scholarly journals Postprandial Blood Glucose can be less than Fasting Blood Glucose and this is not a Laboratory Error

2019 ◽  
Vol 57 (215) ◽  
Author(s):  
Vivek Pant ◽  
Keyoor Gautam ◽  
Santosh Pradhan

Higher fasting blood glucose level than post prandial level can be seen in variety of conditions in both normal population and diabetics. Various modifiable factors along with underlying condition of patient behind such laboratory picture are discussed in this article. Keywords: clinical laboratory; diabetes; fasting blood glucose; postprandial blood glucose.

2017 ◽  
Vol 5 (2) ◽  
pp. 117
Author(s):  
Ketut Adi Jaya Sutana ◽  
Komang Ayu Kartika Sari ◽  
I Wayan Weta

Background and purpose: The prevalence of diabetes mellitus (DM) in Indonesia is increasing, including in Buleleng District, Bali Province. Studies regarding determinants of blood glucose control in DM patients show varied findings. This study aims to examine association between blood glucose level with physical activity, compliance to medication and glycemic load among DM patients.Methods: A cross-sectional survey was conducted in Buleleng District General Hospital from March to April 2017. A total of 73 patients were concecutively recruited to participate in our study. Data were collected through interview, observation and measurement. Data collected included socio-demographic characteristics, fasting blood glucose level, 1-hour and 2-hour postprandial blood glucose levels, carbohydrate intake, body mass index, glycemic index, glycemic load, physical activity, genetic or family history, and compliance to medication. A bivariate analysis was performed to examine association between independent variables and blood glucose levels. Multivariate analysis was also conducted to calculate adjusted odd ratio using a binary logistic regression.Results: Our study found that blood glucose levels of most respondents were relatively well managed–63% for fasting, 61.6% for 1-hour postprandial, and 63% for 2-hours postprandial. Multivariate analysis revealed that fasting blood glucose level were associated with regular physical activities (AOR=74.09; 95%CI: 7.52-729.69) and compliance to medication (AOR=11.90; 95%CI: 2.24-63.29). Furthermore, 1-hour postprandial blood glucose level were associated with breakfast glycemic load (AOR=0.63; 95%CI: 0.47-0.85) and compliance to medication (AOR=27.29; 95%CI: 2.29-323.95), while 2-hour postprandial blood glucose level were associated with breakfast glycemic load (AOR=0.69; 95%CI: 0.54-0.89) and compliance to medication (AOR=19.81; 95%CI: 2.31-170.14).Conclusions: Factors associated with fasting blood glucose level were regular physical activities and adherence to medication, while 1-hour and 2-hours postprandial blood glucose levels were both influenced by breakfast glycemic load and compliance to medication.


Author(s):  
Shibu Narayan Jana ◽  
Papiya Mitra Mazumder

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.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kimimasa Sasaki ◽  
Shin Kobayashi ◽  
Masashi Kudo ◽  
Motokazu Sugimoto ◽  
Shinichiro Takahashi ◽  
...  

Abstract Background Immune checkpoint inhibitors (ICIs) are emerging agents used for the treatment of various malignant tumors. As ICIs are generally used for unresectable malignant tumors, there have been only a few reports of patients who underwent surgery after receiving these drugs. Therefore, it remains unclear how immune-related adverse events (irAEs) affect the postoperative course. Here, we report a patient with advanced gastric cancer who underwent laparoscopic hepatectomy for liver metastases after an objective response with lenvatinib plus pembrolizumab and developed hypothyroidism and hypopituitarism as irAEs in the immediate postoperative period. Case presentation A 73-year-old man had undergone total gastrectomy for pT4aN2M0 gastric cancer followed by adjuvant chemotherapy with S-1 and docetaxel, and developed liver metastases in segments 6 and 7. He was enrolled in phase 2 clinical trial of lenvatinib plus pembrolizumab. He continuously achieved a partial response with the study treatment, and the liver metastases were decreased in size on imaging. The tumors were judged to be resectable and the patient underwent laparoscopic partial hepatectomy for segments 6 and 7. From the 1st postoperative day, the patient continuously presented with fever and general fatigue, and his fasting blood glucose level remained slightly lower than that before the surgery. On the 4th postoperative day, laboratory examination revealed hypothyroidism and hypopituitarism, which were suspected to be irAE caused by lenvatinib plus pembrolizumab after surgery. He received hydrocortisone first, followed by levothyroxine after adrenal insufficiency was recovered. Subsequently, his fever, general fatigue, and any abnormality regarding fasting blood glucose level resolved, and he was discharged on the 12th postoperative day. After discharge, his laboratory data for thyroid and pituitary function remained stable while receiving hydrocortisone and levothyroxine without recurrence of gastric cancer. Conclusion We present a case of laparoscopic hepatectomy after receiving lenvatinib plus pembrolizumab and developed hypothyroidism and hypopituitarism after surgery. Regarding surgery after ICI therapy, it is important to recognize that irAEs might occur in the postoperative period.


Author(s):  
Luh Putu Febrayana Larasanty ◽  
I GNA. Dewantara Putra ◽  
Rhyce Dewata Sari ◽  
Komang Dede Saputra ◽  
I GA. Gede Minanjaya ◽  
...  

This study aims to investigate the influence of patient characteristics on the choice of insulin therapy in type 2 diabetes mellitus outpatients in Denpasar municipality. This is a descriptive analysis study using the patient's medical records as research material. Patients who meet inclusion and exclusion criteria are being recorded based on their medical records. Characteristics that are taken are age, gender, fasting blood glucose level (FBG), 2-hour postprandial blood glucose level (2-hours PPG) and HbA1c values of patients. Types of insulin therapy gained from patient medical records and drug use report in pharmacy. Characteristics data and type of insulin analyzed using correlation test to determine the effect of the patient characteristics on the selection of insulin therapy. 43 patients became the research subject. Males gendered patients (72.09%) and the patients aged less than 65 years (90.70%) are the dominant characteristics of the research subjects. The average value of FBG of patients is 212 mg / dL; 2-hours PPG 280 mg / dL and HbA1c 10.1%. There is a correlation between sex, age, HbA1c value and FBG with the type of insulin obtained by patients (p <0.05). Based on the results of statistical tests, age and gender have a strong correlation on insulin choice, HbA1c and FBG level has a moderate influence and 2-hours PPG have a weak correlation. Patient characteristics had an influence on the type of insulin choice for diabetes mellitus type 2 outpatient in the Denpasar municipality.


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