Evaluation of NAFLD fibrosis, FIB-4 and APRI score in diabetic patients receiving exenatide treatment for non-alcoholic fatty liver disease

There is a closely relationship between the development and progression of nonalcoholic fatty liver disease (NAFLD) or metabolic associated fatty liver disease (MAFLD) and obesity and diabetes. NAFLD fibrosis scores should be routinely used to rule out patients with advanced fibrosis. High scores may help identify patients at higher risk of all causes andliverrelated morbidity and mortality. The aim of this study was to investigate the association between exenatide and fibrosis scores. The effect of exenatide treatment on fibrosis scores was evaluated in type 2 diabetes mellitus (DM) patients with MAFLD. Evaluation was made of 50 patients with type 2 DM and MAFLD. The NFS, FIB4 and APRI scores were calculated before and after 6 months of treatment. After 6 months of exenatide treatment, the NFS and APRI scores were determined to have decreased significantly. Exenatide was observed to control blood glucose, reduce body weight and improve fibrosis scores in MAFLD patients with type 2 diabetes.

Control Blood Sugar Levels by Brisk Walking Method

Diabetes mellitus (DM) is a chronic disease, and specific treatments are needed in order to control blood glucose. In addition to pharmacological therapy, non-pharmacology therapy also takes an important role to control blood glucose levels and should be done regularly. Brisk walking is one example of physical activity which included in non-pharmacology therapy and can improve body expenditure. This activity can help DM patient to control their blood glucose level within the normal range. The physical activity of Brisk Walking, which is one type of exercise that can maintain blood sugar levels within the normal range, especially in people with Diabetes Mellitus. This study aimed to determine the effect of Brisk Walking on the blood glucose level of DM patients at Tamalenrea Health Center Makassar City. This study adopted a quasy experiment and a one-group pre-post test design. A total of 16 respondents were selected purposively based on the determined criteria. Data analysis of the difference of blood sugar level between the treatment and control was carried out by using the Spearman correlation test with SPSS version of 21. The difference was significant with the value of p < 0.05. The results showed that the physical activity of Brisk Walking could control blood sugar levels. Statistical analysis showed that the average blood sugar content was significantly lower in patients practicing Brisk Walking (blood sugar level <200 mg/dl)(176.06%) than the control (blood sugar level > 200 mg/dl) (218.81%). So it can be concluded that by doing physical activity Brisk Walking can control blood glucose levels.

Effect of Continuous Subcutaneous Injection of Insulin Analogues in Pregnant Women with Diabetes Mellitus Complicated with Ketoacidosis

Objective. To investigate the clinical effect of continuous subcutaneous injection of insulin analogues in pregnant women with diabetes mellitus complicated with ketoacidosis. Methods. A total of 92 pregnant patients with diabetes mellitus complicated with ketoacidosis from June 2014 to January 2021 were selected. All patients were randomly divided into an observation group and control group according to the method of random number. The control group received intravenous infusion of insulin, and the observation group received continuous subcutaneous infusion of quick-acting insulin analogues. The clinical effects of the two groups were observed. Results. The time needed to control blood glucose <13.8 mmol/L, the amount of insulin needed to control blood glucose <13.8 mmol/L, the time needed to correct DKA, and the amount of insulin needed to correct DKA in the observation group were significantly less than those in the control group ( P < 0.05 ). Compared with the control group, the average occurrence times of hypoglycemia, the length of stay, the total amount of insulin in hospital, and the total amount of insulin used during pregnancy in the observation group were significantly less than those in the control group ( P < 0.05 ). The values of SCr, CRP, BUN, arterial blood gas pH, and adiponectin in the two groups were significantly improved as compared with those before treatment, and the improvement in the observation group was significantly better than that in the control group ( P < 0.05 ). After treatment, the fasting blood glucose, 2-hour postprandial blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin in the experimental group were significantly better than those in the routine group, and the difference was statistically significant ( P < 0.05 ). Conclusion. Continuous subcutaneous injection of insulin analogues is effective in the treatment of diabetic patients with ketoacidosis, which can effectively improve blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin and accelerate the negative conversion of urinary ketone body. It is worth popularizing to reduce the occurrence of hypoglycemia and the dose of insulin and shorten the time of hospitalization.

PP259 Invisible Resilience: The Value Of Medical Technology In Reducing Population And Health Systems’ Vulnerability To COVID-19.

IntroductionCOVID-19 has exposed population and health systems’ vulnerability to a highly infectious disease. People with diabetes have a higher risk of COVID-19 hospitalization and death than those without. Medicines that control blood glucose reduce this risk. We quantified COVID-19 hospital admissions and deaths averted by diabetes medicines in the UK during the March-May 2020 wave.MethodsWe estimated COVID-19 hospital and intensive care unit (ICU) admissions averted and COVID-19 hospital deaths avoided by diabetes medicines, considering a counterfactual where those medicines were not available. We used published UK-data sources on diabetes prevalence, proportion of patients achieving diabetes control with medicines, COVID-19 infection risk, probabilities for COVID-19 hospital admission, subsequent ICU admission and hospital death. We calculated the relative risk reduction of controlled vs. uncontrolled diabetes on COVID-19 hospital or ICU admission (71% and 66%, respectively), and hospital death (38%) from the UK Open Safely data.ResultsDiabetes medicines are estimated to have averted 17,417 hospital admissions, 2,752 ICU-admissions and 438 hospital deaths due to COVID-19 compared to a counterfactual where those medicines had not been available in the UK.ConclusionsEffective medicines to control diabetes contribute to population and health systems resilience against COVID-19. Health technology assessment and policy makers should recognize that adoption and usage of health technology reduces societies’ vulnerability to similar shocks.

Anti-Diabetic Potential of Plant-Based Pentacyclic Triterpene Derivatives: Progress Made to Improve Efficacy and Bioavailability

Diabetes mellitus (DM) results from the inability of the pancreas to produce sufficient insulin or weakened cellular response to the insulin produced, which leads to hyperglycemia. Current treatments of DM focus on the use of oral hypoglycemic drugs such as acarbose, alpha-glucose inhibitors, sulphonylureas, thiazolidinediones, and biguanides to control blood glucose levels. However, these medications are known to have various side effects in addition to their bioavailability, efficacy, and safety concerns. These drawbacks have increased interest in the anti-diabetic potential of plant-derived bioactive compounds such as oleanolic and maslinic acids. Although their efficacy in ameliorating blood glucose levels has been reported in several studies, their bioavailability and efficacy remain of concern. The current review examines the anti-diabetic effects of oleanolic, maslinic, asiatic, ursolic, and corosolic acids and their derivatives, as well as the progress made thus far to enhance their bioavailability and efficacy. The literature for the current review was gathered from leading academic databases—including Google Scholar and PubMed—the key words listed below were used. The literature was searched as widely and comprehensively as possible without a defined range of dates.

Efficacy of Shenqi Jiangtang Granules-Assisted Western Medi-cine in the Treatment of Gestational Diabetes Mellitus (GDM)

Background: We aimed to investigate the efficacy of Shenqi Jiangtang granules-assisted Western medicine in the treatment of gestational diabetes mellitus (GDM). Methods: A total of 147 patients with GDM treated in Qilu Hospital of Shandong University from Jan 2018 to Apr 2019 were enrolled. They were randomly divided into traditional Chinese medicine (TCM) combined with Western medicine group, Western medicine group and control group. The control group was treated with exercise combined with diet therapy, and the Western medicine group was additionally treated with metformin tablets. The TCM combined with Western medicine group was additionally treated with Shenqi Jiangtang granules. Results: After treatment, the levels of 10 indicators in the three groups were lower than those before treatment (P < 0.05). These indicators were the lowest in the TCM combined with Western medicine group. However, high-density lipoprotein cholesterol (HDL-C), glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) after treatment increased in the three groups compared with those before treatment (P < 0.05), which was the most obvious in the TCM combined with Western medicine group. After treatment, the number of patients with natural delivery in the TCM combined with Western medicine group was the largest. The incidences of complications in pregnant women, fetuses and newborns were the lowest in the TCM combined with Western medicine group. Conclusion: Application of Shenqi Jiangtang granules-assisted Western medicine in patients with GDM can effectively control blood glucose and lipid levels, enhance antioxidant capacity, reduce the levels of inflammatory cytokines and decrease the incidence of adverse pregnancy outcomes.

Analysis and design process for predicting and controlling blood glucose in Type 1 diabetic patients

Engineering smart software that can monitor, predict, and control blood glucose is critical to improving patients' quality of treatments with type 1 Diabetic Mellitus (T1DM). However, ensuring a reasonable glycemic level in diabetic patients is quite challenging, as many methods do not adequately capture the complexities involved in glycemic control. This problem introduces a new level of complexity and uncertainty to the patient's psychological state, thereby making this problem nonlinear and unobservable. In this paper, we formulated a mathematical model using carbohydrate counting, insulin requirements, and the Harris-Benedict energy equations to establish the framework for predicting and controlling blood glucose level regulation in T1DM. We implemented the framework and evaluated its performance using root mean square error (RMSE) and mean absolute error (MAE) on a case study. Our framework had less error rate in terms of RMSE and MAE, which indicates a better fit with reasonable accuracy.

Examining the Validity of Mobile-based Nutrient Assessment Tools for Chinese Patients with Diabetes (Preprint)

BACKGROUND Chinese patients with diabetes do not receive adequate education in dietary management to control blood glucose. Technology-based tools can help them track their dietary intake. However, limited research examined mobile dietary tracking tools with dish-based composition database for Chinese populations. OBJECTIVE The study aimed to examine the validity of mobile-based nutrient analysis tools against nutrient analysis conducted by dietitians on assessment of Chinese dishes. METHODS Registered Dietitian (RD)-performed nutrient analysis was used as the reference. Two mobile-based nutrient analysis tools were selected for the comparison: BD Diabetes Health Coach (an Artificial Intelligence (AI) Coach developed in the current study upon a dish composition database) and Boohoo App (a popular open-access dietary tracking tool in China). Both RDs and mobile-based tools conducted nutrient analysis of the same dishes commonly consumed in China regarding total calories, carbohydrate, fat, and protein content. Descriptive statistics were analyzed. Paired t-tests, Wilcoxon signed rank tests, linear regression and Bland-Altmanwere used to compare results between the RDs and the mobile tools. RESULTS Strong positive correlations between AI Coach- and RD-performed analyses results and moderate positive correlations between Boohoo-performed and RD-performed analyses results were observed for energy and all macronutrients. Bland-Altman plots showed small bias and narrow limit of agreement between AI Coach- and RD-performed analyses, indicating AI Coach-performed analysis is comparable to RD-performed analysis. CONCLUSIONS The AI Coach tool developed in the current study supported by a dish composition database consisting of commonly consumed Chinese dishes was an effective alternative to dietitians in total calorie and macronutrient analysis. This is promising in helping patients with diabetes manage blood glucose through dietary tracking.

Identification of Movements and Postures Using Wearable Sensors for Implementation in a Bi-Hormonal Artificial Pancreas System

Background: Closed loop bi-hormonal artificial pancreas systems, such as the artificial pancreas (AP™) developed by Inreda Diabetic B.V., control blood glucose levels of type 1 diabetes mellitus patients via closed loop regulation. As the AP™ currently does not classify postures and movements to estimate metabolic energy consumption to correct hormone administration levels, considerable improvements to the system can be made. Therefore, this research aimed to investigate the possibility to use the current system to identify several postures and movements. Methods: seven healthy participants took part in an experiment where sequences of postures and movements were performed to train and assess a computationally sparing algorithm. Results: Using accelerometers, one on the hip and two on the abdomen, user-specific models achieved classification accuracies of 86.5% using only the hip sensor and 87.3% when including the abdomen sensors. With additional accelerometers on the sternum and upper leg for identification, 90.0% of the classified postures and movements were correct. Conclusions: The current hardware configuration of the AP™ poses no limitation to the identification of postures and movements. If future research shows that identification can still be done accurately in a daily life setting, this algorithm may be an improvement for the AP™ to sense physical activity.

Comparison of rat tooth eruption in rats born from diabetic mothers

Background: Tooth eruption begins after crown and root formation and may be delayed by gestational diabetes mellitus. Metformin can control blood glucose levels through gluconeogenesis inhibition, and consuming thymoquinone for diabetic treatment will regenerate pancreatic β cells and reduce oxidative stress. Purpose: The objective of this study is to compare the tooth eruption in rats that were born with diabetes and are being treated with either metformin or thymoquinone. Methods: This study used 48 Wistar rats (Rattus norvegicus L.), and the rat sample was divided into four groups, including rats who were born from healthy mothers, rats who were born from untreated diabetic mothers, rats who were born from diabetic mothers that were treated with metformin and rats who were born from diabetic mothers that were treated with thymoquinone. Diabetes was induced by intraperitoneal injection of a single dose of streptozotocin (40 mg/kg BB). Each rat sample was taken with simple random sampling from different mothers, and body weight, blood glucose levels and levels of tooth eruption were recorded. Eruptions of the maxillary right first molar were measured from the cusp of the tooth to the alveolar epithelial lining. Results: Based on the measurements of tooth eruption, it was found that groups A, C and D were closer to mucosa on day 1, 7 and 14 than group B. Based on statistical analysis, there were significant differences (p = 0.03) between group B and groups C and D. Conclusions: Rats born from untreated diabetic mothers have more delays in tooth eruption than those born from diabetic mothers who are treated with metformin and thymoquinone. Thymoquinone has the potential to be an alternative to metformin because it has been shown to be similarly effective.