Socio-Demographic, Clinical and Diabetes Status of Foot Ulcer Patients

Background: Foot ulcers are considered as a serious complication, especially for patients with diabetes. People with diabetes and people with peripheral vascular disease are more likely to develop foot ulcers. If an infection occurs in an ulcer and is not treated in the proper way, it can develop into cellulitis, osteomyelitis, or gangrene that may require some part of the toe, foot, or lower leg to be amputated. The aim of this study was to find the socio-demographic, clinical, and diabetes status of foot ulcer patients. Material & Methods: This prospective observational study was conducted in the Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, during the period from March 2012 to August 2012. In total 100 patients with foot ulcers in the different surgical units of the mentioned hospital were enrolled in this study as study subjects. Data from the study regarding age, sex, occupation, smoking habit, and socio-demographic condition were recorded in the prescribed questionnaire. The purposive sampling technique was used for this study. All data were processed, analyzed, and disseminated using MS Excel and SPSS version 23 programs as necessary. Results: In this study, the male-female ratio of the participants was 2:1. The maximum number of patients (42%) were from the age of 51-60 years and the highest number of patients were housewives (28%), followed by farmers (22%). Among the total male patients, 87.88% were smokers. Low HDL was found in 51% of patients and 68% of patients had been suffering from diabetes mellitus,18% from Buerger’s disease and 6% from atherosclerosis, and 8% from malignant foot ulcer. Most of the diabetic patients (95.59%) were hyperglycemic on admission and 55.88% had diabetes for 6-10 years. On admission, 3 patients (4.41%) had controlled blood sugar and 65 patients (95.59%) had uncontrolled blood sugar. Conclusion: The frequency of foot ulcers among the male population was higher than that in females. Concerning occupation of the patients, housewives and farmers were the most prevalent. Smokers were most affected groups among the study population. Pre-diagnosed diabetes mellitus for a long period was one of the major clinical issues in most of the patients. Uncontrolled blood sugar was also seen in majority of the patients regarding clinical background.

Simultaneous measurement of HbA1C and Hemoglobin by Turbidimetric inhibition immunoassay from a single punch of dried blood spot samples

Hemoglobin and glycosylated hemoglobin (HbA1C) are frequently monitored health indicators in population based studies for information about the status of nutrition and diabetes control. We present here possibly for the first time the findings of simultaneous estimation of Hemoglobin and HbA1C on Dried blood spot (DBS) samples by a single test. Validation was done by turbidimetric inhibition immunoassay (TINIA) using Roche Integra 400 plus instrument. Paired whole blood and DBS samples were tested for HbA1C estimation by Integra 400 plus. Total hemoglobin values obtained during HbA1C estimation were compared with hemoglobin values estimated by Coulter AcT 5 Diff CP Hematology counter. Agreement in HbA1C and hemoglobin values between paired whole blood and DBS samples was found to be high with R2 values of 0.994 and 0.9349, respectively. Intra- and inter- assay precision was found to be within 10% for both parameters. Values obtained after assaying DBS samples prepared by spotting proficiency samples on Whatman 903 protein saver cards demonstrated acceptable standard deviation indices resulting in successful participation in EQAS programs for both these parameters. The results reveal the potential of TINIA for simultaneous estimation of hemoglobin and HbA1C from a single punch of the DBS samples.

Analysis of blood glucose fluctuations and related influencing factors in non-diabetic patients with type A aortic dissection after surgery / 中华内分泌外科杂志

Objective:To investigate the influencing factors of blood glucose fluctuation after surgery for type A aortic dissection in non-diabetic patients.Methods:A total of 109 patients with non-diabetic type A aortic dissection who underwent surgical treatment in Ningbo Medical Center Li Huili Hospital from Dec. 2016 to Mar. 2022 were selected as the research subjects. Logistic regression analysis was used to explore the influencing factors of blood glucose fluctuation in non-diabetic patients with type A aortic dissection surgery, and a nomogram model of blood glucose fluctuation in non-diabetic patients with type A aortic dissection surgery was constructed.Results:Logistic regression analysis showed that BMI≥24 kg/m 2, poor sleep quality, depression, cardiopulmonary bypass time>5 h and intraoperative bleeding were the risk factors for postoperative blood glucose fluctuation in non-diabetic type A aortic dissection patients ( P<0.05). The C-index of the nomogram model was 0.746 (95% CI: 0.711-0.781) ; the calibration curve was in good agreement with the ideal curve; the AUC of the nomogram model was 0.804. Conclusion:BMI≥24 kg/m 2, poor sleep quality, depression, cardiopulmonary bypass time>5 h and intraoperative bleeding are risk factors for postoperative blood glucose fluctuation in non-diabetic type A aortic dissection patients.

Clinical study on the comprehensive treatment of diet and Chinese medicine on type 2 diabetes mellitus based on pattern differentiation / 国际中医中药杂志

Objective:To explore the effectiveness and safety of comprehensive treatment of type 2 diabetes mellitus (T2DM) based on syndrome differentiation and diet.Methods:Prospective clinical study. A total of 147 patients with T2DM from September 2021 to August 2022 who met the inclusion criteria were included in the self-controlled trial. On the basis of diet and exercise intervention, the subjects were treated and observed with comprehensive treatment based on syndrome differentiation for 120 days. The main outcome indicators including TCM symptom score, fasting blood glucose (FPG), 2 hPG, HbA1c , Fasting insulin (FINS), C-peptide(C-PR), and the secondary outcome indicators including blood lipid (TC, TG, HDL-C, LDL-C), blood pressure, and safety indicators were performed before and after treatment.Results:After treatment, the FPG of subjects decreased from (8.75±2.26) mmol/L to (7.05±1.23) mmol/L, 2 hPG decreased from (10.75±3.01) mmol/L to (7.07±0.78) mmol/L, HbA1c decreased from (6.82±1.47)% to (5.49±0.63)%, and FINS decreased from (15.4±9.33) μIU/ml to (8.82±7.28) μIU/ml, C-PR decreases from (1.95±0.91) nmol/L to (1.72±1.53) nmol/L, SBP decreased from (137.51±17.94) mmHg to (125.79±7.57) mmHg, DBP decreased from (82.85±9.65) mmHg to (77.54±6.21) mmHg,TG decreased from (1.57±1.04) mmol/L to (1.25±1.24) mmol/L, HDL-C increased from　(1.48±0.41) mmol/L to (1.66±0.46)mmol/L. The above differences were statistically significant ( P<0.05). Conclusion:The comprehensive treatment of T2DM based on syndrome differentiation and diet can significantly reduce the blood glucose indicators including FPG, 2 hPG, HbA1c, FINS and C-PR, and benefit blood pressure and blood lipids with no adverse reactions.

The Effect of Mindfulness-Based Stress Reduction Counseling on Blood Glucose and Perceived Stress in Women with Gestational Diabetes / O efeito do aconselhamento para redução do estresse baseado na atenção plena sobre a glicose no sangue e o estresse percebido em mulheres com diabetes gestacional

Abstract Objective Gestational diabetes can cause maternal and neonatal morbidity. Psychological factors, especially stress, play a meaningful role in diabetes management. Therefore, the present study aimed to investigate the effect of Mindfulness-Based Stress Reduction counseling on blood sugar and perceived stress in women with gestational diabetes. Methods The present quasi-experimental interventional study was performed on 78 women with gestational diabetes. In the intervention group, a Mindfulness-Based Stress Reduction counseling program was conducted by the researcher in 8 sessions of 90 minutes twice a week. The Cohen stress questionnaire was filled in both groups. Also, fasting blood sugar and 2-hour blood sugar levels were measured in both groups. Statistical analysis was performed using the independent T-Test, the paired T-Test, the Mann-Whitney and Wilcoxon Tests using IBM SPSS Statistics for Windows version 20 version (IBM Corp., Armonk, NY, USA). Results The mean age of pregnant women in the intervention group was 28.84 ± 6.20 years old and 29.03 ± 5.42 years old in the control group. There was a significant mean difference between the fasting blood sugar score (p= 0.02; - 6.01; and - 11.46) and the 2-hour fasting blood sugar score (p< 0.001;12.35; and - 5.3) and the perceived stress score (p< 0.001; 35.57; and - 49.19) existed between the intervention and control groups after the intervention. Conclusion The results of the present study showed that mindfulness-based stress reduction counseling is effective in reducing blood sugar levels and reducing perceived stress in women with gestational diabetes treated with diet.

Effect of Electroacupuncture at “Fenglong”（ST 40） on Liver Lipid Synthesis and Insulin Resistance in Hyperlipidemic Model Rats / 中医杂志

ObjectiveTo explore the effect and possible mechanism of electroacupuncture （EA） at Fenglong （ST40） on liver lipid synthesis and insulin resistance （IR） in hyperlipidemic （HLP） rats. MethodEighteen rats were randomly divided into three groups， blank group， model group， and EA group， each consisting of six rats. The blank group rats were with fed a basic diet， while those in the model group and EA group were fed high-fat diet for 8 weeks. After modeling， the rats in the EA group received bilateral EA treatment at “Fenglong” （ST 40）. The rats in the model group underwent daily binding treatment， once a day， continuously 5 days a week， for a total of 4 weeks. Following the intervention， the levels of triglycerides （TG） and free fatty acids （FFA） in liver tissue was determined using ELISA. Serum TG， FFA， fasting insulin （FINS）， alanine transaminase （ALT）， aspartate Transaminase （AST）， tumor necrosis factor-ɑ （TNF-ɑ）and interleukin 6 （IL-6） were also measured. The fasting plasma glucose （FBG） assessed using a glucose meter and the homeostatic model assessment of insulin resistance （HOMA-IR） was calculated. Liver pathology was examined through HE staining and oil red O staining. The expression of hepatic sterol regulator binding protein 1c （SREBP1c）， recombinant fatty acid synthase （FASN） and stearoyl-CoA desaturase 1 （SCD1） were detected through immunofluorescence. The protein expression levels of liver insulin receptor substrate 1 （IRS1） and tyrosine-phosphorylated insulin receptor substrate 1 （p-IRS1-Tyr） were determined via Western blot. ResultsWhen compared to the blank group， the model group of rats exhibited elevated serum and liver tissue levels of TG and FFA， as well as increased serum levels of AST， ALT， TNF-α， IL-6， FBG， FINS， and HOMA-IR （P＜0.05）. HE staining revealed disordered arrangements of liver cells， indicating widespread fatty degeneration. Oil red O staining showed abundant bright red lipid droplets within liver cell cytoplasm， indicating severe lipid accumulation. The average fluorescence intensity of SREBP1c， FASN， and SCD1 in liver tissue significantly increased （P＜0.05）， while p-IRS1-Tyr protein expression levels significantly decreased （P＜0.05）. In comparison to the model group， the EA group of rats showed significantly reduced serum and liver tissue levels of TG and FFA， along with decreased serum levels of AST， ALT， TNF-α， IL-6， FBG， FINS， and HOMA-IR （P＜0.05）. HE staining indicated more regular arrangements of liver cells， and oil red O staining revealed a significant reduction in liver cell lipid droplets， indicating a less severe degree of lipid accumulation. The average fluorescence intensity of SREBP1c， FASN， and SCD1 in liver tissue significantly decreased （P＜0.05）， while p-IRS1-Tyr protein expression levels significantly increased （P＜0.05）， with no significant difference in IRS1 protein expression （P＞0.05）. ConclusionEA at “Fenglong” （ST 40） can significantly decrease serum lipid in HLP rats， improves liver fat accumulation， and also ameliorate insulin resistance. The mechanism may be related to the inhibition of hepatic lipid synthesis molecule expression， reduced serum inflammatory factors， and an increase in insulin substrate receptor phosphorylation levels.

Effect of Hyperglycemia on the Duration of Hospital Stay and Rate of Mortality in Patients of Chronic Obstructive Pulmonary Disease in Acute Exacerbation: A 1-year Hospital-based Observational Study

Background: Chronic obstructive pulmonary disease (COPD) is not only a respiratory disease but is also a systemic disease associated with comorbidities such as diabetes mellitus (DM), hypertension, osteoporosis, etc. Diabetes being one of the comorbidities, COPD is thought to be a causative factor for developing insulin resistance. Similarly, poor glycemic control is associated with worsened COPD outcomes. Thus, this study has been taken up to analyze the effect of hyperglycemia on the duration of hospital stay and rate of mortality, and other outcomes in patients with COPD with exacerbation. Methods: It was an observational study conducted for 1 year in KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, Karnataka, India. A total of 84 patients were enrolled and divided into two groups based on the mean random blood sugar (RBS) levels. Group I had 40 patients with mean RBS <250 mg/dL and group II had 44 patients with mean RBS ?250 mg/dL. Outcomes and variables of the patients with COPD were compared between both groups. Results: Patients in group II had poor outcomes compared to group I. The mean duration of hospital stays in groups I and group II were 5.43 and 7.34, respectively, with a significant p < 0.0001. The mean duration of intensive care unit (ICU) stay was 3.33 and 4.47 in groups I and II, respectively, which was statistically significant. The rate of mortality in groups I and II was 5.00 and 11.36%, respectively. Conclusion: Patients with hyperglycemia had an increased duration of hospital stay and rate of mortality. Optimal glycemic control plays a significant role in patients with COPD in reducing the severity of exacerbation and mortality.

KAP � Knowledge, Attitude, and Practice & Prevalence Study of Diabetes Mellitus among Morning Walkers in the City of Ahmedabad

Background: Growing evidence from knowledge, attitude, and practice (KAP) studies indicates an urgent need to improve diabetes awareness, early diagnosis, risk factor control, and management & disease burden. Objective: Objective of this present study was to know awareness of the diabetes risk factors & management among morning walkers of the city of Ahmedabad and to know the prevalence of diabetes cases among the general population of Ahmedabad. Methodology: The present study is a cross-sectional study based in the Ahmedabad district of Gujarat. After obtaining signed informed consent at first & Data will be collected according to a standard protocol using an interview-based questionnaire, and random blood sugar will be checked using an instant glucometer and strips. Result: The mean 盨D scores of the study population regarding the knowledge, attitude, and practice outcomes were 4.04 � 1.03 ,2.20 � 0.90, 3.80 � 0.85. prevalence of Diabetes Mellitus found in this study is 43.49% which is predicted by value of Random Blood sugar 100-125 and ? 125 mg/dl. Conclusion: Variables other than knowledge and attitude have a role in illness management. Poor self-management, a lack of desire, insufficient social support, or a lack of resources needed for sustained lifestyle adjustment behaviour are all potential explanations.

Iron Profile in Patients with Type II Diabetes Mellitus in — A study in a Tertiary Care Hospital

Background: The most prevalent metabolic condi?on, type 2 diabetes mellitus, is characterized by persistent hyperglycemia caused by abnormali?es in insulin produc?on, insulin ac?on, or both. Iron, a transi?onal metal, has been demonstrated to play a key role in the pathophysiology of Type 2 Diabetes Mellitus, with a bidirec?onal link in which iron influences glucose metabolism, which in turn influences the iron metabolic pathways. The current study aimed to es?mate the iron profile in Type 2 diabetes mellitus cases. Methods: This cross-sec?onal study was done in the Department of Biochemistry, Prathima Ins?tute of Medical Sciences, Naganoor, Karimnagar. A total of n=100 cases of type II diabetes mellitus were included in the study and age and sex-matched healthy controls were also included in the study. Laboratory inves?ga?ons included Fas?ng Blood glucose, Serum ferri?n, Total iron-binding capacity, serum iron, and serum transferrin satura?on. Results: The fas?ng blood glucose was found to be significantly higher in the diabetes mellitus cases. The serum ferri?n mean values were 105.32 µgm/dl. In the controls, the range of ferri?n levels was 145 µgm/dl. The serum ferri?n levels were found to be significantly reduced in the study cases as compared to the controls. Similarly, the total iron-binding capacity (TIBC) of the cases was found to be significantly increased as compared to the controls. The serum transferrin levels were also found to be elevated in the study cases as compared to the controls. Conclusion: Iron is closely related to the development of diabetes mellitus. Elevated iron and ferri?n levels are risk factors for diabetes and can lead to a variety of problems. Conversely in chronic diabe?cs, there is a tendency to develop iron deficiency anemia and other nutri?onal deficiency anemias as observed by the results of the current study. As a result, iron profile evalua?on can be a valuable output of the expected inves?ga?ons on diabetes and related problems.

Association of serum lactate levels among patients with Type 2 diabetes mellitus of a tertiary care hospital, Uttar Pradesh

Background: Serum lactate levels are a direct quantification of gap in between energy-expenditure and oxidative capacity. Variation in the lactate levels among the resting individuals could be exigent, requiring attention often and raised lactate levels can be observed among the individuals with mitochondrial impairments in the oxidative phosphorylation pathways. Aim and Objectives: Aim and objectives of the study was to evaluate the association of serum lactate levels among Type 2 diabetes mellitus patients. Materials and Methods: This present observational cross-sectional study involved 300 diabetic patients who presented to the tertiary care hospital of Uttar Pradesh. The patients were stratified according to their random blood sugar, Glycated hemoglobin and lactate levels. Student t-test was used for assessing the significance, a probability of <0.05 is considered significant. Results: A total of 300 patients have been included in this study, of which 150 are males and 150 are females, the median age was 48 years. The highest age of patient included was 84 years, and the lowest of patient included in the study was 34 years. The patients with high lactate levels are found to have poor glycaemic control, which may further proceed to worst outcome of the disease. Conclusion: Serum lactate levels could be the potential predictor and reliable indicator of poor glycemic control/status of diabetic patients.

Nisha-Amalaki in Uncontrolled Type 2 Diabetes Mellitus- A Case Report

During the last few years India has maximum increase of Type 2 diabetes mellitus. Type 2 diabetes is characterized by high blood sugar, insulin resistance, and relative lack of insulin. There are approximate 72.96 million cases of diabetes mellitus in adult population of India. In modern era single anti-diabetic drug is not sufficient for glucose control. These days multidrug therapy is building its popularity for maintaining glycaemic levels. A 59-year-old female presented with known case of Type 2 diabetes with evidence of polyuria, itching over extremities, and fatigue was poorly controlled despite a drug regimen consisting of oral metformin and glimepiride. Her Blood Sugar level was constantly around 200 mg/dl in spite of having modern medicine with adjusted doses. She has administered Nisha-Amalaki Churna with warm water early in the morning along with standard conventional treatment for 8 weeks. The effect of therapy was evaluated at the interval of 4 weeks for 8 weeks which is done on the basis of objective parameters. Objective parameters were fasting and post prandial Blood Sugar Level. Nisha-Amalaki churna has reduced Blood Sugar Level to normal. It also reduced the dose of conventional drug which may cause side effects with long term use. There is a need for combined multidisciplinary treatment to maintain suggested glycaemic control. Thus, the present case study is to understand the significant effect of Nisha-Amalaki as an adjuvant to standard conventional treatment in chronic uncontrolled type 2 Diabetes Mellitus.

Influence of small-group experiential learning of integrated traditional Chinese and Western medicine on the oral health knowledge, beliefs, and behaviors of elderly patients with diabetes

SUMMARY OBJECTIVE: This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life. METHODS: A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention. RESULTS: Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05). CONCLUSION: The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge-beliefs-behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health.

Effects of standardized treatment combined with medical nutrition intervention on blood glucose level, body mass management and glucose metabolism at 3 months after delivery in patients with gestational diabetes mellitus / 中国基层医药

Objective:To investigate the effects of standardized treatment combined with medical nutrition intervention on blood glucose level, body mass management and glucose metabolism at 3 months postpartum in patients with gestational diabetes mellitus (GDM).Methods:A total of 114 patients with GDM who received treatment in Shunyi District Hospital of Beijing from June 2017 to October 2019 were included in this study. They were randomly divided into observation group ( n = 57) and control group ( n = 57). The control group was treated with standardized therapy, and the observation group was treated with standardized therapy combined with medical nutrition intervention. Blood glucose level, body mass management, glucose metabolism outcomes at 3 months postpartum, pregnancy outcome, and neonatal outcome were compared between the two groups. Results:After treatment, hemoglobin A1c (HbA1c), fasting blood glucose, 2-hour plasma glucose (2hPG) after breakfast, and 2hPG after dinner in the observation group were (5.20 ± 0.34)%, (4.69 ± 0.31) mmol/L, (7.32 ± 2.13) mmol/L, and (7.54 ± 2.36) mmol/L, respectively, which were significantly lower than those in the control group [(6.38 ± 0.42)%, (6.34 ± 0.45) mmol/L, (9.01 ± 2.27) mmol/L, (9.35 ± 2.47) mmol/L, t = 16.48, 22.79, 4.09, 4.00, all P < 0.001]. The increases in body mass and body mass index during pregnancy in the observation groups were (12.19 ± 2.35) kg and (4.52 ± 1.13) kg/m 2, respectively, which were significantly lower than those in the control group [(16.21 ± 2.64) kg, (6.11 ± 1.25) kg/m 2, t = 8.58, 7.12, both P < 0.001]. The abnormal rate of glucose metabolism at 3 months postpartum in the observation group was significantly lower than that in the control group [5.3% (3/57) vs. 8.8% (5/57), χ2 = 0.53, P = 0.462]. The incidences of premature rupture of membranes, polyhydramnios, and cesarean section in the observation group were 5.3% (3/57), 14.0% (8/57) and 15.8% (9/57), which were significantly lower than those in the control group [22.8% (13/57), 35.1% (20/57), 40.4% (23/57), χ2 = 7.27, 6.81, 8.51, all P < 0.05]. There were no significant differences in the incidences of pregnancy-induced hypertension and postpartum hemorrhage between the two groups (both P > 0.05). The incidences of premature births, macrosomia, respiratory distress, neonatal hypoglycemia and hyperbilirubinemia in the observation groups were 5.3% (3/57), 3.5% (2/57), 7.0% (4/57), 3.5% (2/57), 5.3% (3/57), respectively, which were significantly lower than those in the control group [22.8% (13/57), 17.5% (10/57), 21.1% (12/57), 15.8% (9/57), 19.3% (11/57), χ2 = 7.27, 5.96, 5.60, 4.93, 5.21, all P < 0.05). Conclusion:Standardized treatment combined with medical nutrition intervention can effectively reduce blood glucose level in patients with GMD, control body mass, and improve glucose metabolism at 3 months after delivery.

Current situation and influencing factors of blood glucose management in diabetic patients aged 15 and above in Gansu / 公共卫生与预防医学

Objective To analyze the relationship between follow-up service, personal characteristics, lifestyle and blood sugar management of diabetic patients in Gansu Province, and put forward scientific suggestions on influencing blood sugar management of diabetic patients. Methods Based on the data of the 6th National Health Service Questionnaire, 273 subjects were included. Chi-square test and unconditional logistic regression were used to analyze the blood glucose control and its influencing factors of diabetic patients. Results A total of 39.56% patients' blood sugar status was well controlled. 76.92% patients signed up for family doctor service, and 77.66% patients took hypoglycemic drugs according to the law of doctor's advice. There were significant differences in blood sugar control among patients in different regions, educational levels and occupational types (P <0.05) , logistic regression analysis showed that Hui patients (OR=0.21), doctors without family contract (OR=2.86) and patients taking hypoglycemic drugs intermittently (OR = 6.58). Conclusion The blood sugar control rate of diabetic patients in Gansu is low, and the nationality, contracted family doctors and medication plan affect the blood sugar control level of patients. In order to ensure the high efficiency of follow-up treatment, the related follow-up services provided by primary medical institutions, it is necessary to provide self-management programs that meet the individual characteristics and meet the needs of the disease.

Anti-hyperlipidemic and anti-diabetic evaluation of ethanolic leaf extract of Catharanthus roseus alone and in combination therapy

The use of plants in disease treatment is cost effective and relatively safe. This study was designed to investigate anti-hyperlipidemic and anti-diabetic activity of ethanolic leaf extract of Catharanthus roseus alone and in combination therapy in hyperlipidemic & diabetic mice. Eight groups comprising five mice each were used. Group A was hyperlipidemic control, group B, C, D received atorvastatin (20 mg/kg), leaf extract (200 mg/kg) and leaf extract in combination with atorvastatin (200 mg/kg and 20 mg/kg) orally for 15 days. Group E was diabetic control. Group F, G, H received sitagliptin (40 mg/kg), leaf extract (200 mg/kg) and extract in combination with sitagliptin (200 mg/kg and 40 mg/kg) orally for 7 days. Blood cholesterol levels were measured at 1st, 5th, 10th and 15th day and fasting blood sugar levels were measured at 2, 12, 24, 72 and 168 hours during treatment. One-way ANOVA with tukey- kramer multiple comparison test was used. The chemical characterization of ethanolic extract of Catharanthus roseus leaves showed presence of alkaloids, saponins, tannins and flavonoids. Ethanolic extract of Catharanthus roseus has significant anti-hyperlipidemic & anti-diabetic effects (p<0.05, p<0.01) when compared with control but had not cause significantly increase in anti-hyperlipidemic effects of atorvastatin. While significantly increased the antidiabetic effect of sitagliptin (p<0.05)

Association of Duration of Valproic Acid Treatment and Glycemic Indexes among Adult

@#Introduction: Valproic acid (VA) is one of the commonly used for epilepsy, psychiatric problems, and recurrent migraine medication. Long-term use of VA maybe affects the metabolic processes, resulting in the gain of weight and disturbance of glycemic indexes which play an important role in cardiovascular consequences. Unfortunately, these impacts have not been fully understood. The study investigates the long-term impact of VA on the level of fasting blood sugar, 2-hour after-meal blood sugar and HbA1C among adults. Methods: An observational study with the cross-sectional study approach among forty participants (n=21, with less than 1-year medication, and n=19, with the 1 year or more medication) who fulfill the inclusion and exclusion criteria. The level of fasting blood sugar, 2 hours after-meal blood sugar, and HbA1C levels were examined. The two-independent T-test was performed to determine the statistical differences of the level of the fasting blood sugar, 2-hour after-meal blood sugar, and HbA1C from both groups. Results: There are no significant differences in most of the demographic and clinical characteristics of participants except for age, and there are no significant differences in the level of fasting blood sugar, 2-hour after-meal blood sugar, and HbA1C among both groups. Conclusion: There is no significant impact of long-term VA treatment on the homeostatis of blood sugar among adults measured by the level of fasting blood sugar, 2-hour after-meal blood sugar, and HbA1C.

Effect of the antimicrobial photodynamic therapy in the treatment of periodontitis in type 2 diabetes mellitus: a systematic review and meta-analysis / 口腔疾病防治

Objective@#This systematic review and meta-analysis was undertaken to evaluate the efficacy of antibacterial photodynamic therapy (aPDT) in the treatment of periodontitis in type-2 diabetes mellitus (T2DM) patients and to provide better treatment for patients with T2DM complicated with periodontitis.@*Methods@#The PubMed, Cochrane, Embase, Web of Science, CNKI, CBM, and Wanfang databases were searched for relevant randomized controlled trials (RCTs). RevMan 5.3 was applied for the meta-analysis, and a systematic evaluation was conducted.@*Results@#A total of 8 RCTs were included. The results showed that compared to simple subgingival scaling and root planing (SRP), aPDT assisted SRP had a better effect on improving the probing depth (PD) at 3 months after treatment, The difference was statistically significant [WMD=-0.32,95%CI（-0.45, -0.2）, P < 0.05], but 6 months after treatment, there was no significant difference in the two groups [ WMD=-0.15,95%CI（-0.40, 0.10）,P=0.23]. During the 6-month follow-up period, there were no significant differences in the clinical attachment level (CAL), bleeding on probing (BOP) or hemoglobin A1c (HbA1c) between the two groups (P> 0.05).@*Conclusion@#aPDT-assisted periodontal nonsurgical treatment in T2DM patients can improve PD in the short term but has no significant effect on the improvement of CAL, BOP and HbA1c.

Blood Glucose Response to Unilateral and Bilateral Resistance Training Among Trained Women (Respon Glukosa Darah ke atas Latihan Bebanan Satu Anggota Badan dengan Dua Anggota Badan dalam Kalangan Wanita Terlatih) / Jurnal Sains Kesihatan Malaysia

@#Exercise selection is one of crucial factors in designing a comprehensive training programme. The exposure of different exercise selection may stimulate the specific adaptation imposed demand. In the construction of any resistance training (RT) programme, it is important to choose whether to apply bilateral (BI) or unilateral (UNI) exercise. The present study aimed to look into the physiological responses of blood glucose (BG) between UNI and BI RT. Quantitative research method was used, RT (UNI versus BI training) as the independent variables whereas BG set as the dependent variable. In order to measure training effects following a single bout of different training intervention (UNI versus BI), a crossover experimental pre and post test design was implemented. A total of sixteen (n = 16) trained women with mean age of 23 (SD = 1.35) years old went through a single bout of RT involved a total body exercise using major muscles group with 80% of 1RM for each protocols (UNI and BI) for 10 repetitions to maximal effort (for 3 sets). Crossover design would be more accurate in exposing different training protocol to a similar characteristic of individuals as compared using different individuals. The results revealed that blood glucose (BG) were statistically changed (p < .001) across times (between PRE to IP, between PRE and 15P as well as between PRE and 30P), and finding shows there is no difference between training protocols (p = .39). Thus, similar responses of UNI and BI RT on BG concentration provides wide selection of exercise method to practitioners specifically to trained women. Future research on UNI versus BI RT could venture onto other types of hormones analysis including insulin, growth hormone and cortisol can be included. Besides, future research should consider a long run study that involve chronic adaptation of RT on human body in order to prevent and alleviate disease.

Awareness of Effect of Ashwagandha (Withania somnifera) on Blood Sugar Levels - A Survey

Introduction: Ashwagandha (Withania somnifera) is a spice utilized in Ayurveda, the conventional medication of India. Its root has a horsey smell (in Sanskrit, ashva signifies "horse" and gandha signifies "smell") and is said to present the quality and virility of a pony. Different pieces of the plant are utilized, yet the most well-known in supplements is a concentrate of its underlying foundations. Aim: aim of this study is to compare and assess the awareness among people on the effects of ashwagandha on blood sugar levels. Materials and Methods: A well structured questionnaire containing 10 questions was circulated among Indian population. The questionnaire has covered basic demographic data such as age, gender, weight, blood pressure and about the awareness of effects of ashwagandha on blood sugar levels Conclusion: From the above outcomes, it might be presumed that the Withania somnifera root extract can reduce blood sugar levels. It's mindfulness among individuals must be expanded

Study of correlation between adequacy of dialysis and glycemic control in patients of type 2 diabetes mellitus with chronic kidney disease stage 5

Background: The adequacy of haemodialysis in patients of type 2 diabetes mellitus with chronic kidney disease stage 5 depends on several clinical as well as laboratory parameters. Previous studies from Western literature have identified several clinical and laboratory markers for predicting adequacy of dialysis. There is a dearth of literature regarding the same in Indian patient populace. Authors aimed to find correlation, if any, between glycemic control and adequacy of dialysis in this cohort of patients.Methods: A set of 200 patients of type 2 diabetes mellitus who have undergone hemodialysis at a tertiary care hospital were included in the study. Random blood sugar (RBS), Glycated hemoglobin (HbA1c) were measured at admission. After 4 hours of dialysis, the urea reduction ratio (URR) and Kt/V was measured for each patient. The correlation coefficient as well as linear equation of the association between these variables were calculated. Standard statistical method and software were used in the process.Results: The study revealed a linear negative correlation between the variables RBS, HbA1c and URR as well as Kt/V. This suggests the importance of pre dialysis glycemic control in patients undergoing hemodialysis.Conclusions: Authors formulate the hypothesis that glycated hemoglobin and random blood sugar at admission correlate well with the outcome and adequacy of dialysis in patients of stage 5 chronic kidney disease undergoing haemodialysis.  Good glycemic control (HbA1c <6.5 % and RBS <120 mg/dL) have shown to be important predictive markers of adequate dialysis. The hypothesis needs to be tested with a larger study.