Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 7 de 7
Filter
1.
J Clin Endocrinol Metab ; 107(3): e1009-e1019, 2022 02 17.
Article in English | MEDLINE | ID: covidwho-1496303

ABSTRACT

PURPOSE: To assess whether dysglycemia diagnosed during severe acute respiratory syndrome coronavirus 2 pneumonia may become a potential public health problem after resolution of the infection. In an adult cohort with suspected coronavirus disease 2019 (COVID-19) pneumonia, we integrated glucose data upon hospital admission with fasting blood glucose (FBG) in the year prior to COVID-19 and during postdischarge follow-up. METHODS: From February 25 to May 15, 2020, 660 adults with suspected COVID-19 pneumonia were admitted to the San Raffaele Hospital (Milan, Italy). Through structured interviews/ medical record reviews, we collected demographics, clinical features, and laboratory tests upon admission and additional data during hospitalization or after discharge and in the previous year. Upon admission, we classified participants according to American Diabetes Association criteria as having (1) preexisting diabetes, (2) newly diagnosed diabetes, (3) hyperglycemia not in the diabetes range, or (4) normoglycemia. FBG prior to admission and during follow-up were classified as normal or impaired fasting glucose and fasting glucose in the diabetes range. RESULTS: In patients with confirmed COVID (n = 589), the proportion with preexisting or newly diagnosed diabetes, hyperglycemia not in the diabetes range and normoglycemia was 19.6%, 6.7%, 43.7%, and 30.0%, respectively. Patients with dysglycemia associated to COVID-19 had increased markers of inflammation and organs' injury and poorer clinical outcome compared to those with normoglycemia. After the infection resolved, the prevalence of dysglycemia reverted to preadmission frequency. CONCLUSIONS: COVID-19-associated dysglycemia is unlikely to become a lasting public health problem. Alarmist claims on the diabetes risk after COVID-19 pneumonia should be interpreted with caution.


Subject(s)
Blood Glucose/analysis , COVID-19/metabolism , Hyperglycemia/etiology , SARS-CoV-2 , Aged , Aged, 80 and over , COVID-19/complications , Fasting/metabolism , Female , Humans , Male , Middle Aged
2.
PLoS One ; 15(12): e0243192, 2020.
Article in English | MEDLINE | ID: covidwho-1004444

ABSTRACT

OBJECTIVE: To evaluate the role of fasting blood glucose (FBG) to minimise the use of the oral glucose tolerance test in pregnancy (POGTT) for the diagnosis of gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: We analysed the POGTTs of 26,242 pregnant women in Queensland, Australia, performed between 1 January 2015 and 30 June 2015. A receiver operator characteristics (ROC) assessment was undertaken to indicate the FBG level that most effectively identified women at low risk of an abnormal result. RESULTS: There were 3,946 (15.0%) patients having GDM with 2,262 (8.6%) having FBG ≥ 5.1mmol/l. The ROC identified FBG levels >4.6mmol/l having the best specificity (77%) and sensitivity (54%) for elevated 1 and/or 2hr BGLs. There were 19,321 (73.7%) women having FBG < 4.7mmol/l with a prevalence of GDM of 4.0%, less than 1/3rd the overall rate. Only 4,638 (17.7%) women having FBGs from 4.7-5.0mmol/l would require further evaluation to confirm or exclude the diagnosis. CONCLUSION: This contemporary study of women across the state of Queensland, Australia suggests the FBG can be used effectively to define glucose tolerance in pregnancy, minimising their contact with pathology laboratories and potential exposure to the corona virus. This analysis, used in conjunction with outcome data from the HAPO study, provides reassurance to women and their health professionals that FBG < 4.7mmol/l has both a low rate of abnormal glucose tolerance and minimal adverse pregnancy-associated complications.


Subject(s)
Blood Glucose/analysis , COVID-19/epidemiology , Diabetes, Gestational/blood , Adult , Blood Glucose/metabolism , Diabetes, Gestational/diagnosis , Diabetes, Gestational/epidemiology , Fasting/metabolism , Female , Glucose Tolerance Test/methods , Glucose Tolerance Test/standards , Humans , Pregnancy , Queensland
3.
Ann Nutr Metab ; 76(5): 297-303, 2020.
Article in English | MEDLINE | ID: covidwho-781252

ABSTRACT

BACKGROUND: COVID-19 pandemic, a global threat, adversely affects all daily lives, altered governmental plans around the world, and urges the development of therapeutics and prophylactics to avoid the expansion of the viral infection. With the recent gradual opening after long lockdown, several recommendations have been placed, with dietary modification as one of the most important approaches that have been appraised. SUMMARY: Here, we are reviewing how changing the host metabolism, particularly changing the host metabolic state from the carbohydrate-dependent glycolytic state to a fat-dependent ketogenic state, may affect viral replication. Furthermore, the impact of intermittent fasting (IF) in triggering metabolic switch along with the impact of supplementation with medium-chain triglycerides (MCTs) such as lauric acid in repressing the envelope formation and viral replication is also addressed. The amalgamation of IF and a ketogenic diet rich in MCTs is thought to work as a prophylactic measure for normal people and adjunct therapy for infected persons. Key Message: A diet regimen of ketogenic breakfast along with supplementation with two doses of lauric acid-rich MCTs at breakfast and lunch times, followed by 8-12-h IF and a dinner rich with fruits and vegetables, could be a potential prophylactic strategy and adjuvant therapy to combat SARS-CoV-2 infections.


Subject(s)
COVID-19/metabolism , Communicable Disease Control/methods , Diet, Ketogenic/methods , Fasting/metabolism , Virus Replication/physiology , Fasting/physiology , Humans , Pandemics , Triglycerides/administration & dosage , Triglycerides/metabolism
4.
Food Chem Toxicol ; 145: 111701, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-728551

ABSTRACT

Obesity and its related metabolic disorders, as well as infectious diseases like covid-19, are important health risks nowadays. It was recently documented that long-term fasting improves metabolic health and enhanced the total antioxidant capacity. The present study investigated the influence of a 10-day fasting on markers of the redox status in 109 subjects. Reducing power, 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt radical cation(ABTS) radical scavenging capacity, and hydroxyl radical scavenging capacity increased significantly, and indicated an increase of circulating antioxidant levels. No differences were detected in superoxide scavenging capacity, protein carbonyls, and superoxide dismutase when measured at baseline and after 10 days of fasting. These findings were concomitant to a decrease in blood glucose, insulin, glycated hemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) and triglycerides as well as an increase in total cholesterol/high-density lipoprotein (HDL) ratio. In addition, the well-being index as well as the subjective energy levels increased, documenting a good tolerability. There was an interplay between redox and metabolic parameters since lipid peroxidation baseline levels (thiobarbituric acid reactive substances [TBARS]) affected the ability of long-term fasting to normalize lipid levels. A machine learning model showed that a combination of antioxidant parameters measured at baseline predicted the efficiency of the fasting regimen to decrease LDL levels. In conclusion, it was demonstrated that long-term fasting enhanced the endogenous production of antioxidant molecules, that act protectively against free radicals, and in parallel improved the metabolic health status. Our results suggest that the outcome of long-term fasting strategies could be depending on the baseline values of the antioxidative and metabolic status of subjects.


Subject(s)
Fasting/metabolism , Free Radical Scavengers/metabolism , Obesity/diet therapy , Oxidative Stress/physiology , Adolescent , Adult , Aged , Biomarkers/blood , Biomarkers/metabolism , COVID-19 , Coronavirus Infections/prevention & control , Female , Humans , Lipid Metabolism/physiology , Lipid Peroxidation/physiology , Machine Learning , Male , Middle Aged , Obesity/blood , Obesity/metabolism , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Young Adult
5.
Immunol Lett ; 226: 38-45, 2020 10.
Article in English | MEDLINE | ID: covidwho-643130

ABSTRACT

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative pathogen of deadly Coronavirus disease-19 (COVID-19) pandemic, which emerged as a major threat to public health across the world. Although there is no clear gender or socioeconomic discrimination in the incidence of COVID-19, individuals who are older adults and/or with comorbidities and compromised immunity have a relatively higher risk of contracting this disease. Since no specific drug has yet been discovered, strengthening immunity along with maintaining a healthy living is the best way to survive this disease. As a healthy practice, calorie restriction in the form of intermittent fasting (IF) in several clinical settings has been reported to promote several health benefits, including priming of the immune response. This dietary restriction also activates autophagy, a cell surveillance system that boosts up immunity. With these prevailing significance in priming host defense, IF could be a potential strategy amid this outbreak to fighting off SARS-CoV-2 infection. Currently, no review so far available proposing IF as an encouraging strategy in the prevention of COVID-19. A comprehensive review has therefore been planned to highlight the beneficial role of fasting in immunity and autophagy, that underlie the possible defense against SARS-CoV-2 infection. The COVID-19 pathogenesis and its impact on host immune response have also been briefly outlined. This review aimed at revisiting the immunomodulatory potential of IF that may constitute a promising preventive approach against COVID-19.


Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/etiology , Coronavirus Infections/metabolism , Disease Susceptibility , Fasting , Host-Pathogen Interactions , Pneumonia, Viral/etiology , Pneumonia, Viral/metabolism , Autophagy , COVID-19 , Caloric Restriction , Disease Resistance/immunology , Disease Susceptibility/immunology , Fasting/metabolism , Host-Pathogen Interactions/immunology , Humans , Immune Evasion , Immunity , Pandemics , SARS-CoV-2
7.
Diabet Med ; 37(7): 1094-1102, 2020 07.
Article in English | MEDLINE | ID: covidwho-116685

ABSTRACT

The month of Ramadan forms one of the five pillars of the Muslim faith. Adult Muslims are obligated to keep daily fasts from dawn to sunset, with exceptions. This year Ramadan is due to begin on 23 April 2020 and the longest fast in the UK will be approximately 18 hours in length. In addition, due to the often high-calorie meals eaten to break the fast, Ramadan should be seen as a cycle of fasting and feasting. Ramadan fasting can impact those with diabetes, increasing the risk of hypoglycaemia, hyperglycaemia and dehydration. This year, Ramadan will occur during the global COVID-19 pandemic. Reports show that diabetes appears to be a risk factor for more severe disease with COVID-19. In addition, the UK experience has shown diabetes and COVID-19 is associated with dehydration, starvation ketosis, diabetic ketoacidosis and hyperosmolar hyperglycaemic state. This makes fasting in Ramadan particularly challenging for those Muslims with diabetes. Here, we discuss the implications of fasting in Ramadan during the COVID-19 pandemic and make recommendations for those with diabetes who wish to fast.


Subject(s)
Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus, Type 2/therapy , Fasting/metabolism , Holidays , Islam , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/metabolism , Dehydration/epidemiology , Dehydration/metabolism , Dehydration/prevention & control , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/metabolism , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/metabolism , Diabetic Ketoacidosis/epidemiology , Diet Therapy , Disease Management , Fasting/adverse effects , Fluid Therapy , Humans , Hyperglycemia/epidemiology , Hyperglycemia/metabolism , Hyperglycemia/prevention & control , Hyperglycemic Hyperosmolar Nonketotic Coma/epidemiology , Hyperglycemic Hyperosmolar Nonketotic Coma/metabolism , Hypoglycemia/epidemiology , Hypoglycemia/metabolism , Hypoglycemia/prevention & control , Hypoglycemic Agents/therapeutic use , Ketosis/epidemiology , Ketosis/metabolism , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/metabolism , Risk Assessment , SARS-CoV-2 , United Kingdom
SELECTION OF CITATIONS
SEARCH DETAIL