods: 1617 patients (age 25–64 years) were enrolled in an observational cross-sectional study Epidemiology of Cardiovascular Diseases and Their Risk Factors in the Regions of the Russian Federation (ESSE-RF). The standard ESSE-RF protocol has been extended to measure the cardio-ankle vascular index (CAVI), a marker of arterial stiffness. Patients were divided into three groups: patients with type 2 diabetes mellitus (n = 272), patients with prediabetes (n = 44), and persons without CMD (n = 1301). Results: Median CAVI was higher in diabetes and prediabetes groups compared with group without CMD (p = 0.009 and p < 0.001, respectively). Elevated CAVI (≥9.0) was detected in 16.8% of diabetes patients, in 15.9% of those with prediabetes, and in 9.0% of those without CMD (p < 0.001). The factors affecting on CAVI did not differ in CVD groups. In logistic regression the visceral obesity, increasing systolic blood pressure (SBP) and decreasing glomerular filtration rate (GFR) were associated with a pathological CAVI in CMD patients, and age, diastolic blood pressure (DBP), and cholesterol in persons without CMD. Conclusions: the CAVI index values in the prediabetes and diabetes patients were higher than in normoglycemic persons in a population sample of the Russian Federation. Since the identified disorders of arterial stiffness in prediabetes are similar to those in diabetes, their identification is important to prevent further cardiovascular complications.

Copyright of Gastroenterologia (2308-2097) is the property of Zaslavsky O.Yu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The aim of this study was to determine whether there was a difference in delayed healing following dental extractions for insulin-dependent diabetics as compared to non-diabetic patients.Methods: Prospective patients referred to the Adelaide Dental Hospital exodontia clinic for dental extractions were recruited into two groups: Known insulin-dependent diabetics and healthy non-diabetics. All had a random blood glucose level (BGL). Delayed healing cases were identified, and statistical evaluation was performed.Results: There were 56 insulin-dependent diabetic patients (BGL 10.03, range 4.9-26) and 49 non-diabetic, age- and sex-matched patients. Seven patients (12.5%) in the study group showed delayed healing following extraction, while only four patients (8.2%) in the control group suffered delayed healing. This difference was not statistically significant. Two of the study group developed postextraction infections, requiring incision, drainage and antibiotics.Conclusion: The study shows that Type 1 and insulin-dependent Type 2 diabetic patients, if well controlled, tend to heal up well following dental extractions but with a small but not statistically different rate of postextraction complications including infection. This is contrary to what is usually taught. Clinicians should take great care with management of insulin-dependent diabetic patients, as compared to non-insulin dependent diabetics or non-diabetic patients. [ABSTRACT FROM AUTHOR]

Aims: Free fatty acids (FFA) mediate adverse metabolic effects such as downregulated carbohydrate metabolisms, providing causal links between obesity and the development of type 2 diabetes mellitus (T2DM). Here, we investigated the plasma concentrations of FFA alone and in combination with protein glycation as potential diagnostic and prognostic biomarkers of T2DM. Materials and methods: EDTA‐plasma obtained from 48 newly diagnosed male T2DM patients, 48 long‐term controlled (24 male and 24 female) T2DM patients, 20 prediabetic male T2DM patients and two age‐matched control cohorts (48 non‐diabetic (ND) men; 24 male and 24 female ND partipants) were analysed for a set of clinical parameters including FFA. Glycation sites were quantified after tryptic digestion using tandem mass spectrometry. Results: Median plasma concentrations of FFA were almost three‐fold higher in samples obtained from newly diagnosed (long‐term controlled) T2DM patients than in those obtained from the control group, providing diagnostic sensitivity (SN) of 92% (85%) and specificity (SP) of 90% (88%). When combined with the glycation level of lysine‐141 of haptoglobin, diagnostic accuracy improved further for newly diagnosed (SN, 94%; SP 96%) and long‐term controlled (SN, 85%; SP, 94%) T2DM patients (HbA1c: SN, 88%; SP, 96%). A prospective pilot study evaluating the prognostic value revealed initially low FFA levels for pre‐diabetic patients that increased in the following four years in patients whose prediabetic state worsened or who developed T2DM. Conclusions: FFA levels are elevated in newly diagnosed and long‐term controlled T2DM patients, providing high diagnostic accuracy of 87% and 91%, respectively, which improved further when combined with the glycation degree of lysine‐141 in haptoglobin. Additionally, FFA showed higher mean fold‐changes than HbA1c or FPG in subjects developing T2DM, indicating higher sensitivity towards the progression of the disease. [ABSTRACT FROM AUTHOR]

The mucopolysaccharidoses belong to the large group of inherited metabolic disorders. The primary pathophysiologic basis lies in a deficiency of specific lysosomal hydrolytic enzymes leading to an accumulation of glycosaminoglycans (originally mucopolysaccharides) in the lysosomes and extracellular tissues. Multisystemic and highly variable clinical manifestations include craniofacial dysmorphy, musculoskeletal involvement, joint contractures, hepato-and splenomegaly, inguinal or umbilical hernias and eventually cognitive impairment. Ear, nose, and throat problems are very common and are often among the first symptoms to appear already in the early childhood. ENT manifestation invariably includes otological involvement (recurrent acute otitis media, otitis media with effusion, hearing loss), adenotonsillar hypertrophy and progressive airway obstruction. Thus, otorhinolaryngologist has an integral role in early recognition of the disease, in initiating of further examination leading to the diagnosis of MPS and future management and treatment of children with mucopolysaccharidoses. [ABSTRACT FROM AUTHOR]

This prospective cross-sectional study aimed to investigate the potential association between primary-adult lactose malabsorption, fructose malabsorption, tryptophan (TRP) metabolism and the presence of depressive signs. Overall 251 patients, who were referred for lactase gene C/T -13910 polymorphism genotyping and fructose hydrogen/methane breath testing, were included. All participants filled out the Beck Depression Inventory (BDI II). Serum concentrations of tryptophan (TRP), kynurenine (KYN), kynuric acid (KYNA), and TRP competing amino acids (leucine, isoleucine, valine, phenylalanine, tyrosine) were measured by high-pressure liquid-chromatography. Logistic regression analysis was performed with lactose malabsorption, fructose malabsorption and all potential biomarkers of TRP metabolism to assess the effect on signs of depression, defined as a BDI II score > 13. Primary-adult lactose malabsorption and fructose malabsorption was detected in 65 (25.90%) and 65 (25.90%) patients, respectively. Fructose malabsorption was significantly associated with BDI II score, whereas no such relationship was found for lactose malabsorption. Serum levels of TRP and TRP metabolites were no predictors of depression. The authors suggest to conduct further prospective longitudinal studies in order to get further insight of associations between carbohydrate malabsorption, biomarkers and mood disorders. [ABSTRACT FROM AUTHOR]

Background: Obesity is considered problematic not only as a major cause of diabetes, hypertension and dyslipidemia, but also as a risk of intractable dermatosis; however influence of obesity on skin function has not been clarified. To clarify the mechanism of obesity-associated skin disorders, we aimed to characterize the skin function of subjects with obesity and identify possible influencing factors. Methods: Complex analyses including instrumental measurement, biochemical and lipidomics were performed for facial skin and physical evaluation in 93 Caucasian women with obesity (OB) and non-obesity (NOB). Results: In OB, imbalance in metabolism of carbohydrate and lipid, autonomic nerve activity and secreted factors were confirmed. In the skin properties in OB, surface roughness was higher by 70%, the water content was lower by 12% and changes in the lipid profile of stratum corneum ceramide were observed; in particular, a 7% reduction of [NP]-type ceramide, compared with NOB. Moreover, significant redness accompanied by a 34% increase in skin blood flow was observed in OB. Correlation analysis elucidated that the water content was strongly correlated with local skin indices, such as the ceramide composition, redness, blood flow and TNFα in the stratum corneum, whereas roughness was correlated with the systemic indices, such as serum insulin, leptin and IL-6. Conclusions: Characteristics of obesity-associated skin were (A) reduction of the barrier and moisturizing function accompanied by intercellular lipid imbalance, (B) increased redness accompanied by hemodynamic changes, and (C) surface roughness. It was suggested that each symptom is due to different causes in local and/or systemic physiological impairment related to the autonomic nerve-vascular system, inflammation and insulin resistance. [ABSTRACT FROM AUTHOR]

Background: Hypoglycemia is associated with increased mortality rate in patients with diabetes. The underlying mechanisms may involve reduced myocardial tolerance to ischemia and reperfusion (IR) or reduced capacity for ischemic preconditioning (IPC). As IPC is associated with increased myocardial glucose uptake (MGU) during reperfusion, cardioprotection is linked to glucose metabolism possibly by O-linked β-N-acetylglucosamine (O-GlcNAc). We aimed to investigate the impact of hypoglycemia in hearts from animals with diabetes on myocardial IR tolerance, on the efficacy of IPC and whether modulations of MGU and O-GlcNAc levels are involved in the underlying mechanisms. Methods: In a Langendorff model using diabetic ZDF (fa/fa) and non-diabetic (fa/+) rats (n = 6-7 in each group) infarct size (IS) was evaluated after 40 min of global ischemia and 120 min reperfusion during hypoglycemia [(glucose) = 3 mmol/l] and normoglycemia [(glucose) = 11 mmol/l]. Myocardial glucose uptake and O-GlcNAc levels were evaluated during reperfusion. IPC was induced by 2 × 5 min of global ischemia prior to index ischemia. Results: IS increased in hearts from animals with (p < 0.01) and without (p < 0.01) diabetes during hypoglycemia compared to normoglycemia. IPC reduced IS during normoglycemia in both animals with (p < 0.01) and without (p < 0.01) diabetes. During hypoglycemia, however, IPC only reduced IS in hearts from animals with diabetes (p < 0.05). IPC increased MGU during reperfusion and O-GlcNAc levels in animals with diabetes during hypo- (MGU: p < 0.05, O-GlcNAc: p < 0.05) and normoglycemia (MGU: p < 0.01, O-GlcNAc: p < 0.05) and in animals without diabetes only during normoglycemia (MGU: p < 0.05, O-GlcNAc: p < 0.01). Conclusions: Hypoglycemia increases myocardial susceptibility to IR injury in hearts from animals with and without diabetes. In contrast to hearts from animals without diabetes, the hearts from animals with diabetes are amenable to cardioprotection during hypoglycemia. In parallel with IPC induced cardioprotection, MGU and O-GlcNAc levels increase suggesting that increased MGU and O-GlcNAc levels are involved in the mechanisms of IPC. [ABSTRACT FROM AUTHOR]

Chronic inflammation – the crucial pathogenic mechanism of rheumatoid arthritis and ankylosing spondylitis – is the main cause of accelerated atherosclerosis, insulin resistance and well-known consequences related to it. The conservative treatment of rheumatoid arthritis and ankylosing spondylitis may provide a significant influence on glucose metabolism. The paper is a literature overview concerning insulin resistance and impaired glucose metabolism during treatment with disease-modifying drugs including biologic DMARDs (disease-modifying antirheumatic drugs), corticosteroids and commonly used non-steroidal anti-inflammatory drugs (NSAID). It has been found that the risk of carbohydrate disorders among those patients is much lower after therapy with hydroxychloroquine, methotrexate and TNF blockers – particularly with infliximab. The NSAID may play an important protective role in reducing risk of diabetes. The recent data show, contrary to general opinion, the advantageous outcome for glucose metabolism after treatment with corticosteroids, especially in the early active stage of rheumatoid arthritis.

Background: Mucopolysaccharidosis type II (MPS II; Hunter syndrome) is a rare, X-linked disorder caused by deficient activity of the enzyme iduronate-2-sulfatase (I2S). Treatment is available in the form of enzyme replacement therapy (ERT) with recombinant I2S. Clinical outcomes following ≥3 years of ERT with idursulfase were investigated in a broad population of patients with MPS II enrolled in the Hunter Outcome Survey (HOS).Methods: As of January 2016, 639 patients (excluding female patients, individuals who had received a bone marrow transplant and those enrolled in the phase 1/2 [TKT018] or phase 2/3 [TKT024] clinical trial) followed prospectively in the registry had received idursulfase for ≥6 months. These individuals all had data available for ≥1 clinical parameter at baseline and ≥1 additional time point following treatment initiation. Changes in clinical parameters were assessed in the subcohorts of patients with a measurement at baseline and at year 1, 2 or 3 of treatment. Safety data from patients who started treatment at or after enrollment in HOS (n = 233) were also assessed.Results: Median (10th, 90th percentiles) age at first treatment was 6.2 (2.1, 18.2) years and median treatment duration was 56.3 (18.2, 97.6) months. Urinary glycosaminoglycan (uGAG) levels decreased from baseline to year 3 in patients with data available at this time point (median change from baseline: -201.0 [-591.4, -21.9] μg/mg creatinine [n = 121]). Improvements in the following parameters were observed at year 3 in the subcohorts: 6-min walking test (6MWT) distance, 10.6 (-33.6, 50.8)% (n = 26); left ventricular mass index (LVMI), -9.3 (-31.5, 19.7)% (n = 52); absolute forced vital capacity (FVC), 29.7 (-13.4, 66.7)% (n = 23); absolute forced expiratory volume in 1 s (FEV1), 22.8 (-15.2, 62.1)% (n = 22); palpable liver size, -54.5 (-85.7, 50.0)% (n = 53); palpable spleen size, -33.3 (-80.0, 33.3)% (n = 17). No new or unexpected safety concerns were identified in this analysis.Conclusions: These findings suggest that idursulfase has a positive effect on uGAG levels, 6MWT results, LVMI, FVC, FEV1 and hepatosplenomegaly after 1, 2 and 3 years treatment. [ABSTRACT FROM AUTHOR]

Most patients with infantile-onset Pompe disease die in early infancy before beginning enzyme replacement therapy, which has made it difficult to evaluate the impact of Pompe disease on cognitive development. Patients with infantile-onset Pompe disease can survive with enzyme replacement therapy, and physicians can evaluate cognitive development in these patients. We established an effective newborn screening program with quick clinical diagnostic criteria. Cognitive and motor development were evaluated using the Bayley Scales of Infant and Toddler Development–Third Edition at 6, 12, and 24 months of age. The patients who were treated very early demonstrate normal cognitive development with no significant change in cognition during this period (P = .18 > .05). The cognitive development was positively correlated with motor development (r = 0.533, P = .011). The results indicated that very early enzyme replacement therapy could protect cognitive development in patients with infantile-onset Pompe disease up to 24 months of age. [ABSTRACT FROM AUTHOR]

Background: The prevalence of diabetes has increased since the last decade in New Brunswick. Identifying factors contributing to the increase in diabetes prevalence will help inform an action plan to manage the condition. The objective was to describe factors that could explain the increasing prevalence of type 2 diabetes in New Brunswick since 2001. Methods: A critical literature review was conducted to identify factors potentially responsible for an increase in prevalence of diabetes. Data from various sources were obtained to draw a repeated cross-sectional (2001-2014) description of these factors concurrently with changes in the prevalence of type 2 diabetes in New Brunswick. Linear regressions, Poisson regressions and Cochran Armitage analysis were used to describe relationships between these factors and time. Results: Factors identified in the review were summarized in five categories: individual-level risk factors, environmental risk factors, evolution of the disease, detection effect and global changes. The prevalence of type 2 diabetes has increased by 120% between 2001 and 2014. The prevalence of obesity, hypertension, prediabetes, alcohol consumption, immigration and urbanization increased during the study period and the consumption of fruits and vegetables decreased which could represent potential factors of the increasing prevalence of type 2 diabetes. Physical activity, smoking, socioeconomic status and education did not present trends that could explain the increasing prevalence of type 2 diabetes. During the study period, the mortality rate and the conversion rate from prediabetes to diabetes decreased and the incidence rate increased. Suggestion of a detection effect was also present as the number of people tested increased while the HbA1c and the age at detection decreased. Period and birth cohort effect were also noted through a rise in the prevalence of type 2 diabetes across all age groups, but greater increases were observed among the younger cohorts. Conclusions: This study presents a comprehensive overview of factors potentially responsible for population level changes in prevalence of type 2 diabetes. Recent increases in type 2 diabetes in New Brunswick may be attributable to a combination of some individual-level and environmental risk factors, the detection effect, the evolution of the disease and global changes. [ABSTRACT FROM AUTHOR]

Abstract Background In total, 930 urine samples obtained on 2nd and 3rd day from birth have been analyzed for the early diagnosis of Mucopolysaccharidoses. Methods Dimethylmethylene blue (DMB) assay and one-dimensional electrophoresis were performed in all urine samples. Agarose gel electrophoresis, before and after treatment with chondroitinase ABC and heparinases, was used for a comprehensive characterization. Results Out of 930 urine samples 7 showed anomalous electrophoretic pattern; 5 of them had high GAG levels by DMB test. Atypical samples (n = 7) were analyzed by agarose gel electrophoresis. After enzymatic digestion, some slow bands were still visible. A second urine sample of the above 7 newborns was analyzed at the age of 1 month, demonstrating both a normal pattern and normal GAG levels. Additional urine and vaginal mucus samples from 10 term neonates with vaginal bleeding showed the same electrophoretic pattern observed in the 7 false positive samples. Conclusions The altered electrophoretic pattern may be due to the presence of glycoproteins and not to specific GAGs, due to high levels of maternal hormones exposure during pregnancy. To our knowledge, this is the first time maternal estrogen hormones are proposed as a likely cause of false-positive urinary glycosaminoglycan screen test in healthy newborns. Highlights • Urinary glycosaminoglycan analyses were performed in about 1000 term newborns. • For each sample only 1 mL of urine was required to perform both quantitative evaluation and electrophoretic characterization. • False positive results were found in 7 healthy female newborns with vaginal bleeding. • Maternal estrogen hormones are proposed for the first time as a likely cause of false-positive urinary glycosaminoglycan screen test in healthy female newborns. [ABSTRACT FROM AUTHOR]