Effects of high-intensity interval training and moderate-intensity continuous training on body composition and glucose metabolism in overweight or obese patients with type 2 diabetes:a Meta-analysis / 中国组织工程研究

OBJECTIVE:To systematically evaluate the effects of high-intensity interval training(HIIT)and moderate-intensity continuous training(MICT)on body composition and glucose metabolism-related indexes in overweight or obese patients with type 2 diabetes and to compare the improvement effect of the two exercise modalities,thereby providing a reference basis for the development of exercise prescription for overweight or obese patients with type 2 diabetes. METHODS:The Cochrane Library,PubMed,EMbase,Web of Science,CNKI,CBM,WanFang,and ClinicalTrials.gov were searched for randomized controlled trials comparing the effects of HIIT and MICT interventions on body composition and glucose metabolism-related indicators in overweight or obese patients with type 2 diabetes.The search was conducted from database inception to June 2022.Meta-analysis of outcome indicators was performed using RevMan 5.4. RESULTS:(1)A total of 13 randomized controlled trials with 371 subjects were included,and the overall quality of the included studies was relatively high.(2)There was no significant difference in the improvement of body composition between HIIT and MICT[body mass:weighted mean difference(WMD)=2.44,95%confidence interval(CI):-3.01-7.89,P＞0.05;body mass index:WMD=0.28,95%CI:-1.21-1.77,P＞0.05;waist circumference:WMD=2.16,95%CI:-2.04-6.35,P＞0.05;body fat percentage:WMD=0.47,95%CI:-2.11-3.05,P＞0.05).(3)The results of subgroup analysis showed that there was a significant difference in body mass and body mass index between the"training cycle≥12 weeks"subgroup and the"training frequency≤3 times/week"subgroup(training cycle≥12 weeks subgroup:WMD=4.25,95%CI:0.90-7.59,P=0.01;WMD=2.71,95%CI:1.92-3.51,P＜0.000 01;training frequency≤3 times/week subgroup:WMD=5.14,95%CI:1.7-8.57,P=0.003;WMD=1.67,95%CI:0.66-2.67,P=0.001).(4)The results of sensitivity analysis showed that there was a significant difference in body fat percentage between the HIIT and MICT groups(WMD=2.17,95%CI:1.20-3.14,P＜0.000 1),while there was no significant difference in the improvement of glucose metabolism between the HIIT and MICT groups(fasting blood glucose:WMD=0.31,95%CI:-0.17-0.79,P＞0.05;glycosylated hemoglobin:WMD=0.01,95%CI:-0.19-0.20,P＞0.05;insulin resistance index:WMD=-0.14,95%CI:-0.71-0.42,P＞0.05).(5)The results of subgroup analysis showed that fasting blood glucose was significantly different in the subgroup of"training frequency≤3 times/week"(WMD=0.92,95%CI:0.25-1.60,P=0.007)and glycosylated hemoglobin was significantly different in the"training frequency＞3 times/week"subgroup(WMD=-0.2,95%CI:-0.3 to-0.1,P＜0.000 1). CONCLUSION:Overall,there is no significant difference between HIIT and MICT in improving body composition such as body mass,body mass index,waist circumference,body fat percentage as well as improving glucose metabolic indexes such as fasting blood glucose,glycated hemoglobin and insulin resistance index in overweight or obese patients with type 2 diabetes.When the training period is≥12 weeks and the training frequency is≤3 times/week,MICT has a better effect on the improvement of body mass as well as body mass index.

Analysis of the interaction of fasting blood glucose and serum uric acid on di-abetic retinopathy / 眼科新进展

Objective To investigate the impact of the interaction of fasting blood glucose(FBG)and serum uric acid(SUA)on diabetic retinopathy(DR).Methods A total of 306 diabetes mellitus(DM)patients diagnosed and re-ceived comprehensive ophthalmic examination in the First Affiliated Hospital of Gannan Medical University from January 2019 to January 2021 were selected.According to the presence or absence of DR,these patients were divided into the DR group(178 patients)and the non-DR(NDR)group(128 patients).The general clinical data of patients in the two groups were compared.The least absolute shrinkage and selection operator(LASSO)regression method and multivariate Logistic regression analysis were used to screen the independent influencing factors of DR in DM patients,and the odds ratio of risk factors was calculated.The sensitivity analysis of the results was performed using the E-value method.The interaction of FBG and SUA on DR in DM patients was analyzed by an additive interaction model.The Nomogram model to predict DR in DM patients was constructed and verified internally.The receiver operating characteristic curve(ROC)was used to evalu-ate the effects of FBG,SUA and both FBG and SUA on DR in DM patients.Results Compared with the NDR group,the course of DM in the DR group was significantly longer,the proportion of patients with history of oral medication was signif-icantly lower,the proportion of patients with history of insulin therapy was significantly higher,and the levels of total cho-lesterol,triglyceride,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,blood urea nitrogen,serum creatinine,SUA and FBG were significantly higher(all P＜0.05).The history of insulin therapy,course of DM≥9.66 years,TG≥2.07 mmol·L-1,SUA ≥ 297.73 μmol·L-1 and FBG ≥8.92 mmol·L-1 were the risk factors for DR in DM pa-tients,while the history of oral medication was the protective factor for DR in DM patients.The Nomogram model based on the above independent risk factors was accurate in predicting the occurrence of DR in DM patients.SUA and FBG had inter-active effects on DR in DM patients.The value of SUA-FBG interaction in the diagnosis of DR was greater than that of both alone.Conclusion SUA≥ 297.73 μmol·L-1 and FBG ≥8.92 mmol·L-1 are the risk factors for DR in DM patients.The value of interaction of FBG and SUA in the diagnosis of DM accompanied by DR is greater than that of both alone.

Effects of long-term exposure to ambient fine particulate matter on diabetes mellitus and the moderating effects of diet / 环境与职业医学

Background Long-term exposure to ambient fine particulate matter (PM2.5) may increase the risk of diabetes, and a healthy diet can effectively control fasting blood glucose levels. However, it is unclear whether dietary factors have a moderating effect on the risk of diabetes associated with atmospheric PM2.5 exposure. Objective To investigate the association between long-term exposure to PM2.5 and diabetes in rural areas of Ningxia, and potential interaction of long-term exposure to atmospheric PM2.5 and diet on diabetes. Methods The study subjects were selected from the baseline survey data of the China Northwest Cohort-Ningxia (CNC-NX) , a natural population cohort. A total of 13917 subjects were included, excluding participants with missing covariate information. We utilized the annual average ambient PM2.5 concentration from 2014 to 2018 as the long-term exposure level. Logistic regression and multiple linear regression were employed to analyze the associations of long-term atmospheric PM2.5 exposure with diabetes and fasting blood glucose levels. Stratification by frequency of vegetable consumption, frequency of fruit consumption, and salty taste was used to examine moderating effects on the diabetes risk associated with atmospheric PM2.5 exposure. Results The mean age of the 13917 subjects was (56.8±10.0) years, and the prevalence of diabetes was 9.8%. Between 2014 and 2018, the average annual concentration of PM2.5 was (38.10±4.67) μg·m−3. The risk (OR) of diabetes was 1.018 (95%CI: 1.005, 1.032) and the fasting blood glucose was increased by 0.011 (95%CI: 0.004, 0.017) mmol·L−1 for each 1 μg·m−3 increase in PM2.5 concentration. Compared to those who consumed vegetables < 1 time per week, individuals who consume vegetables 1-3 times per week and ≥4 times per week had a reduced risk of developing diabetes by 27.1% (OR=0.729, 95%CI: 0.594, 0.893) and 16.8% (OR=0.832, 95%CI: 0.715, 0.971) respectively. Similarly, when compared to those who consumed fruits <1 time per week, individuals who consumed fruits 1-3 times per week and ≥4 times per week exhibited a reduced risk of diabetes by 16.4% (OR=0.836, 95%CI: 0.702, 0.998) and 18.2% (OR=0.818, 95%CI: 0.700, 0.959) respectively. Fasting blood glucose decreased by 0.202 (95%CI: -0.304, -0.101) mmol·L−1 in participants who ate vegetables 1-3 times per week. The effect of salty taste on diabetes and fasting blood glucose was not significant. The results of stratified analysis by dietary factors and PM2.5 concentration showed that the risks of diabetes were increased in the low PM2.5 pollution-low vegetable intake frequency group and the high PM2.5 pollution-low vegetable intake frequency group compared with the low PM2.5 pollution-high vegetable intake frequency group, with OR values of 3.987 (95%CI: 2.943, 5.371) and 1.433 (95%CI: 1.143, 1.796) respectively. The risk of diabetes was 50.1% higher in participants with high PM2.5 pollution and low fruit intake frequency than in participants with low PM2.5 pollution and high fruit intake frequency (OR=1.501, 95%CI: 1.171, 1.926). No interaction was found between salty taste and PM2.5 on diabetes. Conclusion Long-term exposure to ambient PM2.5 is associated with an increased fasting blood glucose and an elevated risk of diabetes in rural Ningxia population. Increasing the frequency of weekly consumption of vegetables or fruits may have a certain protective effect against diabetes occurrence, as well as a moderating effect on diabetes and fasting blood glucose levels associated with long-term exposure to atmospheric PM2.5.

Effect of fasting glucose levels on carotid intima-media thickness in premenopausal versus postmenopausal women

ABSTRACT Objective: To investigate the relationship between fasting blood glucose (FBG) and carotid intima-media thickness (IMT) in premenopausal and postmenopausal women. Subjects and methods: The study enrolled 2,959 women seen at the Maanshan People's Hospital of Anhui Province from December 2013 to December 2018. Carotid IMT was measured using Doppler ultrasound. Linear regression and R smoothing curves were used to analyze the relationship between blood glucose level and carotid IMT in the premenopausal and postmenopausal groups. Results: Postmenopausal compared with premenopausal women had higher mean IMT (mIMT; 0.81 ± 0.23 mm versus 0.70 ± 0.14 mm, respectively, p < 0.001) and maximum IMT (maxIMT; 0.86 ± 0.35 mm versus 0.74 ± 0.16 mm, respectively, p < 0.001) values. On linear regression analysis, mIMT values increased with increasing FBG values when FBG level was ≤ 7 mmol/L, but no significance was found between FBG and maxIMT. After stratification by menopausal status, mIMT and maxIMT increased with increasing FBG when FBG was ≤ 7 mmol/L in the premenopausal group. In the postmenopausal group, mIMT and maxIMT increased with increasing FBG. After adjustment for covariate factors, the relationship between FBG and mIMT remained the same as before the adjustment, but when FBG was ≤ 11 mmol/L, the maxIMT increased with increasing FBG. In the stratification analysis, maxIMT increased with increasing FBG when FBG was ≤ 7 mmol/L in the premenopausal group, while both mIMT and maxIMT increased with increasing FBG when FBG was > 10 mmol/L in the postmenopausal group. Conclusion: Levels of FBG contributed more to increased IMT in postmenopausal than premenopausal women. The influence of FBG was greater on maxIMT than mIMT. Additionally, FBG was helpful in assessing focal thickening of the carotid intima.

Relación entre el Finnish Diabetes Risk Score, glucemia en ayunas y hemoglobina A1c / Relationship between the Finnish Diabetes Risk Score, fasting blood glucose and glycohemoglobin A1c

Introducción: el Finnish Diabetes Risk Score (FINDRISC) mostró alta sensibilidad y especificidad para la detección de personas que evolucionarían a diabetes mellitus (DM) en las poblaciones estudiadas, por lo cual se decidió utilizarlo entre quienes concurrieron por diferentes motivos a realizarse análisis de laboratorio en centros de la Asociación de Laboratorios de Alta Complejidad (ALAC), con el objeto de identificar personas con diferentes niveles de riesgo de presentar alteraciones de la glucemia en ayunas (GA) y de la HbA1c. Objetivos: explorar la asociación entre la puntuación del FINDRISC con GA y HbA1c, estableciendo el punto de corte de mayor sensibilidad y especificidad para encontrar una GA ≥100 mg/dL y una HbA1c ≥5,7% (38,8 mmol/mol), en una población que concurrió a centros de la ALAC. Materiales y métodos: se incluyeron 1.175 individuos de 45 laboratorios de la ALAC, procesamiento local de glucemia y centralizado de HbA1c (high performance liquid chromatography, HPLC). Análisis estadístico: chi-cuadrado, Odds Ratio, ANOVA, test de Tukey, regresión logística binomial y curvas ROC. Resultados: los puntajes totales del FINDRISC se asociaron de manera positiva y estadísticamente significativa, tanto con los valores de GA como con los niveles de HbA1c. Entre sus variables, una edad mayor o igual a 45 años, un perímetro abdominal de alto riesgo, un índice de masa corporal mayor o igual a 25 Kg/m., la presencia de antecedentes familiares de DM (padres, hermanos o hijos) y la existencia de antecedentes de medicación antihipertensiva se asociaron de manera significativa con valores de GA iguales o superiores a 100 mg/dL y/o niveles de HbA1c iguales o mayores a 5,7% (38,8 mmol/mol). No se halló asociación significativa con la realización de actividad física (al menos 30 minutos diarios) ni con el registro de ingesta diario de frutas y verduras. Los valores medios de GA y HbA1c en individuos con puntajes totales del FINDRISC menores o iguales a 11 fueron de 89,9 mg/dL y 5,2% (33,0 mmol/mol), respectivamente, elevándose hasta valores medios de 116,1 mg/dL y 6,1% (43,0 mmol/mol) en los individuos con puntajes iguales o superiores a 21, siguiendo una asociación del tipo "dosis/respuesta". Por curvas ROC, un FINDRISC de 13 presenta una sensibilidad del 81,89%, especificidad del 67,60% y 70,55% de diagnósticos correctos de HbA1c ≥5,7% (38,8 mmol/mol), y una sensibilidad del 72,50%, especificidad del 70,62% y 71,20% de diagnósticos correctos para encontrar personas con una GA ≥100 mg/dL. Conclusiones: el puntaje del FINDRISC se relacionó con niveles crecientes de GA y HbA1c, resultando útil para encontrar personas con GA ≥100 mg/dL y HbA1c ≥5,7% (38,8 mmol/mol) en la población estudiada.

Introduction: the Finnish Diabetes Risk Score (FINDRISC) has high sensitivity and specificity for the identification of people at risk of diabetes mellitus (DM) in various populations. Therefore, we aimed to use this index to identify individuals at risk of having alterations in fasting glycemia (FG) and HbA1c among those who underwent laboratory analysis at ALAC, Argentina. Objectives: to explore the relationships of the FINDRISC score with the fasting blood glucose (FG) concentration and glycated hemoglobin (HbA1c) level, and to establish appropriate cut-off scores to predict FG ≥100 mg/dL and HbA1c ≥5.7% (38.8 mmol/mol) in this population. Materials and methods: we recruited 1,175 individuals from 45 ALAC laboratories for whom FG and HbA1c had been measured. We analyzed the data using the chi square test, odds ratios, ANOVA plus Tukey's post-hoc test, binomial logistic regression, and receiver operating characteristic (ROC) curves. Results: total FINDRISC score significantly positively correlated with both FG and HbA1c. Of the constituent variables, age ≥45 years, a large waist circumference, a body mass index ≥25 kg/m., a close family history of DM, and the use of antihypertensive medication were significantly associated with FG ≥100 mg/dL and/or HbA1c ≥5.7% (38.8 mmol/mol). However, no significant association was found with physical activity or the daily consumption of fruit and vegetables. The mean FG and HbA1c for individuals with total FINDRISC scores ≤11 were 89.9 mg/dL and 5.2% (33.0 mmol/mol), respectively, which increased to 116.1 mg/dL and 6.1% (43.0 mmol/mol) for individuals with scores ≥21, with a dose/response-type relationship. ROC analysis showed that a FINDRISC of 13 was associated with a sensitivity of 81.89%, a specificity of 67.60%, and a correct diagnosis rate of 70.55% for HbA1c ≥5.7% (38.8 mmol/mol); and a sensitivity of 72.50%, a specificity of 70.62%, and a correct diagnosis rate of 71.20% for FG ≥100 mg/dL. Conclusions: FINDRISC score increases with increasing FG and HbA1c, and is a useful means of identifying people with FG ≥100 mg/dL and HbA1c ≥5.7% (38.8 mmol/mol).

Opiniones y recomendaciones de la Sociedad Argentina de Diabetes. Glucemia en ayunas alterada: ¿es oportuno utilizar el punto de corte en 100 mg/dl en Argentina? / Opinions and recommendations of the Argentine Diabetes Society. Impaired fasting blood glucose: is it appropriate to use a cut-off point of 100 mg/dl in Argentina?

Establecer el punto de corte entre la glucemia en ayunas normal y la alterada resulta de suma importancia a los efectos de considerar a un paciente en riesgo, tanto de progresar a estdos más avanzados de la enfermedad como de sufrir complicaciones micro y macroangiopáticas. Desde 2006 la Sociedad Argentina de Diabetes (SAD), sobre la base de la evidencia considerada en ese momento, estableció el límite inferior de la glucemia alterada en ayunas (GAA) en 110 mg/dl; posteriormente, durante 2022, la Comisión Directiva de la SAD convocó a un grupo de expertos con el objeto de evaluar si esta recomendación debía mantenerse o, al igual que otras sociedades científicas de prestigio, adoptar a tal efecto 100 mg/dl. En este documento de Opiniones y Recomendaciones se encuentran los fundamentos por los cuales la SAD adoptará, de ahora en más, 100 mg/dl como límite inferior de la GAA, en base a las nuevas evidencias científicas que muestran que desde este punto de corte se produce un aumento en la progresión a la diabetes mellitus y de las complicaciones tanto macro como microangiopáticas.

To establish the cut-off point between normal and impaired fasting glycemia (IFG) is extremely important for the purposes of considering a patient at risk both of progressing to more advanced stages of the disease and of suffering micro- and macroangiopathic complications. Since 2006, the Argentine Diabetes Society (ADS), based on the evidence considered at that time, established the lower limit of IFG at 110 mg/d, laterduring the year 2022, The Board of Directors of the ADS vened a group of experts in order to assess whether this recommendation should be maintained or, like other prestigious scientific societies, adopt 100 mg/dl for this purpose. This Opinions and Recommendations document contains therationale for which the SAD will adopt, from now on, 100 mg/dlas the lower limit of the IFG, based on the new scientific edence that shows that from this cut-off point it produces increase in progression to diabetes and both macro and microangiopathic complications.

Association between fasting blood glucose level and the risk of early vascular aging / 中华内分泌代谢杂志

Objective:To investigate the association between fasting blood glucose levels and the risk of early vascular aging(EVA).Methods:The basic information, medical history, and laboratory results of 695 individuals who underwent health check-up at the Physical Examination Center of the First People′s Hospital of Changzhou from January 2020 to March 2021 were retrospectively analyzed.Results:A total of 695 healthy individuals were included in the study, among whom there were 249 cases of EVA and 446 cases of non-EVA. Compared to the non-EVA group, the EVA group showed significant differences in age, gender, triglycerides, high density lipoprotein-cholesterol(HDL-C), fasting blood glucose, left brachial-ankle pulse wave velocity(L-baPWV), right brachial-ankle pulse wave velocity(R-baPWV), systolic blood pressure, and diastolic blood pressure(all P<0.01). All participants were divided into three groups( T1, T2, T3) based on fasting blood glucose levels. As fasting blood glucose levels increased, body mass index, total cholesterol, triglycerides, HDL-C, low density lipoprotein-cholesterol, L-baPWV, R-baPWV, systolic blood pressure, diastolic blood pressure, and EVA indicators showed significant differences among the three groups(all P<0.05). Univariate logistic regression analysis showed that age, gender, triglycerides, HDL-C, systolic blood pressure, diastolic blood pressure, and fasting blood glucose levels were significantly associated with the occurrence of EVA(all P<0.05). For the continuous variable of fasting blood glucose, in the regression equations without correction, with preliminary correction, and with full correction of covariates, higher fasting blood glucose levels significantly increased the risk of EVA, with odds ratios( OR) of 2.249, 2.580, and 2.413, respectively(all P<0.001). Compared to the T1 group, the risk of EVA in the T2 group, after no correction, preliminary correction, and full correction of covariates, was 1.881, 2.040, and 1.972, respectively(all P<0.01). The risk of EVA in the T3 group, unadjusted, preliminary adjustment, and full adjustment of covariates, was 3.234, 3.733, and 3.410, respectively(all P<0.001). After adjusting for confounding factors, a linear relationship between fasting blood glucose levels and the occurrence of EVA was observed through smooth curve fitting. Conclusion:Elevated fasting blood glucose may increase the risk of developing EVA.

A comparative study of cholecalciferol and vildagliptin on fasting blood glucose level of streptozotocin-nicotinamide-induced Type 2 diabetic albino rats

Background: The lack of vitamin D deficiency has been found to be closely associated with many health problems such as metabolic syndrome, cancer, cardiovascular disease, and type 2 diabetes. This interest has also arisen due to the identification that most cells, along with the pancreatic beta-cells, incorporate the vitamin D receptor. Aims and Objectives: In this study, we tested the potential anti-diabetic effect of cholecalciferol, one of the vitamin D analogs, alone or in combination with vildagliptin in type 2 diabetic rats. Materials and Methods: Type 2 diabetic model rats were induced by intraperitoneal injection of streptozotocin followed by nicotinamide. Rats were assigned into five groups each of six rats divided as follows: Normal (non-diabetic) control (Group A), untreated diabetic group receiving the vehicles only (Group B), cholecalciferol-treated group (Group C), vildagliptin-treated group (Group D), and group receiving a combination of cholecalciferol and vildagliptin (Group E). The treatment course lasted for 1 month. For the estimation of fasting blood sugar, the rats were kept deprived of food overnight and were allowed free access to water. Blood samples were collected from the tail of rat with the help of glucometer. Statistical analysis was performed using SPSS version 20 software. One-way ANOVA test was used to compare the effect of drugs on different group. Post hoc analysis was done using Turkeys HSD (honestly significant difference) test. Differences were considered significant at (P < 0.05). Results: Mean FBS value of vitamin D, vildagliptin, and their combination was 181.50 mg/dl, 95.0 mg/dl, and 84.83 mg/dl on day 28. It showed that the combination of both drugs acquired much closer value of FBS as compared to normal non-diabetic control group and thus achieved normal glucose level more effectively. Furthermore, coadministration showed greater fall in fasting blood glucose at the extent of 61.15% as compared to 56.45% by vildagliptin and 17% by cholecalciferol alone on day 28. Conclusion: Therefore, it may be suggested through this study that vitamin D has blood glucose lowering property and coadministration of vitamin D and vildagliptin potentiate the action of each other.

Glucemia en ayunas entre 100 y 109 mg/dL versus prediabetes según hemoglobina glicosilada / Fasting blood glucose between 100 and 109 mg/dL versus prediabetes according to glycosylated hemoglobin

Introducción: algunos estudios han señalado que valores de glucemia en ayunas entre 100 y 109 mg/dL se asocian con frecuencias elevadas de prediabetes cuando el criterio de clasificación son los valores de HbA1c. La Sociedad Argentina de Diabetes (SAD) sostiene a 110 mg/dL como valor a partir del cual se clasifica a un paciente como portador de glucemia en ayunas alterada; la frecuencia de individuos posiblemente clasificados en forma incorrecta, según este criterio, aún no se conoce en la población argentina. Objetivos: establecer la frecuencia con que se presenta prediabetes según HbA1c en una población sin diagnóstico de diabetes mellitus (DM) con glucemias en ayunas entre 100 y 109 mg/dL; correlacionar las dos variables y cuantificar la probabilidad de que esto ocurra respecto de otros con glucemias en ayunas <100 mg/dL. Materiales y métodos: se incluyeron 1.002 muestras de igual número de sujetos desde 45 laboratorios de análisis clínicos de la Asociación de Laboratorios de Alta Complejidad (ALAC), con procesamiento local de glucemia y centralizado de HbA1c por high performance liquid chromatography (HPLC). Análisis estadístico: chi cuadrado, odds ratio, coeficiente de correlación y determinación de Pearson, y correlación serial de Durbin-Watson. Resultados: frecuencia de HbA1c ≥5,7% en la población estudiada con glucemias de ayunas entre 100 y 109 mg/dL=29,7%; test de chi cuadrado: p<0,001; odds ratio de tener HbA1c ≥5,7% entre la población con glucemias en ayunas de 100 a 109 mg/dL vs aquella con valores <100 mg/dL=4,328 (IC 95% 2,922-6,411); r=0,852, r2 = 0,727, Durbin-Watson=1,152. Conclusiones: la prediabetes diagnosticada por HbA1c resultó cuatro veces más frecuente en la población estudiada con glucemias en ayunas entre 100 y 109 mg/dL, que en aquella con valores por debajo de 100 mg/dL.

Introduction: some studies have shown that fasting blood glucose values between 100 and 109 mg/dL are associated with high rates of prediabetes when the classification criteria are HbA1c values. The Argentine Diabetes Society still maintains 110 mg/dL as the value from which a patient is classified as having impaired fasting blood glucose; the frequency of individuals possibly incorrectly classified, according to this criterion, is not yet known in any Argentine population. Objectives: to establish the frequency in a population without a diagnosis of diabetes mellitus with fasting blood glucose levels between 100 and 109 mg/dL in which prediabetes occurs according to HbA1c, to correlate both variables and to quantify the probability that this predicts with respect to others with fasting blood glucose levels <100 mg/dL. Materials and methods: 1.002 samples from the same number of subjects from 45 clinical laboratories belonging to ALAC, with local processing of blood glucose and centralized processing of HbA1c by high performance liquid chromatography (HPLC). Statistical analysis: chi square, odds ratio, Pearson correlation coefficient, coefficient of determination and Durbin-Watson serial correlation. Results: frequency of HbA1c ≥5.7% in the studied population with fasting blood glucose levels between 100 and 109 mg/ dL = 29.7%, chi square test: p<0.001; odds ratio of having HbA1c ≥5.7% between the population with fasting blood glucose levels of 100 to 109 mg/dL vs that one with values <100 mg/dL=4.328 (95% CI 2.922-6.411); r=0.852, r2 =0.727, DurbinWatson=1.152. Conclusions: prediabetes diagnosed by HbA1c was four times more frequent in the studied population with fasting glucose values between 100 and 109 mg/dL than in that one with values below 100 mg/dL.

RELATIONSHIP OF PSYCHOLOGICAL WELL-BEING WITH BLOOD GLUCOSE LEVELS OF DIABETIC TYPE II PATIENTS

The study was analysed to ?nd out the relationship of psychological well being with blood glucose levels of diabetic type II subjects. Only aged male patients (N=30) were selected as subjects for this study and age ranged from 45 to 55 years. The fasting blood glucose level was measured for the measurement of these glucose levels to the nearest mg/dl. Carol Ryff psychological well-being questionnaire was used for measuring the psychological well-being. Co- ef?cient correlation method was applied to investigate the relationship of depression with blood glucose levels. The results of this study suggest that there is a negative relationship between blood glucose level and the psychological well-being at 0.05 level of con?dence.

Indian Diabetes Risk Score (IDRS): An effective tool to screen undiagnosed diabetes

Background: Diabetes is an insidious public health problem. India has the second largest number of adults living with diabetes worldwide (77 million). Indian Diabetes Risk Score (IDRS) is a simple, cost-effective and feasible tool for mass screening programme at community level. Aim & Objective: To assess diabetes risk in adults aged 30 years and above and to identify high risk subjects for screening undiagnosed diabetes in an urban population of Meerut. Settings and Design: Community based cross-sectional study. Methods and Material: All adults who were ?30 years of age and non-diabetic were interviewed using pre-designed, pre-tested questionnaire for their socio-demographic profile and lifestyle. Fasting Blood glucose of all study subjects were done to screen undiagnosed diabetics. Statistical analysis used: Centers for Disease Control (CDC), Epi Info TM 7.2.3.1 was used. Pearson’s Chi Square were applied. Results: 33.4% were found to have high diabetes risk. Risk of diabetes increases with age. 7.6% of the study subjects were found to be diabetic and were unaware of their diabetic status. Physical inactivity and increasing waist circumference were found to be significantly associated with risk of diabetes. Diabetes risk was also significantly associated with positive family history. Conclusions: Screening and early identification of high risk individuals would help in early diagnosis and treatment to prevent or to delay the onset of diabetes mellitus and its complications.

The relationship between cumulative fasting blood glucose exposure and all-cause mortality / 中华内分泌代谢杂志

Objective:To investigate the relationship between cumulative fasting blood glucose(cumFPG)exposure and all-cause mortality.Methods:The prospective cohort study included 56 845 subjects of Kailuan Group who participated in physical examinations from 2006 to 2007, 2008 to 2009, and 2010 to 2011 with complete data and a median of 7.77 years of follow up. The end point event was all-cause mortality. The incidence of all-cause mortality was compared in various groups divided by four quartile of cumFPG. The Cox proportional hazards model and natural spline were used to analyze the effect of cumFPG on all-cause mortality.Results:During the average(7.77±1.05)years of follow-up, the incidence density of all-cause mortality was on the rise with the increase of cumFPG(4.93, 5.87, 8.48, and 14.02 per 1 000 person-years), with statistically significant difference by Log- rank test( P<0.001). Cox proportional hazards model showed that after adjusting for potential confounding factors(age, sex, body mass index, hypertension, baseline fasting plasma glucose), the HR value(95% CI)of all-cause mortality in the fourth quartile group was 1.28(1.15-1.42)compared to the first quartile. When cumFPG increased every standard deviation, the risk of all-cause mortality increased by 17%. Natural spline analysis exhibited a similar J curve relationship between cumFPG and all-cause mortality. Conclusion:High cumFPG is a risk factor of all-cause mortality.

Glucemia materna de primer trimestre de embarazo y probabilidad de padecer diabetes gestacional. Categorización según índice de masa corporal pregestacional / Maternal glycemia of first trimester of pregnancy and probability of suffering gestational diabetes. Categorization according to pregestational body mass index

Introducción: la glucemia de ayuno >85 mg/dl en el primer trimestre de embarazo es uno de los factores de riesgo para el desarrollo de diabetes gestacional (DG). El aumento del sobrepeso y obesidad en las mujeres en edad fértil junto con la ganancia de peso excesiva a lo largo del embarazo son predisponentes para el desarrollo de esta patología, además de favorecer el estado de hipertrigliceridemia materna que en su conjunto predisponen a la macrosomía fetal. Entender la asociación entre estas variables es de importancia para individualizar el riesgo y tomar conductas precoces a fin de disminuir las complicaciones materno/fetales. Objetivos: primario: determinar la probabilidad de desarrollar DG según glucemia de ayunas del primer trimestre de embarazo (GA1erT>85 mg/dl) por categoría de índice de masa corporal (IMC), edad y ganancia de peso materno. Secundario: comparar trigliceridemia (TG) materna del último trimestre, peso fetal y glucemia de ayuno (GA) de prueba de tolerancia oral a la glucosa (PTOG) según IMC en pacientes con y sin DG. Determinar la prevalencia de macrosomía. Materiales y métodos: se analizaron historias clínicas (HC) de pacientes con DG de la Unidad de Diabetes y Embarazo y del Servicio de Maternidad de pacientes sin DG del Hospital Perrupato, San Martín, Mendoza. Los criterios de inclusión fueron: edad >18 años, registros completos de historias clínicas y diagnóstico de DG por PTOG. Se incluyeron 127 HC de pacientes con DG y 169 HC de pacientes sin DG, y se categorizaron según IMC pregestacional: IMC <24,9, IMC 25-30 y IMC >30. Resultados: para la variable de GA1erT>85 mg/dl en la categoría de IMC <24,9 la probabilidad de padecer DG fue 15 veces superior respecto a presentar un valor glucémico inferior, para el IMC 25-30 fue 9,2 veces más probable, mientras que para el IMC >30 fue 10,7 veces más probable, con efecto de magnitud grande para las tres categorías de IMC. No hubo diferencias entre peso fetal entre las distintas categorías de IMC analizadas (p=0,14, 0,36 y 0,59 respectivamente). Se observó aumento en el valor de GA de la PTOG en todas las categorías de IMC del grupo con DG (p=0,002, 0,01 y <0,001 respectivamente). La TG materna del último trimestre fueron significativamente más altos en las categorías de IMC <24,9 y 25-30 (p=0,04 y 0,026 respectivamente). La prevalencia de macrosomía aumentó en relación al incremento del IMC. Conclusiones: la glucemia de ayuno del primer trimestre demostró ser un fuerte predictor de DG en todas las categorías de IMC evaluadas.

Introduction: fasting blood glucose >85 mg/dl in the first trimester of pregnancy is one of the risk factors for the development of gestational diabetes (GD). The increase in overweight and obesity in women of childbearing age, and the excessive weight gain throughout pregnancy, are predisposing to the development of this pathology leading a rol in maternal hypertriglyceridemia, favoring to fetal macrosomia. Understanding the association between these variables is important to individualize the risk and take early behaviors in order to reduce maternal/fetal complications. Objectives: primary: determine the probability of developing GD according to fasting glycemia of the firts trimester of pregnancy (>85 mg/dl) by body mass index (BMI) category, age and maternal weight gain. Secondary: compare maternal triglyceridemia (TG) of the last trimester, fetal weight and fasting glycemia of oral glucose tolerance test (OGTT) according to BMI in patients with and without GD. Determine the prevalence of macrosomia. Materials and methods: medical records (MR) of patients with GD from the Diabetes and Pregnancy Unit and from the Maternity Service of patients without GD from the Perrupato´s Hospital, San Martin, Mendoza. Included were: age over 18 years, complete records of MR, diagnosis of GD by OGTT. 127 MR from patients with GD and 169 MR from patients without GD were included and classified according to pre-pregnancy BMI: BMI <24.9, BMI 25-30 and BMI> 30. Results: GD OR for category A was 15 times, for category B it was 9.2 times and for category C 10.7 times with large magnitude effect for the three categories. There were no differences between fetal weight (p=0.14, 0.36 and 0.59 respectively). fasting glycemia OGTT was significant in all categories (p=0.002; 0.01 and <0.001 respectively), maternal TG in the last trimester were significant in categories A and B (p=0.04 and 0.026 respectively). The prevalence of macrosomia increased in relation to the increase in BMI. Conclusions: fasting blood glucose of the first trimester is a strong predictor of DG in all evaluated categories.

Prevalence of diabetes and glycemic control in Mexico: national results from 2018 and 2020 / Prevalencia de diabetes y control glucémico en México: resultados nacionales 2018 y 2020

Abstract: Objective: To estimate the prevalence of diabetes (diagnosed and undiagnosed), glycemic control in Mexico, and its associated factors. Materials and methods: We used data from Ensanut 2018 (n=12 648) and 2020 (n=2 309). We defined diabetes as fasting glucose ≥126 mg/dl or HbA1c≥6.5% or previously diagnosed; glycemic control was defined as HbA1c<7%. We fitted Poisson regression models to assess the association between diabetes, glycemic control, and potential associated factors. Results: The total prevalence of diabetes was 16.8% in 2018 and 15.7% in 2020. In 2018, 38% of adults with diabetes were unaware of their disease, while in 2020 this figure was 29%. Glycemic control was observed in 42% of participants in 2018 and 39% in 2020. Longer disease duration was associated with lower glycemic control, while older age, having a diet, and being affiliated to IMSS, Pemex, Sedena, or private healthcare were associated with better control. Conclusion: Mexico is among the countries with the highest diabetes prevalence. A high proportion of adults with diabetes did not have a previous diagnosis, and the proportion with glycemic control is low. Strengthening screening to achieve a timely diagnosis, and improving glycemic control, should be key actions in the management of diabetes.

Resumen: Objetivo: Estimar la prevalencia de diabetes total (diagnosticada y no diagnosticada), control glucémico en México y sus factores asociados. Material y métodos: Se analizó información de la Ensanut 2018 (n=12 648) y 2020 (n=2 309). Se definió diabetes como glucosa en ayunas ≥126 mg/dl o HbA1c≥6.5% o diagnóstico previo; se consideró control glucémico si HbA1c<7%. Usando modelos de regresión de Poisson, se estimaron los factores asociados con diabetes y control glucémico. Resultados: La prevalencia de diabetes fue de 16.8% en 2018 y 15.7% en 2020. En 2018, 38% de los adultos con diabetes desconocían su enfermedad, en 2020 fue 29%. El control glucémico se observó en 42% de los participantes en 2018 y en 39% en 2020. Mayor tiempo de diagnóstico se asoció con descontrol glucémico mientras que mayor edad, seguir una dieta y estar afiliado al IMSS, Pemex/Sedena o privados se asoció con control glucémico. Conclusión: México se encuentra entre los países con mayor prevalencia de diabetes. Una alta proporción de adultos con diabetes no tenía un diagnóstico previo y la proporción con control glucémico es baja. Fortalecer la detección, el diagnóstico oportuno y el control glucémico es clave para el manejo de la diabetes.

Prevalencia de diabetes mellitus y glucemia en ayuno alterada al momento del diagnóstico de cáncer de páncreas, en un grupo de pacientes asistidos en un centro de referencia gastroenterológico en Argentina / Prevalence of diabetes mellitus and altered fasting blood glucose at the time of pancreatic cancer diagnosis, in a group of patients assisted in a gastroenterological referral center in Argentina

Introducción: la diabetes mellitus (DM) se considera un factor de riesgo para el desarrollo de adenocarcinoma ductal de páncreas (ACDP). Objetivos: describir la prevalencia de DM y glucemia en ayuno alterada (GAA) al diagnóstico de ACDP en pacientes asistidos en un centro de referencia gastroenterológico; analizar las diferencias en las características personales y nutricionales en pacientes con ACDP y DM, ACDP y GAA, y ACDP sin DM ni GAA; establecer el tiempo transcurrido desde el diagnóstico de DM hasta diagnosticar ACDP. Materiales y métodos: de octubre de 2019 a marzo de 2020 se revisaron 465 historias clínicas de las Secciones Oncología y Nutrición de pacientes >18 años con diagnóstico de ACDP. Resultados: se registraron 171 historias clínicas (36,7%) con ACDP y DM, y 294 (63,2%) con ACDP sin DM. En el 45,1% de las primeras, el intervalo entre el diagnóstico de DM y el de ACDP fue <1 año, y en el 17,65%, 15,69% y 21,57% los lapsos correspondieron a 1 y 5 años, entre 5 y 10 años y >10 años respectivamente. Conclusiones: la prevalencia de DM en ACDP fue superior a la registrada en la población general (37% vs 12,7%), siendo del 45,10% cuando se presentó dentro del primer año del diagnóstico oncológico. Nuestros resultados concuerdan con la bibliografía internacional que relaciona la DM de reciente diagnóstico como factor asociado a la presencia de ACDP por factores de riesgo compartidos, variables fisiopatológicas de la DM o a consecuencia de la terapéutica farmacológica de la misma.

Introduction: diabetes mellitus (DM) is considered to be a risk factor for the development of pancreatic ductal adenocarcinoma (PDAC). Objectives: describe the prevalence of DM and of impaired fasting glucose (IFG) at the diagnosis of PDAC, among patients assisted in a gastroenterological reference center. Analyze differences in personal and nutritional characteristics in patients with both PDAC and DM; with both PDAC and IFG; and with PDAC but neither DM nor IFG. Determine the time lapse between the diagnosis of DM and the diagnosis of PDAC. Materials and methods: between October 2019 and March 2020, we analyzed 465 clinical records of PDAC-diagnosed patients over 18 years, from Oncology and Nutrition Sections. Results: 171 clinical records (36.7%) showed both PDAC and DM; 294 clinical records (63.2%) showed PDAC but not DM. In 45.1% of the former, the interval between the diagnosis of DM and that of PDAC was <1 year, and in 17.65%, 15.69% and 21.57%, the lapses corresponded to 1 and 5 years, between 5 and 10 years y >10 years, respectively. Conclusions: the prevalence of DM in PDAC patients (37%) is higher than that registered in the overall population (12.7%), reaching a 45.10% when detected during the first year of oncological diagnosis. Our results match the international literature relating recently-diagnosed DM with the presence of PDAC, as effect of shared risk factors between both diseases, or DM pathophysiology factors, or DM pharmacological therapeutic

Mechanism of Astragali Radix Vesicle-like Nanoparticles for Reducing Blood Glucose in db/db Diabetic Mice by Regulating Gut Microbiota / 中国实验方剂学杂志

Objective:To study the extraction method and characteristics of vesicle-like nanoparticles （VLNs） in Astragali Radix decoction， and to explore the mechanism of the VLNs in reducing blood glucose by regulating the gut microbiota of db/db diabetic mice. Method:Ultracentrifugation and size exclusion chromatography were used to enrich VLNs from Astragali Radix decoction， and the morphology， particle size and concentration of the VLNs were analyzed by transmission electron microscope and nanoparticle tracking analyzer. The db/db diabetic mice were randomly divided into model group， Astragali Radix VLNs high-， medium- and low-dose （21.1， 10.6， 5.3 g·kg^-1） groups and metformin group （0.25 g·kg^-1） according to their blood glucose levels. There were 7 mice in each group， and another 7 C57BL/6 mice were set as the normal group. The mice were given intragastrically for 3 weeks （once a day）， and the changes of fasting blood glucose were observed every week. Hematoxylin-eosin （HE） staining was used to observe the pathological morphology of liver and pancreas of diabetic mice. The feces of mice were collected for 16S rRNA diversity detection of intestinal microbes. Result:The size of the nanoparticles obtained by the two methods was about 200 nm. Astragali Radix VLNs extracted by ultracentrifugation had a typical saucer-like shape with the concentration of 3.0×10¹¹ particles·mL^-1. The morphology of Astragali Radix VLNs obtained by size exclusion chromatography was relatively poor with the concentration of 2.2×10¹¹ particles·mL^-1. After 3 weeks of administration， compared with the model group， Astragali Radix VLNs high-， medium- and low-dose groups could significantly reduce the fasting blood glucose of diabetic mice （<italic>P</italic><0.05， <italic>P</italic><0.01）. The VLNs could improve the gut microbiota dysbiosis， significantly decrease the ratio of Firmicutes/Bacteroidota， and increase the relative abundance of beneficial bacteria and reduce the relative abundance of harmful bacteria. Conclusion:Astragali Radix VLNs may reduce the blood glucose of db/db diabetic mice by adjusting the ratio of Firmicutes/Bacteroidota in the intestinal flora.

The relationship between impaired fasting blood glucose and blood indicators based on random forest: a follow-up cohort risk prediction study / 中国实用护理杂志

Objective:To explore the relationship between blood test indicators and their changes and impaired fasting blood glucose, and to conduct risk prediction research.Methods:This study selected people who underwent a physical examination at a health management center in Jinan from 2018 to 2019, with an interval of 6 months or more between the two physical examinations, and had no history of diabetes and normal fasting blood sugar during the first year of the physical examination. We took the fasting blood glucose level in the second year as the dependent variable, and took the general examination and blood test indicators in the first year as well as the changes of these indicators as independent variables to construct the model. First, the random forest model was used to screen the independent variables, and then the logistic regression model is fitted to calculate the effect values of the independent variables.Results:A total of 4 416 subjects were enrolled in this study. After a 1-year follow-up, 3.45% (133/3 851) subjects developed prediabetic blood glucose, and 0.42% (16/3 851) developed diabetic blood glucose. The sensitivity of the model using blood test indicators to predict the risk of impaired fasting blood glucose after 1 year was 67.1%, and the specificity was 100.0%. The risk of impaired fasting blood glucose after 1 year was high in the population with older age ( OR value was 1.024, 95% CI 1.014-1.035), higher systolic blood pressure ( OR value was 1.018, 95% CI 1.011-1.025), higher body mass index ( OR value was 1.079, 95% CI 1.036-1.125), higher uric acid ( OR value was 1.003, 95% CI 1.002-1.005), higher glutamyl transpeptidase ( OR value was 1.006, 95% CI 1.003-1.010), lower creatinine ( OR value was 0.971, 95% CI 0.957-0.985), lower AST/ALT ( OR value was 0.614, 95% CI 0.411-0.917)) and lower estimated glomerular filtration rate ( OR value was 0.972, 95% CI 0.958-0.988). The sensitivity of the model using the changes of blood test indicators to predict the risk of impaired fasting blood glucose after 1 year was 65.2%, and the specificity was 99.7%. The risk of impaired fasting blood glucose is high in the population with increased triglycerides ( OR value was 1.152, 95% CI 1.057-1.257), increased alkaline phosphatase ( OR value was 1.021, 95% CI 1.012-1.030), increased albumin ( OR value was 1.087, 95% CI 1.029-1.148), increased aspartate aminotransferase ( OR value was 1.006, 95% CI 1.003-1.009), increased weight ( OR value was 1.049, 95% CI 1.019-1.081) within 1 year. Conclusions:The possibility of impaired fasting blood glucose after 1 year is high in the population with older age, higher systolic blood pressure, higher body mass index, higher uric acid, higher glutamyl transpeptidase, lower creatinine, lower AST/ALT and lower estimated glomerular filtration rate. The possibility of impaired fasting blood glucose is high in the population with increased triglycerides, increased alkaline phosphatase, increased albumin, increased aspartate aminotransferase and increased weight with in 1 year. When the above situation occurs in the physical examination, the blood glucose should be monitored and timely intervention should be taken to prevent the development of diabetes.

Factores de riesgo de diabetes gestacional en mujeres embarazadas de una maternidad de La Habana / Risk Factors for Gestational Diabetes in Pregnant Women at a Maternity Hospital in Havana

Introducción: La diabetes gestacional constituye la enfermedad endocrina más frecuente del embarazo y aparece generalmente cuando existen factores de riesgo. Objetivo: Describir los factores de riesgo de la diabetes gestacional. Métodos: Estudio transversal-descriptivo de una base de datos que incluyó a 242 mujeres con diabetes gestacional, atendidas en el Hospital Ginecobstétrico América Arias de La Habana, en el periodo 2004-2006. Se analizaron variables categóricas (dicotómicas), consideradas como factores de riesgo de diabetes gestacional: diabetes en familiar de primer grado, edad ≥ 30 años, peso pregestacional excesivo, historia de diabetes gestacional, macrosomía fetal y muerte fetal inexplicable, hipertensión arterial relacionada con embarazo y glucemia en ayunas de riesgo . Se efectuó análisis porcentual (determinación de frecuencias relativas). Resultados: La media de edad fue 29,2 ± 5,3 años y de índice de masa corporal, 27,1 ± 4,2 kg/m2. Un 96,69 por ciento tenía factores de riesgo y 79,49 por ciento de estas, más de uno, los más frecuentes fueron: glucemia en ayunas de riesgo (64,53 por ciento), edad; 30 años (60,26 por ciento) y peso pregestacional excesivo (51,71 por ciento). Predominó la forma combinada de presentación de factores de riesgo, en forma única solo se presentó: glucemia en ayunas de riesgo (14,57 por ciento), diabetes en familiar de primer grado (8,43 por ciento), edad 30 años (7,80 por ciento) y peso pregestacional excesivo (5,79 por ciento). Conclusiones: Los factores de riesgo de diabetes gestacional se presentaron en la mayoría de las mujeres con la enfermedad, fundamentalmente de forma combinada(AU)

Introduction: Gestational diabetes is the most frequent endocrine disease of pregnancy and generally appears when there are risk factors. Objective: To describe the risk factors for gestational diabetes. Methods: Cross-sectional and descriptive study of a database that included 242 women with gestational diabetes, treated at América Arias Gyneco-obstetric Hospital in Havana, in the period 2004-2006. Categorical (dichotomous) variables were analyzed, considered as risk factors for gestational diabetes: diabetes in a first-degree relative, age equal to or over 30 years, excessive pre-pregnancy weight, clinical history of gestational diabetes, fetal macrosomia and unexplained fetal death, pregnancy-related high blood pressure, and at-risk fasting blood glucose. Percentage analysis (determination of relative frequencies) was carried out. Results: The mean age was 29.2±5.3 years. The mean body mass index was 27.1±4.2 kg/m2. 96.69 percent had risk factors; 79.49 percent of these had more than one risk factor. The most frequent were at-risk fasting blood glucose (64.53 percent), age equal to or over 30 years (60.26 percent), and excessive pre-pregnancy weight (51.71 percent). There was a predominance in manifestation of combined risk factors; manifestation of one risk factor alone occurred only in at-risk fasting blood glucose (14.57 percent), diabetes in first-degree relative (8.43 percent), age equal to o over 30 years (7, 80 percent), and excessive pre-pregnancy weight (5.79 percent). Conclusions: The risk factors for gestational diabetes appeared in the majority of women with the disease, mainly in combination(AU)

Adiponectin and Body Mass Index in Type 2 Diabetes Mellitus

Introduction: Foot Ulcer is the most frequent complicationof Diabetes Mellitus related to lower extremities with highmorbidity. Infection is an important component of foot ulcer.The present study was undertaken to study the clinical andmicrobiological profile of diabetic foot ulcer in a tertiary carecenter.Material and Methods: It is a prospective observational studywhich has been conducted at VIMSAR, Burla from November2017 to November 2019. Consecutive patients of Diabeticfoot ulcers were included in this study. After admissiondetailed history and biochemical investigations were donein all cases. Nerve Conduction study, doppler of lower limbwere performed to assess peripheral neuropathy and vasculardisease. The ulcers were graded according to Wagner’sstaging. Swabs were taken for culture and sensitivity.Results: Out of 1234 patients of DM admitted to the hospital,116 (9.4%) patients had foot ulcer. There were 87 (75.0%)males and 29 (25.0%) females with M:F ratio of 3:1. 95(81.9%) patients were from rural and 21 (18.1%) from urbanarea. Majority (n=44, 38.0%) of patients belonged to 51-60years of age and only 3 (2.0%) were within 21 to 30 years.Type-1 and -2 DM was found in 4 (3.0%) and 112 (97.0%)patients and the duration of DM was given. Grade-2 ulcerwas found in 62 (53.5%) cases. Risk factors like peripheralneuropathy, retinopathy and nephropathy were present in(n=65, 56.1%), 24 (20.7%) and 35 (30.1%) cases respectively.Early signs of ulcerative lesion like abundant callus, crackfoot, blistering was present in 28 (24.1%), 54 (46.6%),10(8.6%) cases respectively.Conclusion: This study showed that foot ulcer is a commonchronic complication of DM mostly found in elderly patientswith poor glycemic control from rural areas. S.aureus andP.aeruginosa are the common organisms detected from theulcer.

Evaluation of hyperglycaemic risk of atorvastatin: a dose dependent study on hyperlipidaemic rats

Background: Statins (?-hydroxy ?-methylglutaryl-CoA (HMG-CoA) reductase inhibitors) are the most prescribed medications worldwide to treat hyperlipidaemia with a proven ability to reduce major cardiovascular events. Recent data have revealed that statin therapy is associated with an increased risk for developing diabetes. The risk was most significant in patients taking atorvastatin, rosuvastatin and simvastatin.Methods: Rats were divided into 3 groups, each comprising of 6 rats. Hyperlipidaemia was induced in all the animals after feeding with high fat diet for 15 days. Rats of groups 1, 2 and 3 were given atorvastatin 1.8 mg/kg (low-dose), 3.6 mg/kg (moderate-dose) and 7.2 mg/kg (intensive-dose) respectively orally for 60 days. 12 hours fasted blood samples were collected and analyzed for serum lipid profile, fasting blood glucose and HbA1c levels.Results: The percentage increase in plasma blood glucose after 60 days of treatment in groups 1, 2, and 3 is 29.93%, 60.03% and 72.42% respectively and the variation in all the groups is statistically significant, p<0.0001. Regarding HbA1c values, the variation in low-dose group is statistically insignificant whereas the percentage increase in moderate-dose and intensive-dose groups is 19.45% (p<0.001) and 43.37% (p<0.0001) respectively.Conclusions: In conclusion, there is significant increase in blood glucose and HbA1c levels leading to new-onset diabetes in both moderate-dose and intensive-dose groups. The risk is more in intensive-dose group when compared to moderate-dose group.