Association between hematological indices and blood glucose level among patients with type 2 diabetes.

BACKGROUND: Diabetes mellitus is a major health problem with a variety of implications: cellular, metabolic, and hematological. Hematological alterations observed in type 2 diabetes are related to hyperglycemia and have a vital role in vascular-associated diabetes complications which could be used as a marker for these complications. The aim of this study is to assess the association between hematological indices and blood glucose levels in patients with type 2 diabetes attending outpatient clinics in Mosul. PATIENTS AND METHODS: A case-control study was done on 100 patients with type 2 diabetes and 100 healthy controls attending Alwafa Center for Diabetes and Endocrinology and four family medicine health centers in Mosul for the period 1st of January 2024-30th of March 2024. Data collection was done by a direct interview with participants. Hematological indices were tested by using an automatic hematology analyzer. RESULTS: Statistically significant differences in Hb were found between diabetic patients and controls (P = 0.007). The total WBC count, neutrophils, and lymphocytes were significantly higher in diabetic patients compared to controls (P = 0.001 for all). Moreover, platelet indices (platelets count and PDW) showed a significant difference between diabetic patients and controls (P = 0.004 and 0.000) respectively. In addition, total WBC count, neutrophil count, and lymphocytes show a statistically significant positive correlation with FBS (P = 0.026, 0.050, and 0.019) respectively. CONCLUSION: This study revealed statistically significant differences in various hematological parameters between patients with type 2 diabetes and healthy controls. Regular testing of hematological indices helps in early detection and proper management of diabetic complications.

Point prevalence of metabolic syndrome in HIV positive patients.

Introduction: Human immunodeficiency virus (HIV)-related morbidity and mortality have declined over time, but this increased longevity may lead to the development of other diseases, which may further manifest as the metabolic syndrome (MS). Method: To find out the point prevalence of MS in HIV positive patients, a cross-sectional prospective observational study was conducted on 200 patients who approached ART plus Centre of Government Medical College and Hospital Jammu, including 50 symptomatic patients HIV negative as controls. Results: The mean age group in MS was 37.85 ± 6.61. Males consisted of 55% (110) and females consisted of 45% (90). The overall prevalence of MS was 13.5%, with prevalence in males being 16.3% and in females 10%. Patients receiving first line highly active antiretroviral therapy (HAART) showed a 24% prevalence, while that of second line HAART showed a 14% prevalence. Central obesity (47.3%) was the most common component of MS followed by hyperglycemia (43.3%), hypertriglyceridemia (38.6%), and low high density cholesterol (HDL-C) level (38.6%). Out of 84 males with MS, 94% (79) males were having hypertriglyceridemia, 88% (74) were hypertensive, and 72% (60) were having FBS >=100. Out of 66 females with MS, 100% (66) females had central obesity and 88% (58) had hypertriglyceridemia and low HDL-C levels. Conclusion: The metabolic complications as a result of treatment with HAART leave HIV patients at a risk of developing cardiovascular disease and diabetes in spite of improvements in morbidity and mortality. Risk factors like central obesity, hypertension, hyperglycemia, and hypertriglyceridemia should be taken into consideration well before to prevent the add-on effect of developing MS.

The association between dietary meal intake habits and coronary artery stenosis and cardio-metabolic risk factors.

BACKGROUND AND OBJECTIVE: We are not aware of studies examining the association between dietary meal intake habits (DMIH) and severity of coronary artery stenosis (CAS). This study was conducted to investigate the relationship between DMIH and the severity of CAS as well as cardiometabolic risk factors in adults undergoing coronary angiography. METHODS: This cross-sectional study was done on 720 patients undergoing coronary angiography (aged 35-75 years) who were admitted to Afshar Hospital, a referral hospital for cardiovascular diseases in Yazd, Iran. Data on DMIH were gathered by interview. Blood samples were taken for biochemical analysis. Blood pressure, anthropometric indices, and body composition were also evaluated. The relationship between DMIH and the severity of CAS [examined by angiography based on Gensini Score (GS) and Syntax Score (SS)] and cardiometabolic risk factors were assessed using logistic regression and the analysis of covariance (ANCOVA), respectively, in crude and multivariable adjusted models. RESULTS: After adjustment for all possible confounding variables, the study revealed that people who ate 3 meals/day had a lower risk of severe CAS compared to people who ate 2 or fewer meals (OR = 0.48, 95% CI: 0.26, 0.88, P-trend = 0.02). There was an inverse association between the number of snacks /day and the severity of CAS (OR = 0.43, 95% CI: 0.22, 0.87, P-trend = 0.02). There was also an inverse relationship between breakfast frequency/week and the severity of CAS based on both GS and SS (P < 0.05). Breakfast consumption, meal frequency, lunch consumption, snack frequency, and more food consumption on holidays were also associated with different cardiometabolic markers and anthropometric measures (P < 0.05). CONCLUSION: According to the results of the present study, meal frequency and breakfast consumption might be inversely associated with CAS and cardiometabolic risk factors.

Relationship between blood lead (Pb) concentration with risk of diabetes mellitus in women living in mining area.

Diabetes is a global health concern with significant implications for individuals and societies. Diabetes results from a complex interaction between genes and environmental factors, including metal exposure. Lead or plumbum (Pb) is a heavy metal pollutant and is predicted to be associated with the morbidity of diabetes. The aim of this study was to assess the relationship between blood Pb level and possible risk factors (body mass index insulin resistance, carbohydrate intake, sugar intake, and physical activity) with fasting blood sugar (FBS) level in women living in the mining area. A cross-sectional study was conducted in a mining area of Indonesia located in Pemali District, Bangka Belitung Regency, involving women aged 30-49, selected through purposive sampling. Logistic regression was used to assess the relationship between the risk factors and FBS level, while the Spearman correlation was used to analyze the correlations between the risk factors and FBS level. Our data indicated that blood Pb concentration and other risk factors (carbohydrate intake, sugar intake and physical activity) were neither associated nor correlated with FBS level. However, as predicted, insulin resistance was associated with FBS level with OR: 9.66; 95%CI: 1.13-82.29; p=0.038. In addition, the Homeostatic Model Assessment Insulin Resistance (HOMA-IR) score was also correlated with FBS level (r=0.316, p=0.002). This study highlights the level of Pb is not associated with the risk of diabetes in women living in mining area.

The Impact of Resistance Exercise Training on Glycemic Control Among Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: The prevalence of type 2 diabetes mellitus (T2DM) presents a challenge for health organizations because of its high likelihood of morbidity and mortality. There is an increasing body of evidence exploring the efficacy of resistance training (RT) alone on glycemic control. Objective: To update the effectiveness of RT on glycosylated hemoglobin (HbA1c) and fasting glucose in adults diagnosed with T2DM. Methods: CINAHL (EBSDCO), PubMed, MEDLINE (Ovid), and EMBASE (Ovid) databases were searched from inception to 30 January 2024. Published randomized controlled trials (RCTs) of adult humans with T2DM assessing the impact of RT on HbA1c and fasting glucose compared with control condition were included. Data were pooled by the inverse-variance method and reported as mean differences (MDs) with 95% confidence intervals (CIs). Results: Forty-six RCTs totaling 2130 participants met the inclusion criteria. Meta-analysis demonstrated RT significantly reduced HbA1c (MD -0.50% [95% CI, -0.67, -0.34 %], p < .00,001) and fasting glucose (MD -12.03 mg/dl [95% CI, -19.36, -4.69 mg/dl], p = .001). Subgroup analyses found that exercise training durations, gender, and risk of bias had statistically significant effects on HbA1c levels and fasting glucose concentrations after resistance training. However, meta-regression analyses revealed that variables including year of publication, number of sessions per week, mean sample age, sample size, and study quality scores did not significantly affect the change in either HbA1c or glucose. Conclusion: Our meta-analysis with meta-regression delivers further evidence that RT programs are effective approach in attenuation of HbA1c and fasting glucose in individuals with T2DM.

Educational intervention based on the extended parallel process model improves adherence to diabetic diet and glycaemic control indices: a randomised, double-blind, controlled, factorial field trial.

Nutritional education is pivotal in the medical nutritional therapy of type 2 diabetes mellitus (T2DM). The extended parallel process model (EPPM) is a health education method for inducing desirable health behaviours. The present study aimed to investigate the effect of nutritional education based on the EPPM in T2DM patients on knowledge, attitude, practice, anthropometric indices, glycaemic factors, lipid profile and adherence to the diabetic diet. A randomised, double-blind, controlled, factorial field trial was designed for T2DM patients aged 30-59 years (n 88). Participants were randomly allocated into four groups to receive EPPM-based nutritional education through gain framed message (GFM), loss framed message (LFM), their combination (G\LFM) or usual diabetic education in the control group (CG). Participants were assessed before and after the study duration. After 3 months of intervention, eighty participants finished the study. The EPPM-based intervention increased participants' knowledge, behavioural intention, perceived sensitivity, severity, self-efficacy (P < 0·001 for all) and response efficacy (P = 0·029) in comparison with CG. GFM (P = 0·004) and G\FLM (P = 0·034) reduced carbohydrate intake and LFM (P = 0·034) and G\LFM (P = 0·047) decreased fat intake. Between-group analysis indicated interventions reduced weight (P = 0·046), BMI (P = 0·038), fasting blood sugar (P = 0·030), 2-hour postprandial blood glucose (P = 0·027) and TAG (P = 0·002) in comparison with the CG. Results were NS for protein intake, waist and hip circumference, waist:hip ratio, HbA1c, total cholesterol, LDL and HDL. Nutritional education based on EPPM could increase the knowledge and awareness of T2DM patients. Also, it could be beneficial for blood glucose amendment. Further investigations are recommended.

Association Between Serum Ferritin and the Duration of Type 2 Diabetes Mellitus in a Tertiary Care Hospital in Chennai.

BACKGROUND: Hyperinsulinemia has been linked to increased ferritin production and iron absorption in type 2 diabetes mellitus, ultimately leading to increased iron storage. Glucose intolerance is intimately linked to this issue. Increased oxidative stress from iron decreases insulin's ability to be taken into cells and used for energy. Researchers suggest that increased iron levels in the body play a role in the emergence of insulin resistance, glucose intolerance, and vascular repercussions associated with diabetes. OBJECTIVE: The aim of this study is to assess the levels of serum ferritin and fasting plasma glucose in both diabetic and nondiabetic individuals while establishing a relationship between the two. Exploring the connection between serum ferritin levels and the duration of diabetes mellitus in individuals diagnosed with diabetes is our objective. METHODOLOGY: In this study, 80 men diagnosed with type 2 diabetes mellitus were included, and they were compared with 70 male volunteers who were in good health. We took blood samples while the subjects fasted, and we analyzed the plasma glucose and serum ferritin levels. RESULTS: In the diabetic group, there were notably higher levels of serum ferritin and fasting plasma glucose compared to the nondiabetic subjects. Furthermore, a correlation was observed between the duration of diabetes among participants with diabetes and elevated serum ferritin levels. CONCLUSION: The findings suggest that low-grade inflammation and increased body iron stores are positively related to hyperglycemia in type 2 diabetes mellitus.

Medicinal herbs consumption in relation to cardiometabolic indices and coronary artery stenosis in participants undergoing coronary angiography: A cross-sectional study.

Few studies have investigated the association between herbal medicine consumption and coronary artery disease severity. This cross-sectional study aimed to investigate the association between the frequency of medicinal herbs consumption and coronary artery stenosis (CAS), lipid profile, fasting blood sugar (FBS), and blood pressure level in participants undergoing coronary angiography. This study was conducted on 662 participants aged 35-75 years. Serum cardiometabolic markers were measured using standard kits. The extent and severity of CAS were evaluated using the Gensini score (GS) and syntax score (SS). Higher consumption of Thymus vulgaris and Sumac was associated with decreased odds of artery-clogging according to the GS. A higher intake of Thymus vulgaris and Mentha was associated with lower levels of serum cholesterol and triglyceride. Monthly intake of Thymus vulgaris, and weekly/daily intake of Mentha, Nigella Sativa, and Cuminum Cyminum were associated with lower low-density lipoprotein. Weekly/daily intake of Turmeric and Thymus vulgaris were associated with lower high-density lipoprotein levels and monthly intake of Mentha was related to lower serum FBS levels. Higher consumption of Mentha, Mentha pulegium L, Lavandula angustifolia, and Nigella Sativa was associated with lower levels of systolic blood pressure. According to the results of the present study, herbs consumption might be related to a reduction in CAS risk factors.

Interleukin Levels and Non-Alcoholic Fatty Liver Disease in Chronic Plaque Psoriasis: An Analytical Case Control Study.

Background: Psoriasis is a chronic, immune mediated inflammatory condition of the skin and imbalance in inflammatory mediators could result in insulin resistance, metabolic syndrome and facilitate the occurrence and progression of Non-alcoholic fatty liver disease (NAFLD). Objectives: Primary objectives: To study the frequency of NAFLD in cases of chronic plaque psoriasis and controlsTo study the interleukin levels in cases of chronic plaque psoriasis and controls. Secondary objectives: To study the BMI, lipid profile, waist circumference, FBS (fasting blood sugar), PPBS (post prandial blood sugar) and serum insulin in cases and controlsTo study the association of age, duration of psoriasis, PASI (psoriasis area severity index), BSA (body surface area) involved, BMI (body mass index), lipid profile, obesity, waist circumference, FBS (fasting blood sugar), PPBS (post prandial blood sugar) and serum insulin levels with NAFLD in patients of chronic plaque psoriasisTo correlate serum levels of IL1-ß, IL6 and TNF-α with NAFLD in patients of chronic plaque psoriasis. Methods: 50 clinically diagnosed cases of chronic plaque psoriasis with age ≥ 18years, diseases duration ≥ 6 months and 30 age and sex matched controls were recruited. PASI, BSA of cases was calculated and BMI, BP, WC of all subjects was measured. Serum lipid profile, FBS, PPBS, insulin level, IL1- ß , IL6, TNF- α , high frequency B-mode ultrasound, LFT and fibroscan were done in all subjects. Results: 28(56.0%) cases and 2(6.6%) controls had NAFLD with statistically significant difference. Significantly elevated WC, serum insulin, deranged lipid profile, fatty liver, transaminitis, fibroscan score, liver fibrosis, NAFLD and interleukins were found in cases vs controls. There was a significant association of NAFLD in psoriatic patients with increasing duration of psoriasis, BMI ≥23 Kg/m2, high WC, increasing BSA involved, deranged lipid profile, raised total cholesterol levels and increasing number of risk factors. Nonsignificant but positive association of NAFLD in cases was found with high levels of IL1 - ß, IL - 6, TNF-α, FBS and increasing PASI. Conclusion: Significantly increased interleukin levels and their weak positive correlation with the severity of psoriasis (PASI, BSA) in patients of chronic plaque psoriasis explains the possible role of inflammation in the causation of psoriasis. Screening may be considered in psoriatic patients with increasing duration of psoriasis, high WC, high BSA involved, high BMI, obesity, dyslipidemia and insulin resistance. Limitations: Small sample size. Conflict of Intrest: NONE.

Selenium supplementation effect on glycemic control: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.

Results from different studies on the effects of selenium supplementation on glycemic control are still debated. To fill this knowledge gap, we investigated the overall effects of selenium supplementation on some glycemic parameters such as fasting blood sugar (FBS), hemoglobinA1c (HbA1c), fasting insulin, quantitative insulin sensitivity check index (QUICKI), and homeostatic model assessment of insulin resistance (HOMA-IR). A comprehensive literature search was conducted from inception to April 2023 on Scopus, Web of Science, PubMed, Google Scholar, and Cochrane databases. All randomized controlled trials (RCTs) which reported an effect of selenium supplementation on glycemic parameters were included. A random-effects model was used to estimate the weighted mean difference (WMD) and 95% CI for each outcome. Between-studies heterogeneity was assessed by the I2 and Cochran's Q test. 20 trials were included in the meta-analysis. Pooled analysis showed that selenium intake significantly reduced fasting insulin (WMD: -3.02 µIu/mL, 95% CI; -5.13, -0.90, P = 0.005) and increased QUICKI levels (WMD: 0.01, 95% CI: 0.01, 0.02, P = 0.005). However, selenium supplementation did not change FBS (WMD: -1.32 mg/dL, 95% CI; -4.02, 1.37, P = 0.332), HbA1c (WMD = 0.05%, 95% CI: -0.19, 0.28, p = 0.701), and HOMA-IR (WMD: -0.82, 95% CI; -2.14, 0.50, P = 0.223). Moreover, we found that there is a non-linear association between selenium supplementation dosage and FBS (P-nonlinearity = 0.008). In conclusion, our study findings indicate some benefits of selenium on fasting insulin, and QUICKI compared with placebo, but elicits no effect on HbA1c, HOMA-IR, and FBS. Further well-designed RCTs with larger samples are necessary to ascertain the effects of selenium supplementation on glycemic control.

Effects of eicosapentaenoic acid supplementation on heat shock protein 27, glycemic status and anthropometric indices in type 2 diabetes patients.

Purpose: Heat shock proteins (HSP-27) are reported to be involved in the pathophysiology of diabetes complications. The purpose of the current study is to assess the effects of eicosapentaenoic acid (EPA) supplementation on serum HSP-27, glycemic status and anthropometric indices in type 2 diabetes mellitus (T2DM) patients. Methods: Thirty-six patients with T2DM were randomly allocated to obtain 2 g per day EPA (n = 18) or placebo (n = 18) for 8 weeks in a randomized, double-blind, placebo-controlled clinical trial. Fasting serum levels of HSP 27, fasting blood sugar, hemoglobin A1C, as well as anthropometric indices were measured. Results: EPA supplementation reduces the serum level of HSP 27 in the EPA group compared with the placebo (P < 0.03). Although waist circumference (WC) decreased significantly in the EPA group at the end of the trial (P < 0.02), there was no significant difference in weight, WC, body mass index (BMI), and glycemic markers in both groups after intervention (P > 0.05). Conclusions: We found that EPA supplementation reduces HSP 27 serum level in T2DM patients. However, future large-scale trials are needed.

Mid-Trimester Fetal Anterior Abdominal Wall Subcutaneous Tissue Thickness: An Early Ultrasonographic Predictor of Gestational Diabetes Mellitus.

Background This study aimed to determine whether mid-trimester fetal anterior abdominal wall subcutaneous tissue thickness (FASTT) is an early sonographic predictor of gestational diabetes mellitus (GDM), as well as to study its correlation with maternal glycemic values on GDM screening at 24-28 weeks. Methodology We conducted a prospective, case-control study. FASTT was assessed at anomaly scan in 896 uncomplicated singleton pregnancies. The 75-gram oral glucose tolerance test (OGTT) was done for all included patients at 24-28 weeks. Women diagnosed with GDM were taken as cases and appropriately matched in equal numbers as controls. Statistical analysis was done using SPSS version 20 (IBM Corp., Armonk, NY, USA). Independent-samples t-test, chi-square test, receiver operating characteristic curve, and Pearson's correlation coefficient (r) were performed wherever applicable. Results A total of 93 cases and 94 controls were included. Fetuses of women with GDM had significantly higher mean FASTT at 20 weeks (1.605 ± 0.328 mm vs. 1.222 ± 0.121 mm; p < 0.001). The FASTT cut-off obtained was 1.35 mm (sensitivity = 79.6%, specificity = 87.2%, positive predictive value = 86%, negative predictive value = 81.2%). There was a moderate positive correlation between fasting blood sugar (FBS) and two-hour OGTT values and FASTT (r = 0.332, p < 0.001 and r = 0.399, p < 0.001, respectively). FASTT >1.35 mm had an independent predictive value for GDM and was associated with a 19.608-fold increased risk of GDM. Conclusions FASTT values greater than 1.35 mm at 20 weeks are associated with a significantly increased risk of GDM. In addition, FASTT correlates with FBS and two-hour OGTT at 24-28 weeks and is a simple predictor of GDM at 18-20 weeks.

The role of serum lipid profile, fasting blood sugar, and body mass index on recurrence and metastasis in patients with estrogen receptor-positive breast cancer: A case-control study.

Background: Breast cancer (BC) is the leading cause of cancer death in women. The current study is designed to evaluate the association of lipid profiles, FBS, and body mass index (BMI) with BC recurrence and metastasis. Materials and Methods: This is a case-control study on estrogen receptor-positive BC patients in Isfahan Province, Central Iran, between 2008 and 2020. The control group was patients who had no evidence of recurrence or metastasis at least 1 year after the end of chemotherapy and hormone therapy. The case group was patients with evidence of metastasis or recurrence within 1 year after the end of chemotherapy and hormone therapy. Fasting blood sugar (FBS), total cholesterol (Chol), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured before treatment, after chemotherapy, and after hormone therapy as well as BMI in the case and control groups. Results: There were 108 patients in the case and 119 patients in the control group with a mean age of 50.72 ± 13.26 and 51.91 ± 11.79, respectively. There were no meaningful differences between the case and control groups regarding serum FBS, Chol, TG, HDL, LDL, and BMI. Conclusion: We found no association between serum FBS, lipid profile, and BMI at initial diagnosis and BC recurrence or metastasis.

Association of Glycosylated Haemoglobin (HbA1c) Level With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes.

Background Some literature has shown a high prevalence of pre-clinical diastolic dysfunction in subjects with type 2 diabetes mellitus. The current study was carried out to determine the association of glycosylated hemoglobin (HbA1c) levels with left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes. Methods An observational cross-sectional study was conducted in a tertiary health care center in Jharkhand. A total of 100 subjects diagnosed with type 2 diabetes mellitus who gave informed consent and fulfilled the inclusion and exclusion criteria were studied in our center from April 2019 to September 2020. Logistic regression was carried out to determine the association of potential variables with outcomes. Multivariable logistic regression analysis was conducted to determine the independent effects of variables for LVDD prediction. Results The mean HbA1c of the population with LVDD was found to be higher (11.07 ± 3.66%) as compared to the population with normal LVDD (9.11 ± 2.95%), which was found statistically significant (probability value (P) =0.004). This signifies that a higher level of HbA1c in a patient with diabetes will have a higher incidence of LVDD. On applying multivariate analysis to determine the independent effect of variables for LVDD, HbA1C was found to be significant with an odds ratio (OR) of 1.26, 95% CI 1.08-1.48. The duration of diabetes was also found to be significant with OR 1.48 and CI 95 % (1.20-1.82) P <0.001. On plotting the receiver operating characteristic curve (ROC), the area under the ROC curve to predict the left ventricular function with the model was 0.8137. Conclusions Patients who have higher HbA1C are linked to a higher risk of left ventricular diastolic dysfunction in patients with type 2 diabetes. The combination of diabetes and left ventricular dysfunction can lead to increase morbidity and mortality in those patients in whom it is not identified timely and appropriate measures are not taken. Our work emphasizes the requirement of screening intermittently symptomless diabetic patients for diastolic dysfunction through a Doppler echocardiography so that timely action can be taken.

A personalized multi-interventional approach focusing on customized nutrition, progressive fitness, and lifestyle modification resulted in the reduction of HbA1c, fasting blood sugar and weight in type 2 diabetes: a retrospective study.

BACKGROUND: Type 2 diabetes (T2D) is a chronic, progressive lifestyle disease and the most rapidly growing health challenge of the twenty-first century. The American Diabetes Association recommends that T2D reversal can be achieved through an organized, and systematic approach focusing on nutrition, fitness, and lifestyle management. AIM: This study aimed to evaluate the effectiveness of a comprehensive and multi-interventional diabetes care program called Sugar. Fit Diabetes Reversal Programme (SDRP) on glycosylated haemoglobin (HbA1c), fasting blood sugar (FBS), and body weight for T2D reversal. METHODOLOGY: SDRP is a personalized intervention study that uses technology-enabled medical management, dedicated coach-led diabetes, and nutrition experts. The study involved 150 patients living with type 2 diabetes in the age group of 20 to 80 years and having HbA1c of > 6.5%. In SDRP, the participants were assigned personal medical doctors specializing in diabetes, along with health coaches for providing customized nutrition, personalized fitness routines, relevant lifestyle modifications to holistically reverse type 2 diabetes. The HbA1c level, fasting blood sugar, and weight of the participants were measured at baseline and the end of the study (90th day). The effectiveness of SDRP was analyzed by comparing it with a control group that involved 110 individuals with type 2 diabetes managed by conventional pharmacotherapy and regular dietary advice but not participating in the SDRP. RESULTS: All 150 participants adhered to the program for 90 days. The analysis was performed on participants and represented as mean ± standard deviation (mean ± SD). At the end of SDRP, a significant reduction in HbA1c level, FBS, and weight was observed as compared to the control group. The results showed that Hba1c levels dropped from 9.0 ± 1.5% to 7.1 ± 1.3% with a mean change of 1.9 ± 1.5%; FBS levels decreased from 178.3 ± 57.1 mg/dL to 116.1 ± 24.2 mg/dL with a mean loss of 62.2 ± 51.8 mg/dL, and the weight decreased from 76.7 ± 12.7 kg to 73.8 ± 11.8 kg with a mean weight loss of 2.8 ± 1.6 kg. The results also showed that participants between 20 to 35 years showed the highest drop in HbA1c, FBS, and weight. CONCLUSION: The findings indicate that a comprehensive and multi-interventional diabetes care program involving personalized nutrition, fitness, and lifestyle modification such as SDRP, help in significant and sustained improvements in HbA1c level, glycaemic control, and weight loss in adults with type 2 diabetes.

Longitudinal modeling of fasting blood sugar with diabetes: A case study of Adama Hospital Medical College, Ethiopia.

Objective: The aim of this study was to evaluate the change in fasting blood sugar (FBS) over time and its determinants in diabetic patients. Methods: A longitudinal data analysis retrospective-based study was considered with a sample of 312 patients, and the linear mixed effect model was applied. Results: Based on the linear mixed model, the 3-month change in time decreases the average FBS level by 0.0111. An increase of one unit of body mass index (BMI) increases the FBS level by 0.0434. Similarly, an increase in blood pressure (DBP) per unit increased the average log FBS level by 0.0005. Secondary and higher education levels lower log FBS levels by 99.41% and 99.45%, respectively, compared with noneducated individuals. Conclusion: The study showed that hypertension history, type of diet, age, status of education, type of drug, body mass index, diastolic blood pressure, and time were statistically significant factors. Implications: According to the study, eating a healthy diet, maintaining a healthy body weight, and a low blood sugar level are essential to controlling blood sugar and preventing long-term complications. The government should build an educational institution proportional to the population and open programs to increase awareness about the prevention mechanism of diabetes in communities.

Role of Intermittent Fasting in the Management of Prediabetes and Type 2 Diabetes Mellitus.

Diabetes mellitus (DM) is a highly prevalent disease in the modern society. It can be defined as a group of metabolic diseases marked by chronic hyperglycemia arising from defects in insulin secretion or resistance to insulin action, or both. Its predecessor, prediabetes, is also an important entity, and its management is essential to prevent its progression to DM. Together, these entities burden global health and the world economy, and therefore, prevention and management are key to improving global health and reducing the financial burden on the world economy. Comprehensive lifestyle modification has been proven to be a safe and effective method for preventing the progression of prediabetes and treatment of type 2 diabetes mellitus. Lifestyle modifications such as weight loss, exercise, and diets such as low-carbohydrate one, Mediterranean, and very low calorie diets are traditionally recommended. These particular diets aim to attain calorie deficits and thus induce weight loss. Intermittent fasting (IF) is one such diet that focuses more on the timing of calorie consumption. However, there are several methods of achieving this, which are highlighted in this review. IF has been shown to promote weight loss, reduce insulin resistance, improve glycemic control and lower the risk of cardiometabolic diseases. However, little literature is available regarding the use of IF in managing DM. This review intends to elucidate the role of intermittent fasting in preventing and treating DM, including its benefits and limitations. From the various studies reviewed in this article, it can be deduced that intermittent fasting can achieve suitable glycemic targets and weight control.

Measurement of visceral fat for early prediction of prediabetes-Cross-sectional study from Southern India.

Objective: Prediabetes is a precursor to type 2 diabetes mellitus and routine screening of prediabetes is crucial. Visceral fat (VF) is associated with prediabetes and insulin resistance. Ethnic and racial differences resulting in different levels of VF in the Indian population necessitates an India-specific study. There is a dearth of literature on the cut-off values of VF measured using a bioelectrical impedance analyzer (BIA) to predict prediabetes in the Indian population. Hence, the main objective of this study was to determine the sex-specific cut-off value of VF on BIA to predict prediabetes in the Indian population. Methods: Three hundred individuals aged 18-55 years of both sexes were selected for this cross-sectional study. VF was evaluated as a part of body composition analysis using BIA. The body composition variables for the prediction of prediabetes were examined using backward logistic regression. Optimal cut-off levels of VF to predict prediabetes were identified using receiver operator characteristic curve (ROC) analysis. Results: VF, total fat, and age were found to be associated with prediabetes (p ≤ 0.05). In females, the cut-off value of VF for predicting prediabetes was identified as 8 with 77.8% sensitivity and 69.3% specificity; in males, it was 11 with 84% sensitivity and 62.9% specificity. Conclusion: This study contributes to the sex-specific cut-off values of VF level on BIA that can be used for predicting prediabetes in the Indian population.

High Fasting Blood Sugar and Increased Waist Circumference as Risk Factors for Diabetic Retinopathy in Type 2 Diabetes Patients Older than 45 Years.

Introduction Diabetes mellitus (DM) has a long-term impact on retinal micro-blood vessels, culminating in the progression of diabetic retinopathy (DR); however; screening for DR is not widely used due to a lack of accessibility and economic constraints, especially in resource-limited settings. Thus, a longitudinal marker that is associated with the development of DR is required. This study sought to assess the association of DR with fasting blood sugar (FBS) levels and waist circumference. Methodology A cross-sectional study was conducted in a tertiary care hospital for one year. All individuals diagnosed with Type 2 DM (T2DM) and ≥45 years of age were included in the study. Individuals with fasting blood glucose levels of <126 mg/dl and <3 years of diagnosis with T2DM were excluded from the study. Individuals having one or more retinal microaneurysms or retinal blot hemorrhages, with or without any additional abnormalities, were diagnosed with DR. The results were analyzed using SPSS version 21 (IBM Corp., Armonk, NY). Results The prevalence of diabetic retinopathy among the study participants was 67.6 %. There was a significant association between increasing waist circumference (p = 0.009) and High FBS levels (p = 0.032) with the presence of DR. Conclusion Approximately two-thirds of the patients with T2DM aged >45 years and above have diabetic retinopathy. High FBS and waist circumference were associated with DR.

Effects of tart cherry juice consumption on cardio-metabolic risk factors: A systematic review and meta-analysis of randomized-controlled trials.

BACKGROUND: Tart cherries are rich in bioactive compounds, such as anthocyanins and other phytochemicals known to have antioxidant properties and exert cardiovascular protective effects. However, there is no definitive consensus on this context. The present systematic review and meta-analysis aimed to investigate the effect of tart cherry juice consumption on cardio-metabolic risk factors. METHODS: A systematic search was conducted on electronic databases, including PubMed, Web of Science, Scopus, and Google Scholar from inception up to December 2021 to identify eligible RCT studies. A random-effect model was utilized to estimate the weighted mean difference (WMD) and 95% confidence (95% CI). RESULTS: Ten RCTs were included in the present meta-analysis. The pooled analysis revealed that tart cherry juice consumption led to a significant reduction in the fasting blood sugar (FBS) levels (WMD = -0.51 mg/dl [95% CI: -0.98, -0.06]). This lowering effect of FBS was robust in subgroups with cross-over studies, participants with age range ≥ 40, duration of follow-up ≤ 4 weeks, and baseline BMI ≥ 30. In contrast, tart cherry juice had no effect on total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), insulin, body mass index (BMI), fat mass, systolic and diastolic blood pressure. However, in the subgroup analysis, some significant effects were observed for insulin, TG, TC, LDL-C, and HDL-C. CONCLUSION: In summary, this meta-analysis showed that tart cherry juice mostly had a favorable effect on FBG levels. However, further RCTs with long-term intervention with different doses of administration are needed.