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Jun 2016 DOI 10.14302/issn.2374-9431.jbd-15-647
Diabetes is a metabolic disorder that results in human body due to insulin deficiency, insulin resistance or both. In the management of diabetes, glucose monitoring technology has been used for the last three decades. The aim of this review article is to describe concise and organized information about different techniques of non-invasive continuous blood glucose monitoring. Many research groups have been working to develop wearable sensors for continuous blood glucose monitoring, but at present, there are to our knowledge no commercially successful non-invasive glucose monitors on the market. To achieve an acceptable sensor system, a glucose sensor should have accuracy better than 15mg/dl (0.8 mmol/l). In future development, continuous glucose sensor systems may become predictable, selective, reliable and acceptable for patient use.
Jan 2025 DOI 10.14302/issn.2694-2283.jsem-24-5363
Physiological performance may be limited by reduced systemic glucose availability to working muscles. Continuous glucose monitors (CGM) measure interstitial glucose every 1-15 minutes, offering a practical way to assess glucose during sporting activity. However, empirical research has predominantly focused on endurance-based sports, whereas glucose responses during professional competitive football matches remain unknown. This study evaluated the feasibility and utility of CGM in professional football. Eight professional, male outfield footballers from the English third tier participated in the study. Participants completed a 14-day food diary control period, followed by a 28-day observation period wearing CGM devices during six matches and sixteen training sessions. CGM devices remained in situ for 98% of training sessions and matches. Mean glucose concentrations were 6.5 ± 1.2 mmol/L during training sessions, 7.5 ± 2.1 mmol/L during match play, and 5.4 ± 0.3 mmol/L overnight. No significant differences were found between glucose concentrations during match play (p = 0.060) or training (p = 0.510), compared to overnight fasted glucose concentrations. There was also no difference between training and match-play glucose concentrations (p = 0.788). Glucose concentrations were highly individualised, with one player displaying minimal change throughout match play (-0.2 mmol/L) whereas another experienced increases of up to 5.8 mmol/L. Non-nutritional factors appeared to influence glucose concentrations; participants (n=3) who used nicotine pouches displayed an transient increase in blood glucose in the 10-55 minutes after administration. This study concludes that CGM use in professional football is feasible for assessing individual glucose responses to training and match-play.
Sep 2023 DOI 10.14302/issn.2576-9383.jhhr-23-4713
A global increase in incidence of chronic liver disease (CLD) indicated the necessity of dietary and lifestyle modification. Low glycemic index (GI) diet was reported to have a significant role in controlling diabetes caused by liver dysfunction. The International Standards Organisation (ISO) has standardized the determination of GI of a food in healthy individuals. This study aimed to estimate GI value of a high protein, energy dense liver nutritional supplement. This cross-over randomized controlled study randomly allotted 15 participants to consume either reference food 27.5 gm glucose (glucose monohydrate) or 77 gm nutritional supplement (equivalent to 25 gm of available carbohydrates); switching to another arm was done after 3 days wash-out period. After overnight fast, blood samples were collected at 15, 30, 45 and 60 minutes post-consumption of s upplement or reference food. The GI was calculated from the incremental area under the blood glucose response elicited by the nutritional supplement as a percentage of the response after consumption of 27.5 gm of glucose (glucose monohydrate) by the same participant using a standard formula. Mean GI of the nutritional supplementwas estimated as 11.4 ± 2.4.With the consumption of this nutritional supplement, the blood glucose levels were reduced at all postprandial time points, compared to the reference food. The liver nutritional supplement tested has a low GI, and comparatively slower and more sustained blood glucose response. Therefore, it can be used in patients with CLD to prevent CLD-associated metabolic complications and improve health outcomes and quality of life.
May 2022 DOI 10.14302/issn.2379-7835.ijn-22-4170
Garden egg nutritional values are numerous. However, few nutritional and epidemiological data exist on the impacts of garden egg consumption on diabetes control. In this experimentally-control designed nutritional study, the effects of scarlet garden egg species (Solanum aethiopicum L.) on lipoglycemic profile, weight control and, pancreas histoarchitecture in diabetic male Wistar rats were examined. Twenty-One adult male Wistar rats inducted with diabetes were randomly categorized into three groups (n = 7, each): Diabetic control (DC); Diabetic treated with aqueous extract of garden egg (DEE) and Diabetic fed with garden egg-supplemented diet (DSE). Animals were fed for six weeks according to the experimental design. Glycemic status and body weights were assessed twice weekly while lipid analysis was conducted at the entry and 6th week of the study. Oral glucose tolerance (OGT) test was conducted. Gross analysis and tissue histology of the pancreas were assessed by Hematoxylin and Eosin (H&E) staining technique. Statistical analysis was done using analysis of variance, and the results were expressed as mean ± S.E.M. at P < 0.05. Garden egg reduced mean body weight gain (DSE: 14.53%; DEE: 10.58%; P value = 0.04) and decreased blood glucose concentrations (DEE: 37.33%; DSE: 18.68%; P = 0.03) with corresponding improved lipid profile, glycemic tolerance and control (DEE > DSE) and, preserved pancreas histoarchitecture in diabetic Wistar rats. Solanum aethiopicum (garden egg) consumption (as fresh fruit or supplemented diet) preserves pancreatic tissue histoarchitecture and improves lipoglycemic profile and weight control in diabetic Wistar rats.
May 2022 DOI 10.14302/issn.2379-7835.ijn-22-4149
In Ethiopia stunting, underweight and wasting in school children are very common. The aim of this research was to evaluate the impact of intestinal helminthes and schistosomiasis on malnutrition, anaemia and haematological indices in the school age children of Azezo Elementary School in Gondar town. Kato Katz technique was performed to determine infection and intensity of intestinal helminth infections. AnthroPlus software version 1.04 was used to get malnutrition indices while fully automated haematological analyzers were used to determine haematological and biochemical parameters. A total of 384 school children were recruited in this study. The overall prevalence of helminth infection was 45.8% (178/384) with the leading Ascarislumbericoides infection (20.6%) compared to the second leading Schistosomamansoni (17.4%) and third leading hook worm infections (13.3%). The prevalences of body mass indexes for age Z-scores (BAZ) indices were 9.6% (37) very sever thin, 17.2% (66) sever thin, 38.3% (147) thin, 34.4% (132) normal and 0.5% (2) overweight. On the other hand, the prevalences of height for age Z-scores (HAZ) indices were 12.2% (47) stunt, 87% (334) normal and 0.8% (3) over height. Of the total 384 school age children, 335 (87.2%) had normal blood glucose level (70 – 110 mg/dL) while the remaining 49 (12.8%) school age children were hypoglycemic. The number of the school children with normal total protein level (6.6 – 8 g/dL) was 259 (67.4%) while the remaining 125 (32.6%) school children were hypo-proteinaemic. The prevalence of anemia in the school age children was 33.1% (127). Intestinal helminth infections were statistically significantly associated (p = 0.000) with hypo-proteinaemia, anemia and number of lymphocytes compared with non-infected school children. The likelihood of anemia in intestinal helminth infected school children, when it was compared with uninfected, was 148 times higher for both Ascaris lumbericoides-Schistosoma mansoni co-infection, 38 times for Hookworm, 20 times for Schistosoma mansoni and 3 times for Ascaris lumbericoides mono-infections. Conclusion: Intestinal helminth infections in school age children aggravate malnutrition. Prolonged malnutrition and intestinal helminth infections could result in stunting in school-age children.
Mar 2022 DOI 10.14302/issn.2638-4469.japb-22-4102
The safety of plant-derived bioactive compounds has become a global concern. The present study investigated the dose response of total saponins isolated from the stem bark of Dialiumguineense. Adultmale Wistar rats (n = 15) weighing 170 – 190 g (mean weight = 180 ± 10 g) were randomly assigned to three groups (5 rats per group). The rats received varied doses of total saponins isolated from the stem bark of the medicinal plant (50 - 150 mg/kg body weight, bwt) orally for a period of 9 days. The concentration of fasting blood glucose (FBG) was used as the therapeutic index.The results of the analysis revealed that total saponins isolated from the stem bark of D. guineense significantly reduced the Fasting Blood Glucose (FBG) levels of normal Wistar rats (p < 0.05). The graded and quantal dose-response curves showed that150 mg/kg bwt was effective in reducing the blood glucose of rats (produced the best hypoglycemic effect). The study concluded that total saponins isolated from the stem bark of D. guineense possesses hypoglycemic effect at a relatively good dose.
Dec 2020 DOI 10.14302/issn.2474-3585.jpmc-20-3672
Background Prevalence of Metabolic syndrome is high among Asians including Indians, and is high among those having sedentary occupations. Teaching is one of the important occupations, which demands no strenuous physical activity. However, there is little information available about the prevalence of metabolic syndrome among teaching staff of engineering college. Hence, the present study was conducted to study its prevalence, certain risk factors and co-morbidities among teaching staff of engineering institutes. Methods Teachers from engineering colleges of Nagpur city were the study subjects. Data was collected by interview technique. Clinical examination and laboratory investigations like Fasting blood glucose, High Density Lipoproteins and Serum Triglycerides were done. National Cholesterol Evaluation Programme (NCEP) Adult Treatment Panel Three (ATPIII) criteria were used to study Metabolic syndrome. Blood pressure and anthropometric measurements like height, weight and waist circumference were obtained by standard methods. Results The prevalence of metabolic syndrome was found to be 20.5%. It was 25.32% in females and 19.31% in males. It was more common in subjects of higher age group, muslim religion, and among widows and separated. Alcohol consumption, smoking and sedentary life style was found to be significantly associated with presence of metabolic syndrome. Frozen shoulder, fungal infection and stroke were common co morbidities found among subjects having metabolic syndrome.
Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3463
Background Evidence suggests that low birth weight (LBW) is associated with increased cardiovascular and metabolic risk in adulthood, including increased arterial stiffness, a marker of early vascular aging (EVA) assessable by pulse wave velocity (PWV), obesity and glucose homeostasis abnormalities. The present study aimed to explore the late impact of LBW on PWV and cardiometabolic phenotypes among young adult Cameroonians. Methods The study evaluated 120 subjects (mean age: 26 ± 5 years; 54% male sex) at the Cameroon Heart Institute, Douala, Cameroon, between January and June 2018. Birth weight (BW) and gestational age, sociodemographic, anthropometrics and fasting capillary blood glucose were recorded in all participants. Blood pressure (BP) and PWV were measured using an automatic oscillometric device (Mobil-O-Graph®). Multiple-adjusted linear regression was used to determine predictive factors for PWV. For assessment of potential impact of BW on EVA, PWV was adjusted for age, sex, body mass index (BMI) and mean arterial pressure (MAP). Results 28 participants (23.3%) of the study sample had LBW (<3000g). There was no gender difference between LBW or normal birth weight patients (NBW; controls). Age- and MAP-adjusted PWV (aPWV) were higher in women with LBW compared to NBW (5.6 m/s and 5.3 m/s respectively, P = 0.038). In men, aPWV was similar in LBW and NBW. In this study population, aPWV was higher (on average +15 cm/s) in LBW than in controls, although the difference was not statistically significant (P=0.083). Multivariate regression analysis showed age, male sex, BMI and MAP were independent determinants of PWV, but not LBW. Compared to NBW controls, the prevalence of overweight/obesity, impaired glucose homeostasis and diabetes was higher in LBW: 42.9% vs 37%; 10.7% vs 3.3%, and 3.6 % vs 1.1%, respectively. Moreover, compared with controls, LBW individuals who were overweight/obese in adulthood had a much higher mean fasting capillary glucose (1.54 ±0.17 g/l vs 0.87 ±0.11 g/l in NBW, p=0.003). Conclusion This study suggests that although LBW is associated with increased aortic stiffness in young adulthood, mainly in women, the association was predominantly driven by aging, MAP, BMI and male sex. In adulthood, LBW subjects exhibited higher obesity indices and altered glucose homeostasis.
Oct 2015 DOI 10.14302/issn.2470-5020.jnrt-15-726
Background: A higher incidence of symptomatic lacunar infarction (LI) was confirmed in metropolitan areas. The aim of this study was to determinethe prevalence characteristics and early predictors of LI in a population of elderly outpatients in northern China. Methods: From February 2011 to March 2012, a retrospective cohort of new patients was selected for study, all registered neurologic outpatients of the tertiary teaching hospital in northern China. A total of 453 outpatients, clinically only having had an initial visit and a magnetic resonance imaging study of the brain, were enrolled. The prevalence characteristics and vascular risk factors of LI were assessed. Results: Of 453 symptomatic outpatients, 258(57.0%) patients had symptomatic LI. We found that the main types of symptomatic LI were nonfocal symptoms, such as dizziness and headache, dizziness/vertigo, and migraine/headache. Age, BMI, smoking, history of hypertension, duration of hypertension, existing hypertension, headache and dizziness, pure motor hemiparesis, blood glucose, hypercholesterolemia, systolic blood pressure, and ABCD2 score, were significantly higher in patients with LI than in those without LI (P<0.05). Multivariate logistic regression confirmed that hypertension ≥3years in duration (odds ratio=1.092; 95% CI, 1.019 -1.170) and a median mABCD2 score ≥4 (odds ratio=3.912; 95% CI, 2.955- 5.180) were independent, early predictors of symptomatic LI. Conclusions: The incidence of LI in Northern China was located at the higher end of range in northern China, and common type of symptomatic LI was nonfocal symptoms. Hypertension of long duration and high-risk ABCD2 scores are early predictors of symptomatic LI.
May 2014 DOI 10.14302/issn.2374-9431.jbd-13-283
Continuous-time glucose monitoring (CGM) effectively improves glucose control, as oppose to infrequent glucose measurements (i.e. using Lancet Meters), by providing frequent blood glucose concentration (BGC) to better associate this variation with changes in behavior. Currently, the most widely used CGM devices rely on a sensor that is inserted invasively under the skin. Because of the invasive nature and also the replacement cost of sensors, the primary users of current CGM devices are insulin dependent people (type 1 and some type 2 diabetics). Most non-insulin dependent diabetics use only lancet glucose measurements. The ultimate goal of this research is the development of CGM technology that overcomes these limitations (i.e. invasive sensors and their cost) in an effort to increase CGM applications among non-insulin dependent people. To meet this objective, this preliminary work has developed a methodology to mathematically infer BGC from measurements of non-invasive input variables which can be thought of as a “virtual” or “soft” sensor approach. In this work virtual sensors are developed and evaluated on 20 subjects using four BGC measurements per day and eight input variables representing meals, activity, stress, and clock time. Up to four weeks of data are collected for each subject. One evaluation consists of 3 days of training and up to 25 days of testing data. The second one consists of one week of training, one week of validation, and 2 weeks of testing data. The third one consists two weeks of training, one week of validation and one week of testing data. Model acceptability is determined on an individual basis based on the fitted correlation to CGM testing data. For 3 day, 1 week, and 2 weeks training studies, 35%, 55% and 65% of the subjects, respectively, met the Acceptability Criteria that we established based on the concept of usefulness.
Nov 2013 DOI 10.14302/issn.2329-9487.jhc-12-154
Objective: To determine whether age at menarche is an independent predictor of common carotid artery intima-media thickness in overweight and obese adult women. Methods: 403 overweight and obese women, aged 18–72 years, were evaluated. We examined the associations among common carotid artery intima-media thickness (CCA-IMT), age at menarche, body mass index, central fat accumulation (indirectly measured by waist circumference), and other well-known cardiovascular risk factors (blood pressure; fasting serum insulin, glucose and lipids concentrations; insulin resistance (estimated by homeostasis model assessment for insulin resistance)). Results: CCA-IMT was significantly and positively correlated with age (r=0.632, p<0.001), age of menarche (r=0.156, p<0.01), waist circumference (r=0.110, p<0.05), systolic (r=0.292, p<0.001) and diastolic (r=0.183, p<0.001) blood pressure, fasting blood glucose (r=0.265, p<0.001), triglycerides (r=0.204, p<0.001) and total cholesterol (r=0.396, p<0.001) levels. Conversely, CCA-IMT was negatively associated with high-density lipoprotein cholesterol (r=-0.111, p<0.05). Age at menarche was associated with CCA-IMT (r=0.156, p<0.01), age (r=0.110, p<0.05) and waist circumference (r=0.121, p<0.05). Multiple linear analysis showed that only age and age at menarche maintained an independent positive relationship with the CCA-IMT. Conclusions: Age at menarche is positively associated with CCA-IMT, independently of common cardiovascular risk factors (adverse glucose and lipid levels, higher blood pressure,insulin resistance, body fatness and central body fat). Late age at menarche can be considered as an independent cardiovascular risk factor in obese subjects.