scholarly journals Prospective analysis of glycemic variability in patients with severe traumatic brain injury: modified Leuven’s adjustment process versus conventional adjustment process

2018 ◽  
Vol 46 (4) ◽  
pp. 1505-1516
Author(s):  
Bing Xue ◽  
Shiyan Ruan ◽  
Ping Xie ◽  
Kaixuan Yan ◽  
Zhi'e Gu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Blood Glucose ◽  
Brain Injury ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Severe Traumatic Brain Injury ◽  
Early Stage ◽  
Glycemic Variability ◽  
Adjustment Process ◽  
Significant Difference

Objective This study was performed to evaluate the effect of two different methods of controlling glycemic variability (GV) in patients with severe traumatic brain injury (STBI) undergoing surgery. Methods Patients with STBI were randomly grouped into a conventional adjustment process (CAP) group and modified Leuven’s adjustment process (mLAP) group. Each group included 50 patients. Blood glucose levels were continuously monitored and data were recorded and analyzed. Results The mean blood glucose level was stable in both groups for 5 days postoperatively with no significant difference. The standard deviation of the blood glucose level, mean amplitude of glycemic excursions, and glycemic lability index were significantly higher in the CAP than mLAP group for the first 2 days. In the final 3 days, no significant differences were observed between the two groups. The incidence of hypoglycemia was significantly higher in the CAP than mLAP group on the first day. This value gradually declined during the following 4 days, but the difference between the two groups was not significant. Conclusion The mLAP produced more favorable results than the CAP for GV control in the early stage after surgery for STBI.

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

Trials ◽  
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.

scholarly journals The association between blood glucose level and cognitive dysfunction among acute traumatic brain injury in Manado, Indonesia

2018 ◽  
Vol 6 (4) ◽  
pp. 1073
Author(s):  
Sekplin A. S. Sekeon ◽  
Mieke A. H. N. Kembuan
Keyword(s):  
Traumatic Brain Injury ◽  
Blood Glucose ◽  
Brain Injury ◽  
Blood Glucose Level ◽  
Cognitive Dysfunction ◽  
Glucose Level ◽  
P Value ◽  
Random Blood Glucose ◽  
History Of ◽  
Acute Traumatic Brain Injury

Background: Traumatic brain injury (TBI) is a public health challenge. TBI contributes to chronic physical impairment and also disrupt mental and personality aspects. Cognitive dysfunction is influenced by multiple factors, including blood glucose level. The objective of the study was to analyze the association between blood glucose level and cognitive dysfunction among TBI patients.Methods: A hospital-based observational study was conducted with cross-sectional design for six months period. Population of research were all of TBI patients treated at the emergency unit. Eligible sample were obtained with total sampling technique. Dyslgycemia was defined as random blood glucose level outside the range of 80-200mg/dl; cognitive dysfunction was defined as MMSE score <26. Statistical analysis with SPSS version 17.0 was employed. Chi square test and odd ratio were executed, p value <0,05 were regarded as significant level.Results: Majority of the 124 patients was male (75.8%), in 21-30 age group (20.7%), mostly due to RTA, specifically from motorcycle-related accident. Most of the motorcyclist (56,5%) were not using helmet. Unconsciousness was in 65.8% sample. Seizure was found in 3.9% of total patients; almost half of patients had history of headache (40.8%). Vomit was found in 30.3% of patients. Vertigo or dizziness post-trauma was in 3.9% patients; almost one third of patients had history of alcohol consumption (30.3%). Majority (65.8%) were in GCS 13-15. Proportion of dysglycemia and cognitive dysfunction were 4.8% and 14.5% consecutively. Odd ratio analysis revealed that dysglycemic group have 3 times higher risk to develop cognitive dysfunction, but the association was statistically not significant.Conclusions: The association between random blood glucose level and cognitive dysfunction among acute traumatic brain injury was statistically not significant.

scholarly journals The Effects of Glucagon and Insulin Combination toward on Neurodegeneration Following Traumatic Brain Injury in Rat Model

2021 ◽  
Vol 9 (A) ◽  
pp. 982-987
Author(s):  
Akhmad Imron ◽  
Bethy Hernowo ◽  
Dany Hilmanto ◽  
Kahdar Wiriadisastra ◽  
Yulius Hermanto
Keyword(s):  
Traumatic Brain Injury ◽  
Blood Glucose ◽  
Brain Injury ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Lower Number ◽  
Secondary Brain Injury ◽  
Neuronal Necrosis ◽  
High Blood Glucose ◽  
Glucagon And Insulin

BACKGROUND: Traumatic brain injury (TBI) is a major cause of death and disability in the productive age. Glutamate excitotoxicity and hyperglycemia those occur following TBI are among the factors those influence secondary brain injury. AIM: This study aimed to determine the effect of glucagon and insulin combination on neuronal necrosis following TBI. METHODS: A total of 28 male wistar rats were randomized into four experimental groups: placebo, insulin, glucagon, and combination of glucagon and insulin. Each animal underwent controlled cortical impact model of TBI. The blood glucose and glutamate levels were measured before and 4 h following TBI. The brain tissues were collected to evaluate neuronal necrosis. RESULTS: Glucagon or glucagon and insulin combination were able to prevent the increased of blood glutamate levels following TBI (p < 0.05). Glucagon administration was associated high blood glucose level (198.10 ± 32.58 mg/dL); a combination with insulin was able to minimize the increased of blood glucose level (166.53 ± 18.48 mg/dL). Combination of glucagon and insulin had a lower number of neuronal necrosis compare to the other groups (p < 0.005). CONCLUSION: The combination of glucagon and insulin potentially exhibit neuroprotection effect on rats following TBI as being demonstrated by lower number of neuronal necrosis. This finding further indicates the role of glucose homeostasis in neuroprotection.

scholarly journals Comparison between the QRMA Measurement with the Anamnesis and the Capillary Blood Glucose Test

Jurnal NERS ◽  
2020 ◽  
Vol 14 (2) ◽  
pp. 224
Author(s):  
Muflih Muflih ◽  
Suwarsi Suwarsi ◽  
Fajarina Lathu Asmarani
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Blood Sugar ◽  
Glucose Level ◽  
Blood Sugar Level ◽  
Capillary Blood ◽  
Capillary Blood Glucose ◽  
Blood Glucose Test ◽  
Significant Difference ◽  
Glucose Test

ABSTRACTIntroduction: The examination of patients with diabetes mellitus (DM) can be done by reviewing their complaints and through a capillary blood glucose level test to determine the value of their Random Blood Glucose Level. QRMA (Quantum Resonance Magnetic Analyzer) is claimed to be able to check the patient’s bodily condition (including blood glucose) with an accuracy of 85%. The purpose of this study was to verify the validity of the QRMA tool and its accuracy by comparing the results of the anamnesis and the examination conducted using the capillary blood glucose test method.Methods: The research method used was a cross-sectional design. The total sample consisted of 44 respondents in the working area of the Community Health Centers in Yogyakarta with the risk factor being blood sugar level instability. The sampling technique used was purposive sampling. The main variable in this study was the value of the blood sugar level measured based on the coefficient value of the QRMA tool and the value of Random Blood Glucose obtained through the capillary blood glucose test.Results: The blood glucose value was not correlated significantly with the coefficient value of QRMA. The value of blood glucose when examined alongside the result of the respondent's anamnesis showed there to be a significant difference. The value of the QRMA coefficient when examined against the results from the history of the respondents showed no significant difference. Linear regression showed that the variables of height, body weight, and IMT had a correlation with the QRMA coefficient value.Conclusion: The QRMA tool was not able to provide a picture of the actual condition of the blood glucose level of the respondents when compared with the results of the anamnesis and the blood glucose value from the capillary blood glucose test. Non-invasive health measurement devices such as QRMA are not used by nurses as a standard for determining the health status of DM patients.

Impact of muscle mass on blood glucose level

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Murtada Taha ◽  
Yaser A. AlNaam ◽  
Thekra Al Maqati ◽  
Lenah Almusallam ◽  
Gharam Altalib ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Muscle Mass ◽  
Glucose Level ◽  
Glucose Utilization ◽  
Treatment Modalities ◽  
Healthy Population ◽  
Inverse Association ◽  
Significant Difference ◽  
The Mean

Abstract Objectives At present, diabetes is one of the leading causes of mortality across the world. It was hypothesized that muscle mass could have a significant influence on blood glucose level and this corelation if established successfully could pave way for novel treatment modalities for type 2 diabetes mellitus (T2DM). In the present study, the association between muscle mass and blood glucose level was examined in a healthy population who was not having T2DM at baseline and was undergoing a regular course of exercise. Methods The clinical study was performed involving 53 healthy male populations between 10 and 60 years of age. The participants were sampled in accordance with the quantitative experimental study design, using nonprobability sampling techniques. The independent variable measured among the subjects included muscle mass and blood glucose level, using bioelectrical impedance and a simple glucometer respectively. Subgroup analysis amongst different substantial parameters including body mass index (BMI), myostatin inhibitor usage, and age factor that could affect the muscle mass and glucose level correlation were also studied simultaneously. Results The study findings demonstrated a negative correlation between muscle mass and glucose utilization levels. There was a significant difference in the mean muscle mass of the participants which was 36.2453, and the mean glucose utilization level which was 15.1493%. Pearson correlation between the muscle mass and percentage of glucose utilization of the participants indicated a significant difference (since p-value <0.05) between these two studied parameters. Conclusions The study finding suggests an inverse association of the skeletal muscle mass with blood glucose level which encourages the implication of muscle-building exercises as the preventive measure for T2DM.

scholarly journals EFFECT OF AEROBIC EXERCISES AND RESISTANCE TRAINING ON GLUCOSE LEVELS IN TYPE 2 DIABETIC SUBJECTS.

2017 ◽  
Vol 10 (7) ◽  
pp. 360
Author(s):  
Aishwarya Pramod Benkar ◽  
Smita Bhimrao Kanase
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Resistance Training ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Postprandial Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Significant Difference

Objective: Diabetes mellitus is a leading cause of death and disability in the world and its prevalence is predicted to rise to 10% by 2030. Hence, this study is conducted with objectives to find out the effect of aerobic exercises and resisted exercises on blood glucose levels in type 2 diabetes mellitus (T2DM) subjects and to compare the effect of both exercises on blood glucose level.Method: The comparative study was conducted at Krishna Institute of Medical Sciences Deemed University, Physiotherapy department, Karad. 30 participants with age group between 30 and 65 years were taken. Subjects were selected as per inclusion and exclusion criteria. Group A (15) participants were given aerobic exercise on static bicycle, and Group B (15) participants were given resistance training using dumbbells and weight cuffs for 5 days/week for 4 weeks. Diet recommendations were given to every participant.Results: Statistical analysis was performed using paired and unpaired t-test. Analysis showed statistically extremely significant difference in fasting blood glucose level and postprandial blood glucose level in both the groups (p≤0.0001).Conclusion: Thus, this study concludes that both aerobic exercises and resistance training prove to be beneficial in controlling blood glucose levels in T2DM subjects.

scholarly journals Pengaruh suplementasi β-carotene terhadap kadar glukosa darah dan kadar malondialdehida pada tikus sprague dawley yang diinduksi Streptozotocin

2014 ◽  
Vol 2 (2) ◽  
pp. 41-46
Author(s):  
Elida Soviana ◽  
Banundari Rachmawati ◽  
Nyoman Suci Widyastiti
Keyword(s):  
Free Radicals ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Negative Control ◽  
Male Rats ◽  
Sprague Dawley ◽  
Significant Difference ◽  
Decrease Blood Glucose ◽  
Β Carotene

Background : Hyperglycemia on diabetes mellitus can cause increasing of free radicals production. Free radicals caused lipid peroxidation reaction by forming malondialdehyde (MDA). β-carotene has antioxidant activity may inhibit the formation of ROS.Objective : To prove the effect of multilevel doses β-carotene 1 mg/kg BW, 20 mg/kg BW and 20 mg/kg BW on alternate days within 30 days orally supplementation on blood glucose level and MDA level on Sprague Dawley male rats induced by streptozotocin (STZ). Methods : Thirty rats were randomly divided into 5 groups: X1=Negative control/diabetic, X2 (STZ 40 mg/kg BW + BC 1 mg/kg BW), X3 (STZ 40 mg/kg BW + BC 10mg/kg BW), X4 (STZ 40 mg/kg BW + BC 20 mg/kg BW), X5 (technic control/non diabetic). β-Carotene supplementation was given by nasogastric tube on alternate days within thirty days. Blood glucose level was measured by GOD-PAP and MDA level by ELISA with TBARS methods. Data was analized using paired t-test, wilcoxon, one way anova and post hoc bonferroni. Results : there was a significant difference of blood glucose level (p = 0,0001) and MDA level (p = 0,0001) after suplementation β-carotene on alternate days within 30 days orally. β-carotene 10 mg/kg BW was the most effective and efficient dose to lowering blood glucose, while 20 mg/kg BW to lowering MDA level. Conclusion : The multilevel doses β-carotene (1 mg/kg BW, 10 mg/kg BW and 20 mg/kg BW) on alternate days within 30 days orally supplementation can decrease blood glucose and MDA level. β-carotene 10 mg/kg BW is the most effecetive and efficient to decrease blood glucose and β-carotene 20 mg/kg BW to decrease MDA level.

scholarly journals Differential temporal profile of lowered blood glucose levels (3.5 - 6.5 mM versus 5 - 8 mM) in patients with severe traumatic brain injury

Critical Care ◽  
2008 ◽  
Vol 12 (4) ◽  
pp. R98 ◽  
Author(s):  
Regula Meier ◽  
Markus Bechir ◽  
Silke Ludwig ◽  
Jutta Sommerfeld ◽  
Marius Keel ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Blood Glucose ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Temporal Profile ◽  
Glucose Levels ◽  
Blood Glucose Levels

Association between elevated brain tissue glycerol levels and poor outcome following severe traumatic brain injury

2005 ◽  
Vol 103 (2) ◽  
pp. 233-238 ◽  
Author(s):  
Tobias Clausen ◽  
Oscar Luis Alves ◽  
Michael Reinert ◽  
Egon Doppenberg ◽  
Alois Zauner ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Tissue ◽  
Severe Traumatic Brain Injury ◽  
Time Course ◽  
Glycerol Concentration ◽  
Significant Information ◽  
Content Type ◽  
Significant Difference ◽  
Fine Print

Object. Glycerol is considered to be a marker of cell membrane degradation and thus cellular lysis. Recently, it has become feasible to measure via microdialysis cerebral extracellular fluid (ECF) glycerol concentrations at the patient's bedside. Therefore the aim of this study was to investigate the ECF concentration and time course of glycerol after severe traumatic brain injury (TBI) and its relationship to patient outcome and other monitoring parameters. Methods. As soon as possible after injury for up to 4 days, 76 severely head-injured patients were monitored using a microdialysis probe (cerebral glycerol) and a Neurotrend sensor (brain tissue PO2) in uninjured brain tissue confirmed by computerized tomography scanning. The mean brain tissue glycerol concentration in all monitored patients decreased significantly from 206 ± 31 µmol/L on Day 1 to 9 ± 3 µmol/L on Day 4 after injury (p < 0.0001). Note, however, that there was no significant difference in the time course between patients with a favorable outcome (Glasgow Outcome Scale [GOS] Scores 4 and 5) and those with an unfavorable outcome (GOS Scores 1–3). Significantly increased glycerol concentrations were observed when brain tissue PO2 was less than 10 mm Hg or when cerebral perfusion pressure was less than 70 mm Hg. Conclusions. Based on results in the present study one can infer that microdialysate glycerol is a marker of severe tissue damage, as seen immediately after brain injury or during profound tissue hypoxia. Given that brain tissue glycerol levels do not yet add new clinically significant information, however, routine monitoring of this parameter following traumatic brain injury needs further validation.

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