THE RELATION BETWEEN QUALITY AND QUANTITY OF SLEEP WITH BLOOD GLUCOSE LEVELS IN WOMEN CHILDBEARING AGE

Background: The quality and quantity of sleep can affect blood glucose levels, so it is at risk of hyperglycemia. Hyperglycemia in women childbearing age can affect the cycle of menstruation and fertility. Based on previous research shows that more than half of students have poor sleep quality and found an increase in blood glucose levels in students who sleep less than 7 hours. This study aims to analyze the relationship between quality and quantity of sleep with blood glucose levels in women of childbearing age. Methods: This research method was observational analytic with cross sectional design. The number of samples was 43 students with a purposive sampling technique. The independent variable is the quality and quantity of sleep measured using the PSQI questionnaire, while the dependent variable is the blood glucose level which is checked during fasting for at least 8 hours. Analysis using the spearman rho statistical test. Results: The results showed that 27.9% of students had good sleep quality, including 4.6% with low blood glucose levels and 23.3% with normal blood glucose levels. 72.1% of students have poor sleep quality, including 65.1% with normal blood glucose levels and 7% with high blood glucose levels. The results of the analysis between sleep quality with blood glucose levels obtained rs = 0.345 and p value = 0.023, while the quantity of sleep with blood glucose levels obtained rs = 0.359 and p value = 0.018. Conclusions: The quality and quantity of sleep is significantly associated with blood glucose levels. Women childbearing age should maintain quality and quantity of sleep to prevent increased blood glucose levels. Health workers need to pay attention to the quality and quantity of patient’s sleep especially in women childbearing age.

Perbedaan Frekuensi Pemberian Enteral Feeding terhadap Toleransi Feeding dan Kadar Glukosa Darah

Medical nutrition therapy is one of the interventions to provide sufficiently nutrition and to optimize glycemic controls in meeting the body metabolic needs. An Enteral Feeding is an alternative feeding method when there are obstacles to fulfill patients nutrition orally. This study aims to determine feeding tolerances and blood glucose controls in Type2 Diabetes Mellitus patients with different Enteral Feeding frequencies-three and six times preserving. This research is a quasi-experimental design study involving 26 patients admitted in a hospital. The results of the study on respondents with enteral feeding of a frequency 3x/24 hours found that 2respondents (15.4%) were tolerant with enteral feeding given and as many as 3respondents (23.1%) had normal blood glucose, while the results of the study for respondents with enteral feeding of a frequency 6x / 24 hours, 12 respondents (92.3%) were tolerant with enteral feeding given and as many as 12 respondents (92.3%) had normal blood glucose. The results showed that there was a statistically difference between the three times and six times Enteral Feeding with feeding tolerance (p = 0.005). There was a difference between the frequency of enteral feeding six times and three times in the blood glucose level (p = 0.005). Results of this study will assist in controlling blood glucose by regulating the timing of feeding in patients with type 2 diabetes mellitus.

Effects of Stress Hyperglycemia on Short-Term Prognosis of Patients Without Diabetes Mellitus in Coronary Care Unit

Background: Diabetes mellitus (DM) has a high morbidity and mortality worldwide, and it is a risk factor for cardiovascular diseases. Non-diabetic stress hyperglycemia is common in severely ill patients, and it could affect prognosis. This study aimed to analyze the influence of different blood glucose levels on prognosis from the perspective of stress hyperglycemia by comparing them with normal blood glucose levels and those of patients with DM.Methods: A retrospective study of 1,401 patients in coronary care unit (CCU) from the critical care database called Medical Information Mart for Intensive Care IV was performed. Patients were assigned to the following groups 1–4 based on their history of DM, random blood glucose, and HbA1c levels: normal blood glucose group, moderate stress hyperglycemia group, severe stress hyperglycemia group and DM group. The main outcome of this study was 30- and 90-day mortality rates. The associations between groups and outcomes were analyzed using Kaplan–Meier survival analysis, Cox proportional hazard regression model and competing risk regression model.Results: A total of 1,401 patients in CCU were enrolled in this study. The Kaplan–Meier survival curve showed that group 1 had a higher survival probability than groups 3 and 4 in terms of 30- and 90-day mortalities. After controlling the potential confounders in Cox regression, groups 3 and 4 had a statistically significant higher risk of both mortalities than group 1, while no difference in mortality risk was found between groups 2 and 1. The hazard ratios [95% confidence interval (CI)] of 30- and 90-day mortality rates for group 3 were 2.77(1.39,5.54) and 2.59(1.31,5.12), respectively, while those for group 4 were 1.92(1.08,3.40) and 1.94(1.11,3.37), respectively.Conclusions: Severe stress hyperglycemia (≥200 mg/dL) in patients without DM in CCU may increase the risk of short-term death, which is greater than the prognostic effect in patients with diabetes. Patients with normal blood glucose levels and moderate stress hyperglycemia (140 mg/dL ≤ RBG <200 mg/dL) had no effect on short-term outcomes in patients with CCU.

Deceptive Late Maternal Euglycaemia

Background: Strict glycemic control is the most critical factor determining outcome in Gestational Diabetes mellitus. But having capillary blood glucose readings within the target levels, in the late trimester may be deceptive. If fetal hyperinsulinaemia and fetopathy have already set in, maternal glucose may be spuriously normal. We support this hypothesis based on our experience with 4 GDM patients who apparently reported normal blood glucose in late trimester, yet ended up with neonatal complications. Materials and Methods: Records of mothers of four neonates (Infant of diabetic mother) admitted in neonatal ICU with GDM associated complications were retrospectively analyzed. Diagnosis of GDM was made as per the ADA guidelines. The blood glucose values of the 9-point readings (Fasting, pre-lunch, pre-dinner, 1hr and 2hr post breakfast, lunch and dinner) every 3 to 5 days, which the patients shared online were plotted and studied. Mode of delivery and neonatal outcome were noted. Results: All patients (mean age 28.5years, range 24–31) presented to us only in third trimester though two of them had deranged OGTT during first trimester screening elsewhere. The average HbA1c at the time of presentation was 5.425 (Range 4.8 to6.3). Only one of them was on insulin for a short term, which she stopped on her own as the readings continued to be in range even after stopping insulin. Of the 529 last trimester readings shared by the patients, 91.3% were within the target range of FBS< 92mg/dl, 1and 2 post meals <140 and 120 respectively, and pre meals < 95mg/dl. Three of them were induced (Two at 40 weeks and one at 38.4 weeks) for labour. The obstetrical outcomes were as follows: one had LSCS due to non-descent of head, second had vacuum assisted delivery, third had shoulder dystocia and fourth had normal delivery. The neonatal outcomes in respective cases were large for date baby with hypocalcaemia, transient HOCM with hypocalcaemia, shoulder dystocia with perinatal depression, PDA with respiratory distress. Conclusion: GDM should be intervened before the establishment of diabetic fetopathy. Missing the initial spikes in maternal glucose and the consequent surreptitious transfer of glucose to fetus can initiate such fetopathy. There is rerouting or detour of the maternal glucose, to the fetal system, for its disposal. Hence low or normal blood glucose readings in a known GDM patient should alert the clinician about the possibility of fetal glucose steal.1 Highly suspicious cases can be monitored for polyhydramnios and fetal and maternal weight gain. The best ways to prevent this are pre-conceptional screening for IGT and universal screening for GDM with OGTT in each trimester. Reference: 1. Desoye, Gernot & Nolan, Christopher. (2016). The fetal glucose steal: an underappreciated phenomenon in diabetic pregnancy. Diabetologia. 59. 10.1007/s00125-016-3931-6.aq`

Effects of Fermentated Feed and Probiotic + Acidifier Supplements on Glucose Levels and Abdomen Chicken Fat Broiler

The purpose of this study was to determine the effect of adding probiotic acidifier on the condition of the digestive tract, glucose levels and abdominal fat in broiler chickens. This research conducted in Takengon, Central Aceh District. The parameters observed were the condition of the digestive tract, blood glucose levels and the percentage of abdominal fat. The data obtained were analyzed using analysis of variance (ANOVA). The results showed the use of a 1: 1 mixture of probiotics and acidifier to level 0. The 3% added to the commercial ration which was substituted with 10% fermented feed ingredients (R-KFPA) had no significant effect (P <0.05) on weight and percentage of Gizzard, Gizzard pH and Intestine pH, Intestinal Length, Weight and Percent of Abdominal Fat, as well as blood glucose levels in broiler chickens. Although statistically not significantly different, giving a mixture of probiotics and acidifier at the level of 0.3% (R4) showed a positive effect on decreasing the percentage of abdominal fat from 1.52% (R1) to 1.35% (R4). The blood glucose obtained in this study was slightly higher than normal blood glucose levels in chickens as reported by Swenson weight and percentage of abdominal fat, as well as blood glucose levels of broiler chickens. Although statistically not significantly different, giving a mixture of probiotics and acidifier at the level of 0.3% (R4) showed a positive effect on decreasing the percentage of abdominal fat from 1.52% (R1) to 1.35% (R4). The blood glucose obtained in this study was slightly higher than normal blood glucose levels in chickens as reported by Swenson weight and percentage of abdominal fat, as well as blood glucose levels of broiler chickens. Although statistically not significantly different, giving a mixture of probiotics and acidifier at the level of 0.3% (R4) showed a positive effect on decreasing the percentage of abdominal fat from 1.52% (R1) to 1.35% (R4). The blood glucose obtained in this study was slightly higher than normal blood glucose levels in chickens as reported by Swenson (1993), which ranges from 13 to 27 ml / dl or 130 to 270 mg / dl. It is suspected that this is due to increased digestive activity in chickens so that more nutrients are absorbed.