scholarly journals Glycemic control is associated with lower odds of mortality and successful extubation in severe COVID-19

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jay M. Pescatore ◽  
Juan Sarmiento ◽  
Ruben A. Hernandez-Acosta ◽  
Britt Skaathun ◽  
Nancy Quesada-Rodriguez ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Patient Characteristics ◽  
Lower Blood Glucose ◽  
Lower Odds ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Lower Blood ◽  
Peak Blood ◽  
Peak Blood Glucose ◽  
Successful Extubation

Abstract Context Corticosteroids, specifically dexamethasone, have become the mainstay of treatment for moderate to severe COVID-19. Although the RECOVERY trial did not report adverse effects of corticosteroids, the METCOVID (Methylprednisolone as Adjunctive Therapy for Patients Hospitalized with COVID-19) study reported a higher blood glucose level in patients receiving methylprednisolone. Objectives This study aims to analyze the association between corticosteroids and COVID-19–related outcomes in patients admitted to the medical ICU (MICU) for COVID-19 pneumonia. Methods This is an observational study of 141 patients admitted to the MICU between March 18 and June 7, 2020. Data on demographics, laboratory and imaging studies, and clinical course were obtained, including data on corticosteroid use. Bivariate analyses and logistic regression were performed between patient characteristics and mortality and successful extubation. Results Of the 141 patients, 86 required mechanical ventilation, 50 received steroids, and 71 died. Regarding demographics, patients had a median age of 58 (interquartile range [IQR] 48, 65), Hispanic (57.4%, n=81), and non-Hispanic Black (37.5%, n=53). The most prevalent comorbidities were hypertension (49.6%, n=70) and diabetes (48.2%, n=68). Lower blood glucose levels on admission (125.5 vs. 148 mg/dL, p=0.025) and lower peak blood glucose levels on corticosteroids (215.5 vs. 361 mg/dL, p=0.0021) were associated with lower prevalence of mortality. Patients who were successfully extubated had a lower admission blood glucose (126.5 vs. 149 mg/dL, p=0.0074) and lower peak blood glucose on corticosteroids (217 vs. 361 mg/dL, p=0.0023). Conclusions Lower blood glucose on admission and lower maximum blood glucose on corticosteroids were associated with lower odds of mortality and successful extubation, regardless of preexisting diabetes. Hyperglycemia may be negating any potential benefit of corticosteroid therapy. These findings suggest that glucose control could be a parameter that impacts the outcome of patients receiving corticosteroids for COVID-19 pneumonia.

scholarly journals Exogenous Ketones Lower Blood Glucose Level in Rested and Exercised Rodent Models

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2330 ◽  
Author(s):  
Ari ◽  
Murdun ◽  
Koutnik ◽  
Goldhagen ◽  
Rogers ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Rodent Models ◽  
Lower Blood Glucose ◽  
Post Exercise ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Lower Blood Glucose Level ◽  
Lower Blood

Diseases involving inflammation and oxidative stress can be exacerbated by high blood glucose levels. Due to tight metabolic regulation, safely reducing blood glucose can prove difficult. The ketogenic diet (KD) reduces absolute glucose and insulin, while increasing fatty acid oxidation, ketogenesis, and circulating levels of β-hydroxybutyrate (βHB), acetoacetate (AcAc), and acetone. Compliance to KD can be difficult, so alternative therapies that help reduce glucose levels are needed. Exogenous ketones provide an alternative method to elevate blood ketone levels without strict dietary requirements. In this study, we tested the changes in blood glucose and ketone (βHB) levels in response to acute, sub-chronic, and chronic administration of various ketogenic compounds in either a post-exercise or rested state. WAG/Rij (WR) rats, a rodent model of human absence epilepsy, GLUT1 deficiency syndrome mice (GLUT1D), and wild type Sprague Dawley rats (SPD) were assessed. Non-pathological animals were also assessed across different age ranges. Experimental groups included KD, standard diet (SD) supplemented with water (Control, C) or with exogenous ketones: 1, 3-butanediol (BD), βHB mineral salt (KS), KS with medium chain triglyceride/MCT (KSMCT), BD acetoacetate diester (KE), KE with MCT (KEMCT), and KE with KS (KEKS). In rested WR rats, the KE, KS, KSMCT groups had lower blood glucose level after 1 h of treatment, and in KE and KSMCT groups after 24 h. After exercise, the KE, KSMCT, KEKS, and KEMCT groups had lowered glucose levels after 1 h, and in the KEKS and KEMCT groups after 7 days, compared to control. In GLUT1D mice without exercise, only KE resulted in significantly lower glucose levels at week 2 and week 6 during a 10 weeks long chronic feeding study. In 4-month and 1-year-old SPD rats in the post-exercise trials, blood glucose was significantly lower in KD and KE, and in KEMCT groups, respectively. After seven days, the KSMCT group had the most significantly reduced blood glucose levels, compared to control. These results indicate that exogenous ketones were efficacious in reducing blood glucose levels within and outside the context of exercise in various rodent models of different ages, with and without pathology.

scholarly journals Protective effect of cyanidin-3-O-glucoside on neonatal porcine islets

2017 ◽  
Vol 235 (3) ◽  
pp. 237-249 ◽  
Author(s):  
Chao Li ◽  
Bin Yang ◽  
Zhihao Xu ◽  
Eric Boivin ◽  
Mazzen Black ◽  
...  
Keyword(s):  
Drinking Water ◽  
Blood Glucose ◽  
Related Factor ◽  
Post Transplantation ◽  
Lower Blood Glucose ◽  
Glucose Levels ◽  
Porcine Islets ◽  
Blood Glucose Levels ◽  
Lower Blood ◽  
Neonatal Porcine Islets

Oxidative stress is a major cause of islet injury and dysfunction during isolation and transplantation procedures. Cyanidin-3-O-glucoside (C3G), which is present in various fruits and vegetables especially in Chinese bayberry, shows a potent antioxidant property. In this study, we determined whether C3G could protect neonatal porcine islets (NPI) from reactive oxygen species (H2O2)-induced injury in vitro and promote the function of NPI in diabetic mice. We found that C3G had no deleterious effect on NPI and that C3G protected NPI from damage induced by H2O2. Significantly higher hemeoxygenase-1 (HO1) gene expression was detected in C3G-treated NPI compared to untreated islets before and after transplantation (P < 0.05). Western blot analysis showed a significant increase in the levels of phosphorylated extracellular signal-regulated kinase 1/2 (ERK1/2) and phosphatidylinositol 3-kinase (PI3K/Akt) proteins in C3G-treated NPI compared to untreated islets. C3G induced the nuclear translocation of nuclear erythroid 2-related factor 2 (NRF2) and the significant elevation of HO1 protein. Recipients of C3G-treated NPI with or without C3G-supplemented drinking water achieved normoglycemia earlier compared to recipients of untreated islets. Mice that received C3G-treated islets with or without C3G-supplemented water displayed significantly lower blood glucose levels at 5–10 weeks post-transplantation compared to mice that received untreated islets. Mice that received C3G-treated NPI and C3G-supplemented drinking water had significantly (P < 0.05) lower blood glucose levels at 7 and 8 weeks post-transplantation compared to mice that received C3G-treated islets. These findings suggest that C3G has a beneficial effect on NPI through the activation of ERK1/2- and PI3K/AKT-induced NRF2-mediated HO1 signaling pathway.

Peripherally active dextromethorphan derivatives lower blood glucose levels by targeting pancreatic islets

2021 ◽  
Author(s):  
Okka Scholz ◽  
Silke Otter ◽  
Alena Welters ◽  
Laura Wörmeyer ◽  
Jurij Dolenšek ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Pancreatic Islets ◽  
Lower Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Lower Blood

scholarly journals Association of Hyperglycaemia with Outcome in Critically Ill Children in Central India - A Prospective Study

2021 ◽  
Vol 8 (13) ◽  
pp. 811-815
Author(s):  
Suman Sudha Tirkey ◽  
Rakesh Kumar Verma
Keyword(s):  
Intensive Care Unit ◽  
Blood Glucose ◽  
Critically Ill ◽  
Central India ◽  
Critically Ill Children ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Mean Blood Glucose ◽  
Peak Blood ◽  
Peak Blood Glucose

BACKGROUND Hyperglycaemia is a common occurrence in children with critical illness. Several studies relate hyperglycaemia occurring during intensive care unit (ICU) admission to be associated with increased mortality. We wanted to evaluate the incidence of hyperglycaemia and its association with mortality among critically ill children. METHODS A prospective observational study was conducted among critically ill children admitted to the Paediatric Intensive Care Unit (PICU) of a tertiary care centre, Raipur, Chhattisgarh in central India, from 1st May 2016 to 31st October 2016. All patients aged 1 month to 14 years who were admitted in PICU during this study period (N = 113) were included. Children who were known cases of diabetes mellitus, hepatic failure or renal failure requiring dialysis and children who left against medical advice (LAMA) or died within 24 hours of admission were excluded (N = 13). Thus 100 children were included in the study. RESULTS In the study population, incidence of hyperglycaemia was 60 %; overall 37 (37 %) died and the mortality rate was significantly higher (46.6 % vs. 19.4 %) in children with hyperglycaemia than in children without hyperglycaemia. Nonsurvivors had higher mean blood glucose levels at 48 hours (218.35 ± 87.42 mg / dL) than survivors (141.12 ± 55.26 mg / dL) (P < .001). Peak blood glucose (218.35 ± 87.42 mg / dL vs. 141.12 ± 55.26 mg / dL), need for mechanical ventilation (54.5 % vs. 27.3 %), need for inotropes (76.4 % vs. 23.5 %) and Paediatric Risk of Mortality Score (PRISM) III (16.25 ± 5.46 vs. 9.06 ± 4.35) were significantly higher in non-survivors than in survivors. On regression analysis, blood sugar at 24 hours and duration of stay were found to be significant. CONCLUSIONS In this study, in the PICU, the mortality rate was significantly higher in children with hyperglycaemia than in children without hyperglycaemia. Non-survivors had significantly higher mean blood glucose levels at 48 hours than survivors. Peak blood glucose, need for mechanical ventilation, need for inotropes and PRISM III scores were significantly higher in non-survivors than in survivors. KEYWORDS Hyperglycaemia, Critically Ill, PICU, Outcome, Mortality

scholarly journals Activity Antidiabetic Of The Ethanol Extract Green Gedi Leaves Medical) On Mice (Mus musculus

MEDULA ◽  
2019 ◽  
Vol 6 (3) ◽  
Author(s):  
Parawansah Parawansah
Keyword(s):  
Blood Glucose ◽  
Oral Administration ◽  
Leaf Extract ◽  
Ethanol Extract ◽  
Effective Concentration ◽  
Lower Blood Glucose ◽  
Antidiabetic Effect ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Lower Blood

ABSTRACTBackground: Green  gedi leaves  (Abelmoschus manihot (L.)  Medik)  is one plant that has efficacy in treating various diseases one of which is antidiabetic. The nature of the active substance green gedi leaves that capable lower blood glucose levels are flavonoids. Purpose: The purpose of this  study  was  to  determine  the effective  concentration  of  the  extract  of  green  gedi  leaves (Abelmoschus  manihot  (L.)  Medik)  to  lower  the  blood  glucose  levels on  mice  Induced  by Streptozotocin. Method: This type of research is experimental research that consists of 5 treatments with 3 variations dose and 2 controls. The study was conducted by measuring the blo od glucose levels in mice, blood glucose levels after induction to return normal blood glucose levels after oral administration with a suspension of Na. CMC as a control, and the suspension glibenclamid as a comparison with the extract of green gedi leaves concentration of 30 mg/KgBB, 60 mg/KgBB and 90 mg/KgBB with a time of observation for seven days. Result: The data obtained were analyzed using ANOVA and LSD. Conclusion: From this study that the green gedi leaf extract (Abelmoschus manihot (L.) Medik) at a concentration of 90 mg/kgBB is more effectife to give antidiabetic effect with the average reduction in blood glucose levels reach 68,67 mg/dL to mice.Keywords: antidiabetic, abelmoschus manihot (L.) Medik, green gedi leaves, Streptozotocin

scholarly journals Dapagliflozin suppresses glucagon signaling in rodent models of diabetes

2017 ◽  
Vol 114 (25) ◽  
pp. 6611-6616 ◽  
Author(s):  
May-yun Wang ◽  
Xinxin Yu ◽  
Young Lee ◽  
Sara Kay McCorkle ◽  
Shiuhwei Chen ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucagon Secretion ◽  
Zucker Rats ◽  
Hepatic Glycogen ◽  
Alpha Cells ◽  
Lower Blood Glucose ◽  
Glucagon Receptor ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Lower Blood

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of antidiabetic drug used for the treatment of diabetes. These drugs are thought to lower blood glucose by blocking reabsorption of glucose by SGLT2 in the proximal convoluted tubules of the kidney. To investigate the effect of inhibiting SGLT2 on pancreatic hormones, we treated perfused pancreata from rats with chemically induced diabetes with dapagliflozin and measured the response of glucagon secretion by alpha cells in response to elevated glucose. In these type 1 diabetic rats, glucose stimulated glucagon secretion by alpha cells; this was prevented by dapagliflozin. Two models of type 2 diabetes, severely diabetic Zucker rats and db/db mice fed dapagliflozin, showed significant improvement of blood glucose levels and glucose disposal, with reduced evidence of glucagon signaling in the liver, as exemplified by reduced phosphorylation of hepatic cAMP-responsive element binding protein, reduced expression of phosphoenolpyruvate carboxykinase 2, increased hepatic glycogen, and reduced hepatic glucose production. Plasma glucagon levels did not change significantly. However, dapagliflozin treatment reduced the expression of the liver glucagon receptor. Dapagliflozin in rodents appears to lower blood glucose levels in part by suppressing hepatic glucagon signaling through down-regulation of the hepatic glucagon receptor.

scholarly journals Association of increased morbidity with the occurrence of hyperglycemia in the immediate postoperative period after elective pediatric neurosurgery

2016 ◽  
Vol 17 (5) ◽  
pp. 625-629 ◽  
Author(s):  
Nazel Oliveira Filho ◽  
Rodrigo L. Alves ◽  
Adriano T. Fernandes ◽  
Fernanda S. P. Castro ◽  
José Roberto Tude Melo ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Pediatric Neurosurgery ◽  
Perioperative Period ◽  
Cns Tumors ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Peak Blood ◽  
Peak Blood Glucose

OBJECTIVE The acute elevation of blood glucose in perioperative pediatric patients subjected to cardiac surgery and in victims of head trauma is associated with higher rates of postoperative complications. Data on the occurrence of hyperglycemia and its association with unfavorable outcomes among patients who have undergone elective neurosurgery are scarce in the literature. This study aimed to determine whether the occurrence of hyperglycemia during the perioperative period of elective neurosurgery for the resection of tumors of the CNS in children is associated with increased morbidity. METHODS This retrospective cohort analysis included 105 children up to 12 years of age who underwent elective neurosurgery for resection of supratentorial and infratentorial CNS tumors between January 2005 and December 2010 at the São Rafael Hospital, a tertiary care medical center in Salvador, Brazil. Demographic data and intraoperative and postoperative information were collected from the medical records. Differences in blood glucose levels during the perioperative period were evaluated with nonparametric tests. RESULTS The patients who developed postoperative complications exhibited higher blood glucose levels on admission to the intensive care unit (ICU) (162.0 ± 35.8 mg/dl vs 146.3 ± 43.3 mg/dl; p = 0.016) and peak blood glucose levels on postoperative Day 1 (171.9 ± 30.2 mg/dl vs 156.1 ± 43.2 mg/dl; p = 0.008). Multivariate analysis showed that peak blood glucose levels on postoperative Day 1 were independently associated with a higher odds ratio for postoperative complication (OR 1.05). The occurrence of hyperglycemia (>150 mg/dl) upon admission to the ICU was associated with longer ICU (p = 0.003) and hospital (p = 0.001) stays. CONCLUSIONS The occurrence of hyperglycemia during the postoperative period after elective pediatric neurosurgery for the resection of CNS tumors was associated with longer hospital and ICU stays. Postoperative complications were associated with higher blood glucose levels upon admission to the ICU and higher peak blood glucose on the first postoperative day.

scholarly journals Effects of Coffee Consumption In Improving Hyperglicemia In Diabetes-Induced Mice

2019 ◽  
Vol 1 (1) ◽  
pp. 72-80
Author(s):  
Hesti Riany
Keyword(s):  
Blood Glucose ◽  
Coffee Consumption ◽  
Systemic Diseases ◽  
Cell Degeneration ◽  
Lower Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Coffee Arabica ◽  
Lower Blood ◽  
Mice Liver

Diabetes mellitus (DM) is a chronic metabolic disease. It was caused by lack of insulin or cells cannot use insulin so that blood glucose becomes high (hyperglycemia). And it will cause other systemic diseases of the disease (metabolic syndrome) that can increase the factor of death. Coffee is one of the consumed plants that contain antioxidants and chlorogenic acid that have a role as antihyperglycemia. In other hand Jambi as one of the coffee producing regions (arabica, robust and liberica) in Sumatra and it has a potency as a coffee producer. In addition, people's habits in consuming coffee have the opportunity to be one solution in overcoming diabetes. This study aimed to determine the effect of hyperglycemia disease. The method was experimental with 5 treatments (metformin, arabica, robust, liberica and aquades) and 3 replications. Before threatments mice were injected with streptozotosin in order to be hyperglycemia, then mice with blood glucose ≥ 116 mg / dl were measured their blood glucose, weight and made the histology of the liver. Then the datas were analyzed using ANAVA. The results showed that Jambi coffee (arabica, robust and liberica) can lower blood glucose levels hyperglycemia mice until day 16. And the treatment with liberica coffee lowers hyperglycemia with the lowest glucose levels. While the histological features of mice liver showed lower cell degeneration especially in mice by coffee treatment, especially arabica coffee.

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