Effect of Carbohydrate-Restricted Dietary Pattern on Insulin Treatment Rate, Lipid Metabolism and Nutritional Status in Pregnant Women with Gestational Diabetes in Beijing, China

Carbohydrates play an important role in blood glucose control in pregnant women with GDM. Carbohydrate-restricted dietary (CRD) pattern for gestational diabetes mellitus (GDM) has been widely used in clinics, but the change in insulin utilization rate beyond CRD intervention in GDM remains unclear. The aim of the present study was to explore the application of insulin in pregnancy with GDM, as well as the influence of CRD pattern on lipid metabolism and nutritional state. A retrospective study of 265 women with GDM who delivered in Peking University People’s Hospital from July 2018 to January 2020 was conducted using a questionnaire survey. Women were divided into a CRD group or a control group according to whether they had received CRD intervention during pregnancy. There was no statistically significant difference in the rate of insulin therapy between the two groups (p > 0.05), the initial gestational week of the CRD group combined with insulin treatment was significantly higher than that of the control group (p < 0.05), and the risk of insulin therapy was positively correlated with fasting plasma glucose (FPG) in early pregnancy (p < 0.05). The incidence of abnormal low-density lipoprotein cholesterol levels in the CRD group was significantly lower than that in the control group (p < 0.05). There were no significant differences in nutritional indexes between the two groups. The results indicate that CRD intervention may be effective in delaying the use of insulin and improving the blood lipids metabolism during GDM pregnancy, while nutritional status may not be significantly affected under CRD intervention, and a high FPG in early pregnancy with GDM may be a risk factor for combined insulin therapy with CRD intervention.

Development and Greenness Assessment of HPLC Method for Studying the Pharmacokinetics of Co-Administered Metformin and Papaya Extract

Foods with medical value have been proven to be beneficial, and they are extensively employed since they integrate two essential elements: food and medication. Accordingly, diabetic patients can benefit from papaya because the fruit is low in sugar and high in antioxidants. An RP-HPLC method was designed for studying the pharmacokinetics of metformin (MET) when concurrently administered with papaya extract. A mobile phase of 0.5 mM of KH2PO4 solution and methanol (65:35, v/v), pH = 5 ± 0.2 using aqueous phosphoric acid and NaOH, and guaifenesin (GUF) were used as an internal standard. To perform non-compartmental pharmacokinetic analysis, the Pharmacokinetic program (PK Solver) was used. The method’s greenness was analyzed using two tools: the Analytical GREEnness calculator and the RGB additive color model. Taking papaya with MET improved the rate of absorption substantially (time for reaching maximum concentration (Tmax) significantly decreased by 75% while maximum plasma concentration (Cmax) increased by 7.33%). The extent of absorption reduced by 22.90%. Furthermore, the amount of medication distributed increased (30.83 L for MET concurrently used with papaya extract versus 24.25 L for MET used alone) and the clearance rate rose by roughly 13.50%. The results of the greenness assessment indicated that the method is environmentally friendly. Taking papaya with MET changed the pharmacokinetics of the drug dramatically. Hence, this combination will be particularly effective in maintaining quick blood glucose control.

EFFECT OF MORINGA AND OLIVE LEAVES POWDER CONSUMPTION ON HYPERGLYCEMIC STATE IN TYPE 2 DIABETES MELLITUS (A PILOT STUDY)

Study showed effects of Moringa oleifera (MO) and Olea europaea (OE) leaves powder on lowering blood sugar levels in diabetes patients. The aims of this study were to determine the effect of MO and OE leaves powder on blood glucose control in therapy type 2 diabetes mellitus (T2DM).Diabetic patients (160 with diet-controlled type 2 diabetes and 250 non-diabetic) healthy volunteers were asked to fast for 13 hours on three occasions. Blood glucose was measured before and after eating 100g of white carbohydrates (bread) (at 30, 60, 90, 120, 150 and 180 minutes). On their second and third study visits, they were given 1g and 2g respectively, of Moringa oleifera and Olea europaea leaves powder for 30 minutes after eating the bread.Ingestion of Moringa oleifera (MO) and Olea europaea (OE) leaves powder had no effect on blood glucose in non-diabetic participants, but in diabetic patients, Moringa oleifera and Olea europaea powder reduced post-prandial glycaemia in diabetic patients. A larger study is needed to define the optimal dose and to assess whether this translates into longer-term benefits.

Determinants of blood glucose control among people with Type 2 diabetes in a regional hospital in Ghana

Aims To assess the determinants of glycaemic control among patients with Type 2 diabetes mellitus (T2DM) presenting at the Greater Accra Regional Hospital, Ghana. Methods The study employed semi-structured questionnaires and review of clinical records of patients 16 years and above with Type 2 Diabetes. Results The mean age of participants was 56.6 ± 13.8 years, with majority (71.6%) being females. A total of 161 (59.4%) of patients had poor glycaemic control (HbA1c ≥8.1%; 95% CI: 53.6 to 65.3%). Poor glycaemic control was significantly associated with high body mass index of the patient (AOR 13.22; 95% CI: 1.95 to 89.80), having only elementary education (AOR 5.22, 95% CI 2.12–12.86, p<0.0001) and being on insulin therapy (AOR 2.88; 95% CI: 1.05 to 7.88). On the other hand, seldom coffee intake (AOR: 0.27; 95% CI: 0.11 to 0.64), high physical activity (AOR 1.57, 95% CI 1.06–2.35, p = 0.025) and having a cardiovascular disease (AOR: 0.15; 95% CI: 0.05 to 0.46) appeared to positively influence glycaemic control. Self-monitoring of blood glucose and diet interventions did not appear to influence glycaemic control. Conclusions The study results showing that a high proportion of patients attending the Diabetes Clinic with uncontrolled diabetes has serious implications for the management of T2DM diabetes as it suggests that current hospital-based treatment measures are less effective. Comprehensive management of T2DM targeting all the key factors identified in this study and incorporating a multispectral collaborative effort based on holistic approach, combined with non-pharmacological components are strongly warranted.

Influence of Diversity Nursing on Patients’ Rehabilitation in Cardiology Treatment

With the improvement of living standards, people have more and more physical health problems. Among them, high-risk cardiovascular diseases such as hypertension, diabetes, and coronary heart disease are the most prominent. The number of cardiology patients is increasing year by year. Effectively improving the treatment of cardiology patients and speeding up the recovery of cardiology patients have become a social problem. This article aims to explore the impact of diverse nursing care on patients in cardiology treatment. This article first gives a detailed introduction to the treatment of diverse nursing and cardiology diseases, then takes 300 cardiology patients in our hospital as experimental subjects, and conducts a controlled experiment of nursing intervention, which is categorized into an experimental group of 150 cases (including 35 cases of hypertension, 46 cases of diabetes, 28 cases of coronary heart disease, 24 cases of angina pectoris, and 17 cases of multiple complications) and a control group of 150 cases (including 30 cases of hypertension, 47 cases of diabetes, 39 cases of coronary heart disease, 21 cases of angina pectoris, and 13 cases of multiple complications). The experimental results showed the following: the general information of the two groups of patients was not statistically different ( P > 0.05 ); after the nursing intervention, the blood glucose levels of the two groups of patients decreased, but the experimental group decreased more significantly and the blood glucose control effect was more obvious; after the intervention, in the experimental group that implemented diversified nursing interventions, the patient’s condition management effect was better and their scores were between 8 and 10; the mental state self-evaluation of the two groups of patients was significantly different from the domestic reference value ( P < 0.05 ), and there is a very significant statistical difference between the two groups after nursing intervention ( P < 0.01 ); after nursing intervention, compared with the control group, the quality of life of the experimental group improved more significantly and the highest score reached about 70; the overall satisfaction of the experimental group with nursing work reached 92%, while the satisfaction of the control group with nursing work was only 44.67%. Studies have shown that diversified care has a positive impact on the rehabilitation of patients in cardiology treatment.

Using an Online Disturbance Rejection and Anticipation System to Reduce Hyperglycemia in a Fully Closed-Loop Artificial Pancreas System

Introduction: Hyperglycemia following meals is a recurring challenge for people with type 1 diabetes, and even the most advanced available automated systems currently require manual input of carbohydrate amounts. To progress toward fully automated systems, we present a novel control system that can automatically deliver priming boluses and/or anticipate eating behaviors to improve postprandial full closed-loop control. Methods: A model predictive control (MPC) system was enhanced by an automated bolus system reacting to early glucose rise and/or a multistage MPC (MS-MPC) framework to anticipate historical patterns. Priming was achieved by detecting large glycemic disturbances, such as meals, and delivering a fraction of the patient’s total daily insulin (TDI) modulated by the disturbance’s likelihood (bolus priming system [BPS]). In the anticipatory module, glycemic disturbance profiles were generated from historical data using clustering to group days with similar behaviors; the probability of each cluster is then evaluated at every controller step and informs the MS-MPC framework to anticipate each profile. We tested four configurations: MPC, MPC + BPS, MS-MPC, and MS-MPC + BPS in simulation to contrast the effect of each controller module. Results: Postprandial time in range was highest for MS-MPC + BPS: 60.73 ± 25.39%, but improved with each module: MPC + BPS: 56.95±25.83 and MS-MPC: 54.83 ± 26.00%, compared with MPC: 51.79 ± 26.12%. Exposure to hypoglycemia was maintained for all controllers (time below 70 mg/dL <0.5%), and improvement came primarily from a reduction in postprandial time above range (MS-MPC + BPS: 39.10 ± 25.32%, MPC + BPS: 42.99 ± 25.81%, MS-MPC: 45.09 ± 25.96%, MPC: 48.18 ± 26.09%). Conclusions: The BPS and anticipatory disturbance profiles improved blood glucose control and were most efficient when combined.

Impacts of Social Capital Factors on Blood Glucose Control and Depressive Symptoms

Social capital, conceptualized as resources arising from social networks, is receiving increased attention for its role in prevention and management of chronic conditions such as diabetes and depression that commonly co-occur. Although social capital has been linked to control of blood glucose and depression, previous research has not considered these two outcomes simultaneously while distinguishing between cognitive (i.e., perceived social support, shared values and trust in community) and structural (i.e., social connectedness and participation) domains. This study examined how these two domains of social capital relate to glucose control and depressive symptoms, and whether physical exercise and care access mediate those relationships, using structural equation modeling. The sample included 3,043 older adults aged 57 and above from wave 2 of the National Social Life, Health and Aging Project. Although a higher level of cognitive social capital was associated with higher levels of physical exercise (b=.38, p&lt;.001), access to care (b=.40, p=.007), lower levels of blood glucose (b=-.43, p&lt;.001) and depressive symptoms (b=-.84, p&lt;.001), a higher level of structural social capital was associated only with a higher level of physical exercise (b=.16, p=.002). The mediating effects of physical exercise and access to care were not significant. Findings suggest that cognitive social capital may have greater influence on blood glucose and depressive symptoms than structural social capital, and therefore have different implications for practice, especially in the context of pandemic-related disruptions to social capital. Future research should examine other mediators and investigate how promotion of cognitive social capital might improve health outcomes.