BACKGROUND Autonomous cortisol secretion(ACS)is linked to a higher prevalence of metabolic abnormalities and an increased risk of major adverse cardiovascular events.AIM To evaluate glucose and bone metabolism in pati...BACKGROUND Autonomous cortisol secretion(ACS)is linked to a higher prevalence of metabolic abnormalities and an increased risk of major adverse cardiovascular events.AIM To evaluate glucose and bone metabolism in patients with ACS using a continuous glucose monitoring system(CGMS)and dual-energy X-ray absorptiometry(DXA).METHODS Patients diagnosed with ACS,including Cushing syndrome,mild ACS(MACS),and nonfunctional adrenal incidentaloma(NFAI),were recruited for this study.Glucose variability and glycemic status were assessed using CGMS.Regional bone mineral content(BMC),bone mineral density(BMD),and bone area(BA)were evaluated using DXA.CGMS-and DXA-derived parameters were compared across the subgroups of ACS.Correlation analysis was performed to examine relationships between varying degrees of cortisol secretion,measured by cortisol after 1 mg overnight dexamethasone suppression test(DST)or 24-hour urine free cortisol(24h UFC),and CGMS-or DXA-derived parameters.RESULTS A total of 64 patients with ACS were included in this study:19 with Cushing syndrome,11 with MACS,and 34 with NFAI.Glucose variability,time above range(TAR),and time in range(TIR)along with specific areal BMC,BMD,and BA,differed significantly between groups of Cushing syndrome and NFAI.A significant positive correlation was observed between glucose variability or TAR and cortisol after 1 mg overnight DST or 24h UFC.By contrast,TIR,along with regional BMC,BMD,and BA,were negatively correlated with varying degrees of cortisol secretion.CONCLUSION Glucose and bone metabolism impairments are on a continuum alteration from NFAI to MACS and Cushing syndrome.Prompt attention should be given to these patients with ACS,especially those with mild hormone secretion.Parameters of glucose variability and glycemic status along with bone condition in regions rich in cancellous bone will provide valuable information.展开更多
BACKGROUND Continuous glucose monitoring(CGM)metrics,such as time in range(TIR)and glycemic risk index(GRI),have been linked to various diabetes-related complications,including diabetic foot(DF).AIM To investigate the...BACKGROUND Continuous glucose monitoring(CGM)metrics,such as time in range(TIR)and glycemic risk index(GRI),have been linked to various diabetes-related complications,including diabetic foot(DF).AIM To investigate the association between CGM-derived indicators and the risk of DF in individuals with type 2 diabetes mellitus(T2DM).METHODS A total of 591 individuals with T2DM(297 with DF and 294 without DF)were enrolled.Relevant clinical data,complications,comorbidities,hematological parameters,and 72-hour CGM data were collected.Logistic regression analysis was employed to examine the relationship between these measurements and the risk of DF.RESULTS Individuals with DF exhibited higher mean blood glucose(MBG)levels and increased proportions of time above range(TAR),TAR level 1,and TAR level 2,but lower TIR(all P<0.001).Patients with DF had significantly lower rates of achieving target ranges for TIR,TAR,and TAR level 2 than those without DF(all P<0.05).Logistic regression analysis revealed that GRI,MBG,and TAR level 1 were positively associated with DF risk,while TIR was inversely correlated(all P<0.05).Achieving TIR and TAR was inversely correlated with white blood cell count and glycated hemoglobin A1c levels(P<0.05).Additionally,achieving TAR was influenced by fasting plasma glucose,body mass index,diabetes duration,and antidiabetic medication use.CONCLUSION CGM metrics,particularly TIR and GRI,are significantly associated with the risk of DF in T2DM,emphasizing the importance of improved glucose control.展开更多
CuO nanoparticles were successfully synthesized via a two-jet electrospun method,and then screen-printed on silver-carbon electrodes,forming CuO-modified Ag-C(CuO/Ag-C)disposable strip electrodes.In natural environmen...CuO nanoparticles were successfully synthesized via a two-jet electrospun method,and then screen-printed on silver-carbon electrodes,forming CuO-modified Ag-C(CuO/Ag-C)disposable strip electrodes.In natural environment condition for glucose detection,the obtained CuO/Ag-C electrodes show a high sensitivity of 540 nA·mM^(-1)·cm^(-2),and a low limit of detection(0.68 mM)in a wide linear response range of 0.68 mM and 3 mM(signal/noise=3),respectively.In addition,the CuO/Ag-C electrodes also exhibit excellent anti-interference,air stability and repeatability.As a result,the fabrication of CuO nanoparticles via an electrospun process and the technique of screen-printed electrodes are of great significance for glucose detection.展开更多
A mesocosm-based study was conducted to assess the effect of glucose and hydrogen peroxide on periphyton communities. These chemicals have been found to be effective at controlling cyanobacteria blooms in the water co...A mesocosm-based study was conducted to assess the effect of glucose and hydrogen peroxide on periphyton communities. These chemicals have been found to be effective at controlling cyanobacteria blooms in the water column but their impact on attached communities is unknown. The experimental design included a total of 4 treatments: control (no chemicals;3 replicates);hydrogen peroxide (3 replicates);glucose alone (3 different concentrations [no replicates]);and additive glucose (3 replicates). After 34 days, mean values of chlorophyll a were lower in all experimental treatments compared to the control;mean AFDM values were lower in all treatments except the unreplicated high glucose alone treatment. In contrast, mean autotrophic index values (AFDM/chlorophyll a) were greater in all treatments compared to the control, indicating heterotrophs were more resistant to the chemical treatments than autotrophs. Periphyton community biodiversity was much lower in the additive glucose and moderate glucose alone treatments than the hydrogen peroxide and control treatments. The relative abundance of the bacteria Asticcacaulis and Sphingorhabdus responded positively to the glucose treatments, whereas relative abundance of Nevskia and Caenimonas declined in both the hydrogen peroxide and glucose treatments. In terms of relative abundance, no cyanobacteria taxa were detected among the top 20 taxa. We conclude that the autotrophic component of periphyton communities is especially vulnerable to hydrogen peroxide and glucose treatments, and that any management strategy employing these chemicals should be aware of this potential impact.展开更多
BACKGROUND Insulin therapy plays a crucial role in managing diabetes.Regulatory guidelines mandate assessing the pharmacokinetics(PK)and pharmacodynamics(PD)of new insulin formulations with euglycemic clamp techniques...BACKGROUND Insulin therapy plays a crucial role in managing diabetes.Regulatory guidelines mandate assessing the pharmacokinetics(PK)and pharmacodynamics(PD)of new insulin formulations with euglycemic clamp techniques before entry into the market.Typically,blood glucose(BG)levels are maintained at 5%below baseline to suppress endogenous insulin secretion in healthy volunteers.However,in scenarios where BG baseline is relatively low,maintaining it at 5%below baseline can increase hypoglycemic risk.Consequently,we adjusted to maintain it at 2.5%below a baseline of<4.00 mmol/L.It remains uncertain whether this adjustment impacts endogenous insulin inhibition or the PD of study insulin.AIM To evaluate and compare the PD and C-peptide status using two different target BG setting methods.METHODS Data came from euglycemic clamp trials assessing the PK/PD of insulin aspart(IAsp)in healthy participants.Target BG was set at 2.5%below baseline for those with a basal BG of<4.00 mmol/L(group A),and at 5%below baseline for others(group B).The area under the curve(AUC)of IAsp(AUC_(IAsp,0-8 h))and GIR from 0 to 8 hours(AUCGIR,0-8 h)was used to characterize the PK and PD of IAsp,respectively.The C-peptide reduction and PK/PD of IAsp were compared between the two groups.RESULTS Out of 135 subjects,15 were assigned to group A and 120 to group B;however,group B exhibited higher basal Cpeptide(1.59±0.36 vs 1.32±0.42 ng/mL,P=0.006).Following propensity score matching to adjust for basal Cpeptide differences,71 subjects(15 in group A and 56 in group B)were analyzed.No significant differences were observed in demographics,IAsp dosage,or clamp quality.Group B showed significantly higher baseline(4.35±0.21 vs 3.91±0.09 mmol/L,P<0.001),target(4.13±0.20 vs 3.81±0.08 mmol/L,P<0.001),and clamped(4.10±0.17 vs 3.80±0.06 mmol/L,P<0.001)BG levels.Both groups exhibited comparable C-peptide suppression(32.5%±10.0%vs 35.6%±12.1%,P=0.370)and similar IAsp activity(AUCGIR,0-8 h:1433±400 vs 1440±397 mg/kg,P=0.952)under nearly equivalent IAsp exposure(AUC_(IAsp,0-8 h):566±51 vs 571±85 ng/mL×h,P=0.840).CONCLUSION Maintaining BG at 2.5%below a baseline of<4.00 mmol/L did not compromise the endogenous insulin suppression nor alter the observed pharmacodynamic effects of the study insulin.展开更多
Athletes often use branched-chain amino acid (BCAAs) supplements with a ratio of 2:1:1 (leucine:isoleucine:valine) for their impact on muscle building. Research suggests that by altering the ratio, an improvement in g...Athletes often use branched-chain amino acid (BCAAs) supplements with a ratio of 2:1:1 (leucine:isoleucine:valine) for their impact on muscle building. Research suggests that by altering the ratio, an improvement in glucose metabolism might be possible. The purpose of this study was to examine how isoleucine would influence glucose tolerance. We recruited healthy male (n = 13) and female (n = 5) participants who were asked to fast for 12 hours before coming to the laboratory. A fasting blood sample was collected, followed by the subjects consuming a breakfast containing 113 g carbohydrates, 8 g protein, 1.5 g fat, and BCAA powder in the 2:1:1 ratio (Control) or BCAA powder enriched with Isoleucine (2:6:1), both added to orange juice. The opposite meal was consumed on a second visit one week apart. Blood was collected at 30, 60, 90, and 120 minutes post-meal. No differences were observed between the Control and Isoleucine for changes in serum glucose or insulin response when examining all subjects together. However, when comparing between genders, males tended to have a significantly lower serum glucose response compared to females when consuming the Isoleucine, with no difference between the genders when consuming the Control. Also, males had significantly lower serum glucose responses when consuming the Isoleucine compared to when they consumed the Control, while females had significantly higher serum glucose responses when consuming the Isoleucine compared to when they consumed the Control. In general, males tended to have a lower serum insulin response than females when consuming both the Control and the Isoleucine. Our study indicates a significant difference in the way genders respond to BCAA supplementation, where isoleucine may improve glucose tolerance and insulin response in males but not females.展开更多
BACKGROUND The efficacy of various bariatric surgeries varies in reducing blood glucose levels.Given the distinct mechanisms and anatomical alterations associated with each procedure,it is crucial to compare their gly...BACKGROUND The efficacy of various bariatric surgeries varies in reducing blood glucose levels.Given the distinct mechanisms and anatomical alterations associated with each procedure,it is crucial to compare their glycemic control outcomes.We hypothesize that proximal small intestinal bypass(PSIB)is superior in blood glucose reduction over Roux-en-Y gastric bypass(RYGB)and jejunoileal bypass(JIB).AIM To compare the effectiveness of PSIB,RYGB,and JIB in lowering blood glucose.METHODS Rats with streptozotocin-induced diabetes were randomly divided into PSIB,RYGB,JIB,and sham-operated groups.Body weight,food intake,fasting blood glucose level,oral glucose tolerance test,insulin tolerance test,liver enzymes,and blood lipids were measured.RESULTS Postoperatively,only the JIB group had a lower body weight compared to the sham group.The food intake of the rats in all three surgical groups was significantly less than that in the sham group.Fasting blood glucose was reduced in all surgical groups and was lower in the PSIB group than in the RYGB and JIB groups.Glucose tolerance and insulin sensitivity improved in all three surgical groups compared to the sham group,but the improvement appeared earliest in the PSIB group.At six weeks postsurgery,the PSIB group showed a reduction in alanine transaminase levels and maintained a normal lipid profile.CONCLUSION PSIB demonstrated excellent hypoglycemic effects in the early postoperative period,and had better efficacy than RYGB and JIB.展开更多
Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in ...Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.展开更多
BACKGROUND Retinal microcirculation alterations are early indicators of diabetic microvascular complications.Optical coherence tomography angiography(OCTA)is a noninvasive method to assess these changes.This study ana...BACKGROUND Retinal microcirculation alterations are early indicators of diabetic microvascular complications.Optical coherence tomography angiography(OCTA)is a noninvasive method to assess these changes.This study analyzes changes in retinal microcirculation in prediabetic patients during short-term increases in blood glucose using OCTA.AIM To investigate the changes in retinal microcirculation in prediabetic patients experiencing short-term increases in blood glucose levels using OCTA.METHODS Fifty volunteers were divided into three groups:Group 1[impaired fasting glucose(IFG)or impaired glucose tolerance(IGT)],Group 2(both IFG and IGT),and a control group.Retinal microcirculation parameters,including vessel density(VD),perfusion density(PD),and foveal avascular zone(FAZ)metrics,were measured using OCTA.Correlations between these parameters and blood glucose levels were analyzed in both the fasting and postprandial states.RESULTS One hour after glucose intake,the central VD(P=0.023),central PD(P=0.026),and parafoveal PD(P<0.001)were significantly greater in the control group than in the fasting group.In Group 1,parafoveal PD(P<0.001)and FAZ circularity(P=0.023)also increased one hour after glucose intake.However,no significant changes were observed in the retinal microcirculation parameters of Group 2 before or after glucose intake(P>0.05).Compared with the control group,Group 1 had a larger FAZ area(P=0.032)and perimeter(P=0.018),whereas Group 2 had no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Compared with Group 1,Group 2 had greater central VD(P=0.013)and PD(P=0.008)and a smaller FAZ area(P=0.012)and perimeter(P=0.010).One hour after glucose intake,Group 1 had a larger FAZ area(P=0.044)and perimeter(P=0.038)than did the control group,whereas Group 2 showed no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Group 2 had greater central VD(P=0.042)and PD(P=0.022)and a smaller FAZ area(P=0.015)and perimeter(P=0.016)than Group 1.At fasting,central PD was significantly positively correlated with blood glucose levels(P=0.044),whereas no significant correlations were found between blood glucose levels and OCTA parameters one hour after glucose intake.CONCLUSION A short-term increase in blood glucose has a more pronounced effect on retinal microcirculation in prediabetic patients with either IFG or IGT.展开更多
BACKGROUND The FreeStyle Libre flash glucose monitoring(FGM)system entered the Chinese market in 2017 to complement the self-monitoring of blood glucose.Due to its increased usage in clinics,the number of studies inve...BACKGROUND The FreeStyle Libre flash glucose monitoring(FGM)system entered the Chinese market in 2017 to complement the self-monitoring of blood glucose.Due to its increased usage in clinics,the number of studies investigating its accuracy has increased.However,its accuracy has not been investigated in highland populations in China.AIM To evaluate measurements recorded using the FreeStyle Libre FGM system compared with capillary blood glucose measured using the enzyme electrode method in patients with type 2 diabetes(T2D)who had migrated within 3 mo from highlands to plains.METHODS Overall,68 patients with T2D,selected from those who had recently migrated from highlands to plains(within 3 mo),were hospitalized at the Department of Endocrinology from August to October 2017 and underwent continuous glucose monitoring(CGM)with the FreeStyle Libre FGM system for 14 d.Throughout the study period,fingertip capillary blood glucose was measured daily using the enzyme electrode method(Super GL,China),and blood glucose levels were read from the scanning probe during fasting and 2 h after all three meals.Moreover,the time interval between reading the data from the scanning probe and collecting fingertip capillary blood was controlled to<5 min.The accuracy of the FGM system was evaluated according to the CGM guidelines.Subsequently,the factors influencing the mean absolute relative difference(MARD)of this system were analyzed by a multiple linear regression method.RESULTS Pearson’s correlation analysis showed that the fingertip and scanned glucose levels were positively correlated(R=0.86,P=0.00).The aggregated MARD of scanned glucose was 14.28±13.40%.Parker's error analysis showed that 99.30%of the data pairs were located in areas A and B.According to the probe wear time of the FreeStyle Libre FGM system,MARD_(1 d) and MARD_(2-14 d) were 16.55%and 14.35%,respectively(t=1.23,P=0.22).Multiple stepwise regression analysis showed that MARD did not correlate with blood glucose when the largest amplitude of glycemic excursion(LAGE)was<5.80 mmol/L but negatively correlated with blood glucose when the LAGE was≥5.80 mmol/L.CONCLUSION The FreeStyle Libre FGM system has good accuracy in patients with T2D who had recently migrated from highlands to plains.This system might be ideal for avoiding the effects of high hematocrit on blood glucose monitoring in populations that recently migrated to plains.MARD is mainly influenced by glucose levels and fluctuations,and the accuracy of the system is higher when the blood glucose fluctuation is small.In case of higher blood glucose level fluctuations,deviation in the scanned glucose levels is the highest at extremely low blood glucose levels.展开更多
Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level mon...Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests,the advent of continuous glucose monitoring(CGM)systems has revolutionized the approach.These devices offer a safe and reliable means of tracking glucose levels in real-time,benefiting both women with diabetes during pregnancy and the healthcare providers.Moreover,CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes,especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device.Such a combined approach has been demonstrated to improve overall blood sugar control,lessen the occurrence of preeclampsia and neonatal hypoglycaemia,and minimize the duration of neonatal intensive care unit stays.This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.展开更多
Diabetes is a condition that can come to the surface at any point throughout a person’s life. Although Type 1 and Type 2 Diabetes have different triggers that cause them to arise, a person can experience similar comp...Diabetes is a condition that can come to the surface at any point throughout a person’s life. Although Type 1 and Type 2 Diabetes have different triggers that cause them to arise, a person can experience similar complications from either if not monitored and treated accordingly. Through the Diabetes Control and Complications Trial, it was found that a significant way to monitor diabetes is through glucose levels in a person’s body. The research surrounding glucose monitoring dates to the mid-1800s, with the first successful reagent for glucose testing being developed in 1908. Since then, glucose sensing has become one of the most rapidly growing areas of research and development in biosensor technology, creating a competitive market for more advanced, accurate, and convenient glucose monitoring. This article reviews the history of biosensors used for glucose monitoring, and major advancements in biosensor technology to enhance performance and improve quality of life for patients with diabetes.展开更多
BACKGROUND The possible existence of an acini–islet–acinar(AIA)reflex,involving mutual amylase and insulin interactions,was investigated in the current acute experiment on pigs.AIM To confirm the existence of an AIA...BACKGROUND The possible existence of an acini–islet–acinar(AIA)reflex,involving mutual amylase and insulin interactions,was investigated in the current acute experiment on pigs.AIM To confirm the existence of an AIA reflex and justify the placement of the exocrine and endocrine pancreatic components within the same organ.METHODS The study was performed on six pigs under general anesthesia.An intravenous glucose tolerance test was performed,with a bolus infusion of 50%glucose to the jugular vein,while amylase(5000 U/kg)or vehicle intrapancreatic infusions were administered via the pancreaticoduodenalis cranialis artery during 30 min with a 1 mL/min flow rate.RESULTS The amylase infusion to pancreatic arterial circulation inhibited and delayed the insulin release peak which is usually associated with the highest value of blood glucose and is typically observed at 15 min after glucose infusion,for>1 h.The intrapancreatic infusion of the vehicle(saline)did not have any effect on the time frame of insulin release.Infusion of 1%bovine serum albumin changed the insulin release curve dramatically and prolonged the high range of insulin secretion,far beyond the glucose peak.CONCLUSION Intrapancreatic arterial infusion of amylase interrupted the integrated glucose–insulin interactions.This confirms an AIA reflex and justifies placement of the exocrine and endocrine pancreatic components within the same organ.展开更多
BACKGROUND Sodium-dependent glucose transporter 2 inhibitors(SGLT2i)have shown efficacy in reducing heart failure(HF)burden in a very heterogeneous groups of patients,raising doubts about some contemporary assumptions...BACKGROUND Sodium-dependent glucose transporter 2 inhibitors(SGLT2i)have shown efficacy in reducing heart failure(HF)burden in a very heterogeneous groups of patients,raising doubts about some contemporary assumptions of their mechanism of action.We previously published a prospective observational study that evaluated mechanisms of action of SGLT2i in patients with type 2 diabetes who were in HF stages A and B on dual hypoglycemic therapy.Two groups of patients were included in the study:the ones receiving SGLT2i as an add-on agent to metformin and the others on dipeptidyl peptidase-4 inhibitors as an add-on to metformin due to suboptimal glycemic control.AIM To evaluate the outcomes regarding natriuretic peptide,oxidative stress,inflammation,blood pressure,heart rate,cardiac function,and body weight.METHODS The study outcomes were examined by dividing each treatment arm into two subgroups according to baseline parameters of global longitudinal strain(GLS),N-terminal pro-brain natriuretic peptide,myeloperoxidase(MPO),high-sensitivity C-reactive protein(hsCRP),and systolic and diastolic blood pressure.To evaluate the possible predictors of observed changes in the SGLT2i arm during follow-up,a rise in stroke volume index,body mass index(BMI)decrease,and lack of heart rate increase,linear regression analysis was performed.RESULTS There was a greater reduction of MPO,hsCRP,GLS,and blood pressure in the groups with higher baseline values of mentioned parameters irrespective of the therapeutic arm after 6 months of follow-up.Significant independent predictors of heart rate decrease were a reduction in early mitral inflow velocity to early diastolic mitral annular velocity at the interventricular septal annulus ratio and BMI,while the predictor of stroke volume index increase was SGLT2i therapy itself.CONCLUSION SGLT2i affect body composition,reduce cardiac load,improve diastolic/systolic function,and attenuate the sympathetic response.Glycemic control contributes to the improvement of heart function,blood pressure control,oxidative stress,and reduction in inflammation.展开更多
BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCT...BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and urinary infection-20(8.8%)&17(7.5%)with dapagliflozin;9(5.6%)&5(3.13%)with canagliflozin;and 4(5%)&4(5%)with empagliflozin.Diabetic ketoacidosis was observed in 4(1.8%)with dapagliflozin and 1(0.63%)with canagliflozin.CONCLUSION Treatment of patients with SGLT-2i is associated with statistically significant reductions in HbA1c,body weight,and better than those reported in RCTs,with low side effect profiles.A review of large-scale real-world data is needed to inform better clinical practice decision making.展开更多
Highland barley(HB)is a high-altitude cereal with rich nutritional components and potential health benefits.To clarify its hypoglycemic effect and mechanism,we investigated the effect of whole grain HB and fecal micro...Highland barley(HB)is a high-altitude cereal with rich nutritional components and potential health benefits.To clarify its hypoglycemic effect and mechanism,we investigated the effect of whole grain HB and fecal microbiota transplantation(FMT)on glucose metabolism and gut microbiota in high-fat diet and streptozotocin(HFD/STZ)-induced diabetic mice.The results showed that HB(40%)significantly decreased fasting blood glucose and the area under the glucose tolerance curve,significantly increased insulin secretion and improved insulin resistance in HFD/STZ-induced diabetic mice(P<0.05).Inflammatory factors and blood lipid indices were also significantly alleviated after 12 weeks of 40%HB intervention(P<0.05).Additionally,beneficial bacteria,such as Bifidobacterium and Akkermansia,were significantly enriched in the gut of diabetic mice after whole grain HB intervention.Meanwhile,the results of further FMT experiments verified that the fecal microbiota after the 40%HB intervention not only significantly increased the relative abundance of Bifidobacterium and Akkermansia but also effectively improved glucose metabolism and alleviated the inflammatory state in HFD/STZ-induced diabetic mice.Collectively,our study confirmed the bridge role of gut microbiota in improving glucose metabolism of whole grain HB,which could promote the development of precision nutrition.展开更多
Background Promoting the synchronization of glucose and amino acid release in the digestive tract of pigs could effectively improve dietary nitrogen utilization.The rational allocation of dietary starch sources and th...Background Promoting the synchronization of glucose and amino acid release in the digestive tract of pigs could effectively improve dietary nitrogen utilization.The rational allocation of dietary starch sources and the exploration of appropriate dietary glucose release kinetics may promote the dynamic balance of dietary glucose and amino acid supplies.However,research on the effects of diets with different glucose release kinetic profiles on amino acid absorption and portal amino acid appearance in piglets is limited.This study aimed to investigate the effects of the kinetic pattern of dietary glucose release on nitrogen utilization,the portal amino acid profile,and nutrient transporter expression in intestinal enterocytes in piglets.Methods Sixty-four barrows(15.00±1.12 kg)were randomly allotted to 4 groups and fed diets formulated with starch from corn,corn/barley,corn/sorghum,or corn/cassava combinations(diets were coded A,B,C,or D respectively).Protein retention,the concentrations of portal amino acid and glucose,and the relative expression of amino acid and glucose transporter m RNAs were investigated.In vitro digestion was used to compare the dietary glucose release profiles.Results Four piglet diets with different glucose release kinetics were constructed by adjusting starch sources.The in vivo appearance dynamics of portal glucose were consistent with those of in vitro dietary glucose release kinetics.Total nitrogen excretion was reduced in the piglets in group B,while apparent nitrogen digestibility and nitrogen retention increased(P<0.05).Regardless of the time(2 h or 4 h after morning feeding),the portal total free amino acids content and contents of some individual amino acids(Thr,Glu,Gly,Ala,and Ile)of the piglets in group B were significantly higher than those in groups A,C,and D(P<0.05).Cluster analysis showed that different glucose release kinetic patterns resulted in different portal amino acid patterns in piglets,which decreased gradually with the extension of feeding time.The portal His/Phe,Pro/Glu,Leu/Val,Lys/Met,Tyr/Ile and Ala/Gly appeared higher similarity among the diet treatments.In the anterior jejunum,the glucose transporter SGLT1 was significantly positively correlated with the amino acid transporters B0AT1,EAAC1,and CAT1.Conclusions Rational allocation of starch resources could regulate dietary glucose release kinetics.In the present study,group B(corn/barley)diet exhibited a better glucose release kinetic pattern than the other groups,which could affect the portal amino acid contents and patterns by regulating the expression of amino acid transporters in the small intestine,thereby promoting nitrogen deposition in the body,and improving the utilization efficiency of dietary nitrogen.展开更多
Electrocatalytic glucose oxidation reaction(GOR)has attracted much attention owing to its crucial role in biofuel cell fabrication.Herein,we load MoO_(3)nanoparticles on carbon nanotubes(CNTs)and use a discharge proce...Electrocatalytic glucose oxidation reaction(GOR)has attracted much attention owing to its crucial role in biofuel cell fabrication.Herein,we load MoO_(3)nanoparticles on carbon nanotubes(CNTs)and use a discharge process to prepare a noblemetal-free MC-60 catalyst containing MoO_(3),Mo_(2)C,and a Mo_(2)C–MoO_(3)interface.In the GOR,MC-60 shows activity as high as 745μA/(mmol/L cm^(2)),considerably higher than those of the Pt/CNT(270μA/(mmol/L cm^(2)))and Au/CNT catalysts(110μA/(mmol/L cm^(2))).In the GOR,the response minimum on MC-60 is as low as 8μmol/L,with a steady-state response time of only 3 s.Moreover,MC-60 has superior stability and anti-interference ability to impurities in the GOR.The better performance of MC-60 in the GOR is attributed to the abundant Mo sites bonding to C and O atoms at the MoO_(3)–Mo_(2)C interface.These Mo sites create active sites for promoting glucose adsorption and oxidation,enhancing MC-60 performance in the GOR.Thus,these results help to fabricate more effi cient noble-metal-free catalysts for the fabrication of glucose-based biofuel cells.展开更多
Efficient and selective glucose-to-fructose isomerization is a crucial step for production of oxygenated chemicals derived from sugars,which is usually catalyzed by base or Lewis acid heterogeneous catalyst.However,hi...Efficient and selective glucose-to-fructose isomerization is a crucial step for production of oxygenated chemicals derived from sugars,which is usually catalyzed by base or Lewis acid heterogeneous catalyst.However,high yield and selectivity of fructose cannot be simultaneously obtained under mild conditions which hamper the scale of application compared with enzymatic catalysis.Herein,a Li-promoted C_(3)N_(4) catalyst was exploited which afforded an excellent fructose yield(40.3 wt%)and selectivity(99.5%)from glucose in water at 50℃,attributed to the formation of stable Li–N bond to strengthen the basic sites of catalysts.Furthermore,the so-formed N_(6)–Li–H_(2)O active site on Li–C_(3)N_(4) catalyst in aqueous phase changes the local electronic structure and strengthens the deprotonation process during glucose isomerization into fructose.The superior catalytic performance which is comparable to biological pathway suggests promising applications of lithium containing heterogeneous catalyst in biomass refinery.展开更多
BACKGROUND Mesenchymal stem cells(MSCs)have been extensively studied for therapeutic potential,due to their regenerative and immunomodulatory properties.Serial passage and stress factors may affect the biological char...BACKGROUND Mesenchymal stem cells(MSCs)have been extensively studied for therapeutic potential,due to their regenerative and immunomodulatory properties.Serial passage and stress factors may affect the biological characteristics of MSCs,but the details of these effects have not been recognized yet.AIM To investigate the effects of stress factors(high glucose and severe hypoxia)on the biological characteristics of MSCs at different passages,in order to optimize the therapeutic applications of MSCs.METHODS In this study,we investigated the impact of two stress conditions;severe hypoxia and high glucose on human adipose-tissue derived MSCs(hAD-MSCs)at passages 6(P6),P8,and P10.Proliferation,senescence and apoptosis were evaluated measuring WST-1,senescence-associated beta-galactosidase,and annexin V,respectively.RESULTS Cells at P6 showed decreased proliferation and increased apoptosis under conditions of high glucose and hypoxia compared to control,while the extent of senescence did not change significantly under stress conditions.At P8 hAD-MSCs cultured in stress conditions had a significant decrease in proliferation and apoptosis and a significant increase in senescence compared to counterpart cells at P6.Cells cultured in high glucose at P10 had lower proliferation and higher senescence than their counterparts in the previous passage,while no change in apoptosis was observed.On the other hand,MSCs cultured under hypoxia showed decreased senescence,increased apoptosis and no significant change in proliferation when compared to the same conditions at P8.CONCLUSION These results indicate that stress factors had distinct effects on the biological processes of MSCs at different passages,and suggest that senescence may be a protective mechanism for MSCs to survive under stress conditions at higher passage numbers.展开更多
基金Supported by National Natural Science Foundation of China(General Program),No.82073909Four‘Batches’Innovation Project of Invigorating Medical through Science and Technology of Shanxi Province,No.2023XM022The Shanxi Provincial Central Leading Local Science and Technology Development Fund Project,No.YDZJSX2022A059 and No.YDZJSX20231A059。
文摘BACKGROUND Autonomous cortisol secretion(ACS)is linked to a higher prevalence of metabolic abnormalities and an increased risk of major adverse cardiovascular events.AIM To evaluate glucose and bone metabolism in patients with ACS using a continuous glucose monitoring system(CGMS)and dual-energy X-ray absorptiometry(DXA).METHODS Patients diagnosed with ACS,including Cushing syndrome,mild ACS(MACS),and nonfunctional adrenal incidentaloma(NFAI),were recruited for this study.Glucose variability and glycemic status were assessed using CGMS.Regional bone mineral content(BMC),bone mineral density(BMD),and bone area(BA)were evaluated using DXA.CGMS-and DXA-derived parameters were compared across the subgroups of ACS.Correlation analysis was performed to examine relationships between varying degrees of cortisol secretion,measured by cortisol after 1 mg overnight dexamethasone suppression test(DST)or 24-hour urine free cortisol(24h UFC),and CGMS-or DXA-derived parameters.RESULTS A total of 64 patients with ACS were included in this study:19 with Cushing syndrome,11 with MACS,and 34 with NFAI.Glucose variability,time above range(TAR),and time in range(TIR)along with specific areal BMC,BMD,and BA,differed significantly between groups of Cushing syndrome and NFAI.A significant positive correlation was observed between glucose variability or TAR and cortisol after 1 mg overnight DST or 24h UFC.By contrast,TIR,along with regional BMC,BMD,and BA,were negatively correlated with varying degrees of cortisol secretion.CONCLUSION Glucose and bone metabolism impairments are on a continuum alteration from NFAI to MACS and Cushing syndrome.Prompt attention should be given to these patients with ACS,especially those with mild hormone secretion.Parameters of glucose variability and glycemic status along with bone condition in regions rich in cancellous bone will provide valuable information.
基金Supported by Yunnan Province Academician(Expert)Workstation Project,No.202305AF150097the Basic Research Program of Yunnan Province(Kunming Medical University Joint Special Project),No.202101AY070001-276+3 种基金the National Natural Science Foundation of China,No.82160159the Key Project Program of Yunnan Province(Kunming Medical University Joint Special Project),No.202301AY070001-013the Major Science and Technology Project of Yunnan Province,No.202202AA100004the Double First-class University Construction Project of Yunnan University,No.CY22624106.
文摘BACKGROUND Continuous glucose monitoring(CGM)metrics,such as time in range(TIR)and glycemic risk index(GRI),have been linked to various diabetes-related complications,including diabetic foot(DF).AIM To investigate the association between CGM-derived indicators and the risk of DF in individuals with type 2 diabetes mellitus(T2DM).METHODS A total of 591 individuals with T2DM(297 with DF and 294 without DF)were enrolled.Relevant clinical data,complications,comorbidities,hematological parameters,and 72-hour CGM data were collected.Logistic regression analysis was employed to examine the relationship between these measurements and the risk of DF.RESULTS Individuals with DF exhibited higher mean blood glucose(MBG)levels and increased proportions of time above range(TAR),TAR level 1,and TAR level 2,but lower TIR(all P<0.001).Patients with DF had significantly lower rates of achieving target ranges for TIR,TAR,and TAR level 2 than those without DF(all P<0.05).Logistic regression analysis revealed that GRI,MBG,and TAR level 1 were positively associated with DF risk,while TIR was inversely correlated(all P<0.05).Achieving TIR and TAR was inversely correlated with white blood cell count and glycated hemoglobin A1c levels(P<0.05).Additionally,achieving TAR was influenced by fasting plasma glucose,body mass index,diabetes duration,and antidiabetic medication use.CONCLUSION CGM metrics,particularly TIR and GRI,are significantly associated with the risk of DF in T2DM,emphasizing the importance of improved glucose control.
基金Funded by Cofoe Medical Technology Co.,Ltd and the Scientific Research Start-up Funds of Hexi University(No.KYQD2022006)。
文摘CuO nanoparticles were successfully synthesized via a two-jet electrospun method,and then screen-printed on silver-carbon electrodes,forming CuO-modified Ag-C(CuO/Ag-C)disposable strip electrodes.In natural environment condition for glucose detection,the obtained CuO/Ag-C electrodes show a high sensitivity of 540 nA·mM^(-1)·cm^(-2),and a low limit of detection(0.68 mM)in a wide linear response range of 0.68 mM and 3 mM(signal/noise=3),respectively.In addition,the CuO/Ag-C electrodes also exhibit excellent anti-interference,air stability and repeatability.As a result,the fabrication of CuO nanoparticles via an electrospun process and the technique of screen-printed electrodes are of great significance for glucose detection.
文摘A mesocosm-based study was conducted to assess the effect of glucose and hydrogen peroxide on periphyton communities. These chemicals have been found to be effective at controlling cyanobacteria blooms in the water column but their impact on attached communities is unknown. The experimental design included a total of 4 treatments: control (no chemicals;3 replicates);hydrogen peroxide (3 replicates);glucose alone (3 different concentrations [no replicates]);and additive glucose (3 replicates). After 34 days, mean values of chlorophyll a were lower in all experimental treatments compared to the control;mean AFDM values were lower in all treatments except the unreplicated high glucose alone treatment. In contrast, mean autotrophic index values (AFDM/chlorophyll a) were greater in all treatments compared to the control, indicating heterotrophs were more resistant to the chemical treatments than autotrophs. Periphyton community biodiversity was much lower in the additive glucose and moderate glucose alone treatments than the hydrogen peroxide and control treatments. The relative abundance of the bacteria Asticcacaulis and Sphingorhabdus responded positively to the glucose treatments, whereas relative abundance of Nevskia and Caenimonas declined in both the hydrogen peroxide and glucose treatments. In terms of relative abundance, no cyanobacteria taxa were detected among the top 20 taxa. We conclude that the autotrophic component of periphyton communities is especially vulnerable to hydrogen peroxide and glucose treatments, and that any management strategy employing these chemicals should be aware of this potential impact.
基金This retrospective analysis incorporated data from two clinical trials(CTR20220854 and CTR20222843)sponsored by Chongqing Chenan Biopharmaceutical Co.,Ltd.and Jiangsu Hengrui Pharmaceuticals Co.,Ltd.However,these sponsors did not partake in the study design,data interpretation,or manuscript preparation.
文摘BACKGROUND Insulin therapy plays a crucial role in managing diabetes.Regulatory guidelines mandate assessing the pharmacokinetics(PK)and pharmacodynamics(PD)of new insulin formulations with euglycemic clamp techniques before entry into the market.Typically,blood glucose(BG)levels are maintained at 5%below baseline to suppress endogenous insulin secretion in healthy volunteers.However,in scenarios where BG baseline is relatively low,maintaining it at 5%below baseline can increase hypoglycemic risk.Consequently,we adjusted to maintain it at 2.5%below a baseline of<4.00 mmol/L.It remains uncertain whether this adjustment impacts endogenous insulin inhibition or the PD of study insulin.AIM To evaluate and compare the PD and C-peptide status using two different target BG setting methods.METHODS Data came from euglycemic clamp trials assessing the PK/PD of insulin aspart(IAsp)in healthy participants.Target BG was set at 2.5%below baseline for those with a basal BG of<4.00 mmol/L(group A),and at 5%below baseline for others(group B).The area under the curve(AUC)of IAsp(AUC_(IAsp,0-8 h))and GIR from 0 to 8 hours(AUCGIR,0-8 h)was used to characterize the PK and PD of IAsp,respectively.The C-peptide reduction and PK/PD of IAsp were compared between the two groups.RESULTS Out of 135 subjects,15 were assigned to group A and 120 to group B;however,group B exhibited higher basal Cpeptide(1.59±0.36 vs 1.32±0.42 ng/mL,P=0.006).Following propensity score matching to adjust for basal Cpeptide differences,71 subjects(15 in group A and 56 in group B)were analyzed.No significant differences were observed in demographics,IAsp dosage,or clamp quality.Group B showed significantly higher baseline(4.35±0.21 vs 3.91±0.09 mmol/L,P<0.001),target(4.13±0.20 vs 3.81±0.08 mmol/L,P<0.001),and clamped(4.10±0.17 vs 3.80±0.06 mmol/L,P<0.001)BG levels.Both groups exhibited comparable C-peptide suppression(32.5%±10.0%vs 35.6%±12.1%,P=0.370)and similar IAsp activity(AUCGIR,0-8 h:1433±400 vs 1440±397 mg/kg,P=0.952)under nearly equivalent IAsp exposure(AUC_(IAsp,0-8 h):566±51 vs 571±85 ng/mL×h,P=0.840).CONCLUSION Maintaining BG at 2.5%below a baseline of<4.00 mmol/L did not compromise the endogenous insulin suppression nor alter the observed pharmacodynamic effects of the study insulin.
文摘Athletes often use branched-chain amino acid (BCAAs) supplements with a ratio of 2:1:1 (leucine:isoleucine:valine) for their impact on muscle building. Research suggests that by altering the ratio, an improvement in glucose metabolism might be possible. The purpose of this study was to examine how isoleucine would influence glucose tolerance. We recruited healthy male (n = 13) and female (n = 5) participants who were asked to fast for 12 hours before coming to the laboratory. A fasting blood sample was collected, followed by the subjects consuming a breakfast containing 113 g carbohydrates, 8 g protein, 1.5 g fat, and BCAA powder in the 2:1:1 ratio (Control) or BCAA powder enriched with Isoleucine (2:6:1), both added to orange juice. The opposite meal was consumed on a second visit one week apart. Blood was collected at 30, 60, 90, and 120 minutes post-meal. No differences were observed between the Control and Isoleucine for changes in serum glucose or insulin response when examining all subjects together. However, when comparing between genders, males tended to have a significantly lower serum glucose response compared to females when consuming the Isoleucine, with no difference between the genders when consuming the Control. Also, males had significantly lower serum glucose responses when consuming the Isoleucine compared to when they consumed the Control, while females had significantly higher serum glucose responses when consuming the Isoleucine compared to when they consumed the Control. In general, males tended to have a lower serum insulin response than females when consuming both the Control and the Isoleucine. Our study indicates a significant difference in the way genders respond to BCAA supplementation, where isoleucine may improve glucose tolerance and insulin response in males but not females.
基金Supported by National Natural Science Foundation of China,No.82360168 and No.81960154Natural Science Foundation of Jiangxi Province,No.20212BAB206020the Foundation of Health Commission of Jiangxi Province,No.SKJP220225830.
文摘BACKGROUND The efficacy of various bariatric surgeries varies in reducing blood glucose levels.Given the distinct mechanisms and anatomical alterations associated with each procedure,it is crucial to compare their glycemic control outcomes.We hypothesize that proximal small intestinal bypass(PSIB)is superior in blood glucose reduction over Roux-en-Y gastric bypass(RYGB)and jejunoileal bypass(JIB).AIM To compare the effectiveness of PSIB,RYGB,and JIB in lowering blood glucose.METHODS Rats with streptozotocin-induced diabetes were randomly divided into PSIB,RYGB,JIB,and sham-operated groups.Body weight,food intake,fasting blood glucose level,oral glucose tolerance test,insulin tolerance test,liver enzymes,and blood lipids were measured.RESULTS Postoperatively,only the JIB group had a lower body weight compared to the sham group.The food intake of the rats in all three surgical groups was significantly less than that in the sham group.Fasting blood glucose was reduced in all surgical groups and was lower in the PSIB group than in the RYGB and JIB groups.Glucose tolerance and insulin sensitivity improved in all three surgical groups compared to the sham group,but the improvement appeared earliest in the PSIB group.At six weeks postsurgery,the PSIB group showed a reduction in alanine transaminase levels and maintained a normal lipid profile.CONCLUSION PSIB demonstrated excellent hypoglycemic effects in the early postoperative period,and had better efficacy than RYGB and JIB.
文摘Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.
基金Supported by The Project Foundation of Chongqing Science and Technology Commission of China,No.cstc2018jcyjAX0798.
文摘BACKGROUND Retinal microcirculation alterations are early indicators of diabetic microvascular complications.Optical coherence tomography angiography(OCTA)is a noninvasive method to assess these changes.This study analyzes changes in retinal microcirculation in prediabetic patients during short-term increases in blood glucose using OCTA.AIM To investigate the changes in retinal microcirculation in prediabetic patients experiencing short-term increases in blood glucose levels using OCTA.METHODS Fifty volunteers were divided into three groups:Group 1[impaired fasting glucose(IFG)or impaired glucose tolerance(IGT)],Group 2(both IFG and IGT),and a control group.Retinal microcirculation parameters,including vessel density(VD),perfusion density(PD),and foveal avascular zone(FAZ)metrics,were measured using OCTA.Correlations between these parameters and blood glucose levels were analyzed in both the fasting and postprandial states.RESULTS One hour after glucose intake,the central VD(P=0.023),central PD(P=0.026),and parafoveal PD(P<0.001)were significantly greater in the control group than in the fasting group.In Group 1,parafoveal PD(P<0.001)and FAZ circularity(P=0.023)also increased one hour after glucose intake.However,no significant changes were observed in the retinal microcirculation parameters of Group 2 before or after glucose intake(P>0.05).Compared with the control group,Group 1 had a larger FAZ area(P=0.032)and perimeter(P=0.018),whereas Group 2 had no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Compared with Group 1,Group 2 had greater central VD(P=0.013)and PD(P=0.008)and a smaller FAZ area(P=0.012)and perimeter(P=0.010).One hour after glucose intake,Group 1 had a larger FAZ area(P=0.044)and perimeter(P=0.038)than did the control group,whereas Group 2 showed no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Group 2 had greater central VD(P=0.042)and PD(P=0.022)and a smaller FAZ area(P=0.015)and perimeter(P=0.016)than Group 1.At fasting,central PD was significantly positively correlated with blood glucose levels(P=0.044),whereas no significant correlations were found between blood glucose levels and OCTA parameters one hour after glucose intake.CONCLUSION A short-term increase in blood glucose has a more pronounced effect on retinal microcirculation in prediabetic patients with either IFG or IGT.
基金Supported by Health and Family Planning Project of Sichuan Province,No.17PJ069Tibet Autonomous Region Science and Technology Program,No.XZ202303ZY0011G.
文摘BACKGROUND The FreeStyle Libre flash glucose monitoring(FGM)system entered the Chinese market in 2017 to complement the self-monitoring of blood glucose.Due to its increased usage in clinics,the number of studies investigating its accuracy has increased.However,its accuracy has not been investigated in highland populations in China.AIM To evaluate measurements recorded using the FreeStyle Libre FGM system compared with capillary blood glucose measured using the enzyme electrode method in patients with type 2 diabetes(T2D)who had migrated within 3 mo from highlands to plains.METHODS Overall,68 patients with T2D,selected from those who had recently migrated from highlands to plains(within 3 mo),were hospitalized at the Department of Endocrinology from August to October 2017 and underwent continuous glucose monitoring(CGM)with the FreeStyle Libre FGM system for 14 d.Throughout the study period,fingertip capillary blood glucose was measured daily using the enzyme electrode method(Super GL,China),and blood glucose levels were read from the scanning probe during fasting and 2 h after all three meals.Moreover,the time interval between reading the data from the scanning probe and collecting fingertip capillary blood was controlled to<5 min.The accuracy of the FGM system was evaluated according to the CGM guidelines.Subsequently,the factors influencing the mean absolute relative difference(MARD)of this system were analyzed by a multiple linear regression method.RESULTS Pearson’s correlation analysis showed that the fingertip and scanned glucose levels were positively correlated(R=0.86,P=0.00).The aggregated MARD of scanned glucose was 14.28±13.40%.Parker's error analysis showed that 99.30%of the data pairs were located in areas A and B.According to the probe wear time of the FreeStyle Libre FGM system,MARD_(1 d) and MARD_(2-14 d) were 16.55%and 14.35%,respectively(t=1.23,P=0.22).Multiple stepwise regression analysis showed that MARD did not correlate with blood glucose when the largest amplitude of glycemic excursion(LAGE)was<5.80 mmol/L but negatively correlated with blood glucose when the LAGE was≥5.80 mmol/L.CONCLUSION The FreeStyle Libre FGM system has good accuracy in patients with T2D who had recently migrated from highlands to plains.This system might be ideal for avoiding the effects of high hematocrit on blood glucose monitoring in populations that recently migrated to plains.MARD is mainly influenced by glucose levels and fluctuations,and the accuracy of the system is higher when the blood glucose fluctuation is small.In case of higher blood glucose level fluctuations,deviation in the scanned glucose levels is the highest at extremely low blood glucose levels.
文摘Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests,the advent of continuous glucose monitoring(CGM)systems has revolutionized the approach.These devices offer a safe and reliable means of tracking glucose levels in real-time,benefiting both women with diabetes during pregnancy and the healthcare providers.Moreover,CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes,especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device.Such a combined approach has been demonstrated to improve overall blood sugar control,lessen the occurrence of preeclampsia and neonatal hypoglycaemia,and minimize the duration of neonatal intensive care unit stays.This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.
文摘Diabetes is a condition that can come to the surface at any point throughout a person’s life. Although Type 1 and Type 2 Diabetes have different triggers that cause them to arise, a person can experience similar complications from either if not monitored and treated accordingly. Through the Diabetes Control and Complications Trial, it was found that a significant way to monitor diabetes is through glucose levels in a person’s body. The research surrounding glucose monitoring dates to the mid-1800s, with the first successful reagent for glucose testing being developed in 1908. Since then, glucose sensing has become one of the most rapidly growing areas of research and development in biosensor technology, creating a competitive market for more advanced, accurate, and convenient glucose monitoring. This article reviews the history of biosensors used for glucose monitoring, and major advancements in biosensor technology to enhance performance and improve quality of life for patients with diabetes.
文摘BACKGROUND The possible existence of an acini–islet–acinar(AIA)reflex,involving mutual amylase and insulin interactions,was investigated in the current acute experiment on pigs.AIM To confirm the existence of an AIA reflex and justify the placement of the exocrine and endocrine pancreatic components within the same organ.METHODS The study was performed on six pigs under general anesthesia.An intravenous glucose tolerance test was performed,with a bolus infusion of 50%glucose to the jugular vein,while amylase(5000 U/kg)or vehicle intrapancreatic infusions were administered via the pancreaticoduodenalis cranialis artery during 30 min with a 1 mL/min flow rate.RESULTS The amylase infusion to pancreatic arterial circulation inhibited and delayed the insulin release peak which is usually associated with the highest value of blood glucose and is typically observed at 15 min after glucose infusion,for>1 h.The intrapancreatic infusion of the vehicle(saline)did not have any effect on the time frame of insulin release.Infusion of 1%bovine serum albumin changed the insulin release curve dramatically and prolonged the high range of insulin secretion,far beyond the glucose peak.CONCLUSION Intrapancreatic arterial infusion of amylase interrupted the integrated glucose–insulin interactions.This confirms an AIA reflex and justifies placement of the exocrine and endocrine pancreatic components within the same organ.
文摘BACKGROUND Sodium-dependent glucose transporter 2 inhibitors(SGLT2i)have shown efficacy in reducing heart failure(HF)burden in a very heterogeneous groups of patients,raising doubts about some contemporary assumptions of their mechanism of action.We previously published a prospective observational study that evaluated mechanisms of action of SGLT2i in patients with type 2 diabetes who were in HF stages A and B on dual hypoglycemic therapy.Two groups of patients were included in the study:the ones receiving SGLT2i as an add-on agent to metformin and the others on dipeptidyl peptidase-4 inhibitors as an add-on to metformin due to suboptimal glycemic control.AIM To evaluate the outcomes regarding natriuretic peptide,oxidative stress,inflammation,blood pressure,heart rate,cardiac function,and body weight.METHODS The study outcomes were examined by dividing each treatment arm into two subgroups according to baseline parameters of global longitudinal strain(GLS),N-terminal pro-brain natriuretic peptide,myeloperoxidase(MPO),high-sensitivity C-reactive protein(hsCRP),and systolic and diastolic blood pressure.To evaluate the possible predictors of observed changes in the SGLT2i arm during follow-up,a rise in stroke volume index,body mass index(BMI)decrease,and lack of heart rate increase,linear regression analysis was performed.RESULTS There was a greater reduction of MPO,hsCRP,GLS,and blood pressure in the groups with higher baseline values of mentioned parameters irrespective of the therapeutic arm after 6 months of follow-up.Significant independent predictors of heart rate decrease were a reduction in early mitral inflow velocity to early diastolic mitral annular velocity at the interventricular septal annulus ratio and BMI,while the predictor of stroke volume index increase was SGLT2i therapy itself.CONCLUSION SGLT2i affect body composition,reduce cardiac load,improve diastolic/systolic function,and attenuate the sympathetic response.Glycemic control contributes to the improvement of heart function,blood pressure control,oxidative stress,and reduction in inflammation.
文摘BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and urinary infection-20(8.8%)&17(7.5%)with dapagliflozin;9(5.6%)&5(3.13%)with canagliflozin;and 4(5%)&4(5%)with empagliflozin.Diabetic ketoacidosis was observed in 4(1.8%)with dapagliflozin and 1(0.63%)with canagliflozin.CONCLUSION Treatment of patients with SGLT-2i is associated with statistically significant reductions in HbA1c,body weight,and better than those reported in RCTs,with low side effect profiles.A review of large-scale real-world data is needed to inform better clinical practice decision making.
基金funded by the National Natural Science Foundation of China(32101876)the Discipline ConstructionFood Science and Engineering(SPKX-202202)grants。
文摘Highland barley(HB)is a high-altitude cereal with rich nutritional components and potential health benefits.To clarify its hypoglycemic effect and mechanism,we investigated the effect of whole grain HB and fecal microbiota transplantation(FMT)on glucose metabolism and gut microbiota in high-fat diet and streptozotocin(HFD/STZ)-induced diabetic mice.The results showed that HB(40%)significantly decreased fasting blood glucose and the area under the glucose tolerance curve,significantly increased insulin secretion and improved insulin resistance in HFD/STZ-induced diabetic mice(P<0.05).Inflammatory factors and blood lipid indices were also significantly alleviated after 12 weeks of 40%HB intervention(P<0.05).Additionally,beneficial bacteria,such as Bifidobacterium and Akkermansia,were significantly enriched in the gut of diabetic mice after whole grain HB intervention.Meanwhile,the results of further FMT experiments verified that the fecal microbiota after the 40%HB intervention not only significantly increased the relative abundance of Bifidobacterium and Akkermansia but also effectively improved glucose metabolism and alleviated the inflammatory state in HFD/STZ-induced diabetic mice.Collectively,our study confirmed the bridge role of gut microbiota in improving glucose metabolism of whole grain HB,which could promote the development of precision nutrition.
基金partially supported by the National Key Research and Development Program of China(2021YFD1300201)Jilin Province Key Research and Development Program of China(20220202044NC)。
文摘Background Promoting the synchronization of glucose and amino acid release in the digestive tract of pigs could effectively improve dietary nitrogen utilization.The rational allocation of dietary starch sources and the exploration of appropriate dietary glucose release kinetics may promote the dynamic balance of dietary glucose and amino acid supplies.However,research on the effects of diets with different glucose release kinetic profiles on amino acid absorption and portal amino acid appearance in piglets is limited.This study aimed to investigate the effects of the kinetic pattern of dietary glucose release on nitrogen utilization,the portal amino acid profile,and nutrient transporter expression in intestinal enterocytes in piglets.Methods Sixty-four barrows(15.00±1.12 kg)were randomly allotted to 4 groups and fed diets formulated with starch from corn,corn/barley,corn/sorghum,or corn/cassava combinations(diets were coded A,B,C,or D respectively).Protein retention,the concentrations of portal amino acid and glucose,and the relative expression of amino acid and glucose transporter m RNAs were investigated.In vitro digestion was used to compare the dietary glucose release profiles.Results Four piglet diets with different glucose release kinetics were constructed by adjusting starch sources.The in vivo appearance dynamics of portal glucose were consistent with those of in vitro dietary glucose release kinetics.Total nitrogen excretion was reduced in the piglets in group B,while apparent nitrogen digestibility and nitrogen retention increased(P<0.05).Regardless of the time(2 h or 4 h after morning feeding),the portal total free amino acids content and contents of some individual amino acids(Thr,Glu,Gly,Ala,and Ile)of the piglets in group B were significantly higher than those in groups A,C,and D(P<0.05).Cluster analysis showed that different glucose release kinetic patterns resulted in different portal amino acid patterns in piglets,which decreased gradually with the extension of feeding time.The portal His/Phe,Pro/Glu,Leu/Val,Lys/Met,Tyr/Ile and Ala/Gly appeared higher similarity among the diet treatments.In the anterior jejunum,the glucose transporter SGLT1 was significantly positively correlated with the amino acid transporters B0AT1,EAAC1,and CAT1.Conclusions Rational allocation of starch resources could regulate dietary glucose release kinetics.In the present study,group B(corn/barley)diet exhibited a better glucose release kinetic pattern than the other groups,which could affect the portal amino acid contents and patterns by regulating the expression of amino acid transporters in the small intestine,thereby promoting nitrogen deposition in the body,and improving the utilization efficiency of dietary nitrogen.
基金supported by the National Natural Science Foundation of China(Nos.82170426 and 22078193)Double Thousand Plan of Jiangxi Province(Nos.461654,jxsq2019102052).
文摘Electrocatalytic glucose oxidation reaction(GOR)has attracted much attention owing to its crucial role in biofuel cell fabrication.Herein,we load MoO_(3)nanoparticles on carbon nanotubes(CNTs)and use a discharge process to prepare a noblemetal-free MC-60 catalyst containing MoO_(3),Mo_(2)C,and a Mo_(2)C–MoO_(3)interface.In the GOR,MC-60 shows activity as high as 745μA/(mmol/L cm^(2)),considerably higher than those of the Pt/CNT(270μA/(mmol/L cm^(2)))and Au/CNT catalysts(110μA/(mmol/L cm^(2))).In the GOR,the response minimum on MC-60 is as low as 8μmol/L,with a steady-state response time of only 3 s.Moreover,MC-60 has superior stability and anti-interference ability to impurities in the GOR.The better performance of MC-60 in the GOR is attributed to the abundant Mo sites bonding to C and O atoms at the MoO_(3)–Mo_(2)C interface.These Mo sites create active sites for promoting glucose adsorption and oxidation,enhancing MC-60 performance in the GOR.Thus,these results help to fabricate more effi cient noble-metal-free catalysts for the fabrication of glucose-based biofuel cells.
基金The financial support from the National Natural Science Foundation of China(22278419,21978316,22108289,22172188)the Ministry of Science and Technology of China(2018YFB0604700)Suzhou Key Technology Research(Social Development)Project(2023ss06)。
文摘Efficient and selective glucose-to-fructose isomerization is a crucial step for production of oxygenated chemicals derived from sugars,which is usually catalyzed by base or Lewis acid heterogeneous catalyst.However,high yield and selectivity of fructose cannot be simultaneously obtained under mild conditions which hamper the scale of application compared with enzymatic catalysis.Herein,a Li-promoted C_(3)N_(4) catalyst was exploited which afforded an excellent fructose yield(40.3 wt%)and selectivity(99.5%)from glucose in water at 50℃,attributed to the formation of stable Li–N bond to strengthen the basic sites of catalysts.Furthermore,the so-formed N_(6)–Li–H_(2)O active site on Li–C_(3)N_(4) catalyst in aqueous phase changes the local electronic structure and strengthens the deprotonation process during glucose isomerization into fructose.The superior catalytic performance which is comparable to biological pathway suggests promising applications of lithium containing heterogeneous catalyst in biomass refinery.
基金Supported by the Deanship of Scientific Research,Yarmouk University,Jordan,No.73/2022.
文摘BACKGROUND Mesenchymal stem cells(MSCs)have been extensively studied for therapeutic potential,due to their regenerative and immunomodulatory properties.Serial passage and stress factors may affect the biological characteristics of MSCs,but the details of these effects have not been recognized yet.AIM To investigate the effects of stress factors(high glucose and severe hypoxia)on the biological characteristics of MSCs at different passages,in order to optimize the therapeutic applications of MSCs.METHODS In this study,we investigated the impact of two stress conditions;severe hypoxia and high glucose on human adipose-tissue derived MSCs(hAD-MSCs)at passages 6(P6),P8,and P10.Proliferation,senescence and apoptosis were evaluated measuring WST-1,senescence-associated beta-galactosidase,and annexin V,respectively.RESULTS Cells at P6 showed decreased proliferation and increased apoptosis under conditions of high glucose and hypoxia compared to control,while the extent of senescence did not change significantly under stress conditions.At P8 hAD-MSCs cultured in stress conditions had a significant decrease in proliferation and apoptosis and a significant increase in senescence compared to counterpart cells at P6.Cells cultured in high glucose at P10 had lower proliferation and higher senescence than their counterparts in the previous passage,while no change in apoptosis was observed.On the other hand,MSCs cultured under hypoxia showed decreased senescence,increased apoptosis and no significant change in proliferation when compared to the same conditions at P8.CONCLUSION These results indicate that stress factors had distinct effects on the biological processes of MSCs at different passages,and suggest that senescence may be a protective mechanism for MSCs to survive under stress conditions at higher passage numbers.
