Responses to glycemic control therapy according to age, gender, level of adiposity, and duration of diabetes in type 2 diabetic patients.

CONTEXT: It is established that glycemic control measures involving diet and oral medication reduces glycated hemoglobin concentration (HbA1c) in type 2 diabetic patients. AIMS: To determine whether glycemic levels after diabetic treatment is affected by age, gender, obesity, and diabetic duration in type 2 diabetic patients. SETTINGS AND DESIGN: A total of 52 type 2 diabetic patients participated in a 12-week diabetic management therapy involving oral medication (metformin) and lifestyle intervention (diet). MATERIALS AND METHODS: We compared the glycated hemoglobin reduction after treatment between the elderly and non-elderly; males and females; obese and non-obese; and newly diagnosed and long-standing diabetics. RESULTS: After the diabetic treatment, participants' mean HbA1c level indicated a reduction of 1.1 ± 1.31%, weight loss of 2.46 ± 1.79 kg, and BMI reduction of 0.94 ± 0.69 kg/m 2 . A total of 23 (44.2%) patients had an acceptable HbA1c level of <6.5%. Significantly greater HbA1c reduction was observed in non-elderly, non-overweight/obese, and newly diagnosed diabetic patients compared to the elderly, overweight/obese, and long-standing diabetic patients respectively (P < 0.05 or P < 0.01). HbA1c reduction did not indicate sex differences. CONCLUSION: The present findings suggest lower responses to glycemic control therapy in elderly, overweight/obese, and long-standing diabetic patients when compared to the non-elderly, non-overweight/obese, and newly diagnosed diabetic patients. It is recommended that treatment criteria for type 2 diabetes should account for the age, level of adiposity, and diabetic duration of the patient in order to make optimal therapeutic decisions for the treatment of diabetes mellitus in adults.

The thymus of the guinea fowl from the eighteenth day of incubation until maturity.

The thymus gland of the guinea fowl appeared as a series of pink, irregular-shaped lobes along the jugular veins. These lobes were 13 in number with seven on the right and six on the left side. The third and sixth lobes on the right side were the largest. The largest lobe measured about 20.0 x 5.0 mm while the smallest measured about 5.0 x 4.0 mm. Histologically, it was encircled by a thin layer of poorly stained connective tissue from which strands penetrated the thymic tissue giving incomplete lobules peripherally as early as day 18 of incubation. Lymphocytes and reticular epithelial cells were the two types of cells occurring at this time. Reticular epithelial cells were observed to be vacuolated especially towards the centre of the gland. Macrophages were observed in the thymus on day 20 of incubation for the first time. The blood vessels had accompanied the interlobular septa into the thymus. By day 21 of incubation, blood vessels had actually penetrated the thymic tissue but most of these vessels were of the capillary size. The cortex also became quite distinct from the medulla. At day 22, vacuolation ceased to appear in the cells at the cortical zone. Macrophages were still less than 10 in the slide. At day 23, most blood vessels were within the medulla and they displayed compressed lumina. Mitotic figures became a common site amongst the large lymphocytes and reticular epithelial cells. By day one post-hatch, lobulation of the thymus was still poor and macrophages became difficult to identify. The small and medium lymphocytes had outnumbered the large lymphocytes throughout the thymic tissue except at the most peripheral zone of the cortex. Fine vacuoles had reappeared within the cytoplasm of the reticular epithelial cells in the cortex. By day five, the distribution of blood vessels was almost uniform between the cortex and medulla. At three weeks post-hatch, plasma cells and red blood cells were seen in the stroma of the gland for the first time and most of the red blood cells occurred in the medulla.

The anatomy of the cloacal bursa (bursa of Fabricius) in the helmeted guinea fowl (Numida meleagris galeata).

The cloacal bursa (bursa of Fabricius) in the guinea fowls appeared either as an oval blind sac with a short thick stalk in one group or had a pointed cranial blind end with a slightly bulging middle part that was followed by a thick caudal stalk in the other group. Both groups of bursae originated from the proctodeal wall of the cloaca and were placed dorsal to the rectum. The average length of the bursa was 18 mm while the average width at the mid section was 15 mm. The internal surface showed about 12-14 primary folds. Histologically, the outline of the bursa was well established by day 18 of incubation. The primary folds had also been formed. Lymphocytes had already been encountered within the framework of the bursa at this day. The epithelium bordering the tunica propria was composed principally of two layers of cuboidal cells. Epithelial buds had also formed and some were already detached from the epithelial lining. The blood vessels present were positioned just beneath the outer covering. At day 19 of incubation, most of the epithelial buds had two layers of cells arranged in a circumscribed manner while a few had three layers of cells. Blood vessels had increased in number and were deeper placed inside the bursa than previously. At day 20, the cells of the upper layer of the epithelium were dorsoventrally flattened and stained paler than the cells of the lower layer. It was possible to distinguish the cortex from the medulla and the basement lining between both zones was distinct. Tiny vesicles within the cytoplasm of the epithelial cells at the mucosa and follicles were observed. Macrophages were also observed within the gland. At day 21, blood vessels were observed in the cortex of the follicles. The maximum number of primary folds (14) had been formed. At day 22, several follicles had severed connections with the mucosal epithelium. The mucosal lining had dropped to a single layer of cells in some areas. Goblet cells were observed amongst the mucosal cells. A plasma cell had first appeared. By day 25, dead cells had increased quite in number and there was also an increase in number of medium and small-sized lymphocytes within the gland. By day 26, the upper layer of the surface epithelium was composed primarily of tall columnar cells with numerous large vacuoles. Macrophages had suddenly increased within the thin interfollicular spaces and most of them were crowded internally with various sizes of debris.(ABSTRACT TRUNCATED AT 400 WORDS)

The structure of the harderian gland of the guinea fowl at embryonic and post embryonic stages.

The Harderian gland of the guinea fowl is a bright, pink and relatively large orbital organ situated at the ventromedial aspect of the orbit. It possesses a single duct that has its exit on the convex medial surface. The outline is irregular with its caudal half narrower than the rostral half, and possessing a slight constriction about the mid point. Histologically, the gland had been outlined with the existence of a large contorted lumen by day 18 of incubation. The surface epithelial lining showed two layers of cells all through and lymphocytes were also present. By day 19 of incubation, certain zones of the surface epithelium had become pseudostratified and some of these cells contained vacuoles indicative of secretory materials within their cytoplasm. By day 21, few definitive acini with lumina had been observed and at day 23, the epithelium had assumed only a single layer of cells that were tall columnar cells, except at the junctions of the folds. By day 24, the tunica propria seemed to have completely disappeared with the acini occupying every available space. Plasma cells were seen three days after hatching.