Insulinoma: clinical manifestations, diagnosis and treatment. The significance of the prolonged fasting test and of the fasting blood glucose-insulin relationship

1979 ◽  
Vol 2 (3) ◽  
pp. 285-290 ◽  
Author(s):  
Klaus Johansen
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Clinical Manifestations ◽  
Diagnosis And Treatment ◽  
Prolonged Fasting ◽  
Fasting Test

MODY3 in the children and adolescents: the molecular-genetic basis and clinico-laboratory manifestations

2015 ◽  
Vol 61 (3) ◽  
pp. 16-22 ◽  
Author(s):  
E A Sechko ◽  
T L Kuraeva ◽  
L I Zil’berman ◽  
O N Ivanova ◽  
V A Peterkova
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Molecular Genetic ◽  
Fasting Blood Glucose ◽  
Clinical Manifestations ◽  
Common Mutation ◽  
Molecular Genetic Basis ◽  
Diabetes Mellitus Diagnosis ◽  
History Of ◽  
Hba1c Levels

The present study of HNF1А gene involved 121 children suspected to have the nonimmune-mediated form of diabetes mellitus. Diagnosis of MODY3 was verified in 18 (19.4%) probands. Disturbances of carbohydrate metabolism in one of the parents were documented in 94.5% of the cases. Metabolic disorders were revealed in the probands at the mean age of 11.65 years (9.8; 14.6), the clinical manifestations of diabetes mellitus (DM) were apparent in 16.7% of the children, the fasting blood glucose level was 7.5 mmol/l, HbA1c 6.6% (6.5; 7.7), 66.7% of the children had a history of glucosuria and 33.3% suffered obesity. The normal fasting blood glucose and HbA1c levels were found in 22.2% of the children. In 100% of the cases, results of OGTT suggested diabetes despite insulin secretion. Low titers of anti-GAD and anti-IA2 antibodies were detected in 20.0 and 22.2% of the children respectively. The most common mutation was p.P291fs.

scholarly journals HYPOGLYCAEMIA AS A CONSEQUENCE OF PRE-OPERATIVE FASTING: MYTH OR REALITY?

2018 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Nwosu Arinze DG ◽  
Nwobi Emmanuel A ◽  
Obi Ikechukwu E
Keyword(s):  
Blood Glucose ◽  
Correlation Coefficient ◽  
Whole Blood ◽  
Statistical Significance ◽  
Fasting Blood Glucose ◽  
Prolonged Fasting ◽  
Pearson’S Correlation ◽  
Pearson’S Correlation Coefficient ◽  
Pearson's Correlation ◽  
Pearson's Correlation Coefficient

Background: The fatal risk of pulmonary aspiration of gastric contents during anaesthesia had since been recognized and consequently preoperative fasting guideline is usually prescribed to prevent this. Concern about development of hypoglycaemia during prolonged fasting has often been expressed, especially in children. AIM: This study is intended to determine the fasting blood glucose in preoperative patients of different age groups who were fasted for varying duration of time, and determine whether indeed hypoglycaemia occurs during inadvertently prolonged fasting which we often encounter in our practice setting. Methodology: A prospective cohort study of fasting blood glucose (FBG) of patients presenting for elective surgery in the principal investigator’s operating rooms at the National Orthopaedic Hospital, Enugu, Nigeria was carried out. Blood glucose meter was used for estimation of glucose in capillary whole blood of the patients and the obtained data were analysed using SPSS version 16.0 statistical software. Comparison of mean values was done using the Chi-square test with statistical significance put at P < 0.05.  Results: Out of one hundred and thirty three patients studied with mean age of 30.2 ± 19.60 years (range: 1-72 years), and mean duration of fasting 12.73 ± 2.01 hours, (range: 8-16 hours), the mean fasting blood glucose was found to be 91.49 ± 13.36mg/dl (range: 58 - 124mg/dl). No relationship was found between age and FBG (Pearson’s correlation coefficient, r = 0.025). Likewise duration of fasting did not relate with FBG (Pearson’s correlation coefficient, r = 0.088). One patient (0.8%) had hypoglycaemia, with blood glucose of 58mg/dl. Conclusion: Hypoglycaemia as a consequence of pre-operative fasting is rare, even in non-infants fasted for considerably long hours. Neither patient’s age, gender, nor duration of fasting had any significant influence on the fasting blood glucose of the patients.Keywords: Hypoglycaemia; pre-operative fasting; whole blood; Plasma.

scholarly journals Blood glucose and insulin and correlation of SLC25A13 mutations with biochemical changes in NICCD patients

2017 ◽  
Vol 242 (12) ◽  
pp. 1271-1278 ◽  
Author(s):  
Chun-Ting Lu ◽  
Qi-Ping Shi ◽  
Ze-Jian Li ◽  
Jiong Li ◽  
Lie Feng
Keyword(s):  
Blood Glucose ◽  
Gestational Age ◽  
Fasting Blood Glucose ◽  
Clinical Manifestations ◽  
Gene Mutations ◽  
Biochemical Changes ◽  
Unknown Etiology ◽  
Genetic Mutations ◽  
Control Group ◽  
Case Group

Neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) is a hereditary metabolic disease arising from biallelic mutations of SLC25A13. This study aimed to explore the characteristics of fasting blood glucose (FBG), fasting insulin (FINS) and C-peptide (C-P) levels in NICCD infants, analyze their SLC25A13 genetic mutations and further discuss the correlation between SLC25A13 genetic mutations and biochemical changes. Seventy-two cases of infants with cholestasis disease were gathered. Among them, 36 cases with NICCD diagnosis were case group. Meanwhile, 36 cases with unknown etiology but excluded NICCD were control group. FBG, FINS, C-P, ALT, AST, GGT, ALP, TG, HDL-C, LDL-C and Non-HDL-C were collected from all subjects, and DNA was extracted from venous blood for SLC25A13 mutations detection. The incidence of hypoglycemia was 3% in NICCD group. There were no significant statistical difference of FBG, FINS and C-P between NICCD and INC groups ( P > 0.05). ALT, LDL-C and Non-HDL-C levels in NICCD group were lower than the INC group, while SLC25A13 mutations were associated with the level of GGT ( P < 0.05). Ten different SLC25A13 genetic mutations were detected, among which, 851del4, IVS16ins3kb, IVS6+5 G > A and 1638ins23 mutations made up 82% of all mutations. The incidence of hypoglycemia may be higher in small gestational age infants with NICCD. Low LDL-C may be one of the characteristics of dyslipidemia in NICCD infants. There was a correlation between SLC25A13 gene mutations distribution and the GGT level, but the meaning of this finding remains to be further in-depth study. Impact statement This study aims to compare FBG, FINS, C-P, other biochemical and clinical manifestations between NICCD and non-NICCD infants, and discuss differential diagnosis of NICCD and INC beyond the genetic analysis. And investigate the correlation between SLC25A13 genetic mutations and biochemical changes. This work presented that incidence of hypoglycemia may be higher in small gestational age infants with NICCD. Low LDL-C may be one of the characteristics of dyslipidemia in NICCD infants. There was a correlation between SLC25A13 gene mutations distribution and the GGT level.

Abstract P153: Low Diabetes Diagnosis and Treatment among Individuals with Fasting Blood Glucose Diagnostic of Diabetes is Associated with Income and Health Insurance Status in China, even after Control for Observable and Unobservable Factors

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Samantha M Attard ◽  
David K Guilkey ◽  
Barry M Popkin ◽  
Bing Zhang ◽  
Elizabeth J Mayer-Davis ◽  
...  
Keyword(s):  
Health Insurance ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Diagnosis And Treatment ◽  
Diabetes Diagnosis ◽  
System Of Equations ◽  
Diabetes Treatment ◽  
High Quality ◽  
Diagnosed Diabetes ◽  
Unobservable Factors

Background: The majority of Chinese adults with fasting blood glucose (FBG) diagnostic of diabetes (≥126 mg/dl) are not diagnosed or treated, placing them at high risk for cardiovascular disease-related complications. While demographic and economic factors might differentially predict each step in the continuum from having FBG diagnostic of diabetes to diagnosed and treated diabetes, most of the literature uses separate models to examine these three outcomes. Furthermore, most strategies ignore underlying, observable and unobservable individual and household factors that influence healthcare-seeking behavior and demand for treatment. We address these gaps, using a three-step sequential model to estimate FBG diagnostic of diabetes, diagnosed, and treated diabetes, correcting for observable and unobservable factors. Methods: Data came from 7,653 adults aged 18-75y in the 2009 wave of the China Health and Nutrition Survey, a prospective cohort study of economically diverse Chinese households in 9 provinces (228 communities). We used a Heckman-type system of equations to predict three steps: 1) FBG diagnostic of diabetes; 2) diagnosed diabetes (reported doctor diagnosis); and 3) treated diabetes (reported insulin or diabetes medication use), correcting for unobservable factors. We hypothesized differential prediction of each of the three steps by: age, gender, income (low, medium, or high tertiles), community health infrastructure (number/type of health facilities and pharmacies in or nearby (12 km) each community), and health insurance (none, low, medium, or high quality). Results: Eight percent (301 of 3,544) of men and 6% (248 of 4,059) of women had FBG diagnostic of diabetes. Using our three-step system of equations adjusting for observable and unobservable factors, income and health insurance were not statistically associated with FBG diagnostic of diabetes. Among individuals with FBG diagnostic of diabetes, 47% (95% confidence interval (CI): 44-50%) of high income versus 39% (CI: 36-42%) of low income individuals had diagnosed diabetes. Conditional on FBG≥126 mg/dl and diabetes diagnosis, treatment differed by health insurance quality: 47% (CI: 43-50%) of individuals with high quality insurance [relative to medium: 43% (CI: 39-47%), low: 34% (CI: 30-38%), and none: 29% (CI: 25-33%)] received diabetes treatment. Discussion: Using a three-step model and correcting for observable and unobservable factors, our findings suggest that, in China, income and health insurance play a stronger role in diabetes diagnosis and treatment than in having FBG diagnostic of diabetes. Our results from this unique modeling strategy highlight the stage in the diabetes continuum during which investment in diabetes treatment and screening is likely to have large impact.

Anti-diabetic activity of diphenhydramine in diabetic rats

2020 ◽  
Vol 11 (4) ◽  
pp. 5067-5070
Author(s):  
Pang Jyh Chayng ◽  
Nurul Ain ◽  
Kaswandi Md Ambia ◽  
Rahim Md Noah
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Fasting Blood Glucose ◽  
Insulin Level ◽  
Diabetic Rats ◽  
Group Iv ◽  
Diabetic Rat ◽  
Control Group ◽  
Group I

The purpose of this project is to study the anti-diabetic effect of on a diabetic rat model. A total of Twenty male Sprague rats were used and it randomly distributed into four groups which are Group I: , Group II: negative control, Group III: and Group IV: and . In diabetic model were induced with via injection at the dosage of 65mg/kg. and FBG (Fasting Blood Glucose) level of diabetic rats were assessed every three days. Blood was collected via cardiac puncture at day 21 after the induction of treatment. Insulin level of the rats was assessed with the Mercodia Rat Insulin ELISA kit. FBG level of group I (12.16 ±3.96, p&lt;0.05) and group IV (11.34 ±3.67, p&lt;0.05) were significantly decreased. Meanwhile, the for all rats did not show any significant increase. However, the insulin level was escalated in group IV (0.74+0.25, p&lt;0.05) significantly. The present study shows that the and the combination of and lowered blood glucose level and enhanced insulin secretion.

Clinical manifestations, diagnosis and treatment of HIV infection of stage 4 (severely symptomatic stage) in the practice of a health professional

2020 ◽  
pp. 27-34
Author(s):  
A. Nikitina ◽  
A. Rusanova ◽  
A. Zhilenkova
Keyword(s):  
Hiv Infection ◽  
Health Professional ◽  
Clinical Picture ◽  
Clinical Manifestations ◽  
Significant Problem ◽  
Diagnosis And Treatment ◽  
Modern World ◽  
Infected People ◽  
Stage 4 ◽  
Future Practice

HIV infection is a significant problem in the modern world, because there are more and more infected people every year. This article will consider: the clinical picture, diagnosis and treatment of this disease in different countries. Based on these data, the following conclusions will be made to help doctors in their future practice correctly approach the diagnosis and treatment of patients with this disease.

Effect of Dapagliflozin on Intestinal Flora in MafA-deficient Mice

2018 ◽  
Vol 24 (27) ◽  
pp. 3223-3231 ◽  
Author(s):  
Luyao Li ◽  
Shiyao Xu ◽  
Tingting Guo ◽  
Shouliang Gong ◽  
Chuan Zhang
Keyword(s):  
Blood Glucose ◽  
High Throughput Sequencing ◽  
Fatty Acid Content ◽  
Fasting Blood Glucose ◽  
Intestinal Flora ◽  
Short Chain Fatty Acids ◽  
The Body ◽  
Short Chain ◽  
Control Group ◽  
Deficient Mice

Objective: To investigate the effect of dapagliflozin on intestinal microflora in MafA-deficient mice using an animal model of diabetes. Methods: Male MafA-deficient mice were administered dapagliflozin (1.0 mg/kg/d) intragastrically for 6 weeks. Mouse body weights and fasting blood glucose levels were measured, and intestinal short-chain fatty acids were measured by gas chromatography. A series of methods was used to analyse the number of primary harmful bacteria in the faeces, and high-throughput sequencing was used to sequence the changes in intestinal flora. Results: The weight of the mice decreased after dapagliflozin gavage, and fasting blood glucose was significantly lower than that in the control group (P < 0.001). Acetic acid and butyric acid contents in the intestinal tracts of the mice increased, and the growth of harmful microorganisms, such as Clostridium perfringens, enterococci, Enterobacteriaceae, and intestinal enterococci, was inhibited. Blautia is a species found in the experimental group and was significantly different from the control and blank groups as determined by the LDA score from highthroughput sequencing. Conclusion: Dapagliflozin can reduce fasting blood glucose, decrease body weight, increase short-chain fatty acid content, regulate the intestinal microecological balance of the body and promote blood glucose and energy homeostasis.

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