Insulin reduction of cerebral infarction due to transient focal ischemia

1995 ◽  
Vol 82 (2) ◽  
pp. 262-268 ◽  
Author(s):  
Mark G. Hamilton ◽  
Bruce I. Tranmer ◽  
Roland N. Auer
Keyword(s):  
Blood Glucose ◽  
Focal Ischemia ◽  
Artery Occlusion ◽  
Content Type ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Mean ◽  
Transient Focal Ischemia ◽  
Cerebral Artery Occlusion ◽  
Total Damage

✓ Insulin has recently been shown to ameliorate damage in models of global brain ischemia. To determine whether insulin is also neuroprotective in focal ischemia, 20 rats were given 2 to 3 IU/kg insulin and 10 did not receive treatment prior to normothermic transient middle cerebral artery occlusion for 2 hours at a blood pressure of 60 mm Hg. To further elucidate whether infarction volume is influenced by variations in blood glucose levels within the physiological range, blood glucose was raised in 10 of the insulin-treated animals to levels comparable with the untreated controls. At 1-week survival, damage was assessed using quantitative neuropathological examination of 25 coronal planes. It was found that preischemic insulin lowered the mean intraischemic blood glucose level from 8.4 ± 0.2 mM (µ ± standard error of the mean) in the control group to 3.4 ± 0.2 mM and reduced total damage (atrophy plus cortical and striatal necrosis), expressed as the percentage of the normal hemisphere, from a control of 28.5% ± 2.9% to 14.5% ± 1.6% (p < 0.005). Coadministration of glucose and insulin resulted in a mean intraischemic blood glucose level of 10.1 ± 0.5 mM, with 27.0% ± 2.4% total damage (p = 0.96, compared with control). Total ischemic damage showed an independent correlation with blood glucose levels (r = 0.67, p = 0.0018). The findings indicate that insulin benefits transient focal ischemia and that reducing the blood glucose from 8 to 9 mM to the low-normal range of 3 to 4 mM with insulin dramatically reduces subsequent infarction. The data suggest that the neuroprotective mechanism of insulin action in focal middle cerebral artery occlusion is mediated predominantly via alterations in blood glucose levels. In comparison to global ischemia, focal ischemia appears to show only a minor direct central nervous system effect of insulin. In clinical situations in which transient focal ischemia to the hemisphere can be anticipated, insulin-induced hypoglycemia of a mild degree may be beneficial.

scholarly journals Degradation of Incretins and Modulation of Blood Glucose Levels by Periodontopathic Bacterial Dipeptidyl Peptidase 4

2017 ◽  
Vol 85 (9) ◽  
Author(s):  
Yuko Ohara-Nemoto ◽  
Manami Nakasato ◽  
Yu Shimoyama ◽  
Tomomi T. Baba ◽  
Takeshi Kobayakawa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Dipeptidyl Peptidase ◽  
Oral Glucose ◽  
Content Type ◽  
Dipeptidyl Peptidase 4 ◽  
Glucose Levels ◽  
Flight Mass Spectrometry ◽  
Blood Glucose Levels ◽  
Molecular Events

ABSTRACT Severe periodontitis is known to aggravate diabetes mellitus, though molecular events related to that link have not been fully elucidated. Porphyromonas gingivalis, a major pathogen of periodontitis, expresses dipeptidyl peptidase 4 (DPP4), which is involved in regulation of blood glucose levels by cleaving incretins in humans. We examined the enzymatic characteristics of DPP4 from P. gingivalis as well as two other periodontopathic bacteria, Tannerella forsythia and Prevotella intermedia, and determined whether it is capable of regulating blood glucose levels. Cell-associated DPP4 activity was found in those microorganisms, which was effectively suppressed by inhibitors of human DPP4, and molecules sized 73 kDa in P. gingivalis, and 71 kDa in T. forsythia and P. intermedia were immunologically detected. The k cat/Km values of recombinant DPP4s ranged from 721 ± 55 to 1,283 ± 23 μM−1s−1 toward Gly-Pro-4-methylcoumaryl-7-amide (MCA), while those were much lower for His-Ala-MCA. Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) analysis showed His/Tyr-Ala dipeptide release from the N termini of incretins, glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide, respectively, with the action of microbial DPP4. Moreover, intravenous injection of DPP4 into mice decreased plasma active GLP-1 and insulin levels, accompanied by a substantial elevation in blood glucose over the control after oral glucose administration. These results are the first to show that periodontopathic bacterial DPP4 is capable of modulating blood glucose levels the same as mammalian DPP4; thus, the incidence of periodontopathic bacteremia may exacerbate diabetes mellitus via molecular events of bacterial DPP4 activities.

scholarly journals STROKE OUTCOMES IN NON-DIABETIC, DENOVO DIABETIC AND DIABETIC INDIAN PATIENTS MEASURED BY MODIFIED RANKIN SCALE: AN OBSERVATIONAL STUDY

2017 ◽  
Vol 9 (8) ◽  
pp. 94
Author(s):  
Syed Junaid Ahmed ◽  
Abdur Rahman Mohd Masood ◽  
Safiya Sumana ◽  
Khadeer Ahmed Ghori ◽  
Javed Akhtar Ansari ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Observational Study ◽  
Hospital Admission ◽  
Acute Stroke ◽  
Mean Difference ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Mean

Objective: Hyperglycemia is a known risk factor which adversely impacts the outcomes in stroke patients compared to patients with normal blood glucose levels. Patients suffering from an acute stroke who are previously nonhyperglycemic may show elevated blood glucose levels. The present study was designed to measure the outcomes in denovo diabetic and diabetic stroke patients compared to nondiabetics.Methods: A prospective observational study over a period of 6 mo, in which 103 patients were divided into three cohorts based on their blood glucose levels (nondiabetic, denovo diabetic and diabetics). The modified Rankin scale (mRS) score was calculated at in-hospital admission and discharge in these three cohorts. The initial and final scores were correlated and mean differences with respect to outcomes between all the three cohorts was calculated.Results: The mean mRS at the time of hospital admission in diabetics and nondiabetics was 3.6±0.81 and 3.3±0.78 which decreased to 2.8±0.95 and 2.9±0.83 respectively at the time of discharge. The mean mRS score in denovo diabetic stroke patients during in-hospital admission was 4±0.81 which was calculated as 3.7±0.85 at the time of discharge. The mean difference in mRS score in diabetics vs non-diabetics was found to be 0.73±0.8 (p =<0.001). The mean difference in mRS score of denovo diabetics vs non-diabetics and denovo diabetics vs diabetics was 0.30±0.63 and 0.38±0.61 respectively (p = 0.1).Conclusion: Results of these observational study in Indian patients, highlights the need for controlling hyperglycemia in stroke patients to improve outcomes and to prevent mortality arising out of acute stroke attacks.

scholarly journals Status kesehatan dan asupan mikronutrien vegetarian dan nonvegetarian di Bali

2021 ◽  
Vol 17 (4) ◽  
pp. 157
Author(s):  
Ni Ketut Sutiari ◽  
Ali Khomsan ◽  
Hadi Riyadi ◽  
Faisal Anwar ◽  
Desak Putu Yuli Kurniati ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Micronutrient Intake ◽  
The Mean ◽  
Vegetarian Diets ◽  
Sugar Levels

Health status and micronutrient intake among vegetarian and non-vegetarian in BaliBackground: Several studies have reported that vegetarian diets have health benefits for those adopting the diets.Objective: This study aimed to compare anemia status and micronutrient intake between vegetarians and non-vegetarians in Bali.Methods: This cross-sectional study was conducted in Bali. A total of 240 samples consisting of 160 vegetarians and 80 non-vegetarians were randomly selected. Hemoglobin (Hb) and fasting blood sugar levels were measured using the cyanmethemoglobin method and enzymatic colorimetric, respectively. Meanwhile, the data on micronutrient intakes were collected by interviews using the semi-quantitative food frequency questionnaire (SQFFQ). The data were analyzed using descriptive statistics, and the Mann-Whitney test was performed to analyze the differences.Results: The study’s results showed that the mean Hb levels in the vegetarian group were significantly lower than non-vegetarians (p=0.002; p<0.05), and the anemia status in vegetarian women were higher (22.5%) than non-vegetarian women (2.5%). The mean fasting blood glucose level in non-vegetarians was significantly higher than in the vegetarian group (p=0.000; p<0.05). There were no differences in zinc (Zn) intake between vegetarians and non-vegetarians, but there were significant differences (p<0.05) in vitamin C, vitamin D, vitamin B12, folic acid, magnesium (Mg), calcium (Ca), and iron (Fe) intakes.Conclusions: There were differences in anemia status and fasting blood glucose levels between vegetarians and non-vegetarians. The fasting blood glucose levels of non-vegetarians were higher than vegetarians, and there were differences in the intake of certain micronutrients between vegetarians and non-vegetarians.

Glycemic response of Emblica officinalis powder-incorporated Indian recipes

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Shonima Venugopal ◽  
Uma Iyer ◽  
Richa Sanghvi
Keyword(s):  
Blood Glucose ◽  
Glycemic Response ◽  
Emblica Officinalis ◽  
Physiological Basis ◽  
Content Type ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Capillary Sampling ◽  
Freeze Dried ◽  
Overnight Fasting

Purpose Glycemic index (GI) is a physiological basis for ranking carbohydrate foods based on the blood glucose responses they produce after ingestion. Emblica officinalis (E. officinalis) is a medicinal plant that purportedly has hypoglycaemic and hypolipidemic properties. This study aims to determine the glycemic and lipemic responses of freeze-dried E. officinalis powder-incorporated recipes. Design/methodology/approach Two sets of four equicarbohydrate (50 g) recipes (vegetable cutlet, handvo, muthiya and methi thepla) were developed, one without E. officinalis powder incorporation (standard) and one with E. officinalis powder incorporation at the 2 g level (test). After overnight fasting, 50 g glucose, standard and test recipes were administered to healthy adult volunteers at different instances (each 3–4 days apart) and blood glucose levels were measured using capillary sampling every 15 min for 2 h. The glycemic response and GI values were then calculated. Findings Among the standard recipes, lowest glycemic response was obtained by methi thepla (60.90 ± 15.54) and highest glycemic response by handvo (90.57 ± 33.88). Incorporation of E. officinalis powder brought about a non-significant reduction in the GI of methi thepla (p = 0.94), vegetable cutlet (p = 0.54), muthiya (p = 0.69) and handvo (p = 0.09). Maximum per cent reduction was for handvo, which shifted from the high to medium GI category. The lipemic response was lowest with muthiya, showing a fall in triacylglycerol (TG) levels (3.9%). E. officinalis powder incorporation in muthiya led to a further fall (7.8%) in TG levels. Originality/value Incorporation of freeze-dried E. officinalis powder in Indian recipes can bring about a reduction in the postprandial glycemic and lipemic responses.

scholarly journals Low glycaemic index diet in patients prescribed clozapine: pilot study

2004 ◽  
Vol 28 (8) ◽  
pp. 292-294 ◽  
Author(s):  
Helen Smith ◽  
Tom White
Keyword(s):  
Blood Glucose ◽  
Pilot Study ◽  
Glycaemic Index ◽  
Clinical Implications ◽  
Random Blood Glucose ◽  
Glucose Levels ◽  
Cholesterol Levels ◽  
Blood Glucose Levels ◽  
Potential Benefits ◽  
The Mean

Aims and MethodThis study aimed to investigate the potential benefits of a low glycaemic index diet in patients with schizophrenia taking clozapine. Seven patients consented to participate in a 5-week pilot study. Measurements were taken of body weight, random blood glucose and cholesterol levels.ResultsThe mean weight loss per patient was 2.9 kg in 4 weeks. Random blood glucose levels reduced from a mean of 5.3 mmol/l at the beginning of the study to 4.7 mmol/l at the end.Clinical ImplicationsA low glycaemic index diet may possibly reduce the substantial cardiovascular risk in patients receiving antipsychotic medication.

scholarly journals A randomized, controlled trial of oral versus intravenous fluids for lowering blood glucose in emergency department patients with hyperglycemia

CJEM ◽  
2014 ◽  
Vol 16 (03) ◽  
pp. 214-219 ◽  
Author(s):  
Sanjay Arora ◽  
Marc A. Probst ◽  
Laura Andrews ◽  
Marissa Camilion ◽  
Andrew Grock ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Glucose ◽  
Adverse Events ◽  
Controlled Trial ◽  
Fluid Administration ◽  
Intravenous Fluids ◽  
Glucose Levels ◽  
Randomized Controlled ◽  
Blood Glucose Levels ◽  
The Mean

ABSTRACT Objectives: Blood glucose can be lowered via insulin and/or fluid administration. Insulin, although efficacious, can cause hypoglycemia and hypokalemia. Fluids do not cause hypoglycemia or hypokalemia, but the most effective route of fluid administration has not been well described. This study compared the efficacy and safety of oral versus intravenous fluids for reducing blood glucose in patients with hyperglycemia. Methods: We conducted a prospective, nonblinded, randomized, controlled trial. Inclusion criteria were blood glucose &gt; 13.9 mmol/L, age &gt; 18 years, and ability to tolerate oral fluids. Subjects were excluded for critical illness, contraindication to fluids, and/or hyperglycemia therapy prior to enrolment. Subjects were randomized to receive oral bottled water or intravenous normal saline (maximum 2 L) over 2 hours. The primary outcome of interest was a change in blood glucose at 2 hours across treatment arms. Results: The 48 subjects were randomized. Baseline blood glucose levels and total amount of fluid received were similar between the two groups. The mean decrease in blood glucose at 2 hours was similar for both treatment arms: a mean decrease of 3.4 mmol/L (20.2 mmol/L to 16.8 mmol/L) in the oral fluid group versus a mean decrease of 4.0 mmol/L (19.7 mmol/L to 15.7 mmol/L) in the intravenous fluid group. The mean difference between groups was −0.6 mmol/L (95% confidence interval −2.3–1.2; p = 0.51). No adverse events were observed in either group. Conclusion: In this unblinded randomized trial, oral and intravenous fluids were equally efficacious in lowering blood glucose levels in stable hyperglycemic patients and no adverse events were noted. Physicians should be mindful that, although similar, the reduction in blood glucose was modest in both groups.

scholarly journals THE SIMILAR CHANGES OF GLUCOSE LEVELS BEFORE AND AFTER MODERATE INTENSITY EXERCISE ACUTELY IN THE MORNING AND NIGHT

2020 ◽  
Vol 30 (2) ◽  
pp. 45
Author(s):  
Ronik Harsono Kamal ◽  
Kristanti Wanito Wigati ◽  
Achmad Lefi
Keyword(s):  
Blood Glucose ◽  
Physical Exercise ◽  
Asia Pacific ◽  
Moderate Intensity ◽  
Maximum Heart Rate ◽  
Moderate Intensity Exercise ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Before And After ◽  
The Mean

Background: There is a lot of research on the importance of exercise but studies on the effective time of exercise regarding regulation of blood glucose levels are not clearly known. Objective: This study aims to determine the comparison of changes in blood glucose levels before and after moderate intensity physical exercise in the morning and night. Material and method: Healthy men (n=34), Age between 17-22 years, Body Mass Index (BMI) between 18.5-22.9 kg/m2 (normal Asia Pacific), participating in the morning group (8.00 am) or the night group (20.00 pm) are asked to do moderate intensity physical exercise (55-70% of maximum heart rate) using ergocycle for a total of 40 minutes. Blood glucose levels 2 hours post prandial capillaries are taken before exercise and blood glucose levels after exercise are taken acutely. Result: The mean decrease in blood glucose levels in the morning group was -8.353±9.16 mg/dL and in the night group was -6.294±10.10 mg/dL. Blood glucose levels decreased significantly for the morning group (p=0.002) and the night group (p=0.021). The comparison of changes in blood glucose levels between the morning and night groups was not significant (p=0.538). Conclusion: There is no difference between morning or night exercise related to changes in blood glucose levels.

MO633GLYCAEMIC MARKERS IN PATIENTS WITH TYPE 2 DIABETES UNDERGOING HAEMODIALYSIS EVALUATED BY LONG-TERM CONTINUOUS GLUCOSE MONITORING*

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Tobias Bomholt ◽  
Marianne Rix ◽  
Thomas Peter Almdal ◽  
Filip K Knop ◽  
Susanne Rosthøj ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glucose Monitoring ◽  
Control Group ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Sensor Glucose ◽  
The Mean ◽  
Mean Blood Glucose

Abstract Background and Aims The reliability of haemoglobin A1c (HbA1c) as a glycaemic marker in patients receiving haemodialysis (HD) remains unknown. To assess accuracy, we compared HbA1c and fructosamine levels with interstitial glucose levels measured by continuous glucose monitoring (CGM) in patients with type 2 diabetes receiving HD. Method The HD group (maintenance HD and type 2 diabetes) comprised 30 patients who completed the study period of 17 weeks; the control group (type 2 diabetes and an estimated glomerular filtration rate &gt;60 mL/min/1.73 m2) comprised 36 individuals. CGM (Ipro2®, Medtronic) for periods up to seven days was performed five times (with four weeks intervals) during a 16-week period. HbA1c and fructosamine were measured at week 17. The mean sensor glucose from CGM was compared with the measured HbA1c, its estimated mean blood glucose (eMBGA1c) and fructosamine levels. Results In the HD group, the mean sensor glucose from CGM was 1.4 (95% confidence interval [CI]: 1.0–1.8) mmol/L higher than the eMBGA1c, whereas the difference was 0.1 mmol/L (95% CI: -0.1–[0.4]; P&lt;0.001) in the control group. Adjusted for the mean sensor glucose, HbA1c was -7.3 (95% CI: -10.0–[-4.7]) mmol/mol lower in the HD group than in controls (P&lt;0.001), whereas no difference was detected for fructosamine (P=0.64). Conclusion HbA1c evaluated by CGM underestimates mean blood glucose levels in patients receiving maintenance HD; fructosamine appears to be more accurate. CGM-assessed blood glucose could complement or replace HbA1c in patients where HbA1c underestimates blood glucose levels.

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