Conventional approach to glucose management for diabetic patients undergoing coronary artery bypass surgery

Perfusion ◽  
2002 ◽  
Vol 17 (2) ◽  
pp. 141-144 ◽  
Author(s):  
Patricia A Gustafson ◽  
Debra L Zarro ◽  
David A Palanzo ◽  
Norman J Manley ◽  
Ralph M Montesano ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Insulin Infusion ◽  
Diabetic Patients ◽  
Type I ◽  
Cardioplegic Solution ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Continuous insulin infusion was not an effective mode of treatment in maintaining safe blood glucose levels (<200 mg/dl) during the intraoperative period of diabetic patients requiring open-heart surgery. The two modifications investigated to gain better control of the blood glucose were a change in the base solution of the cardioplegia and the use of a sliding insulin scale. Fifty patients including Type I and Type II diabetics were selected for the purpose of this study. The patients were then randomly divided into two groups categorized by the type of cardioplegic solution administered and the mode of insulin treatment. Group I patients received a dextrose 5%-based cardioplegic solution and blood glucose was treated via continuous intravenous insulin infusion. Group II patients received normal saline 0.9%-based cardioplegic solution and blood glucose was treated via sliding scale. Blood glucose levels were monitored pre- and postcardio- pulmonary bypass (CPB) and every 30 min while on CPB. Glucose values were analyzed by group t test. A p value of < 0.05 was considered statistically significant. When comparing Group I (mean=258 mg/dl) with Group II (mean= 158 mg/dl), there was a statistically significant difference between the glucose values at each of the time intervals when the glucose values were recorded. In conclusion, Group II maintained an acceptable blood glucose level (<200 mg/dl) throughout the entire intra- operative period, which suggests that the combination of the sliding insulin scale and modification of the base cardioplegic solution was an effective mode of treatment.

scholarly journals Assessment of Blood Glucose and Electrolytes during Cardiopulmonary Bypass in Diabetic and Non-Diabetic Patients of Pakistan

2016 ◽  
Vol 8 (9) ◽  
pp. 159
Author(s):  
Muhammad Bilal ◽  
Abdul Haseeb ◽  
Mohammad Hassaan Khan ◽  
Akash Khetpal ◽  
Muhammad Saad ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Cardiopulmonary Bypass ◽  
Repeated Measures ◽  
Artery Bypass ◽  
The Body ◽  
Diabetic Patients ◽  
Blood Electrolytes ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Significant Difference

<p><strong>INTRODUCTION: </strong>Perioperative hyperglycemia has been shown to be related to higher levels of morbidity and mortality in patients on cardiopulmonary bypass (CPB) undergoing coronary artery bypass grafting (CABG), both diabetic and non-diabetic. Blood electrolytes, like sodium, potassium, calcium, and chloride play a very important role in the normal functioning of the body and can lead to a variety of clinical disorders if they become deficient. A minimal number of studies have been conducted on the simultaneous perioperative changes in both blood glucose and electrolyte levels during CPB in Pakistan. Therefore, our aim is to record and compare the changes in blood glucose and electrolyte levels during CPB in diabetic and non-diabetic patients.</p><p><strong>MATERIALS &amp; METHODS: </strong>This was a prospective, observational study conducted on 200 patients who underwent CABG with CPB, from October 2014 to March 2015. The patients were recruited from the Cardiac Surgery Ward, Civil Hospital Karachi after they complied with the inclusion criteria. Repeated-measures analysis of variance (ANOVA) was used to compare the trend of the changes perioperatively for the two groups.</p><p><strong>RESULTS: </strong>There was no significant difference in changes in blood glucose between the two groups (<em>P</em> = 0.62). The only significant difference detected between the two groups was for PaCO<sub>2</sub> (<em>P</em> = 0.001). Besides, further analysis revealed insignificant group differences for the trend changes in other blood electrolytes (<em>P</em> &gt; 0.05).</p><p><strong>CONCLUSION: </strong>Our findings highlighted that there is no significant difference in blood electrolytes changes and the increase in blood glucose levels between diabetic and non-diabetic patients.</p>

scholarly journals EFFECT OF HONEY CONSUMPTION AFTER PHYSICAL EXERCISES ON ELECTROLYTES AND BLOOD GLUCOSE LEVELS

2021 ◽  
Vol 9 (Spl-2-ICOPMES_2020) ◽  
pp. S274-S279
Author(s):  
Aliyah . ◽  
◽  
Ratna Dwi Pujiarti Rahman ◽  
Elly Wahyudin ◽  
Rifka Nurul Utami ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Physical Exercise ◽  
P Value ◽  
Group Iii ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Physical Exercises ◽  
Group I ◽  
Significant Difference ◽  
Honey Solution

Honey has been used as food and medicine for thousands of years. The purpose of this study was to determine the effect of honey in restoring the levels of electrolytes and blood glucose after performing physical exercises. The effect of honey consumption on electrolyte and blood glucose levels was examined on12 healthy male subjects, which were divided into 4 groups with three members in each group. Group I was treated as control and provided only 250 ml of mineral water after exercise, while group II was provided 250 ml commercial isotonic beverage, group III provided honey solution 1 (15 ml honey/250 ml water), and group IV provided honey solution 2 (45 ml honey/250 ml water). The physical exercise performed by the subjects is running on a treadmill at a speed of 5.6 km/h for 40 minutes. Measurements of electrolyte and blood glucose levels were performed 24 hrs before as initial baseline, and these were also measured after the physical exercise as well as after the treatment. Results of the study revealed that honey played a significant role in the restore electrolyte and blood glucose levels in people who have performed physical activities such as exercising and the effect of honey is similar to the commercial isotonic beverage. However, no significant difference (p-value > 0.05) was reported between the honey solution 1 and 2 and other treatment groups in elevating sodium and chloride level.

scholarly journals Mean platelet volume: An economical diagnostic marker of cardiovascular risk assessment in altered fasting blood glucose levels

2015 ◽  
Vol 7 (1) ◽  
pp. 30-33
Author(s):  
Shivali Kapoor ◽  
Manjit Kaur ◽  
Amrit Pal Singh Rana ◽  
A Suryanarayan
Keyword(s):  
Blood Glucose ◽  
Mean Platelet Volume ◽  
Fasting Blood Glucose ◽  
Progressive Increase ◽  
Diabetic Patients ◽  
Platelet Volume ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Group I ◽  
Increased Risk

Background: Platelets with altered morphology or large size are more thrombogenic and are likely to be associated with increased risk of vascular disease. Platelet parameters especially high mean platelet volume (MPV) has been reported in diabetic patients as major contributing factor. The aim of the present study was to find correlation between fasting blood glucose value and hematological variables (PC and MPV), not only in diabetics, but also in the normoglycemic subjects and patients with impaired fasting blood glucose levels.Materials and Methods: In the present study 3471 subjects were analyzed retrospectively and categorized into three groups based on the fasting blood glucose levels as Group I - normoglycemics (FBG ? 109 mg/dl, n = 1158), Group II- impaired fasting blood glucose (FBG ? 126 mg/dl, n = 1158) and Group III – Diabetics (FBG ? 127 mg/dl, n = 1155).Results: We found progressive increase in value of MPV with the increasing FBG levels, in the following order: G1 (8.44 ± 0.842 fl), G2 (8.98 ± 0.898 fl), G3 (9.31 ± 0.967 fl). The platelet count however, did not show much statistical significance with rising glucose levels.Conclusions: MPV increased proportionally with increasing plasma glucose levels. Although the variation between the normoglycemics and impaired fasting group was not very significant, the parameters still showed progressive increase with rising sugar levels significant in diabetic group.Asian Journal of Medical Sciences Vol.7(1) 2015 30-33

Activated Akt Is Associated with Hyperglycemia and Platelet Hyperactivity in a Mouse Model of Diabetes

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5360-5360
Author(s):  
Lin Lu ◽  
Donna Woulfe
Keyword(s):  
Blood Glucose ◽  
Mouse Model ◽  
Platelet Activation ◽  
Diabetic Patients ◽  
Type I ◽  
Platelet Activity ◽  
Akt Phosphorylation ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Fibrinogen Binding

Abstract Platelet hyperactivation has been reported in patients with both Type I and Type II diabetes mellitus and likely contributes to the increased prevalence of thrombotic complications in diabetic patients. However, the mechanisms leading to platelet hyperactivity in diabetes are not fully understood. Our previous studies showed that the Akt signaling pathway positively regulates platelet activity. Here, we evaluate the effect of hyperglycemia on Akt phosphorylation and platelet activation using a Type I diabetic mouse model. Hyperglycemia was induced by intraperitoneal injection of streptozotocin (STZ 50mg/kg for 5 days) in C57BL/6 mice. Blood glucose levels were elevated in 12 mice 4 weeks after STZ injection (mean ± SD: 410 ± 70 mg/ml) compared with 11 mice without STZ injection (212 ± 50 mg/ml). Platelets from hyperglycemic mice showed enhanced agonist-dependent aggregation (max % aggregation: 58% ± 10% in hyperglycemia versus 0% in normoglycemia at 0.6mM AYPGKF, n=3 each), fibrinogen binding (62.2% fibrinogen-bound cells ± 5.4% in hyperglycemic conditions versus 46.1% ± 16.3% in normoglycemia at 2mM AYPGKF) and P-selectin binding (42.1% cells with surface P-selectin ± 3.7% in hyperglycemic platelets, 25.3% ± 5.9% in normoglycemia at 2mM AYPGKF) compared with platelets from mice with normal glucose levels. The blood glucose levels were directly correlated with Alexafluor-fibrinogen binding (r=0.65, p=0.042) when platelets were stimulated with thrombin receptor agonist peptide AYPGKF (1.5mM), and also directly correlated with P-selectin surface exposure (r=0.95, p=0.003) after platelets were stimulated with 1.5mM AYPGKF. To determine whether the Akt pathway is involved in enhanced platelet activation in diabetes, we tested phosphorylation of Akt ser473 by immunoblotting. Akt phosphorylation of this residue was increased (35% ± 4%) in platelets from hyperglycemic mice compared with platelets from nondiabetic mice. In conclusion, platelets from hyperglycemic mice are more sensitive to PAR4 agonist-induced fibrinogen binding and P-selectin exposure compared with nondiabetic platelets. Enhanced activation of Akt in platelets under hyperglycemic conditions may play a role in platelet hyperactivation in diabetes.

scholarly journals THE EFFECT OF SAUCE OF L. LEUCOCEPHALA SEEDS (LEUCAENA LEUCOCEPHALA [LAM.] DE WIT) ON LOWERING BLOOD GLUCOSE IN HYPERGLYCEMIC MICE

2018 ◽  
Vol 11 (13) ◽  
pp. 70
Author(s):  
Sarah Zaidan ◽  
Ria Debby Bp ◽  
Syamsudin Abdillah
Keyword(s):  
Blood Glucose ◽  
Leucaena Leucocephala ◽  
Negative Control Group ◽  
Positive Control ◽  
Negative Control ◽  
Control Group ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Group I ◽  
Group Ii

 Objective: The research to investigate that the source of Leucaena leucocephala can lower blood glucose levels in hyperglycemic mice.Methods: In this study, 42 mice were divided into 7 groups each consisted of 6 mice: Normal Group I, Group II (metformin positive control), Group III (negative control), Group IV (sauce of L. leucocephala at a dose of 0.1 ml), Group V (sauce of L. leucocephala at a dose of 0.2 ml), Group VI (sauce of L. leucocephala with doses of 0.4 ml), and Group VII (sauce of L. leucocephala at a dose of 0.8 ml). The dosage of Group II, IV, V, VI, and VII was orally administered. Blood glucose levels in mice were observed during normal conditions and after administration of 200 mg/kg bw alloxan intraperitoneally (alloxan-induced mice). On day 0, 3, 7, and 14, blood was taken from the tail and glucose levels were measured with a glucometer.Results: Data were analyzed by one-way analysis of variance followed by LSD test. Based on the results, the sauce at a dose of 0.8 ml was able to lower the blood glucose levels up to normal blood glucose levels.Conclusion: There was not significantly different between the groups given sauce of L. leucocephala at a dose of 0.8 ml with the group given metformin (positive control).

Current Approaches in Diabetes Treatment and Other Strategies to Reach Normoglycemia

2020 ◽  
Vol 20 (32) ◽  
pp. 2922-2944
Author(s):  
Worood Sirhan ◽  
Ron Piran
Keyword(s):  
Blood Glucose ◽  
Current Knowledge ◽  
Type I Diabetes ◽  
Current Status ◽  
Control Individual ◽  
Diabetic Patients ◽  
Regulation Mechanism ◽  
Type I ◽  
Glucose Levels ◽  
Blood Glucose Levels

: Cells are mainly dependent on glucose as their energy source. Multicellular organisms need to adequately control individual glucose uptake by the cells, and the insulin-glucagon endocrine system serves as the key glucose regulation mechanism. Insulin allows for effective glucose entry into the cells when blood glucose levels are high, and glucagon acts as its opponent, balancing low blood glucose levels. A lack of insulin will prevent glucose entry to the cells, resulting in glucose accumulation in the bloodstream. Diabetes is a disease which is characterized by elevated blood glucose levels. All diabetes types are characterized by an inefficient insulin signaling mechanism. This could be the result of insufficient insulin secretion, as in the case of type I diabetes and progressive incidents of type II diabetes or due to insufficient response to insulin (known as insulin resistance). We emphasize here, that Diabetes is actually a disease of starved tissues, unable to absorb glucose (and other nutrients), and not a disease of high glucose levels. Indeed, diabetic patients, prior to insulin discovery, suffered from glucose malabsorption. : In this mini-review, we will define diabetes, discuss the current status of diabetes treatments, review the current knowledge of the different hormones that participate in glucose homeostasis and the employment of different modulators of these hormones. As this issue deals with peptide therapeutics, special attention will be given to synthetic peptide analogs, peptide agonists as well as antagonists.

Effect of CYP3A4 and CYP3A5 genetic polymorphism on individualized application of fentanyl in thoracoscopic surgery

2021 ◽  
Author(s):  
Wang Shengyan ◽  
Yao Yibing ◽  
Kong Min ◽  
Zhou Xuyan ◽  
Shen Xu
Keyword(s):  
Blood Glucose ◽  
Genetic Polymorphism ◽  
Thoracoscopic Surgery ◽  
Group Iii ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Group I ◽  
Significant Difference ◽  
American Society

Abstract Background: Studies have confirmed that CYP3A4 and CYP3A5 genotypes affect fentanyl metabolism in vivo. This study explores the application value of CYP3A4 and CYP3A5 genetic polymorphism in the individualized use of fentanyl in thoracoscopic surgery. Patients and Methods: One hundred American Society of Anesthesiologists physical status I or II patients, aged 40–65 years, with a body mass index of <30 kg/㎡ were scheduled for thoracoscopic surgery for lung cancer under general anesthesia. The patients were divided into the wild homozygote group (group I), heterozygote group (group II), and mutant homozygote group (group III) according to gene detection results. The induction dose of fentanyl was 6 µg/kg, 5 µg/kg, and 4 µg/kg, respectively; the background infusion rate of patient-controlled intravenous analgesia (PCIA) was 2 mL/h, 1.5 mL/h, and 1 mL/h, respectively; the patient-controlled analgesia (PCA) dose was 2 mL, 1.5 mL, and 1 mL, respectively; the locking time was 15 min; and the visual analog scale (VAS) score of ≤ 3 was used as the effective analgesia. The operation and recovery times were recorded. Surgical plethysmography index (SPI) and blood glucose levels were recorded on admission, immediately after tracheal intubation, during skin cutting, during surgery for 1 h, and during skin suturing. Furthermore, the VAS and Bruggemann comfort scale (BCS) scores were recorded in the resting states of immediate consciousness and 6 h, 12 h, 24 h, and 48 h after the operation. The total fentanyl consumption, the effective times of PCIA compression, and the incidence of adverse drug reactions (nausea, vomiting, itching, sleepiness, and respiratory depression) were recorded during the operation and within 48 h after the operation. Results: No significant intergroup differences in terms of SPI and blood glucose levels (p > 0.05) were observed. No statistically significant difference in VAS and BCS scores was found after operation (p > 0.05). The intraoperative and postoperative fentanyl doses and the amount of effective PCA decreased in all groups (p < 0.05). There were no significant differences in the incidence of adverse reactions within 48 h after surgery between all groups (p > 0.05). Conclusion: This study suggests that it is feasible to use individualized application of fentanyl according to CYP3A4 and CYP3A5 genotypes

The effect of pirenzepine on growth hormone and blood glucose levels in Type I diabetes mellitus

1988 ◽  
Vol 117 (3) ◽  
pp. 315-319 ◽  
Author(s):  
P. Pietschmann ◽  
G. Schernthaner
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Type I Diabetes ◽  
Anticholinergic Drug ◽  
Serum Levels ◽  
Type I Diabetes Mellitus ◽  
Diabetic Patients ◽  
Type I ◽  
Glucose Levels ◽  
Blood Glucose Levels

Abstract. Increased GH levels in Type I diabetes mellitus have been implicated in the pathogenesis of metabolic complications such as the so-called dawn phenomenon. GH secretion is under control of cholinergic mechanisms. In 21 Type I diabetic patients the effect of oral administration of the anticholinergic drug pirenzepine in addition to intensive insulin therapy on GH and blood glucose levels was studied. At 21.30, 08.00 and 12.00 h, all patients received in random order 50 mg of pirenzepine or placebo po. Blood for determination of GH, blood glucose, cortisol and Cpeptide levels were obtained at 3-h intervals. Serum levels of plasma glucose and GH were significantly lower under pirenzepine than under placebo (P < 0.05 and P < 0.01, respectively). Serum levels of cortisol, free insulin and C-peptide were comparable on the test and the control day. Our data indicate that in Type I diabetes mellitus the anticholinergic drug pirenzepine is effective in decreasing both GH and blood glucose levels.

scholarly journals Cataracts Risk Factors and Comparison of Blood Glucose Levels in Diabetic and Non-Diabetic Patients towards the Occurrence of Cataracts

2019 ◽  
Vol 7 (20) ◽  
pp. 3359-3362
Author(s):  
Juliandi Harahap ◽  
Rashvini Rania
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Blood Glucose ◽  
Body Mass ◽  
High Body Mass Index ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Chronic Hyperglycemia ◽  
Blood Glucose Levels ◽  
Significant Difference

BACKGROUND: Cataracts are a multifactorial systemic disease that causes opacity of the optical lens. One aetiology of cataracts is chronic hyperglycemia, usually caused by uncontrolled diabetes mellitus. AIM: The objective of this study is to identify risk factors of cataracts and to analyse if there is a significant difference in blood glucose values between diabetic patients with cataracts and non-diabetic patients with cataracts. METHODS: This was an analytical case-control study with a sample size of 140 patients that were obtained via consecutive sampling of medical records. This study found that age, high body mass index and hypertension were the dominant risk factors of cataracts. RESULTS: The mean value of blood glucose levels in diabetic patients with cataracts is 195.58 ± 63.9 and 109.7 ± 26.4 in non-diabetic patients with cataracts. There was a significant difference between the blood glucose values of diabetic patients with cataracts and non-diabetic patients with cataracts (p < 0.001). The dominant risk factors of cataracts were old age, high body mass index and hypertension. The majority of hyperglycemic patients belong in the group of diabetic patients with cataracts. CONCLUSION: Chronic hyperglycemia can increase a patient’s risk of cataracts.  

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