Acute severe carbon monoxide exposure in the rat: effects of hyperglycemia and hypoglycemia on mortality, recovery, and neurologic deficit

1991 ◽  
Vol 69 (8) ◽  
pp. 1168-1177 ◽  
Author(s):  
David G. Penney ◽  
C. Clough Helfman ◽  
Joseph C. Dunbar Jr. ◽  
Lowell E. McCoy

Human and animal studies suggest a poorer outcome in the presence of abnormal blood glucose concentration during cerebral hypoxia–ischemia. It is unknown whether this is also the case in acute severe carbon monoxide poisoning. Using Levine-prepared rats, three groups were established and exposed to CO to answer this question: (1) hyperglycemics resulting from the administration of a 50% glucose solution, (2) hypoglycemics resulting from the administration of normal saline, and (3) untreated controls. The rats inhaled 2400 ppm CO for 90 min in the absence of anesthesia. Blood glucose was raised to a mean value of 402 mg/dL just prior to CO exposure in group 1. This resulted in an increased mortality rate (i.e., 54%), and during 4 h of room air recovery an impaired ability to regain body temperature, an increased plasma lactate dehydrogenase activity, and an increased neurologic deficit as compared with group 3. Hypoglycemia, which developed during CO exposure in group 2 (mean minimum glucose after 90 min, 44 mg/dL), resulted in an increased mortality rate (i.e., 46%), and during 4 h of room air recovery an impaired ability to regain body temperature and an increased neurologic deficit as compared with group 3. Blood glucose concentration in the rats in groups 2 and 3 that died during or shortly after CO exposure was significantly depressed relative to the survivors of those groups. Plasma insulin activity was elevated during CO exposure in group 1 as compared with group 3, but fell during recovery; insulin remained low throughout CO exposure and recovery in group 2. The results demonstrate the deleterious effects of both a very high and a very low blood glucose concentration during acute CO exposure.Key words: blood pressure, body temperature, carbon monoxide, glucose, heart rate, hematocrit, hyperglycemia, hypoglycemia, insulin, lactate dehydrogenase, mortality, morbidity, neurologic deficit.

2021 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Radhika R. ◽  
Navaneetha M. ◽  
Ravichandran K. ◽  
Hemavathi P.

<p><strong>Background: </strong>The primary aim of managing diabetes is to maintain blood glucose level to prevent diabetes induced complications. Studies showed that ladies finger and fenugreek seeds are blood sugar stabilizer. The objective of this randomized active controlled trial was to assess the effect of ladies finger water versus fenugreek seeds water on the blood glucose level among subject with type 2 diabetes.</p><p><strong>Methods: </strong>Total of 180 study participants were selected and equally assigned to three groups by computer generated randomization. Group 1-received ladies finger water and oral antidiabetic drug (OAD); group 2-received fenugreek seeds water and OAD; group 3-received only OAD for 15 days. Pre and post intervention fasting blood sugar (FBS) was assessed by accu-chek Performa glucometer. Wilcoxon signed rank test; one-way analysis of covariance followed by post hoc test with Bon-ferroni correction was done.</p><p><strong>Results: </strong>Analysis was done based on 168 subjects. There was a significant reduction in FBS level with the mean difference of group 1-21.0 mg/dl (p&lt;0.001), group 2-20.3 mg/dl (p&lt;0.001) and group 3-4.7 mg/dl (p=0.068). No significant difference found between group 1 and group 2 (p=1.00), but significant difference found between group 1 and group 3 (p=0.032); group 2 and group 3 (p=0.012). Both ladies finger water and fenugreek seeds water were superior in reduction of FBS than OAD.</p><p><strong>Conclusions: </strong>Ladies finger water or fenugreek seeds water can be used as adjunct along with OAD to control type 2 diabetes mellitus.</p><p><strong> </strong></p>


Life Sciences ◽  
1989 ◽  
Vol 45 (16) ◽  
pp. 1467-1473 ◽  
Author(s):  
Angela L. Wood ◽  
Philip A. Healey ◽  
JoséA. Menéndez ◽  
Sarah L. Verne ◽  
Dale M. Atrens

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zheng Liu ◽  
Hang Meng ◽  
Juntian Huang ◽  
Pascal Kwangwari ◽  
Kaijun Ma ◽  
...  

AbstractCarbon monoxide (CO) poisoning is a common cause of death, leading to morbidity and mortality worldwide. Features of the CO poisoning with low carboxyhemoglobin (COHb) levels remain to be characterized. This study collected a total of 307 CO poisoning cases from Shanghai Public Security Bureau, an official organization that handles the most complicated and life-threatening cases across Shanghai municipality in China, and regrouped these cases into three categories: group 1, 10% < COHb% < 30% (n = 58); group 2, 30% ≤ COHb% < 50% (n = 79); group 3, COHb% ≥ 50% (n = 170). Epidemiological, demographic, and forensic aspects of the CO poisoning cases, particularly those with low COHb levels, were analyzed. Our results showed that group 2 and 3 were mostly observed in younger victims (≤ 30 years), while group 1 equally distributed to all age groups (p = 0.03). All the CO poisoning from group 2 and 3 occurred in enclosed spaces, whereas cases from group 1 died additionally in outdoor spaces (p = 0.01). 81.03% of group 1 cases died in fire circumstances, while only 45.57% from group 2 and 30.59% from group 3 were fire-related (p = 0.00). Accordingly, group 1 was mostly related with fire burns, while group 2 or 3 were largely associated with gas leakage (p = 0.00). A combination with alcohol, but not other psychotropic drugs, associated with significant higher levels of blood COHb% in fire-unrelated (p = 0.021) but not fire-related cases (p = 0.23). Five extremely low COHb% (< 30%)-related poisoning deaths were negative of any cardiopulmonary pathology and psychoactive substances. In conclusion, CO poisoning with low COHb% significantly associates with fire circumstances and outdoor spaces and has no age preference. Further diagnostic markers mandates to be identified in order to avoid disputes in cases of extremely low COHb%-related poisoning.


2021 ◽  
Vol 12 ◽  
Author(s):  
Wenjun Wang ◽  
Zhonglin Chai ◽  
Mark E. Cooper ◽  
Paul Z. Zimmet ◽  
Hua Guo ◽  
...  

BackgroundWe aimed to understand how glycaemic levels among COVID-19 patients impact their disease progression and clinical complications.MethodsWe enrolled 2,366 COVID-19 patients from Huoshenshan hospital in Wuhan. We stratified the COVID-19 patients into four subgroups by current fasting blood glucose (FBG) levels and their awareness of prior diabetic status, including patients with FBG&lt;6.1mmol/L with no history of diabetes (group 1), patients with FBG&lt;6.1mmol/L with a history of diabetes diagnosed (group 2), patients with FBG≥6.1mmol/L with no history of diabetes (group 3) and patients with FBG≥6.1mmol/L with a history of diabetes diagnosed (group 4). A multivariate cause-specific Cox proportional hazard model was used to assess the associations between FBG levels or prior diabetic status and clinical adversities in COVID-19 patients.ResultsCOVID-19 patients with higher FBG and unknown diabetes in the past (group 3) are more likely to progress to the severe or critical stage than patients in other groups (severe: 38.46% vs 23.46%-30.70%; critical 7.69% vs 0.61%-3.96%). These patients also have the highest abnormal level of inflammatory parameters, complications, and clinical adversities among all four groups (all p&lt;0.05). On day 21 of hospitalisation, group 3 had a significantly higher risk of ICU admission [14.1% (9.6%-18.6%)] than group 4 [7.0% (3.7%-10.3%)], group 2 [4.0% (0.2%-7.8%)] and group 1 [2.1% (1.4%-2.8%)], (P&lt;0.001). Compared with group 1 who had low FBG, group 3 demonstrated 5 times higher risk of ICU admission events during hospitalisation (HR=5.38, 3.46-8.35, P&lt;0.001), while group 4, where the patients had high FBG and prior diabetes diagnosed, also showed a significantly higher risk (HR=1.99, 1.12-3.52, P=0.019), but to a much lesser extent than in group 3.ConclusionOur study shows that COVID-19 patients with current high FBG levels but unaware of pre-existing diabetes, or possibly new onset diabetes as a result of COVID-19 infection, have a higher risk of more severe adverse outcomes than those aware of prior diagnosis of diabetes and those with low current FBG levels.


2016 ◽  
Vol 85 (2) ◽  
pp. 127-132
Author(s):  
Biljana Radojičić ◽  
Mirjana Joksimović-Todorović ◽  
Maja Bukvić ◽  
Predrag Simeunović ◽  
Murat Kakishev ◽  
...  

The process of gluconeogenesis in ruminants is under the direct influence of insulin and glucocorticoid hormones. The goal of this study was to determine the effects of added Na-propionate on the neuroendocrine regulation of blood glucose in calves at three specific physiological periods: on exclusive milk nutrition; on mixed milk and forage nutrition; and with established ruminant digestion. The influence of Na-propionate on blood glucose, insulin and cortisol concentrations was examined in the same 20 female Holstein calves at different stages of forestomach development (15 days, 2 months, and 4 months of age of calves). Group 1 of calves (n = 10) received Na-propionate intravenously; group 2 (n = 10) received Na-propionate mixed in milk. Blood sampling was performed 1 and 3 h after Na-propionate administration. After i.v. administration of Na-propionate, a significant increase (P < 0.05) in blood glucose concentration was observed 1 h after administration only in calves aged 2 and 4 months; blood insulin concentration was significantly higher (P < 0.01) 1 and 3 h after i.v. administration in 2-month-old calves; and cortisol concentration increased (P < 0.01) 1 h after administration in each selected calf in all testing periods. Orally administered Na-propionate led to a significant increase (P < 0.01) of insulin concentration 1 and 3 h after administration in 15-day-old calves, and 3 h after administration in 2-month-old calves. Based on these results it could be assumed that i.v. and p.o. administration of Na-propionate affects the neuroendocrine regulation of glycaemia in calves of different age.


2021 ◽  
Vol 2 (2) ◽  
pp. 106-113
Author(s):  
P. O. Opara ◽  
V. H. A. Enemor ◽  
F. U. Eneh ◽  
F. C. Emengaha

The blood glucose- lowering potentials of ethanol leaf extract of Annona muricata were studied. Thirty wistar albino rats were divided into six groups of five rats per group. Group 1 served as “Normal control” animals and received normal rat pellets and water. Diabetes mellitus was induced in Groups 2, 3, 4, and 5 by intraperitoneal injection of alloxan (130 mg/kg). Group 6 rats were administered with 400 mg/kg daily of the extract without induction; group 3 rats were treated with glibenclamide (5 mg/kg body weight), groups 4 and 5 received 200 mg/kg and 400 mg/kg body weight of A. muricata leaf extract daily respectively throughout the duration of the experiment of 14 days. Group 2 rats were induced but not treated with any drug, thus it served as the “Negative control” group. Quantitative phytochemical analysis of the leaf extract was carried out using the Association of Official Analytical Chemists (AOAC) methods. Acute toxicity test of the leaf extract of A. muricata was determined using 12 rats by Lorke’s toxicity testing method. The blood glucose levels of the animals in each group were determined using Accu-chek test strip method. The weights of the animals were determined using a standard electronic weighing balance. The result of the quantitative phytochemical analysis of the leaf showed that the ethanol leaf extract contains the following: phenols (74 mg/100 g), flavonoids (3.70 mg/100 g), tannins (2.95 mg/100 g), oxalate (6.48 mg/100 g), terpenoid (13.88 mg/100 g), phytates (130 mg/100 g), saponins (6800 mg/100 g), alkaloids (570 mg/100 g), cardiac glycoside (1690 mg/100g). Acute toxicity studies showed that LD50 was 3807.89 mg/kg body weight. The results of the average blood glucose levels (mg/dl) of the rats in each group were group 1, 82.6071±7.7524, group 2, 309.3571±163.6923, group 3, 226.7143±132.8182, group 4, 146.5000±140.1465, group 5, 150.4783±81.8340, and group 6, 83.4643±12.5329 for each group respectively. The average body weights of the rats in each group were group 1, 192.8571±22.5844, group 2, 185.7143±33.6759, group 3, 177.1429±36.67500, group 4, 219.2857±21.2908, group 5, 119.5455±23.5993, and group 6, 191.7857±25.2475. The findings from this study suggest that ethanolic leaf extract of A. muricata has notable effect in lowering blood glucose levels in diabetic rats and is a more potent drug in the treatment and management of diabetes mellitus and oxidative stress- related diseases.


PEDIATRICS ◽  
1980 ◽  
Vol 65 (6) ◽  
pp. 1170-1172 ◽  
Author(s):  
David K. Stevenson ◽  
Albert L. Bartoletti ◽  
Clinton R. Ostrander ◽  
John D. Johnson

Measurements of the pulmonary excretion rate of carbon monoxide (VEco) as an index of bilirubin production in the first several days of life were taken from 64 breast-fed or bottle-fed infants. Twenty-one infants (≥37 weeks of gestation) were breast-fed; 43 infants (28 to 42 weeks of gestation) were bottle-fed a commercially prepared formula. Information pertaining to their caloric intake during the 24-hour period preceding VECO determination was taken from 38 of the 43 infants who were bottle-fed and they were placed into three groups based on their caloric intake: (1) ≤60 kcal/kg/day (19 infants); (2) 61 to 100 kcal/kg/day (7 infants); and (3) &gt; 100 kcal/kg/day (12 infants). There was no significant difference in bilirubin production between bottle-fed and breast-fed infants. No effect of caloric deprivation on bilirubin production was demonstrated. The mean VECO values were 18.5 ± 0.9 (SE) for group 1, 17.7 ± 1.8 (SE) for group 2, and 16.2 ± 1.1 (SE) µl/kg/hr for group 3.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Kamel ◽  
M R Hosny ◽  
M O Awad ◽  
A M Eid

Abstract Background Insulin has anti-inflammatory effect and vasodilatory effect via endothelial NO release in arteries, veins and capillaries. Insulin inhibits release of inflammatory mediators like IL-6, TNF-α and enhances the immune function of monocytes. Stress-induced hyperglycemia is very common in the ICU, being detected in 50–85% of critically ill patients. It is defined as a blood glucose level &gt;140 mg/dL or glycated hemoglobin (HbA1c) &gt; 6.5 without a past history of pre-existing diabetes. Aim of the Work to evaluate the effect of low dose insulin therapy on the clinical progression of organ dysfunction and on the level of C-reactive protein (CRP), procalcitonin and lipid profile in patients known to be normoglycemic complaining of systemic inflammatory response syndrome (SIRS) or sepsis in intensive care unit. Patients and Methods The study was conducted on 60 patients which were randomized into 2 groups: 30 patients received moderate insulin therapy (group 1) and 30 patients received iv infusion of placebo (normal saline 0.9% NaCl) during the course of the study (group 2). Results There was an improvement in blood pressure, heart rate and body temperature in group 1 compared to group 2 and throughout the study period in group 1. CRP and lactate levels were declined in group 1 with better creatinine values. Triglycerides were decreased in group 1 and hypoxic index was higher in group 1 compared to group 2. Conclusion Insulin therapy with target blood glucose (120-140 mg/dL) has been found in our study that it reduces the complications of SIRS and organ failure, which was expressed by the gradual improvement in heart rate, means arterial blood pressure, body temperature, serum lactate level and urine output. These results support the hypothesis that insulin has a positive inotropic effect. Recommendations Future studies are required to compare between moderate insulin therapy with target blood glucose (120 – 140 mg/dL) and intensive insulin therapy with target blood glucose (80-110 mg/dL) as regard patients' mortality and morbidity.


2021 ◽  
Author(s):  
Cem Haymana ◽  
Ibrahim Demirci ◽  
Ilker Tasci ◽  
Erman Cakal ◽  
Serpil Salman ◽  
...  

Abstract Purpose New coronavirus disease 2019 (COVID-19) has a worse prognosis in patients with diabetes. However, there are insufficient data about the effect of hyperglycemia on COVID-19 prognosis in non-diabetic patients. This study aimed to investigate the relationship between random blood glucose levels measured at the time of diagnosis and prognosis of COVID-19 disease in non-diabetic patients. Methods A nationwide retrospective cohort of non-diabetic patients with confirmed COVID-19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. The patients were stratified into three groups according to blood glucose levels which were <100 mg/dL in group-1, in the range of 100-139 mg/dl in group-2, and the range of 140-199 mg/dl in group-3. Clinical characteristics and outcomes were compared among the groups. The primary outcome was mortality. Results A total of 12,817 non-diabetic patients (median age [IQR]: 44 [25] years, females: 50.9%) were included. Patients in group-2 (5%) and group-3 (14%) had higher mortality rates than patients in group-1 (2.1%). The rates of hospitalization, hospital stays longer than 8 days, intensive care unit (ICU) admission, ICU stay more than 6 days, and mechanical ventilation were also significantly higher in group-3 patients. Likewise, glucose levels in the range of 140-199 mg/dL were an independent associate of mortality and composite of ICU admission and/or mechanical ventilation. ConclusionHyperglycemia at the time of COVID-19 diagnosis is associated with poor prognosis in non-diabetic patients. Clinicians should be more careful in the treatment of non-diabetic COVID-19 patients with hyperglycemia.


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