Association between blood glucose levels and Glasgow Outcome Score in patients with traumatic brain injury: secondary analysis of a randomized trial

Background Blood glucose levels that are too high or too low after traumatic brain injury (TBI) negatively affect patient prognosis. This study aimed to demonstrate the relationship between blood glucose levels and the Glasgow Outcome Score (GOS) in TBI patients. Methods This study was based on a randomized, dual-center, open-label clinical trial. A total of 208 patients who participated in the randomized controlled trial were followed up for 5 years. Information on the disease, laboratory examination, insulin therapy, and surgery for patients with TBI was collected as candidate variables according to clinical importance. Additionally, data on 5-year and 6-month GOS were collected as primary and secondary outcomes, respectively. For multivariate analysis, a generalized additive model (GAM) was used to investigate relationships between blood glucose levels and GOS. The results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). We further applied a two- piecewise linear regression model to examine the threshold effect of blood glucose level and GOS. Results A total of 182 patients were included in the final analysis. Multivariate GAM analysis revealed that a bell-shaped relationship existed between average blood glucose level and 5-year GOS score or 6-month GOS score. The inflection points of the average blood glucose level were 8.81 (95% CI: 7.43–9.48) mmol/L considering 5-year GOS as the outcome and were 8.88 (95% CI 7.43−9.74) mmol/L considering 6-month GOS score as the outcome. The same analysis revealed that there was also a bell relationship between average blood glucose levels and the favorable outcome group (GOS score ≥ 4) at 5 years or 6 months. Conclusion In a population of patients with traumatic brain injury, blood glucose levels were associated with the GOS. There was also a threshold effect between blood glucose levels and the GOS. A blood glucose level that is either too high or too low conveys a poor prognosis. Trial registration ClinicalTrials.gov NCT02161055. Registered on 11 June 2014.

Latitudinal but not elevational variation in blood glucose level is linked to life history across passerine birds

Macrophysiological research is vital to our understanding of mechanisms underpinning global life history variation and adaptation under diverse environments. Birds represent an important model taxon in this regard, yet our knowledge is limited to only a few physiological traits, mostly studied in temperate and Neotropical species. Here, we examined latitudinal and elevational variation in an emerging biomarker of physiological pace of life, blood glucose concentration, collected from 61 European temperate and 99 Afrotropical passerine species. Our data suggest that the slow physiological pace-of-life syndrome, indicated by lower baseline glucose level and stronger stress response, evolves convergently in lowland tropical birds across continents and is shaped by their low fecundity. In contrast, elevational variation in blood glucose levels implied a unique montane pace-of-life syndrome combining slow-paced life histories with fast-paced physiology. The observed patterns suggest an unequal importance of life history in shaping physiological adaptations associated with latitude and elevation.

Knowledge, Attitude, practice, and their associated factor towards Diabetes Mellitus among peoples live in Debre Markos Town, North West Ethiopia, Amhara Regional State, Ethiopia 2020 GC

Background: Diabetes mellitus is a group of metabolic disease in which there is high blood glucose level over a prolonged period of time, chronic multi system disease related to abnormal insulin production, impaired insulin utilization and both. Risk of diabetes are obesity, being young or old age, family history of diabetes, history gestational diabetes, impaired, glucose metabolism, physical inactivity and ethnicity/race respectively. In type one diabetes mellitus insulin injection is needed to control the blood glucose level where as in type two diabetes mellitus the first line treatment is life style modification like diet management, exercise, and weight reduction then if uncontrolled use oral hypoglycemic agent.Objective: The main aim of the study was to assess Knowledge, Attitude, practice and their associated factor towards diabetes mellitus in Debre Markos town, northwest , Amhara Regional state, Ethiopia 2020 GC.Methodology: a community based cross-sectional study was conduct from June to July for 403 respondents using systematic random sampling technique to select the household after select the first household by lottery method. Data collected through self administered questions, the collected data process and analysis manually using pen, pencil, tally sheet and present in tables, graphs and charts respectively.Result: based on our study 138 (34.6%) of the respondents were classified as having inadequate knowledge, whereas 261(65.4%) of the respondents were deemed to be knowledgeable. from the participant 186(46.6%) had unfavorable attitude while 213(53.4%) had favorable attitude towards diabetes mellitus. Overall practice of the participant was 37.8% good practice and 62.2% poor practice. Single individuals 5.133 times (AOR=5.133, CI=1.737, 15.051) more likely knowledgeable than those divorced. Family history of diabetes mellitus 5.019 times (AOR=5.02- CI=1.59-15.76) more likely had favorable attitude than those who had no family history of DM. secondary educational level were 2.34 times (AOR=2.34, CI=1.14- 0.78) more likely good practice than those with able to read and write and persons in primary educational level. DM patients 2.811 times (AOR=2.81-95%, CI=0.99- 7.97) more likely good practice than non-diabetic.Conclusion: majority of the participant’s relatively knowledgeable. The overall attitude of the participant was more than half was favorable attitude. Majority of the study participants were poor practice regarding to DM controlling and management. Knowledge of the participant highly significant association with marital status, income and practice, practice also strong association with level of education and attitude significantly associated with family history of DM

Effects of Exercise in Improving Cardiometabolic Risk Factors in Overweight Children: A Systematic Review and Meta-Analysis

This meta-analysis aims to evaluate the effects of exercise in improving cardiometabolic risk factors in overweight children and adolescents until the adolescent age, which is 18 years. A systemic search was conducted using the electronic databases PubMed/Medline, Cochrane Library, and Google Scholar, from inception to 29 June 2021. All statistical analyses were conducted in Review Manager 5.4.1. All studies meeting the inclusion criteria were selected. A random-effect model was used to pool the studies, and the results are reported in the odds ratio (OR) and corresponding 95% Confidence interval (CI). Twelve randomized control trials were selected for meta-analysis. Significant results were obtained for BMI in children after the interventions (0.38 95% CI 0.14, 0.62; p = 0.002; I2 = 65%). LDL level was also found significantly reduced (0.41 95% CI 0.01, 0.82; p = 0.05; I2 = 83%). Other factors such as HDL level, blood pressure, blood glucose level, body weight, and waist circumference were also analyzed. We found that exercise interventions significantly improved several cardiometabolic risk factors such as BMI, LDL level, BP, and blood glucose level. However, no significant effect on HDL concentration, waist circumference, and body weight were found. Long-term interventions are needed to attain improvement in all cardiometabolic risk factors.

A Randomized Controlled Trial on the Effect of VCO in Reducing Glucose and Body Weight in Post-Acute Coronary Syndrome Patients: A Pilot Study

The aims of this paper were to determine the effect of virgin coconut oil (VCO) on bodyweight and serum glucose level among acute coronary syndrome (ACS) patients. Various clinical trials on animal studies have found that the VCO has many beneficial effects on health. However, there have been limited published human studies on the pharmacological properties of VCO. Investigation on human subjects is extremely required in order to provide more empirical evidence to show the effect of VCO for ACS patients. Randomised single blind study conducted between March 2018 and April 2018. RCT was conducted among 70 ACS patients for 30 days. Participants in group A received their bottles containing 100 pieces of virgin coconut oil soft gels and were required to ingest 10 capsules per day (5 mL/5 gm) and continue routine treatment (diabetic diet and diabetic medication). Group B participants continued receiving routine treatment. Changes in serum fating blood sugar and body weight were identified using a paired t-test and independent t-test. A total of 70 patients participated with ages of 51 years old and older and were mostly male. The serum FBS and body weight of the intervention group that received VCO were reduced about 13.6% on day 30, from the baseline on day 1. They also had body weight reduction of about 2% with p value of less than 0.05. In contrast, the control group that only received routine treatment showed an increment of 12.1% in their serum FBS and had no changes in body weight. These reductions were noted within 30 days of consuming a daily dose of VCO (5 g every day). The properties of lauric acid and antioxidants present in the VCO composition were key players in the reduction of serum glucose levels and body weight. VCO can reduce serum glucose levels and body weight with 5 mL (5 g) of VCO per day for 30 days. Also, VCO may have a positive effect towards the glucose level and other cardiovascular risk factors.

Anti-Diabetic Activity of Polypeptide-K Isolated from Momordica Charantia: A Retrospective Study of 142 Cases

Diabetes Mellitus occurs when the pancreas fails to produce sufficient insulin, or the body is unable to use the insulin produced effectively. In order to regulate the blood glucose of diabetic patients, Diabegard®, a herbal antidiabetic medicine and daily supplement, contains polypeptide-k which exists in the seed of Momordica Charantia (bitter gourd) was prescribed. Purpose: A retrospective study is therefore done with the aim to examine the effectiveness of Diabegard®, polypeptide-k in regulating the blood glucose and cholesterol level of diabetic patients who took Diabegard® for four weeks with a dose of 60 mg per day. Methods: A database record of 105 male and 37 female (ages 25-81) treated with Diabegard®, polypeptide-k was assessed. The effectiveness of Diabegard®, polypeptide-k in blood glucose regulation was determined based on four aspects: gender, three different age categories, four different categories of duration of the disease and five different categories of severity of the disease. The Pearson's correlation was used to find the correlation among variables. Paired sample t-test was used to compare the means of pre- and post-treatment of blood glucose level. One-way ANOVA was used to compare the means of different groups for each aspect. Results: Result showed that age and duration of disease (r2=0.469), pre-treatment of blood glucose and post-treatment of blood glucose (r2=0.606) showed positive relationship. Both paired sample T-test of pre-and post-treatment of blood glucose showed significant difference (p<0.05). Categories with very mild (7 mmol/L), severe (13.9-19.4mmol/L) and very severe (>19.4mmol/L) diabetes showed significant difference (p<0.05). Other tests showed no significant difference. Conclusion: In conclusion, this present retrospective study showed that Diabegard®, polypeptide-k was effective in controlling blood glucose level of all diabetic patients especially in patients with mild (26.87% reduction), severe (40.43% reduction) and very severe diabetes (49.27% reduction).

Serum and Salivary Levels of Glucose and Urea in Pregnant and Non-pregnant Women: A Comparative Study

Background: Pregnancy is one of the most critical periods in the life of most women. Since it is necessary to be aware of the health of the mother and fetus, serum markers (i.e., glucose and urea) need to be monitored during pregnancy. A routine strategy in this area is venipuncture which is applied to measure the level of these markers. It is also a stressful procedure for pregnant women. The purpose of this study was to determine the salivary level of these markers as a stress-free method in pregnant women. Materials and Methods: The samples were collected from 30 pregnant and 30 non-pregnant fasting women. Then, the serum and salivary levels of glucose and urea were measured, analyzed, and compared by photometry. Results: Results indicated that the mean salivary glucose level was 10.2±1.4 mg/dL and 6.4±0.9 mg/ dL in non-pregnant and pregnant women, respectively. In addition, the mean serum glucose level was 106.5±5.3 mg/dL and 82.9±4.5 mg/dL in non-pregnant and pregnant women, respectively. Further, the mean salivary urea level was 37.1±3.3 mg/dL in non-pregnant women and 27.1±1.9 mg/dL in pregnant women. Moreover, the mean serum urea level was 26.9±1.9 mg/dL and 19.5±2.3 mg/dL in non-pregnant and pregnant women, respectively. Conclusion: Serum and salivary levels of glucose and urea in pregnant women were lower than those in non-pregnant women, and there was a positive correlation between serum and salivary levels. Therefore, it seems that saliva can be a substitute for serum regarding the measurement of glucose and urea levels.

Fasting Blood Glucose Level Progression And Its Associated Factors Among Diabetic Patients Attending Treatment In North Shewa Hospitals, Oromia, Ethiopia

Background: Diabetes describes a group of metabolic disorders characterized and identified by hyperglycemia without treatment. It includes defects in insulin secretion, insulin action, or both, and disturbances of carbohydrate, fat, and protein metabolism. The study aimed to assess fasting blood glucose level progression and its associated factors among diabetic patients attending insulin and metformin follow-up in fiche and Chancho hospitals.Methods: A retrospective study was conducted to obtain secondary data among diabetic patients attending treatment from September 2016 to August 2018 in the hospital. The linear- mixed effects model for longitudinal data was employed to measure the changes in fasting blood glucose level.Result: The result of the study revealed that age, body mass index, systolic blood pressure, diastolic blood pressure, marital status, regime, and education level were significantly associated factors for the progression of fasting blood glucose levels among diabetic patients. Conclusion: The study recommended that the progression of blood glucose level was higher among diabetic patients, and the health professionals, health sectors, and government should be paid an intervention on patients who had high systolic and diastolic blood pressure, who had high BMI, and older age patients.