Longitudinal Average Glucose Levels and Variance and Risk of Stroke: A Chinese Cohort Study

Background. Diabetes is a known independent risk factor for stroke. However, whether higher glucose levels (126–139.9 mg/dl) can increase the risk of stroke in people without diabetes is still unknown. Moreover, as a fluctuating parameter, long-term glucose levels may also be related to the risk of stroke outcome. It is important to explore the correlation between long-term average blood glucose, as well as its variability, and stroke. Methods. We used 40,975 clinical measurements of glucose levels and 367 measurements of glycated hemoglobin A1c levels from 12,321 participants without stroke to examine the relationship between glucose levels and the risk of stroke. Participants were from the Weitang Geriatric Diseases study, including 5,707 men and 6,614 women whose mean age at baseline was 60.8 years; 1,011 participants had diabetes, and 11,310 did not. We estimated the long-term average blood glucose level based on the multilevel Bayesian model and fit in Cox regression models, stratified according to diabetes status. Results. Over a median follow-up period of 5 years, stroke developed in 279 of the 12,321 participants (244 without diabetes and 35 with). For people with an average glucose level of 126–139.9 mg per deciliter, compared with 90–99.9 mg per deciliter, the adjusted hazard ratio (HR) for total stroke was 1.78 (95% confidence interval (CI), 1.16–2.75), and the HR for levels higher than 140 mg per deciliter was 1.89 (95% CI, 1.09–3.29). Among those without diabetes whose glucose level was higher than 140 mg per deciliter, compared with 90–99.9 mg per deciliter, the adjusted HRs for total stroke and fatal stroke were 3.66 (95% CI, 1.47–9.08) and 5 (95% CI, 1.77–14.15), respectively. For a glucose standard deviation level higher than 13.83 mg per deciliter, compared with that lower than 5.91 mg per deciliter, the adjusted HR for total stroke was 2.31 (95% CI, 1.19–4.48). Conclusions. Our results suggest that higher average glucose levels (126–139.9 mg/dl) and variance may be risk factors for stroke, even among people without diabetes diagnosis.

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Association between blood glucose levels and Glasgow Outcome Score in patients with traumatic brain injury: secondary analysis of a randomized trial

Trials ◽

10.1186/s13063-022-06005-5 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Tao Yuan ◽

Hongyu He ◽

Yuepeng Liu ◽

Jianwei Wang ◽

Xin Kang ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Blood Glucose ◽

Brain Injury ◽

Blood Glucose Level ◽

Glucose Level ◽

Threshold Effect ◽

Glasgow Outcome Score ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Average Blood Glucose

Abstract Background Blood glucose levels that are too high or too low after traumatic brain injury (TBI) negatively affect patient prognosis. This study aimed to demonstrate the relationship between blood glucose levels and the Glasgow Outcome Score (GOS) in TBI patients. Methods This study was based on a randomized, dual-center, open-label clinical trial. A total of 208 patients who participated in the randomized controlled trial were followed up for 5 years. Information on the disease, laboratory examination, insulin therapy, and surgery for patients with TBI was collected as candidate variables according to clinical importance. Additionally, data on 5-year and 6-month GOS were collected as primary and secondary outcomes, respectively. For multivariate analysis, a generalized additive model (GAM) was used to investigate relationships between blood glucose levels and GOS. The results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). We further applied a two- piecewise linear regression model to examine the threshold effect of blood glucose level and GOS. Results A total of 182 patients were included in the final analysis. Multivariate GAM analysis revealed that a bell-shaped relationship existed between average blood glucose level and 5-year GOS score or 6-month GOS score. The inflection points of the average blood glucose level were 8.81 (95% CI: 7.43–9.48) mmol/L considering 5-year GOS as the outcome and were 8.88 (95% CI 7.43−9.74) mmol/L considering 6-month GOS score as the outcome. The same analysis revealed that there was also a bell relationship between average blood glucose levels and the favorable outcome group (GOS score ≥ 4) at 5 years or 6 months. Conclusion In a population of patients with traumatic brain injury, blood glucose levels were associated with the GOS. There was also a threshold effect between blood glucose levels and the GOS. A blood glucose level that is either too high or too low conveys a poor prognosis. Trial registration ClinicalTrials.gov NCT02161055. Registered on 11 June 2014.

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AKTIVITAS KOMBINASI EKSTRAK BAWANG DAYAK-METFORMIN TERHADAP GULA DARAH MENCIT

Jurnal Ilmiah Manuntung ◽

10.51352/jim.v4i2.190 ◽

2018 ◽

Vol 4 (2) ◽

pp. 114

Author(s):

Aditya Maulana Perdana Putra ◽

Ratih Sari Pratiwi

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Glucose Level ◽

Fasting Blood Glucose ◽

Test Group ◽

Control Group ◽

Onion Extract ◽

Glucose Levels ◽

Reduce Blood Glucose ◽

Average Glucose

Diabetes mellitus is a chronic disease that requires good medical treatment to prevent long-term complications. The proportion of DM patients in Indonesia in 2013 was 3,7 million. Indonesia as one of the countries with the highest diversity has natural resources that can be used as an alternative medicine for diabetes mellitus, one of them is dayak onion. Dayak onions themselves contain compounds that can reduce blood glucose levels. The use of traditional medicine in the community is sometimes combined with chemical drugs. So the purpose of this study was to determine the comparison of the combination activity of dayak onion extract – metformin with single metformin to reduce mice blood sugar induced by alloxan. This research includes experimental research. The test animals used were male white mice which were divided into 2 groups, namely the combination of dayak onion and metformin and the single metformin group. The dose of dayak onion extract used in this study was 100 mg / KgBB and the dose of Metformin used was 45 mg / KgBB. Measurement of glucose levels is carried out every 3 days for 15 days. The decrease in fasting blood glucose from the control group and the test group was analyzed by the General Linear Model test at a 95% confidence level. The results of this study indicate that the combination of dayak onion tuber extract and metformin has better hypoglycemic activity than single metformin. This result can be seen from the average glucose level from day 3 to 15 the combination of dayak onion tuber and metformin is lower than the average glucose level of single metformin. The results of GLM analysis showed the sigvalue <0,05 so it can be concluded that there is a difference in glucose levels between the combination of dayak onion tuber and metformin with a single metformin.

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Diabetes status affects long-term changes in coronal caries - The SHIP Study

Scientific Reports ◽

10.1038/s41598-019-51086-z ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Julia Schmolinsky ◽

Thomas Kocher ◽

Wolfgang Rathmann ◽

Henry Völzke ◽

Christiane Pink ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Population Based ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Term Change ◽

Diabetes Status

Abstract We estimated effects of diabetes mellitus and metabolic control on long-term change in coronal caries and restorative status using 11-year-follow-up data from the population-based Study of Health in Pomerania. Data of 3731 participants with baseline and 5- and 11-year follow-up information were included. Diabetes was defined via self-reported physician´s diagnosis or intake of glucose-lowering drugs or hemoglobin A1c (HbA1c) ≥6.5% or fasting blood glucose levels ≥11.1 mmol/l. The diabetes status was defined as no diabetes (HbA1c < 6.5% or non-fasting blood glucose <11.1 mmol/l), subjects with known or undetected diabetes mellitus and HbA1c ≤ 7% (well-controlled diabetes), and subjects with known or undetected diabetes mellitus and HbA1c > 7% (poorly-controlled diabetes). The caries status was clinically assessed using the half-mouth method and the Decayed Missing Filled Surfaces (DMFS) index and its component scores were determined. Covariate-adjusted linear mixed models were evaluated. Rates in change in DMFS were significantly higher in subjects with poorly-controlled diabetes compared to subjects without diabetes. Subjects with poorly- and well-controlled diabetes had significantly higher rates in change in Missing Surfaces (MS) compared to subjects without diabetes. For the DFS, rates in change were significantly lower for subjects with well-controlled diabetes and higher for subjects with poorly-controlled diabetes as compared to subjects without diabetes. Concordantly, all rates in change increased proportional to HbA1c levels. Effects were even more pronounced in subjects with diabetes duration of ≥5 years. Subjects with poorly-controlled diabetes are at higher risk for caries progression compared to subjects without diabetes, especially in case of longer disease duration.

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The Correlation of Hemoglobin A1c to Blood Glucose

Journal of Diabetes Science and Technology ◽

10.1177/193229680900300305 ◽

2009 ◽

Vol 3 (3) ◽

pp. 429-438 ◽

Cited By ~ 31

Author(s):

Ken Sikaris

Keyword(s):

Blood Glucose ◽

Hemoglobin A1c ◽

Diabetes Management ◽

Glucose Monitoring ◽

Glucose Measurement ◽

Glucose Levels ◽

Average Blood Glucose ◽

Current Concerns ◽

Average Glucose ◽

Hba1c Levels

The understanding that hemoglobin A1c (HbA1c) represents the average blood glucose level of patients over the previous 120 days underlies the current management of diabetes. Even in making such a statement, we speak of “average blood glucose” as though “blood glucose” were itself a simple idea. When we consider all the blood glucose forms—arterial versus venous versus capillary, whole blood versus serum versus fluoride-preserved plasma, fasting versus nonfasting—we can start to see that this is not a simple issue. Nevertheless, it seems as though HbA1c correlates to any single glucose measurement. Having more than one measurement and taking those measurements in the preceding month improves the correlation further. In particular, by having glucose measurements that reflect both the relatively lower overnight glucose levels and measurements that reflect the postprandial peaks improves not only our ability to manage diabetes patients, but also our understanding of how HbA1c levels are determined. Modern continuous glucose monitoring (CGM) devices may take thousands of glucose results over a week. Several studies have shown that CGM glucose averages account for the vast proportion of the variation of HbA1c. The ability to relate HbA1c to average glucose may become a popular method for reporting HbA1c, eliminating current concerns regarding differences in HbA1c standardization. Hemoglobin A1c expressed as an average glucose may be more understandable to patients and improve not only their understanding, but also their ability to improve their diabetes management.

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Differences of Fasting Blood Glucose Level in People with Schizophrenia between Before and After Getting Aripiprazole Treatment

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.403 ◽

2019 ◽

Vol 7 (16) ◽

pp. 2607-2611 ◽

Cited By ~ 1

Author(s):

Dahlia Rosally Turangan ◽

Bahagia Loebis ◽

Surya M. Husada ◽

Nazli Mahdinasari Nasution

Keyword(s):

Blood Glucose ◽

Blood Glucose Level ◽

Glucose Level ◽

Fasting Blood Glucose ◽

Age Group ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Before And After ◽

Schizophrenic Patients ◽

Average Blood Glucose

BACKGROUND: Schizophrenia is a serious disorder of the brain and mind. People with schizophrenia are at high risk of developing type diabetes, due to overall poor physical health, poor health care, unhealthy lifestyles, and side effects of antipsychotic drugs. However, atypical antipsychotics have their deficiencies, because they can be associated with worsening cardiovascular risk factors such as weight gain, hyperglycemia and hyperlipidemia. AIM: Difference in fasting blood glucose levels in people with schizophrenia between before and after receiving aripiprazole treatment. METHODS: This research was conducted in November 2017-September 2018. This research was first conducted in Indonesia, especially North Sumatra. This research is a numerical comparative analytical study paired with an experimental design approach. The number of samples is 44 people. Blood samples are taken in schizophrenia patients before getting the drug, before meals and before activities, assessed fasting blood glucose levels before being treated with aripiprazole and after drug administration for 6 weeks. Data analysis used was a paired test for differences in fasting blood glucose levels in people with schizophrenia between before and after receiving aripiprazole treatment. RESULTS: Based on the demographic characteristics found the research subjects based on the most age group were 31-40 years age group of 30 subjects (68.2%), based on the highest level of education was high school by 26 subjects (59.1%), based on the most marital status was by status not married for 24 subjects (54.5%). It was found that the average blood glucose level before being given aripiprazole in schizophrenic patients was 89.23 ± 7.13. It was found that the average blood glucose level after being given aripiprazole in schizophrenic patients was 86.5 ± 10.1. It was found that there were no differences in blood glucose levels before and after being given aripiprazole in schizophrenic patients CONCLUSION: There was no difference in blood glucose levels before and after being given aripiprazole in schizophrenic patients with p-value (0.078).

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Hypoglycaemia: assessment and management

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.7033 ◽

2011 ◽

pp. 1039-1048

Author(s):

Andrew Cotterill ◽

David Cowley ◽

Ristan Greer

Keyword(s):

Blood Glucose ◽

Blood Glucose Level ◽

Glucose Level ◽

Neurological Impairment ◽

Congenital Hyperinsulinism ◽

Glucose Levels ◽

Energy Demands ◽

The Brain ◽

Homeostatic Mechanisms

Hypoglycaemia is defined as a blood glucose level less than 2.6 mmol/l. This is based on the consistent impairment of central nervous system function observed in subjects when blood glucose levels are below this (1). Glucose homeostatic mechanisms should maintain blood glucose level to preserve cognitive function. Hypoglycaemia triggers protective glucose homeostatic mechanisms and persistent hypoglycaemia is the result of a failure of homeostasis. This is a medical emergency with serious short- and long-term consequences, which result from a reduced supply of glucose to the brain. Recurrent and persistent hypoglycaemia does cause significant morbidity and death due to brain damage. In an adult, after recovery of glucose levels, neurological impairment usually recovers over minutes to hours. In children, the duration of hypoglycaemia leading to permanent damage is not known, but is presumed to depend on the age of the child, the frequency of hypoglycaemia, the degree and the rapidity of the fall in glucose, concurrent circumstances such as infection, trauma and hypoxia, the degree of resilience of the brain tissue at the current stage of development. and the energy demands of the particular parts of the brain. The reasons for the increased sensitivity in children appear to relate to the higher energy requirements and immaturity of the homeostatic mechanisms of the brain. In congenital hyperinsulinism of infancy (CHI) the rates of severe neurological impairment remain high at 20–50%, permanent neurological impairment with damage occurring mainly in the cerebral cortex, hippocampus, and caudate putamen. Appropriate long term management of hypoglycaemia requires the correct diagnosis, and this depends on obtaining ‘critical blood and urine samples’ during a hypoglycaemic episode. In the first 48 h of life 20% of normal full–term infants have a blood glucose level <2.6 mmol/l (2), after this it is relatively uncommon in infancy and childhood with the incidence of various underlying diagnoses varying with age. The causes of hypoglycaemia can be classified into five groups: ◆ excess insulin (or insulin-like factors) for the given circumstances ◆ lack of one or more of the counter regulatory hormones (cortisol, growth hormone) ◆ disturbance of intermediate metabolism causing impairment of gluconeogenesis and/or glycogenolysis ◆ disturbance of fat breakdown or ketone body formation or utilization ◆ lack of nutrient sufficient for current energy demands

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Role of Digital Engagement in Diabetes Care Beyond Measurement: Retrospective Cohort Study (Preprint)

10.2196/preprints.24030 ◽

2020 ◽

Author(s):

Yifat Fundoiano-Hershcovitz ◽

Abigail Hirsch ◽

Sharon Dar ◽

Eitan Feniger ◽

Pavel Goldstein

Keyword(s):

Type 2 Diabetes ◽

Blood Glucose ◽

Glucose Levels ◽

Monthly Average ◽

Diabetes Outcomes ◽

Blood Glucose Levels ◽

Average Blood Glucose ◽

Tagging Behavior ◽

Digital Engagement

BACKGROUND The use of remote data capture for monitoring blood glucose and supporting digital apps is becoming the norm in diabetes care. One common goal of such apps is to increase user awareness and engagement with their day-to-day health-related behaviors (digital engagement) in order to improve diabetes outcomes. However, we lack a deep understanding of the complicated association between digital engagement and diabetes outcomes. OBJECTIVE This study investigated the association between digital engagement (operationalized as tagging of behaviors alongside glucose measurements) and the monthly average blood glucose level in persons with type 2 diabetes during the first year of managing their diabetes with a digital chronic disease management platform. We hypothesize that during the first 6 months, blood glucose levels will drop faster and further in patients with increased digital engagement and that difference in outcomes will persist for the remainder of the year. Finally, we hypothesize that disaggregated between- and within-person variabilities in digital engagement will predict individual-level changes in blood glucose levels. METHODS This retrospective real-world analysis followed 998 people with type 2 diabetes who regularly tracked their blood glucose levels with the Dario digital therapeutics platform for chronic diseases. Subjects included “nontaggers” (users who rarely or never used app features to notice and track mealtime, food, exercise, mood, and location, n=585) and “taggers” (users who used these features, n=413) representing increased digital engagement. Within- and between-person variabilities in tagging behavior were disaggregated to reveal the association between tagging behavior and blood glucose levels. The associations between an individual’s tagging behavior in a given month and the monthly average blood glucose level in the following month were analyzed for quasicausal effects. A generalized mixed piecewise statistical framework was applied throughout. RESULTS Analysis revealed significant improvement in the monthly average blood glucose level during the first 6 months (t=−10.01, P<.001), which was maintained during the following 6 months (t=−1.54, P=.12). Moreover, taggers demonstrated a significantly steeper improvement in the initial period relative to nontaggers (t=2.15, P=.03). Additional findings included a within-user quasicausal nonlinear link between tagging behavior and glucose control improvement with a 1-month lag. More specifically, increased tagging behavior in any given month resulted in a 43% improvement in glucose levels in the next month up to a person-specific average in tagging intensity (t=−11.02, P<.001). Above that within-person mean level of digital engagement, glucose levels remained stable but did not show additional improvement with increased tagging (t=0.82, P=.41). When assessed alongside within-person effects, between-person changes in tagging behavior were not associated with changes in monthly average glucose levels (t=1.30, P=.20). CONCLUSIONS This study sheds light on the source of the association between user engagement with a diabetes tracking app and the clinical condition, highlighting the importance of within-person changes versus between-person differences. Our findings underscore the need for and provide a basis for a personalized approach to digital health.

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PRE-CLINICAL STUDIES ON DIABETES MELLITUS USING PARTIAL PANCREATECTOMY IN SWISS ALBINO MICE

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2018v10i1.21250 ◽

2018 ◽

Vol 10 (1) ◽

pp. 71

Author(s):

Shibu Narayan Jana ◽

Papiya Mitra Mazumder

Keyword(s):

Blood Glucose ◽

Blood Glucose Level ◽

Cholesterol Level ◽

Glucose Level ◽

Fasting Blood Glucose ◽

Fasting Blood Glucose Level ◽

Β Cells ◽

Partial Pancreatectomy ◽

Swiss Albino Mice ◽

Diabetes Status

Objective: The present study was aimed at the development of partial pancreatectomy in a murine model for diabetes.Methods: Diabetes model was successfully developed by partial pancreatectomy method. In this study, cyclosporine was used for influenced the glycaemic status. Diabetes status was evaluated by fasting blood glucose level (FBG), lipid profile (by estimation of total cholesterol level and HDL-level), serum amylase and biochemical assay like glutathione estimation.Results: We report here the restoration of euglycaemic status in cyclosporine-induced diabetic in swiss albino mice after 30% pancreatectomy. In this study, Pancreatectomised (partial) group of animals showed a rapid elevation of glycaemic status, starting from 15th post observational d, but the level of significance decreased gradually from 15th (P<0.01) to 60th (P<0.05) d. This was probably due to nesidioblastotic activity which shifted the fasting blood glucose level towards normoglycaemic status with β-cells regeneration. Cyclosporine treated a group of mice showed normoglycaemic status throughout the whole experimental period, but the cholesterol level remained significant (P<0.001) till the end of the experimental d. Gradually decrements in glycaemia of the diabetic pancreatectomised animals demonstrate islets neogenesis occurring after the operative activity, leading to normoglycaemic condition, probably attributed to β-cells proliferation.Conclusion: The biochemical and histopathological evaluations suggest that there is the development of the diabetic model in the pancreatectomized group and diabetes status induced by pancreatectomy is curable to a certain extent due to the regeneration of β-cells.

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POLYCYSTIC OVARIAN SYNDROME;

The Professional Medical Journal ◽

10.29309/tpmj/2012.19.06.2483 ◽

2012 ◽

Vol 19 (06) ◽

pp. 786-788

Author(s):

KIRAN BUTT ◽

FARAH DEEBA ◽

HAVAIDA ATTIQUE

Keyword(s):

Blood Glucose ◽

Lipid Profile ◽

Glucose Level ◽

Fasting Blood Glucose ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Increased Risk ◽

Commercial Kits ◽

The University ◽

Ovarian Syndrome

Objective: The objective of the present study was to determine the changes in the glucose level and lipid profile in patients withpolycystic ovarian syndrome (PCOS). Study Design: Descriptive study. Place and Duration of the study: This study was conducted atInstitute of Molecular Biology and Biotechnology, The University of Lahore from June 2009 to June 2010. Patients and Methods: Total 50patients with PCOS were included and 50 age-matched control subjects were also selected for comparison. Their glucose levels and lipidprofile were assessed using commercial kits. The data thus obtained was subjected to statistical analysis. Results: Significant differences(P<0.05) in fasting blood glucose level and individual parameters of lipid profile were observed in women with PCOS. A higher prevalence ofhypertriglyceridemia, hypercholesterolemia, higher LDL, lower HDL and higher fasting blood glucose levels was explored in PCOS womenthan controls. Conclusions: Abnormal glucose level and lipid profile in PCOS women showed that these women are at an increased risk ofdeveloping diabetes and subsequently cardiovascular diseases.

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Prevalence of hypoglycemia in diarrheal dehydration at hospitalization in severe acute malnutrition

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20181549 ◽

2018 ◽

Vol 5 (3) ◽

pp. 1092 ◽

Cited By ~ 1

Author(s):

Rameshwar Ninama ◽

Chakshu Chaudhry ◽

Rameshwar Lal Suman ◽

Suresh Goyal ◽

Ramprakash Prakash Bairwa ◽

...

Keyword(s):

Blood Glucose ◽

Acute Diarrhea ◽

Severe Acute Malnutrition ◽

Cross Sectional Study ◽

Acute Malnutrition ◽

Severe Dehydration ◽

Cross Sectional ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Average Blood Glucose

Background: Diarrhea is the major cause of death in children below five years of age. Hypoglycemia has been a potential fatal complication of infectious diarrhea in both well-nourished and poorly nourished children. But prevalence of hypoglycemia in diarrheal dehydration is not exactly known. This study was done to evaluate the glycemic status in children having acute diarrhea with dehydration and specifically associated with severe acute malnutrition (SAM).Methods: This descriptive cross-sectional study was conducted during July 2017 to December 2017 at Bal Chikitsalaya Udaipur, Rajasthan, India. Blood glucose levels were assessed in 150 children of acute diarrhea with dehydration, comprising of 100 SAM and 50 Non SAM children.Results: Average blood glucose of SAM children was 89 mg/dl and of non-SAM, it was 120 mg/dl. Average blood glucose was low in SAM as compared to non-SAM in both some dehydration (116.08±21.26) and severe dehydration (66.69±19.80) as well as with or without ORS intake. Overall 18 (12%) of children had hypoglycemia and all were in severe dehydration and not taking ORS. Blood glucose levels were statistically low in severe dehydration and those who were not taking ORS at the time of hospitalization (p = 0.001). In severe dehydration 25% of children had hypoglycemia means every fourth child had low blood glucose <54 mg/dl.Conclusions: Overall prevalence of hypoglycemia is 12% in diarrheal dehydration and 20% in SAM with dehydration. Twenty five percent of severe dehydration children had hypoglycemia, and all have not started ORS. None of the child started ORS developed hypoglycaemia.

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