Effects of Astragalus membranaceus, Peumus boldus and Curcuma longa extracts in diabetic rats / Efeitos de extratos de Astragalus membranaceus, Peumus boldus e Curcuma longa em ratos com diabetes induzida

Objectives: the aim of this study was to evaluate the effects of the association of dry extracts of Astragalus membranaceus, Peumus boldus and Curcuma longa in rats with induced diabetes. Methods: After the induction of type 2 diabetes by intraperitoneal streptozotocin, male Wistar rats were randomly assigned to groups (n=6) and treated for 20 days. The extracts were suspended in water and administered through orogastric gavage once daily as described: Group I: healthy control (saline); group II: received Astragalus membranaceus, Peumus boldus and Curcuma longa (400 mg/kg/day of each dry extract); group III: received Astragalus membranaceus, Peumus boldus, Curcuma longa (400 mg/kg/day of each dry extract) and glibenclamide (15 mg/kg/day). Fasting glucose, glucose tolerance, alanine aminotransferase, aspartate aminotransferase and fructosamine were evaluated. Results: Fasting blood glucose and glucose tolerance for groups II and III were influenced by treatments (p<0.05). The extracts did not significantly influence the efficacy of glibenclamide. Conclusion: The results found in this study allow us to consider that it is not possible to conclude that the compounds evaluated are not effective in DM in rats, due to variables such as total treatment period, doses, size of pancreatic injury caused by streptozotocin, and diet profile may have influenced the results. The studied compounds have potential for application in diabetes and further studies should be carried out to adjust the treatment.

Objetivos: avaliar os efeitos da associação de extratos secos de Astragalus membranaceus, Peumus boldus e Curcuma longa em ratos com diabetes induzida. Métodos: Após a indução de diabetes tipo 2 (DM) por estreptozotocina intraperitoneal, ratos Wistar machos foram distribuídos aleatoriamente em grupos (n=6) e tratados por 20 dias. Os extratos foram suspensos em água e administrados por gavagem orogástrica uma vez ao dia conforme descrito: Grupo I: controle saudável (solução salina); grupo II: recebeu Astragalus membranaceus, Peumus boldus e Curcuma longa (400 mg/kg/dia de cada extrato seco); grupo III: receberam Astragalus membranaceus, Peumus boldus, Curcuma longa (400 mg/kg/dia de cada extrato seco) e glibenclamida (15 mg/kg/dia). A glicemia de jejum, tolerância à glicose, alanina aminotransferase, aspartato aminotransferase e frutosamina foram avaliados. Resultados: A glicemia de jejum e a tolerância à glicose para os grupos II e III foram influenciadas pelos tratamentos (p<0,05). Os extratos não influenciaram significativamente na eficácia da glibenclamida. Conclusão: Os resultados encontrados neste estudo permitem considerar que não é possível concluir que os compostos avaliados não são eficazes no DM em ratos, devido às variáveis como tempo total de tratamento, doses e tamanho da lesão pancreática causada por estreptozotocina, além do perfil da dieta, que podem ter influenciado os resultados. Os compostos estudados têm potencial para aplicação em diabetes e mais estudos devem ser realizados para adequar o tratamento.

Relación entre los niveles basales de fructosamina y glucosa en adultos mayores / Relationship between basal levels of fructosamine and glucose in older adults

INTRODUCCIÓN: los cambios fisiológicos a los que están expuestos los adultos mayores, son muchas veces factores negativos en su calidad de vida, sobre todo en aquellos que se encuentran en residencias geriátricas, existen parámetros como la glicemia y hemoglobina glucosilada que podrían ser útiles en el control metabólico. OBJETIVO: relacionar los niveles basales de Fructosamina y Glucosa en adultos mayores institucionalizados en residencias geriátricas del municipio de Tiquipaya, septiembre 2019. METODOLOGÍA: estudio no experimental, observacional, prospectivo, transversal, con enfoque de análisis positivista cuantitativo, con un universo de 97 adultos mayores de 65 años, con una muestra de 79 que cumplen con los criterios de inclusión y exclusión, con un 4,77% de error máximo aceptable. RESULTADOS: el 71% (n=56) de los pacientes fueron mujeres. Los ancianos predominaron como grupo etario. Se evidenció que no hay una buena concordancia entre los niveles basales de Glicemia y Fructosamina, mediante el cálculo estadístico del índice de Kappa que fue de 0,023; Test de Wilcoxon 0.081; Test correlación Pearson r=0.281. Los niveles basales de Fructosamina tienen una sensibilidad y especificidad altas del 82,14% (L.I. 62,42% -L.S. 93,23%) y 56.92% (L.I. 47,95% - L.S. 65,48%), respectivamente. CONCLUSIONES: no existe relación entre los niveles basales de Glucosa y la Fructosamina puesto que son parámetros de evaluación metabólica en diferente tiempo y una no remplaza la otra, por lo tanto, se debería implementar adicionalmente a la Glucosa la determinación de la Fructosamina para monitorizar a los pacientes adultos a mediano plazo.

INTRODUCTION: the physiological changes to which older adults are exposed; are many times negative factors in their quality of life, especially in those who are in geriatric residences. Glycemia and glycosylated hemoglobin are useful as metabolic control parameters. OBJECTIVE: to relate the basal levels of Fructosamine and Glucose in institutionalized older adults in geriatric residences in the municipality of Tiquipaya, September 2019. METHODOLOGY: non-experimental, observational, prospective, cross-sectional study, with a quantitative positivist analysis approach, with a universe of 97 adults over 65 years of age, with a sample of 79 that met the inclusion and exclusion criteria, with a maximum acceptable error of 4.77%. RESULTS: 71% (n=56) of the patients were female. The elderly dominated as an age group. It was evidenced that there is not a good agreement between basal levels of Glycemia and Fructosamine, through the statistical calculation of the Kappa index which was 0.023; Wilcoxon test 0.081; Pearson correlation test r= 0.281. The basal levels of Fructosamine have a high sensitivity and specificity of 82.14% (L.I. 62.42% - L.S. 93.23%) and 56.92% (L.I.47.95% - L.S. 65.48%), respectively. CONCLUSIONS: there is no relationship between basal levels of Glucose and Fructosamine since they are parameters of metabolic evaluation in different time and one does not replace the other, therefore, the determination of Fructosamine should be implemented in addition to Glucose to monitor adult patients in the medium term.

Manejo del control glucémico: objetivos de tratamiento y métodos. Hemoglobina glicosilada A1C (HbA1c). Fructosamina. Automonitoreo glucémico. Glucosuria. Cetonuria / Management of glycemia monitoring: objectives of treatment and methods. Glycosilated hemoglobin A1c (HbA1c). Fructosamine. Self-blood glucose monitoring. Glycosuria. Ketonuria

En la medición estándar del control y el seguimiento en pacientes con diabetes, la hemoglobina glicosilada (HbA1C) presenta dificultades en la insuficiencia renal, en la cual puede no ser buen indicador del control glucémico. La fructosamina no es válida cuando la albumina es menor a 3 mg/dl, mientras que la glucosuria y la cetonuria no son herramientas de medición efectiva en enfermedad renal. El automonitoreo glucémico (AMG) individualizado es un método útil en todos los estadios renales y el de mayor valor en el control y seguimiento en insuficiencia renal avanzada y tratamientos renales sustitutivos

Low glycemic index diet reduces body fat and attenuates inflammatory and metabolic responses in patients with type 2 diabetes

ABSTRACT Objective The aim of this study was to verify the effects of glycemic index (GI) on body composition, and on inflammatory and metabolic markers concentrations in patients with type 2 diabetes. Subjects and methods In this randomized controlled parallel trial, twenty subjects (aged 42.4 ± 5.1 years, BMI 29.2 ± 4.8 kg.m-2) were allocated to low GI (LGI) (n = 10) or high GI (HGI) (n = 10) groups. Body composition, inflammatory and metabolic markers were assessed at baseline and after 30 days of intervention. Food intake was monitored during the study using three-day food records completed on two non-consecutive weekdays and on a weekend day. Results Body fat reduced after the LGI intervention compared with baseline (P = 0.043) and with the HGI group (P = 0.036). Serum fructosamine concentration (P = 0.031) and TNF-α mRNA expression (P = 0.05) increased in the HGI group. Serum non-esterified fatty acids were greater in the HGI than in the LGI group (P = 0.032). IL-6 mRNA expression tended to decrease after the consumption of the LGI diet compared to baseline (P = 0.06). Conclusion The LGI diet reduced body fat and prevented the negative metabolic and inflammatory responses induced by the HGI diet.

Correlação das dosagens de frutosamina e de hemoglobina glicosilada com o perfil glicêmico em gestantes com diabetes mellitus / Correlation of the Levels of Fructosamine and Glycated Hemoglobin with the Blood Glucose Profile in Pregnant Women with Diabetes Mellitus

Objetivo Avaliar se há correlação das dosagens de frutosamina e de hemoglobina glicosilada (HbA1c) com as frequências de desvios de glicemia capilar em gestantes com diabetes mellitus. Métodos estudo observacional, retrospectivo, de corte transversal, incluindo todas as gestantes comdiabetes que iniciaram o pré-natal emhospital terciário de ensino durante o ano de 2014 e que apresentavam pelo menos 20 dias de auto monitoramento glicêmico previamente às dosagens séricas de frutosamina e de HbA1c. Os desvios de glicemia capilar foram considerados "hipoglicemias" quando menores que 70mg/dL ou "hiperglicemias" quando acima do alvo glicêmico terapêutico para o horário. Foram testadas as correlações lineares par a par das dosagens de frutosamina e de HbA1c com as frequências de hipoglicemias e de hiperglicemias capilares pelo teste Tau-b de Kendall. Na sequência, foi avaliada a regressão linear entre as dosagens de HbA1c e de frutosamina e as frequências de hipoglicemias e de hiperglicemias. Resultados Foram incluídas 158 gestantes que contribuíram com 266 amostras para dosagem sérica de frutosamina e HbA1c. As dosagens de frutosamina e de HbA1c apresentaram, respectivamente, coeficientes τ de Kendall de 0,29 (p < 0,001) e 0,5 (p < 0,001) com a frequência de hiperglicemias, e de 0,09 (p = 0,04) e 0,25 (p < 0,001) com a frequência de hipoglicemias capilares. No modelo de regressão linear, as dosagens de frutosamina e de HbA1c apresentaram, respectivamente, coeficientes de determinação R2 = 0,26 (p < 0,001) e R2 = 0,51 (p < 0,001) para a predição de hiperglicemias, e R2 = 0,03 (p = 0,003) e R2 = 0,059 (p < 0,001) para a predição de hipoglicemias. Conclusão As dosagens de frutosamina e de HbA1c apresentam correlação fraca a moderada com as frequências de hiperglicemias e hipoglicemias capilares no auto monitoramento glicêmico e não são capazes de traduzir com precisão os desvios da meta glicêmica no tratamento de gestantes com diabetes.

Objective To evaluate the correlation of the levels of fructosamine and of glycated hemoglobin (HbA1c) with the frequency of blood glucose self-monitoring values out of the treatment target range in pregnant women with diabetes mellitus. Methods We performed an observational, retrospective, cross-sectional study, including all pregnant women with diabetes who attended prenatal care visits at a tertiary teaching hospital during the year of 2014 and who presented at least 20 days of blood glucose self-monitoring prior to assessment of serum levels of fructosamine and HbA1c. Capillary blood glucose values out of the treatment target range were considered "hypoglycemia" when lower than 70 mg/dL and "hyperglycemia" when above the glycemic therapeutic target. We evaluated the correlation of the levels of fructosamine and of HbA1c with the frequencies of hyperglycemia and hypoglycemia recorded in the glucometer device by performing Tau-b of Kendall correlation tests. Next, linear regression tests were performed between the levels of HbA1c and of fructosamine and the frequencies of hypoglycemia and hyperglycemia. Results We included 158 pregnant women, from whom 266 blood samples were obtained for assessing fructosamine and HbA1c levels. Measurements of fructosamine and of HbA1c presented, respectively, Kendall's τ coefficient of 0.29 (p < 0.001) and 0.50 (p < 0.001) regarding the frequency of hyperglycemia, and of 0.09 (p = 0.046) and 0.25 (p < 0.001) regarding the frequency of hypoglycemia. In the linear regression model, levels of fructosamine and of HbA1c respectively presented determination coefficients R2 = 0.265 (p < 0.001) and R2 = 0.513 (p < 0.001) for the prediction of hyperglycemia, and R2 = 0.033 (p = 0.003) and R2 = 0.059 (p < 0.001) for the prediction of hypoglycemia. Conclusion Levels of fructosamine and of HbA1c presented a weak to moderate correlation with the frequencies of hyperglycemia and hypoglycemia at blood glucose self-monitoring and were not able to accurately translate the deviations from the glycemic goals in pregnant women with diabetes.

Managing periodontitis in type 1 diabetic patients improves glycemic control: A case report / Journal of the ASEAN Federation of Endocrine Societies

@#<p style="text-align: justify;">This case report describes the long-term follow-up of a 22-year-old, female patient with type 1 diabetes managed by conservative oral care and glycemic control measures. She is on a twice a day insulin regimen. Tooth numbers 13 and 37 had pockets less than 6 mm while all remaining teeth had greater than 6 mm. Periodontal management consisted of root planing combined with instructions on diabetes self-management skills at home. Nine weeks after the first sextant was treated, pocket depth measurements in 93 (81.6%) out of 114 sites and bleeding on probing (BOP) scores in 11 (57.9%) out of 19 teeth decreased. There was a 50% reduction in the C reactive Protein and a 46.7% decrease in the fructosamine assay levels. Initial glycohemoglobin level of 8.3% decreased substantially to 7.1%. The goal of the dentist is no longer just the improvement of oral health but ultimately the overall health of the patient and the physician's goal is to include oral health in the promotion of overall health.</p>

Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance

BACKGROUND: Rebaudioside A and erythritol are nonnutritive sweeteners. There have been several studies of their glycemic effects, but the outcomes remain controversial. The purpose of this study was to evaluate the glycemic effects of rebaudioside A and erythritol as a sweetener in people with glucose intolerance. METHODS: This trial evaluated the glycemic effect after 2 weeks of consumption of rebaudioside A and erythritol as sweeteners in a pre-diabetic population. The patients were evaluated for fructosamine, fasting plasma glucose, C-peptide, insulin, and 2-hour plasma glucose before and after consumption of sweetener. The primary outcome was a change in fructosamine levels from the baseline to the end of treatment. Secondary outcomes were the changes in levels of fasting plasma glucose and 2-hour plasma glucose. RESULTS: From the baseline to the end of experiment, the changes in fructosamine levels after consumption of rebaudioside A and erythritol, did not differ significantly (244.00±19.57 vs. 241.68±23.39 µmol/L, P=0.366). The change in levels from the baseline to end of the study for rebaudioside A and erythritol were fasting plasma glucose (102.56±10.72 vs. 101.32±9.20 mg/dL), 2-hour plasma glucose (154.92±54.53 vs. 141.92±42.22 mg/dL), insulin (7.56±4.29 vs. 7.20±5.12 IU/mL), and C-peptide (2.92±1.61 vs. 2.73±1.31 ng/mL), respectively, and also did not differ significantly (P>0.05 for all). CONCLUSION: Our study suggests that consumption of rebaudioside A and erythritol does not alter the glucose homeostasis in people with glucose intolerance.

Inhibition of advanced glycation end product formation by burdock root extract / 한국영양학회지

PURPOSE: Diabetic complications are a major concern to manage progression of diabetes. Production of advanced glycation end products (AGEs) due to high blood glucose is one of the mechanisms leading to diabetic complications. Multiple pharmacologic AGE inhibitory agents are currently under development, but clinical applications are still limited due to safety issues. Thus, it is necessary to identify a safe anti-glycation agent. It is known that burdock roots have antioxidant, anti-inflammatory, and anti-cancer activities. The objective of the present study was to investigate the inhibitory role of burdock roots on the formation of high glucose-induced glycation of bovine serum albumin (BSA). METHODS: In this study, glycation of BSA by glucose, galactose, or fructose at 37℃ for 3 weeks was assessed based on levels of α-dicarbonyl compounds (early-stage glycation products), fructosamine (intermediate products of glycation), and fluorescent AGEs (late-stage glycation products). In order to compare the inhibitory actions of burdock root extract in AGE formation, aminoguanidine (AG), a pharmacological AGE inhibitor, was used as a positive control. RESULTS: BSA glycation by glucose, fructose, and galatose was dose- and time-dependently produced. Burdock root extract at a concentration of 4 mg/mL almost completely inhibited glucose-induced BSA glycation. The results demonstrate that burdock root extract inhibited AGE formation with an IC₅₀ value of 1.534 mg/mL, and inhibitory activity was found to be more effective than the standard anti-glycation agent aminoguanidine. This study identified a novel function of burdock root as a potential anti-glycation agent. CONCLUSION: Our findings suggest that burdock root could be beneficial for preventing diabetic complications.

Alternative biomarkers for assessing glycemic control in diabetes: fructosamine, glycated albumin, and 1,5-anhydroglucitol

The growing attention to alternative glycemic biomarkers including fructosamine, glycated albumin (GA), 1,5-anhydroglucitol (1,5-AG), is attributable to the limitations of the glycated hemoglobin (HbA1c) assay. It is important to recognize the conditions in which HbA1c levels may be difficult to interpret. Serum fructosamine and GA have been proposed useful tools for monitoring of short-term glycemic control. These biomarkers not only reflect well glycemic control in hematologic disorder, but also represent postprandial glucose fluctuation. Serum 1,5-AG may be useful for estimating within-day glucose variation. Use of these nontraditional tests can be more helpful in the management of diabetes as complement traditional measures. Further larger cohort studies are warranted to determine whether nontraditional biomarkers have potential utility for early diagnosis, management of diabetes, and prevention of diabetic complications.

Clinical usefulness of the measurement of serum fructosamine in childhood diabetes mellitus

PURPOSE: Glycosylated hemoglobin (HbA1c) is often used as an indicator of glucose control. It usually reflects the average glucose levels over two to three months, and is correlated with the development of long-term diabetic complications. However, it can vary in cases of hemoglobinopathy or an altered red blood cell lifespan. The serum fructosamine levels reflect the mean glucose levels over two to three weeks. This study was designed to determine the clinical usefulness of the combined measurement of serum fructosamine and HbA1c in the management of childhood diabetes mellitus and the correlation between them. METHODS: Clinical data on 74 Korean children and adolescents with diabetes mellitus who were under management at the Department of Pediatrics of Dankook University Hospital were evaluated. Their fructosamine and HbA1c levels were reviewed based on clinical information, and analyzed using IBM SPSS Statistics ver. 21. RESULTS: Their HbA1c levels showed a strong correlation with their fructosamine levels (r=0.868, P<0.001). The fructosamine level was useful for the prompt evaluation of the recent therapeutic efficacy after the change in therapeutic modality. It was also profitable in determining the initial therapeutics and for the estimation of the onset of the disease, such as fulminant diabetes. CONCLUSION: The measurement of both fructosamine and HbA1c was useful in managing childhood diabetes mellitus, especially when there was discrepancy between the clinical information and the HbA1c level.

Avaliação da frutosamina como parâmetro de controle glicêmico na gestante diabética / Evaluation of fructosamine as a parameter of blood glucose control in diabetic pregnant women

Objetivo Avaliar parâmetros alternativos para monitorar a glicemia em portadoras de diabetes na gestação estudando a relação entre a frutosamina e a automonitoração em gestantes portadoras de diabetes. Materiais e métodos: A frutosamina sérica e os parâmetros da automonitoração nos 14 dias que antecederam a coleta da frutosamina foram avaliados em 47 gestantes portadoras de diabetes. Resultados Setenta e uma determinações de frutosamina e 2.238 glicemias capilares (GCs) foram analisadas. A frutosamina correlacionou-se com o índice de excursões hiperglicêmicas (HBGI) e o desvio-padrão das glicemias (r = 0,28; p = 0,021 e r = 0,26; p = 0,03, respectivamente). A comparação entre as mães dos neonatos com peso adequado ou grandes ao nascer com as genitoras que tiveram neonatos pequenos para a idade gestacional (PIG) revelou que estas tiveram menor média glicêmica (105 vs. 114 e 119 mg/dL), maior índice de excursões hipoglicêmicas (5,8 vs. 1,3 e 0,7) e maior percentual de hipoglicemias (11 vs. 0 e 0%) mesmo com frutosamina dentro dos valores de referência (242 vs. 218 e 213 μmol/l). Conclusão A frutosamina pode ser utilizada como parâmetro auxiliar à automonitoração para avaliação de hiperglicemias e variabilidade glicêmica, entretanto pode subestimar hipoglicemias em gestantes com fetos PIG. .

Objective To evaluate the alternative parameters to monitor glycemia in pregnant women with diabetes studying the relationship between fructosamine testing and self monitoring of blood glucose in pregnant women with diabetes. Materials and methods Serum fructosamine levels and the self monitoring of blood glucose over 14 days before the collection of fructosamine were evaluated in 47 diabetic pregnant women. Results Seventy-one fructosamine levels and 2,238 glucose measurements (CGs) were analysed. Levels of fructosamine correlated with high blood glucose index (HBGI) and the standard deviation of glycemias (r = 0.28; p = 0.021 and r = 0.26; p = 0.03, respectively). The comparison between the mothers of the newborns with appropriated or large birthweight and those who gave birth to small newborns for their gestational age (SGA) showed that the latter had a lower glycemic mean (105 vs. 114 and 119 mg/dL), a higher low blood glucose index (5.8 vs. 1.3 and 0.7) and a higher percentage of hyperglycemias (11 vs. 0 and 0%) even when the fructosamine falls within the reference values (242 vs. 218 and 213 μmol/l). Conclusion The levels of fructosamine can be used as further parameter to aid self monitoring of blood glucose to evaluate hyperglycemias and glycemic variability, however, this can underestimate hypoglycemias in pregnant women carrying small-for-gestational age fetuses. .

Estudio del control metabólico en pacientes diabéticos en hemodiálisis crónica: hemoglobina glicosilada, fructosamina y glicemias capilares / Study of metabolic control in diabetic patients on chronic hemodialysis: glycated hemoglobin, fructosamine and capillary glycemia

Background: In conditions that may change red blood cell survival, such as hemodialysis, the accuracy of A1c glycosylated hemoglobin (HbA1c) to assess metabolic control can be hampered. Other glycosylated proteins such as fructosamine, could accomplish the role of HbA1c. Aim: To assess if HbA1c is a good metabolic control parameter in diabetic patients on chronic hemodialysis. To compare fructosamine, HbA1c and serial capillary glucose levels in the same patients. Material and Methods: Patients on hemodialysis three times per week were studied. Twenty one subjects with diabetes mellitus and 10 non-diabetic patients were included (70 percent were male). During a period of 14 days, fasting and post prandial capillary glucose levels were measured. Venous glucose, HbA1c and fructosamine were measured at the onset and completion of the monitoring period. Results: Diabetic patients were older than their non-diabetic counterparts (65 and 47 years respectively, p < 0.04). In diabetic and non-diabetic patients respectively, capillary blood glucose levels were 161 +/- 22 and 104 +/- 51 mg/dl, HbA1c levels were 6.8 +/- 1.2 and 5.4 +/- 0.4 percent and fructosamine levels were 282.0 +/- 126.6 and 154.6 +/- 73 umol/L. In all patients there was a positive correlation between blood glucose, HbA1c (r = 0.78 p < 0.01) and fructosamine (r = 0.52, p 0.02). There was a positive correlation between mean capillary glucose, HbA1c (r = 0.77, p < 0.01) and fructosamine (r = 0.69, p < 0.02). Among diabetic patients, the correlation coefficients between mean capillary glucose levels, HbA1c and fructosamine levels were 0.67 (p < 0.01) and 0.51 (NS), respectively. Conclusions: Among diabetic patients on hemodialysis fructosamine levels are not a better indicator of metabolic control than HbA1c.

Valibose, an alpha-glucosidase inhibitor, ameliorates the metabolic disorder of glucose and lipids and the nephropathy in streptozotocin-induced diabetic rats / 药学学报

This study is to evaluate the anti-diabetic effects of the alpha-glucosidase inhibitor valibose in a streptozotocin (STZ)-induced type 1 diabetes rat model. Diabetes was induced by a single dose of STZ (58 mg x kg(-1), ip) in SD rats, rats with elevated fasting blood glucose levels (250-450 mg x dL(-1)) were selected and divided into five groups (n = 10 in each). Another ten normal SD rats were chosen as normal group. Valibose mixed with the high sucrose diets (0.4, 1.0 and 2.5 mg 100 g(-1) diets) or acarbose (30 mg x 100 g(-1) diets) was administrated in the diabetic rats for about 5 weeks. In all groups, fasting and postprandial plasma glucose, plasma lipids, glycosylated serum protein, N-acetyl-beta-D-glucosaminidase (NAG), creatinine (Cre), blood urea nitrogen (BUN) and urine sugar levels were determined during the treatment. At the end of the experiment, the morphological alterations in kidney were evaluated by hematoxylin-eosin (HE) staining. After 3-weeks administration, valibose significantly decreased postprandial and fasting blood glucose, urine glucose, and reduced the levels of serum fructosamine. Valibose also decreased plasma triglyceride and cholesterol levels after 4 weeks treatment. These results indicated that valibose ameliorated metabolic disturbance of glucose and lipids in STZ-induced diabetic rats. In addition, valibose markedly reduced level of serum NAG and BUN, and decreased the weight index of kidney. HE staining showed reduced kidney pathological changes after valibose treatment. The findings of the present study indicate that valibose may be a novel alpha-glucosidase inhibitor for the prevention from hyperglycemia in STZ-induced type 1 diabetes rats. And valibose might have a potential role for protecting against diabetic nephropathy during hyperglycemia.

The Roles of Glycated Albumin as Intermediate Glycation Index and Pathogenic Protein

The conventional glycemic indices used in management of diabetic patients includes A1c, fructosamine, 1,5-anhydroglucitol, and glycated albumin (GA). Among these indices, A1c is currently used as the gold standard. However, A1c cannot reflect the glycemic change over a relatively short period of time, and its accuracy is known to decrease when abnormalities in hemoglobin metabolism, such as anemia, coexist. When considering these weaknesses, there have been needs for finding a novel glycemic index for diagnosing and managing diabetes, as well as for predicting diabetic complications properly. Recently, several studies have suggested the potential of GA as an intermediate-term glycation index in covering the short-term effect of treatment. Furthermore, its role as a pathogenic protein affecting the worsening of diabetes and occurrence of diabetic complications is receiving attention as well. Therefore, in this article, we wanted to review the recent status of GA as a glycemic index and as a pathogenic protein.

Utilidad de la medición de fructosamina como indicador de control en pacientes con diabetes gestacional y pregestacional / Plasma fructosamine to evaluate metabolic control among women with gestational diabetes

Background: Metabolic control of diabetic pregnant women is assessed using glycated hemoglobin (HbAlc) levels and fasting blood sugar. Another glycated protein, namely fructosamine, can be an indicator of average glucose levels during the last three weeks. Aim: To evaluate plasma fructosamine as an indicator of glycemic control in women with gestational diabetes. Patients and Methods: Prospective cohort study of 41 pregnant women aged 30 to 37 years, with gestational and pre-gestational diabetes. Blood glucose, HbAlc, fructosamine were measured. Newborn weight, and other prenatal and postnatal variables, were used to evaluate the correlation between metabolic control and the presence or absence of macrosomia. Results: The correlation observed between fructosamine and fasting blood glucose (r = 0.627, p < 0.001) was superior to that of HbA1c and blood glucose (r = 0.516, p < 0.001). No association was observed between macrosomia and levels of fructosamine, nor between the other studied variables. Conclusions: Fructosamine levels were not associated with macrosomia, but it could be better for the evaluation of glycemic control in patients with gestational diabetes since it allows short-term monitoring.

Glycaemic indices and non-traditional biochemical cardiovascular disease markers in a diabetic Population in Nigeria

To determine the frequency of hyperfibrinogenaemia, elevated C-reactive protein, hyperuricaemia and elevated lipoprotein A in a clinic population of patients with type 2 Diabetes mellitus [DM] compared with healthy controls; and determine the interrelationship between fasting plasma glucose levels and indices of long-term glycaemic control [fructosamine and glycosylated haemoglobin] in DM. Cross-sectional, analytical study. The study was conducted at the Lagos State University Teaching Hospital, Ikeja, from April to June 2009. A total of 200 patients with type 2 DM and 100 age and gender matched healthy controls were recruited for the study. Glycaemic control was assessed using fasting blood glucose, fructosamine and glycosylated haemoglobin levels. The non-traditional risk factors studied included C-reactive protein [CRP], Lipoprotein a [Lpa], serum uric acid [SUA], microalbuminuria and fibrinogen. Mann-whitney, chi-square and Pearson's correlation tests were used for analysis as applicable. Hyperfibrinoginaemia, elevated CRP, LPa, microalbuminuria and hyperuricaemia were present in 3.5%, 65%, 12%, 6% and 57% respectively in type 2 DM. The mean levels of these CV risk factors were significantly higher in subjects with type 2 DM than that of the control subject. There was a positive and significant correlation between HbA1c and FBS [r=0.46, p=0.0001] and HbA1c and fructosamine [r=0.49, p=0.0001]. All studied CVS risk factors were related to indices of glycaemic control which were found to be interrelated. Fasting blood glucose significantly correlated with both HbA1c and fructosamine but HbA1c showed better correlation to FPG than fructosamine [r=0.51 vs. 0.32]. Glycosylated haemoglobin and fasting plasma glucose but not fructosamine are significantly associated with microalbuminuria, fibrinogen SUA and CRP in type 2 DM. HbA1c was found to be better than fructosamine in monitoring overall long-term glycaemic control

Avaliação dos níveis de frutosamina em gatos sob estresse agudo e crônico / Assessment of fructosamine concentrations in cats with acute and chronic-stress

Frutosaminas são proteínas séricas glicadas formadas continuamente resultantes da ligação entre a glicose e proteínas circulantes, e correspondem à avaliação glicêmica de aproximadamente uma a duas semanas em gatos. A concentração de frutosamina tem sido utilizada para a diferenciação entre a hiperglicemia persistente e transitória induzida pelo estresse, sendo considerado o teste padrão ouro para o controle da glicemia em gatos diabéticos. O objetivo deste trabalho consistiu em avaliar a influência dos estados de estresse agudo e crônico em gatos sobre os níveis séricos de frutosamina. Foram selecionados 62 felinos provenientes do atendimento no Hospital Veterinário da FMVZ - UNESP Botucatu, distribuídos em três grupos: felinos com histórico de qualquer doença ou condições de estresse, excluindose o diabetes mellitus (DM), por um período máximo de 48 horas (Grupo A, n = 21) ou por um período superior a 120 horas (Grupo B, n = 27). O terceiro grupo (Grupo C = controle) foi formado por 14 felinos saudáveis. Os grupos foram avaliados quanto às dosagens séricas de frutosamina, glicose, proteína e albumina. Foi constatado um aumento significativo nos valores de frutosamina tanto nos animais submetidos ao estresse agudo quanto crônico, porém os níveis mantiveram-se dentro do intervalo de referência. Da mesma forma, os animais, em média, também se encontravam em normoglicemia, apesar da correlação positiva entre as concentrações de glicose e frutosamina. Conclui-se que a concentração de frutosamina sofre influência dos estados de estresse agudo e crônico em gatos, mantendo-se, porém, dentro dos limites de referência, sendo, portanto, útil no diagnóstico do DM.

circulating proteins, and corresponding to the blood glucose control assessment over the last one to two weeks in cats. The fructosamine concentration has been used for differentiation between persistent and transient hyperglycemia. Therefore, the determination of fructosamine is considered the gold standard for monitoring glycemia into control in diabetic cats. The objective of this study was to evaluate the influence of acute and chronic stress of cats on serum fructosamine. 62 cats were selected from the Veterinary Hospital of FMVZ - UNESP, Botucatu campus. They were distributed into three groups: cats with a history of any illness or stress condition, excluding Diabetes Mellitus (DM), for a maximum of 48 hours (Group A, n = 21) or for a period exceeding 120 hours (Group B n = 27). The third group (Group C = control) was formed by 14 health cats. The groups were evaluated for serum fructosamine, glucose, protein and albumin. In this study, there was a significant increase in the values of fructosamine in animals subjected to acute and chronic stress, but these values remained within the reference range. The animals were, on average, normoglycemic, despite the positive correlation between fructosamine and glucose concentrations. We conclude that the fructosamine concentration is influenced by acute and chronic stress in cats, remaining, however, within the reference range, and therefore, still useful in the diagnosis of DM.

Rastreamento de cardiopatias congênitas associadas ao diabetes mellitus por meio da concentração plasmática materna de frutosamina / Congenital cardiopathies screening associated with diabetes mellitus using maternal fructosamine plasma concentration

OBJETIVO: avaliar a importância da concentração plasmática materna de frutosamina como indicador de cardiopatias congênitas fetais, em gestações complicadas pelo diabetes mellitus. MÉTODOS: o estudo retrospectivo incluiu 91 gestantes portadoras de diabetes mellitus, as quais foram submetidas à ecocardiografia fetal de rotina em centro universitário de referência em Medicina Fetal. Foram selecionadas 65 pacientes que apresentavam diabete pré-gestacional e registro em prontuário médico de frutosamina plasmática anterior ao exame ultrassonográfico. A primeira dosagem registrada foi confrontada com o resultado da ecocardiografia fetal de rotina, realizada por médico especialista do serviço. A presença ou ausência de achados ecográficos de cardiopatia congênita (AECC) foi relacionada aos níveis plasmáticos de frutosamina, por meio de teste de médias, e sua acuidade para AECC verificada por curva ROC. Foram discutidos como pontos de corte os valores da concentração plasmática materna de frutosamina de 2,68, 2,9 e 2,23 mmol/L, que são, respectivamente, o valor de referência local do laboratório, o do kit de dosagem empregado e o de maior acurácia global. RESULTADOS: o AECC foi encontrado em 52,3 por cento dos fetos. A primeira dosagem de frutosamina durante o pré-natal aconteceu em média com 20,4±8,0 semanas de gestação. A capacidade da concentração materna de frutosamina em identificar fetos com AECC foi significante (p<0,0001) e apresentou área sob a curva ROC de 0,78 (IC95 por cento=0,66-0,89). A concentração plasmática de frutosamina de 2,9 mmol/L apontou AECC com maior especificidade e, porém, com maior porcentual de falso-negativo (96,8 e 55,9 por cento). Valores acima de 2,68 mmol/L associam-se à probabilidade de 4,6 em identificar fetos com AECC em relação a valores inferiores, com sensibilidade de 58,8 por cento e especificidade de 87,1 por cento. O valor de 2,23 mmol/L mostrou-se de maior acurácia global entre os três pontos sugeridos, ...

PURPOSE: to evaluate the importance of maternal plasma concentration of fructosamine as an indicator of fetal congenital cardiopathies in pregnancies complicated by diabetes mellitus. METHODS: this was a retrospective study conducted on 91 pregnant women with diabetes mellitus who underwent routine fetal echocardiography at a university reference center in fetal medicine. Sixty-five patientes who presented pre-gestational diabetes mellitus and plasma fructosamine level were registered in the medical records prior to the ultrasound exam. The first measurement recorded was compared with the result of routine fetal echocardiography, carried out by a specialist physician of the service. The presence or absence of echocardiographic findings of congenital cardiopathies (EFCC) was related to plasma levels of fructosamine by the mean t-test and its accuracy for EFCC was verified by the ROC curve. Plsama fructosamine concentrations of 2.68, 2.9 and 2.23 mmol/L, which are, respectively, the local reference laboratory values, the value of the kit employed for measurement and the one of highest overall accuracy, were discussed as the cut-off values. RESULTS: EFCC was found in 52.3 percent of the fetuses. The first measurement of fructosamine, during the prenatal care period, was performed, on average, at 20.4±8.0 weeks of pregnancy. The maternal concentration ability of the fructosamine to identify fetuses with EFCC was significant (p<0.0001) and had an area under the ROC curve of 0.78 (95 percentCI=0.66-0.89). The 2.9 mmol/L plasma concentration of fructosamine revealed EFCC with better specificity, but with a higher percentage of false-negative results (96.8 and 55.9 percent). Values above 2.68 mmol/L were associated with a probability of 4.6 to identify fetuses with EFCC compared with lower values, with 58.8 percent of sensitivity and 87.1 percent, specificity. The value of 2.23 mmol/L proved to be the most overall accurate of the three values ...

Protective effect of extract of Apocynum venetum on kidneys of streptozotocin-induced diabetic rats / 药学学报

The aim of this study is to investigate the effects and mechanism of extract of Apocynum venetum (AV) on kidneys of streptozotocin-induced diabetic rats. Diabetes mellitus (DM) was induced in rats by intraperitoneal injection of streptozotocin (STZ). The indexes of the blood glucose, renal function and oxidative stress were observed. The DM rats were administrated with the AV for 8 weeks, the above-mentioned indexes were detected. The blood glucose level, BUN, 24 h urine protein excretion, urine volume, renal index, renal cortex's MDA level in model groups all increased significantly. Renal cortex's SOD and GSH activities decreased significantly compared with the normal control group (P < 0.05). The above-mentioned indexes were significantly improved by the AV treatment (P < 0.05). AV have protective effects on renal function of kidneys of streptozotocin-induced diabetic rats, and maybe via inhibition of the renal oxidative stress.

Elevated fructosamine concentrations caused by IgA paraproteinemia in two dogs

An 8-year-old male Austrian Pinscher and a 14-year-old male Golden Retriever were presented for evaluation due to unexplainable high fructosamine values despite euglycemia and epistaxis in combination with polydipsia/polyuria, respectively. Blood analysis revealed severe hyperglobulinemia, hypoalbuminemia and markedly elevated fructosamine concentrations in both dogs. Multiple myeloma with IgA-monoclonal gammopathy was diagnosed by serum and urine electrophoresis including immunodetection with an anti-dog IgA antibody and bone marrow aspirations. Diabetes mellitus was excluded by repeated plasma and urine glucose measurements. Fructosamine values were positively correlated with globulin, but negatively correlated with albumin concentrations. These cases suggest that, as in human patients, monoclonal IgA gammopathy should be considered as a possible differential diagnosis for dogs with high fructosamine concentrations.