Glucose 250, MD Notified: A Case Report.

2020 ◽  
pp. 1-3
Keyword(s):  
Insulin Therapy ◽  
Serum Insulin ◽  
Serum Cortisol ◽  
Primary Diagnosis ◽  
Serum Glucose ◽  
High Serum ◽  
Intravenous Glucose ◽  
Glucose Levels ◽  
Normal Ranges ◽  
Low Rate

Background: Hyperglycemia is common in neonates. Insulin therapy is used to treat hyperglycemia. Threshold for treating hyperglycemia varies among the neonatal practitioners. The renal threshold for glucose is 180 mg/dl, so most practitioners wait on insulin therapy till the serum glucose level reaches 180 mg/dl. We describe a case of a neonatal hyperglycemia of greater than 250 mg/dl that was successfully managed conservatively. Clinical Findings: The neonate, who was depressed at birth, was noted to have high serum glucose levels soon after birth. Serial glucose levels within first six hours of life were persistently above 200 mg/dl. The serum cortisol was normal while serum insulin was low. Infant was provided a low rate of intravenous glucose without giving any insulin. The serum glucose declined to normal levels within 24 hours. Primary diagnosis: Stress-induced transitional hyperglycemia. Interventions: We performed a serial monitoring on serum glucose and provided intravenous dextrose solution at a very low rate. The glucose infusion rate used was only 2.6 mg/kg/min. We were able to bring down the serum glucose to normal ranges conservatively without using any insulin therapy. Outcomes: Infant responded to conservative management and serum glucose was normalized within 24-hours. Practical Recommendations: Stress-induced hyperglycemia soon after birth is transitional and could be managed conservatively without insulin therapy.

scholarly journals Diazoxide use for neonatal hyperinsulinaemic hypoglycaemia in a low-resource setting: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 338-343
Author(s):  
AO Adekoya ◽  
TE Adekanye ◽  
OO Abolurin ◽  
OO Adebawojo ◽  
FG Ajayi ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Serum Insulin ◽  
Male Infant ◽  
Serum Cortisol ◽  
High Serum ◽  
Intravenous Glucose ◽  
Hyperinsulinaemic Hypoglycaemia ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Hydrocortisone Administration

The management of neonatal hyperinsulinaemic hypoglycaemia remains a major challenge in hospitalized newborns globally. Diazoxide is one of the recommended therapeutic options. We report a late preterm, male infant of a diabetic mother who suffered severe perinatal asphyxia and had persistent hypoglycaemia requiring progressively increasing intravenous glucose concentrations to as high as 12.5 mg/kg/minute along with intravenous hydrocortisone administration. A critical sample revealed inappropriately high serum insulin, inappropriately low serum cortisol and growth hormone responses. Urinalysis was negative for ketones. With the persistence of hypoglycaemia, oral diazoxide at 5 mg/kg/day with oral hydrochlorothiazide was administered. The infant was diazoxide-responsive with complete resolution of hypoglycaemia. Diazoxide therapy was discontinued after 14 days and he was discharged after one month of admission. This report emphasizes the importance of diazoxide in the management of neonatal transient hyperinsulinaemic hypoglycaemia. The availability and cost of diazoxide, as well as the endocrine and metabolic tests, are major concerns in resource-poor settings.

Hypothalamic noradrenergic and sympathoadrenal control of glycemia after stress

1989 ◽  
Vol 256 (2) ◽  
pp. E231-E235
Author(s):  
G. A. Smythe ◽  
W. S. Pascoe ◽  
L. H. Storlien
Keyword(s):  
Insulin Release ◽  
Acute Stress ◽  
Serum Insulin ◽  
Elevated Serum ◽  
Serum Glucose ◽  
Neural Pathways ◽  
Swim Stress ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Positive Correlations

Central noradrenergic pathways play a significant role in mediating blood glucose levels after neuroglycopenia. To further investigate hypothalamic noradrenergic neuronal activity (NNA) and sympathoadrenal influences in glucoregulation, we studied the effects of acute stress on glycemia and insulin release in normal and adrenalectomized (ADRX) rats. Within 5 min of exposure of rats to ether or cold-swim stress, significant positive correlations were evident between hypothalamic NNA and serum glucose levels (r = 0.70, P less than 0.001; at 15 min r = 0.78, P less than 0.0001). Five minutes after stress in the intact rat, insulin release was inhibited and serum insulin levels inversely correlated to hypothalamic NNA (r = 0.45, P less than 0.05). This relationship between insulin and NNA was no longer present 15 min after stress, but the levels of insulin remained inappropriately low with respect to the elevated serum glucose levels (approximately 30% above basal). Blockade of sympathetic noradrenergic pathways by treatment of intact rats with guanethidine prevented the rise in glucose after cold-swim stress but did not prevent the inhibition of insulin release. Fifteen minutes after exposure of ADRX rats to cold-swim stress their hypothalamic NNA and serum glucose levels were similar to intact animals. However, in contrast to their intact counterparts, serum insulin levels were significantly elevated (P less than 0.01). These data are consistent with central noradrenergic neural pathways directly mediating hepatic glucose release and indirectly inhibiting pancreatic insulin release via activation of adrenal medullary catecholamines.

scholarly journals Endothelial dysfunction precedes hypertension in diet-induced insulin resistance

1998 ◽  
Vol 275 (3) ◽  
pp. R788-R792 ◽  
Author(s):  
Prasad V. G. Katakam ◽  
Michael R. Ujhelyi ◽  
Margarethe E. Hoenig ◽  
Allison Winecoff Miller
Keyword(s):  
Insulin Resistance ◽  
Endothelial Dysfunction ◽  
Serum Insulin ◽  
Serum Glucose ◽  
Mesenteric Arteries ◽  
Control Group ◽  
Sprague Dawley ◽  
Insulin Resistant ◽  
Glucose Levels

The insulin-resistant (IR) syndrome may be an impetus for the development of hypertension (HTN). Unfortunately, the mechanism by which this could occur is unclear. Our laboratory and others have described impaired endothelium-mediated relaxation in IR, mildly hypertensive rats. The purpose of the current study is to determine if HTN is most likely a cause or result of impaired endothelial function. Sprague-Dawley rats were randomized to receive a fructose-rich diet for 3, 7, 10, 14, 18, or 28 days or were placed in a control group. The control group received rat chow. After diet treatment, animals were instrumented with arterial cannulas, and while awake and unrestrained, their blood pressure (BP) was measured. Subsequently, endothelium-mediated relaxation to acetylcholine was determined (in vitro) by measuring intraluminal diameter of phenylephrine-preconstricted mesenteric arteries (∼250 μM). Serum insulin levels were significantly elevated in all groups receiving fructose feeding compared with control, whereas there were no differences in serum glucose levels between groups. Impairment of endothelium-mediated relaxation starts by day 14 [mean percent maximal relaxation (Emax): 69 ± 10% of baseline] and becomes significant by day 18 (Emax: 52 ± 11% of baseline; P < 0.01). However, the mean BP (mmHg) does not become significantly elevated until day 28 [BP: 132 ± 1 ( day 28) vs. 116 ± 3 (control); P < 0.05]. These findings demonstrate that both IR and endothelial dysfunction occur before HTN in this model and suggest that endothelial dysfunction may be a mechanism linking insulin resistance and essential HTN.

scholarly journals Effect of metformin on the expression of SNAER proteins in the skeletal muscle of rats with type 2 diabetes

2021 ◽  
pp. 270-278
Keyword(s):  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Body Weight ◽  
Serum Insulin ◽  
Serum Glucose ◽  
Snare Complex ◽  
Snare Proteins ◽  
Glucose Levels ◽  
Male Wistar Rats

Background and Aims: SNARE proteins are composed of a combination of SNAP-23, Stx-4, and VAMP-2 isoforms that are significantly expressed in skeletal muscle. These proteins control the transport of GLUT4 to the cell membranes. The modifications in the expression of SNARE proteins can cause Type 2 diabetes. The present study aimed to assess the effect of metformin on the expression of these proteins in rats. Materials and Methods: For the purpose of the study, 40 male Wistar rats were randomly selected. Streptozotocin and Nicotinamide were used for the induction of type 2 diabetes. The animals were assigned to five groups (n=8), including healthy and diabetic groups as control, as well as three experimental groups which were treated with different doses of metformin (100, 150, and 200 mg/kg body weight) for 30 days. The quantitative reverse transcription PCR (RT-qPCR) method was applied to evaluate the expression of SNARE complex proteins.. Results: Based on the results, metformin (100, 150, and 200 mg/kg body weight) decreased serum glucose levels and increased serum insulin levels. This difference in dose of 200 mg/kg body weight was statistically significant (P<0.05). Moreover, all three doses of metformin increased the expression of SNAP- 23, syntaxin-4, and VAMP-2 proteins in skeletal muscle tissue. Metformin at a dose of 200 mg/kg body weight demonstrated the most significant effects (P<0.05). Conclusion: As evidenced by the results of the current study, another anti-diabetic mechanism of metformin is to increase the expression of SNARE proteins, which effectively improves insulin resistance and lowers blood glucose.

Strategic administration of an appeasing substance to improve performance and physiological responses of Bos indicus feedlot cattle

2021 ◽  
Author(s):  
Vitor G L Fonseca ◽  
Bruno I Cappellozza ◽  
Osvaldo A de Sousa ◽  
Manuella Sagawa ◽  
Bruna Rett ◽  
...  
Keyword(s):  
Serum Insulin ◽  
Physiological Responses ◽  
Bos Indicus ◽  
Serum Cortisol ◽  
Serum Glucose ◽  
Feedlot Cattle ◽  
Skin Area ◽  
Feeding Period ◽  
Treatment Administration ◽  
To Receive

Abstract This study was designed to evaluate the timing of administration of the bovine appeasing substance (BAS) on performance and physiological responses of Bos indicus feedlot cattle. Nellore bulls (n = 100) were ranked by initial body weight (BW; 341 ± 18.5 kg) and assigned to receive BAS (n = 50) or placebo (CON; n = 50) on d -2 of the experiment. Treatments (5 mL) were applied topically to the nuchal skin area of each bull. Bulls were loaded into commercial livestock trailers immediately after treatment administration, transported for 880 km, and unloaded on d -1 at a commercial feedyard. On d 0, bulls within each treatment were again assigned to receive, in a 2 x 2 factorial arrangement, BAS or CON as previously described (25 bulls/treatment combination). Upon treatment administration on d 0, bulls were housed in 12 feedlot pens (3 pens/treatment) for a 108-d feeding period, which was divided into an adaptation (d 0 – 19), growing (d 20 – 60), and finishing (d 61 – 108) phases. Dry matter intake (DMI) was measured daily from d 0 to 108, whereas blood samples and hair from the tail switch were collected on d -2, 0, 19, 60, and 108. Administration of BAS prior to loading (d -2) improved ADG, FE, and DMI during adaptation and across the 108-d feeding period (P ≤ 0.08), resulting in greater (P = 0.03) hot carcass weight and dressing percentage upon slaughter on d 109. A treatment × day interaction was detected for serum glucose concentrations (P = 0.05), which was greater (P = 0.03) on d 60 of the feeding period in bulls receiving CON prior to loading. Administration of BAS at feedlot entry (d 0) improved DMI, ADG, and FE during adaptation (P ≤ 0.05), but it did not impact (P ≥ 0.18) performance and carcass traits during the 108-d feeding period. Bulls administered BAS prior to loading and at feedlot entry had less (P ≤ 0.05) mean serum cortisol concentrations across the 108-d feeding period (loading × feedlot entry interaction; P = 0.10), and greater (P ≤ 0.05) serum insulin concentration on d 60 (loading × feedlot entry × day interaction; P = 0.05). In summary, BAS administration prior to loading increased overall feedlot performance of Nellore bulls. These outcomes were noted in bulls that received or not a second BAS administration at feedlot entry, suggesting that the benefits of BAS are exploited when this substance is administered before transport to the feedlot.

Changes in Levels of Serum Insulin, C-Peptide and Glucose after Electroacupuncture and Diet Therapy in Obese Women

2006 ◽  
Vol 34 (03) ◽  
pp. 367-376 ◽  
Author(s):  
Mehmet Tuğrul Cabıoğlu ◽  
Neyhan Ergene
Keyword(s):  
Weight Loss ◽  
Serum Insulin ◽  
Diet Therapy ◽  
Serum Glucose ◽  
The Body ◽  
Obese Women ◽  
Diet Restriction ◽  
C Peptide ◽  
Glucose Levels ◽  
Restriction Group

Our purpose was to investigate the effects of electroacupuncture (EA) therapy on body weight and on levels of serum insulin, c-peptide and glucose in obese women. 52 healthy women were included in this study and were allocated into three groups: 1) Placebo EA group ( n = 15; mean age = 41.8 ± 4.6 and mean body mass index { BMI } = 33.2 ± 3.5); 2) EA group ( n = 20; mean age = 42.1 ± 4.4 and BMI = 35.9 ± 3.6) and 3) Diet restriction group ( n = 20; mean age = 42.9 ± 4.3 and BMI = 34.7 ± 2.7). EA was applied to the ear points Hunger and Shen Men on alternating days and to the body points LI 4, LI 11, St 36 and St 44 once a day for 30 minutes over 20 days. Diet restriction that entailed a 1450 kilocalorie (kcal) diet program was applied to the three groups for 20 days. An increase in weight loss was observed when weight loss in the EA group (p < 0.000) was compared to that in the diet restricted and placebo EA groups using the Tukey HSD test. There were increases in the serum insulin (p < 0.001) and c-peptide levels (p < 0.000) in the women treated with EA compared to those in the women treated with the placebo EA and diet restriction groups. A decrease was observed in the glucose levels (p < 0.01)in both the EA and diet restriction groups compared to those in the placebo EA group. Our results suggest that EA therapy is an effective method in treating obesity. EA therapy also helps serum glucose levels to decrease through the increase of serum insulin and c-peptide levels.

Normal Ranges for Diagnostically Important Hematological and Blood Chemistry Characteristics of Rainbow Trout (Salmo gairdneri)

1983 ◽  
Vol 40 (4) ◽  
pp. 420-425 ◽  
Author(s):  
W. Roscoe Miller III ◽  
Albert C. Hendricks ◽  
John Cairns Jr.
Keyword(s):  
Rainbow Trout ◽  
Blood Chemistry ◽  
Serum Glucose ◽  
Salmo Gairdneri ◽  
Total Serum Protein ◽  
Total Serum ◽  
Tolerance Interval ◽  
Glucose Levels ◽  
Normal Ranges ◽  
Nonparametric Techniques

Wytheville strain rainbow trout (Salmo gairdneri) were used in an 11-mo study designed to establish normal ranges for several hematological and blood chemistry characteristics. Two nonparametric techniques, percentile estimation and tolerance interval, were used and produced comparable ranges to those based on the Gaussian distribution. Serum glucose levels appeared to coincide with the condition of the gonads; low glucose levels corresponded with approximate spawning times at the hatchery. Total serum protein and gonadal condition were similarly related. High variability of the serum enzymes LDH and SGOT was partially explained by a positive linear relationship between enzyme activity and acclimation temperatures. In addition to physiological significance, determination of normal ranges for rainbow trout has promise in diagnosis of pathological, disease, and toxicant-induced stresses.

scholarly journals Effect of Injection Site Cooling and Warming on Insulin Glargine Pharmacokinetics and Pharmacodynamics

2019 ◽  
Vol 13 (6) ◽  
pp. 1123-1128 ◽  
Author(s):  
Gabriel Bitton ◽  
Vital Rom ◽  
Uri Hadelsberg ◽  
Itamar Raz ◽  
Eda Cengiz ◽  
...  
Keyword(s):  
Insulin Glargine ◽  
Injection Site ◽  
Serum Insulin ◽  
Fasting Blood Glucose ◽  
Blood Glucose Control ◽  
Random Order ◽  
Serum Glucose ◽  
Glucose Levels ◽  
Long Acting ◽  
Control Study

Background: In type 1 diabetes (T1D), closed-loop systems provide excellent overnight fasting blood glucose control by adjusting the insulin infusion rate based on corresponding changes in sensor glucose levels. In patients on multiple daily insulin (MDI) injections, such control in overnight glucose levels has not been possible due to the inability to alter the absorption rate of long-acting insulin after injection. In this study, we tested the hypothesis that increases/decreases of fasting glucose levels could be achieved by cooling/warming the skin around the injection site, which would result in lower/higher Glargine absorption rates from its subcutaneous depot. Methods: Fourteen subjects with T1D (4 females; age 39.6 ± 16.7 years, HbA1c 7.8 ± 1.1%, BMI 25.4 ± 2.8 kg/m2) on MDI therapy underwent fasting pharmacokinetic and pharmacodynamic studies that started at ~8 am and lasted 240 min on 3 separate days in random order: a control day without warming or cooling of the injection site and two experimental days, one day with injection site warming and the other with cooling. Results: Cooling the skin around the glargine injection site reduced insulin concentrations by >40% ( P < .01 versus the warming study, P = .21 versus the control study), accompanied by a 55 mg/dL increase in serum glucose ( P < .01 versus the control study). Conversely, skin warming prevented the fall in serum insulin ( P = .2 versus the control study; P < .01 versus the cooling study), resulting in a 40 mg/dL reduction in serum glucose ( P < .001 versus the cooling study, P = .11 versus the control study). Conclusions: This proof of concept study has shown that cooling and warming the skin around the injection site provides a means to decrease and increase the rate of absorption and action of insulin glargine from its subcutaneous depot.

scholarly journals Effect of in ovo ghrelin administration on subsequent serum insulin and glucose levels in newly-hatched chicks

2011 ◽  
Vol 56 (No. 8) ◽  
pp. 377-380 ◽  
Author(s):  
A. Lotfi ◽  
H. Aghdam-Shahryar ◽  
J. Ghiasi-Ghalehkandi ◽  
H. Kaiya ◽  
N. Maheri-Sis
Keyword(s):  
Animal Species ◽  
Serum Insulin ◽  
Serum Glucose ◽  
Avian Embryo ◽  
Regulatory Peptide ◽  
In Ovo ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Hatching Time ◽  
Embryonic Life

Ghrelin is a regulatory peptide in glucose homeostasis in animal species. Its effect in the avian embryo is unclear. The aim of this study was to investigate the effects of in ovo ghrelin administration on serum glucose and insulin levels of hatched chicks. A total of 250 fertilized eggs were divided into 5 groups; group T1 as control (without injection), group T2 (in ovo injected with 50 ng/egg ghrelin on day 5), group T3 (in ovo injected with 100 ng/egg ghrelin on day 5), group T4 (in ovo injected with 50 ng/egg ghrelin on day 10) and group T5 (in ovo injected with 100 ng/egg ghrelin on day 10). After hatching, serum insulin and glucose concentrations were determined. Group T4 and T5 showed significantly higher serum insulin levels (0.43 and 0.60 ng/ml, respectively) compared with T1, T2 and T3 (0.09, 0.10, and 0.23 ng/ml, respectively) in hatched chicks. Glucose concentrations have not been affected by in ovo administered ghrelin in all injected groups. It seems that embryonic &beta;-cells were stimulated to secrete a considerable level of insulin in response to in ovo ghrelin in the late embryonic life. The observed stability of glucose rate suggests the incidence of insulin resistance at hatching time or in newly hatched chicks from in ovo ghrelin administered eggs on day 10.

THE EFFECT OF THE ALPHA ADRENERGIC AGONIST CLONIDINE ON THE GROWTH, CARCASS YIELD, MEAT QUALITY AND PHYSIOLOGICAL-ENDOCRINOLOGICAL RESPONSE IN STEERS

1990 ◽  
Vol 70 (3) ◽  
pp. 857-866 ◽  
Author(s):  
A. L. SCHAEFER ◽  
S. D. M. JONES ◽  
A. K. W. TONG ◽  
A. D. KENNEDY ◽  
L. A. ONISCHUK
Keyword(s):  
Serum Insulin ◽  
Venous Blood ◽  
Pilot Trial ◽  
Serum Glucose ◽  
Feed Additive ◽  
Carcass Yield ◽  
Treatment Groups ◽  
Glucose Levels ◽  
Balanced Diet ◽  
Clonidine Hydrochloride

A pilot trial with the alpha-2 agonist clonidine hydrochloride, administered as a feed additive at three levels to crossbred steers (427 kg), was conducted to examine the effectiveness of this class of products as a repartitioning agent. The steers, averaging 427 kg, were divided into four treatment groups of eight animals each, and were individually fed to appetite a balanced diet to which clonidine had been added at levels of 0.0 (C), 1.0 (H), 0.5 (M), or 0.25 (L) g kg body weight−1 d−1. From venous blood samples collected after approximately 12 wk of feeding clonidine, treatments H and M increased serum glucose levels (P ≤ 0.05) by up to 50% above controls (C). In addition, compared to the control steers, the high clonidine dose raised the serum insulin values within 5 h of consuming clonidine (P ≤ 0.03). However, this change was not observed in either the M or L groups. Heart weights increased by up to 15% (P ≤ 0.07) in the H, M and L treatments compared to treatment C. In contrast, at doses of 0.25–1.0 g kg−1 orally administered clonidine displayed little or no consistent carcass repartitioning effect in steers. Key words: Beef cattle, clonidine, physiology, carcass yield

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