The oral glucose tolerance test(OGTT)has been widely used both in clinics and in basic research for a long time.It is applied to diagnose impaired glucose tolerance and/or type 2 diabetes mellitus in individuals.Addit...The oral glucose tolerance test(OGTT)has been widely used both in clinics and in basic research for a long time.It is applied to diagnose impaired glucose tolerance and/or type 2 diabetes mellitus in individuals.Additionally,it has been employed in research to investigate glucose utilization and insulin sensitivity in animals.The main aim of each was quite different,and the details are also somewhat varied.However,the time or duration of the OGTT was the same,using the 2-h post-glucose load glycemia in both,following the suggestions of the American Diabetes Association.Recently,the use of 30-min or 1-h post-glucose load glycemia in clinical practice has been recommended by several studies.In this review article,we describe this new view and suggest perspectives for the OGTT.Additionally,quantification of the glucose curve in basic research is also discussed.Unlike in clinical practice,the incremental area under the curve is not suitable for use in the studies involving animals receiving repeated treatments or chronic treatment.We discuss the potential mechanisms in detail.Moreover,variations between bench and bedside in the application of the OGTT are introduced.Finally,the newly identified method for the OGTT must achieve a recommendation from the American Diabetes Association or another official unit soon.In conclusion,we summarize the recent reports regarding the OGTT and add some of our own perspectives,including machine learning and others.展开更多
BACKGROUND Women with gestational diabetes mellitus(GDM)are at a seven-fold higher risk of developing type 2 diabetes(T2D)within 7-10 years after childbirth,compared with those with normoglycemic pregnancy.Although ra...BACKGROUND Women with gestational diabetes mellitus(GDM)are at a seven-fold higher risk of developing type 2 diabetes(T2D)within 7-10 years after childbirth,compared with those with normoglycemic pregnancy.Although raised fasting blood glucose(FBG)levels has been said to be the main significant predictor of postpartum progression to T2D,it is difficult to predict who among the women with GDM would develop T2D.Therefore,we conducted a cross-sectional retrospective study to examine the glycemic indices that can predict postnatal T2D in Emirati Arab women with a history of GDM.AIM To assess how oral glucose tolerance test(OGTT)can identify the distinct GDM pathophysiology and predict possible distinct postnatal T2D subtypes.METHODS The glycemic status of a cohort of 4603 pregnant Emirati Arab women,who delivered in 2007 at both Latifa Women and Children Hospital and at Dubai Hospital,United Arab Emirates,was assessed retrospectively,using the International Association of Diabetes and Pregnancy Study Groups(IADPSG)criteria.Of the total,1231 women were followed up and assessed in 2016.The FBG and/or the 2-h blood glucose(2hrBG)levels after a 75-g glucose load were measured to assess the prevalence of GDM and T2D,according to the IADPSG and American Diabetes Association(ADA)criteria,respectively.The receiver operating characteristic curve for the OGTT was plotted and sensitivity,specificity,and predictive values of FBG and 2hrBG for T2D were determined.RESULTS Considering both FBG and 2hrBG levels,according to the IADPSG criteria,the prevalence of GDM in pregnant Emirati women in 2007 was 1057/4603(23%),while the prevalence of pre-pregnancy T2D among them,based on ADA criteria,was 230/4603(5%).In the subset of women(n=1231)followed up in 2016,the prevalence of GDM in 2007 was 362/1231(29.6%),while the prevalence of prepregnancy T2D was 36/1231(2.9%).Of the 362 pregnant women with GDM in 2007,96/362(26.5%)developed T2D;142/362(39.2%)developed impaired fasting glucose;29/362(8.0%)developed impaired glucose tolerance,and the remaining 95/362(26.2%)had normal glycemia in 2016.The prevalence of T2D,based on ADA criteria,stemmed from the prevalence of 36/1231(2.9%)in 2007 to 141/1231(11.5%),in 2016.The positive predictive value(PPV)for FBG suggests that if a woman tested positive for GDM in 2007,the probability of developing T2D in 2016 was approximately 24%.The opposite was observed when 2hrBG was used for diagnosis.The PPV value for 2hrBG suggests that if a woman was positive for GDM in 2007 then the probability of developing T2D in 2016 was only 3%.CONCLUSION FBG and 2hrBG could predict postpartum T2D,following antenatal GDM.However,each test reflects different pathophysiology and possible T2D subtype and could be matched with a relevant T2D prevention program.展开更多
BACKGROUND Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive.Furthermore,limited data are available on the reproducibi...BACKGROUND Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive.Furthermore,limited data are available on the reproducibility of the oral glucose tolerance test(OGTT)in children and adolescents who are obese(OB).AIM To investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.METHODS Eighty-one children and adolescents,41 females,either overweight(OW),OB or normal weight(NW)but with a strong positive family history of type 2 diabetes mellitus(T2DM),were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece.One or two 3-h OGTTs were performed and glucose,insulin and Cpeptide concentrations were measured at several time points(t=0 min,t=15 min,t=30 min,t=60 min,t=90 min,t=120 min,t=180 min).RESULTS Good repetitiveness was observed in the OGTT response with regard to T2DM,while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance(IGT)and no repetitiveness with regard to impaired fasting glucose(IFG).In addition,no concordance was observed between IFG and IGT.During the 1st and 2nd OGTTs,no significant difference was found in the glucose concentrations between NW,OW and OB patients,whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs.Also,OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.CONCLUSION In mild or moderate disorders of glucose metabolism,such as IFG and IGT,a diagnosis may not be reached using only one OGTT,and a second test or additional investigations may be needed.When glucose metabolism is profoundly impaired,as in T2DM,one OGTT is probably more reliable and adequate for establishing the diagnosis.Excessive weight and/or a positive family history of T2DM possibly affect the insulin and C-peptide response in the OGTT from a young age.展开更多
The possibility of the 2 h oral glucose tolerance test(OGTT)as an alternative to the 3 h OGTT was investigated based on data from a national survey on pregnancy-associated diabetes.Data were retrieved from 4179 pregna...The possibility of the 2 h oral glucose tolerance test(OGTT)as an alternative to the 3 h OGTT was investigated based on data from a national survey on pregnancy-associated diabetes.Data were retrieved from 4179 pregnant women who had OGTT performed after an abnormal 50 g glucose challenge test(GCT).All of the 4 glucose levels during their OGTT were collected and analyzed.According to American Diabetes Association(ADA)gestational diabetes mellitus(GDM)diagnostic criteria,among the 4179 pregnant women who required OGTT,3429(82.1%)were normal and 750(17.9%)were diagnosed as GDM.If the 3rd h glucose levels were omitted from OGTT,79 cases of GDM(10.5%)would be overlooked.No trend was shown where women with more risk factors were more likely to be overlooked if the 3rd h test was omitted(χ^(2) for trend=0.038,P>0.05).No significant differences were found in the rate of cesarean section(CS),preterm births or macrosomia between the 79 cases and those with normal OGTT results and in the gestational weeks when OGTT was performed.It shows that in order to diagnose one woman with GDM,another 52 pregnant women would have an innocent 3rd h glucose test.Omission of the 3rd h glucose test in OGTT might be reasonable due to its convenience,better compliance and a small number of possibly miss-diagnosed cases,and their pregnancy outcomes have no significant difference from those of normal pregnant women.展开更多
Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gesta...Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.展开更多
Background:One-hour postprandial hyperglycemia is associated with increased risk of type 2 diabetes and cardiovascular disease.Physical activity(PA)has short-term beneficial effects on post-meal glucose response.This ...Background:One-hour postprandial hyperglycemia is associated with increased risk of type 2 diabetes and cardiovascular disease.Physical activity(PA)has short-term beneficial effects on post-meal glucose response.This study compared the oral glucose tolerance test results of 3 groups of people with habitually different levels of PA.Methods:Thirty-one adults without diabetes(age 25.9±6.6 years;body mass index 23.8±3.8 kg/m^2;mean±SD)were recruited and divided into 3 groups based on self-reported PA volume and intensity:low activity<30 min/day of moderate-intensity activity(n=11),moderately active≥30 min/day of moderate-intensity PA(n=10),and very active≥60 min/day of PA at high intensity(n=10).Participants completed an oral glucose tolerance test(50 g glucose)with capillary blood samples obtained at baseline,15 min,30 min,45 min,60 min,90 min,and 120 min post-ingestion.Results:There were no significant differences between groups for age or body fat percentage or glycated hemoglobin(p>0.05).The groups were significantly different in terms of baseline glucose level(p=0.003)and,marginally,for gender(p=0.053)and BMI(p=0.050).There was a statistically significant effect of PA on the 1-h postprandial glucose results(p=0.029),with differences between very active and low activity groups(p=0.008)but not between the moderately active and low activity groups(p=0.360),even when baseline glucose level and gender differences were accounted for.For incremental area under the curve there was no significant effect of activity group once gender and body fat percentage had been accounted for(p=0.401).Those in the low activity group took 15 min longer to reach peak glucose level than those in the very active group(p=0.012).Conclusion:The results suggest that high levels of PA have a beneficial effect on postprandial blood glucose profiles when compared to low and moderate levels of activity.展开更多
Background: Nonalcoholic fatty liver disease(NAFLD) was recently proposed to be renamed metabolic dysfunction-associated fatty liver disease(MAFLD) with the diagnostic criteria revised. We investigated the similaritie...Background: Nonalcoholic fatty liver disease(NAFLD) was recently proposed to be renamed metabolic dysfunction-associated fatty liver disease(MAFLD) with the diagnostic criteria revised. We investigated the similarities and differences in the prevalence and clinical characteristics of MAFLD and NAFLD in Chinese adults. Methods: A cross-sectional study of 9980 Chinese individuals aged 40 years or older was performed between 2011 and 2012 using randomized, stratifed cluster sampling in Shanghai, China. A detailed questionnaire and the results of abdominal ultrasonography, a standardized 2-h 75-g oral glucose tolerance test and blood biochemical examinations were collected. Results: A total of 9927 subjects were included in this study. The prevalence of MAFLD(40.3%) was significantly higher than that of NAFLD(36.9%)( P < 0.05). MAFLD was highly prevalent in type 2 diabetes mellitus(T2DM)(53.8%), impaired fasting glucose(35.7%) and impaired glucose tolerance(40.9%). High risk of advanced fbrosis based on fbrosis-4 was highly prevalent(14.7%) in lean MAFLD with T2DM. Among 9927 subjects, 3481(35.1%) fulflled the diagnostic criteria for MAFLD and NAFLD(MAFLD + NAFLD +), 521(5.2%) MAFLD + NAFLD-, and 181(1.8%) MAFLD-NAFLD +. The MAFLD + NAFLD-group had more signifcant metabolic disorders than those in the MAFLD + NAFLD + group(all P < 0.05). Among MAFLD-NAFLD + subjects, 82.9% had metabolic disorders. Conclusions: The new defnition of MAFLD may better reflect the pathogenesis related to metabolism. Future research should focus on studying the natural history, pathogenesis and treatment effectivity of the overlap and non-overlap of NAFLD and MAFLD subjects.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PA...BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PAPP-A),triglyceride(TG),and 25-hydroxyvitamin D[25-(OH)D]with GDM in early pregnancy.METHODS A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included,and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy.Of these cases with GDM,51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B.Serum PAPP-A,TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed.In addition,their diagnostic value in GDM was determined using receiver operating characteristic(ROC)curve analysis.RESULTS Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B,with statistical significance(P<0.05).Furthermore,Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose(FBG)levels(r=-0.605,P<0.001),(r=-0.597,P<0.001),while TG and FBG levels were positively correlated(r=0.628,P<0.001).The sensitivity,specificity,area under the curve(AUC)and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%,82.35%,0.861 and 16.340,respectively,while the sensitivity of TG in diagnosing GDM was 86.27%,the specificity was 66.67%,the AUC was 0.813,with an optimal cut-off value of 1.796.The corresponding sensitivity,specificity,AUC and optimal cut-off value of serum 25-(OH)D were 64.71%,70.59%,0.721 and 23.140,respectively.Moreover,multivariate logistic regression analysis revealed that FBG,vascular endothelial growth factor,Flt-1,serum PAPP-A,TG,and 25-(OH)D were related risk factors leading to GDM in patients.CONCLUSION Serum PAPP-A,TG,and 25-(OH)D levels are all correlated with blood glucose changes in GDM,and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.展开更多
Objective:To investigate the antidiabetic activity of Ocimum tenuiflorum L.(O.tenuiflorum) leaves used in the traditional medicine management of diabetes in Malaysia.Methods:O.tenuiflorum leaves were extracted sequent...Objective:To investigate the antidiabetic activity of Ocimum tenuiflorum L.(O.tenuiflorum) leaves used in the traditional medicine management of diabetes in Malaysia.Methods:O.tenuiflorum leaves were extracted sequentially with hexane,chloroform,ethyl acetate,methanol,and water.The extracts were evaluated in terms of antidiabetic activity by using acute,subcutaneous glucose tolerance,and sub-chronic tests in streptozotocininduced diabetic rats.The extracts were also subjected to phytochemical analyses.Results:With an acute dose(1 g/kg),the methanol extracts showed significant reduction(31%) in fasting blood glucose(FBG) of the streptozotocin-induced diabetic rats.The FBG-decreasing effect of ethyl acetate extract was more rapid than that of the other extracts;the decreasing rates were 20%after 2 h,21%after 3 h,and 8%after 5 and 7 h.After 7 h(31%),the effect of methanol extract on FBG was significantly lower than that of metformin.In the subcutaneous glucose tolerance test,only methanol and hexane extracts showed the similarity of metformin in diabetic rats.After 14 days,the effects of these extracts were similar to those of metformin(63.33%).The total flavonoid and phenolic contents of extracts decreased as the polarity of the extraction solvent increased.Conclusions:The results obtained provide support for a possible use of O.tenuiflorum leaves in managing hyperglycemia and preventing the complications associated with it in type 2 diabetic.展开更多
AIM:To investigate the postprandial response of bone turnover markers in patients with Crohn’s disease(CD).METHODS:Fifty nine patients with CD aged 38±14years,and 45 healthy individuals matched for age and body ...AIM:To investigate the postprandial response of bone turnover markers in patients with Crohn’s disease(CD).METHODS:Fifty nine patients with CD aged 38±14years,and 45 healthy individuals matched for age and body mass index were included in the study.All participants underwent an oral glucose tolerance test(OGTT)after an overnight fast and serum levels of the bone resorption marker C-terminal crosslinking telopeptide of type?Ⅰ?collagen(CTX-Ⅰ)and the bone formation marker procollagen type?Ⅰ?N propeptide were measured.Activity of the disease was assessed by calculation of the Crohn’s disease activity index(CDAI).RESULTS:Serum CTX-I was significantly higher in patients compared to controls(CTX-I:453±21 pg/mL vs 365±25 pg/mL,P=0.008),and values were significantly correlated with the activity of the disease(r=0.435,P=0.001).Results from OGTT-induced suppression of CTX-I showed two different trends.Patients with more active disease(assessed as CDAI>150)had a more excessive suppression of CTX-I compared to controls(55%vs 43%P<0.001),while patients on remission(assessed as CDAI<150)demonstrated an attenuated CTX-I suppression(30%vs 43%P<0.001).In line with this,CTX-I suppression after oral glucose load was significantly correlated with the activity of the disease(r=0.913,P<0.001).CONCLUSION:The physiological skeletal response of postprandial suppression of bone resorption is maintained in patients with CD and is strongly dependent to the activity of the disease.展开更多
BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the r...BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly diagnosed.AIM To estimate the impact of the World Health Organization(WHO)2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy outcomes.METHODS We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically applied.Women were categorized into four groups:non-GDM by both criteria,GDM by WHO 1999 only(excluded from GDM),GDM by WHO 2013 only(newly diagnosed)and GDM by both criteria.We compared maternal characteristics,pregnancy outcomes and likelihood ratios for adverse pregnancy outcomes.RESULTS Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%,from 19.3%to 32.4%.Discordant diagnoses occurred in 21.3%;4.1%would no longer be labelled as GDM,and 17.2%were newly diagnosed.Compared to the non-GDM group,women newly diagnosed were older,had higher rates of obesity,higher diastolic blood pressure and higher rates of caesarean deliveries.Their infants were more often delivered preterm,large-for-gestational-age and were at higher risk of a 5 min Apgar score<7.Women excluded from GDM were older and had similar pregnancy outcomes compared to the non-GDM group,except for higher rates of shoulder dystocia(4.3%vs 1.3%,P=0.015).Positive likelihood ratios for adverse outcomes in all groups were generally low,ranging from 0.54 to 2.95.CONCLUSION Applying the WHO 2013 criteria would result in a substantial increase in GDM diagnoses.Newly diagnosed women are at increased risk for pregnancy adverse outcomes.This risk,however,seems to be lower than those identified by the WHO 1999 criteria.This could potentially influence the treatment effect that can be achieved in this group.Evidence on treatment effects in newly diagnosed women is urgently needed.展开更多
<strong>Aim</strong>: Evaluation of the occurrence of glucose intolerance after 34 - 36 weeks in pregnant mothers attending the Teaching Hospital, Peradeniya. <strong>Materials & Method</stron...<strong>Aim</strong>: Evaluation of the occurrence of glucose intolerance after 34 - 36 weeks in pregnant mothers attending the Teaching Hospital, Peradeniya. <strong>Materials & Method</strong>: This is a descriptive cross-sectional study carried out from October 2017 to March 2018 among 183 pregnant mothers attending antenatal clinic at Teaching Hospital Peradeniya. After informed consent a repeat Oral Glucose Tolerance Test (OGTT) was done among the pregnant mothers, at period of amenorrhoea of 34 - 36 weeks, whose initial OGTT values were normal. Gestational diabetes was diagnosed according to the NICE guideline cut off values and the percentage of late occurrence of Gestational diabetes (GDM) was analyzed. <strong>Results</strong>: Mean age of the population was 29.1 years and the age range in this group was 18 to 45 years and the majority (73.9%) of women were primipara. There were 3.3% of teenage pregnancies and 14% of mothers were over 35 years. Majority (59.7%) of mothers underwent repeat OGTT test at 34 weeks of gestation and the rest (40.3%) underwent test between 34 to 36 weeks of gestation. Although the mean BMI was 23.74, 9.7% of mothers were obese (>30 kg/m2), 30.3% of mothers were pre-obese (25.0 - 29.9 kg/m2). 8.2% of mothers were diagnosed with Gestational diabetes at 34 - 36 weeks whose initial OGTT values were normal.<strong> Conclusion</strong>: In view of reducing feto-maternal morbidity and mortality, considering a repeat OGTT at a later gestation (34 - 36 weeks of gestation) should be considered in mothers, whose initial OGTT values are normal as Sri Lanka is a high risk country for GDM. <strong>Clinical Significance</strong>: The study may play an important role in guideline alteration process and screening for gestational diabetes in Sri Lankan set-up.展开更多
Background:Yu-Ye decoction is a classic prescription therapy that is widely used in the treatment of type 2 diabetes mellitus(T2DM).In this study,we evaluate and exhibit the protective effect of modified Yu-Ye decocti...Background:Yu-Ye decoction is a classic prescription therapy that is widely used in the treatment of type 2 diabetes mellitus(T2DM).In this study,we evaluate and exhibit the protective effect of modified Yu-Ye decoction on T2DM rats.Methods:Sixty rats with T2DM were included in this study that was induced by high-fat high-glucose diet for 6 weeks.following 6 weeks later,1%streptozotocin 30 mg/kg was injected intraperitoneally,and the T2DM rats were randomly divided into the model group,the metformin(90 mg/kg)positive control group,and the modified Yu-Ye decoction(6.4 g/kg,12.7 g/kg,25.4 g/kg)group.In contrast,standard chow was provided to the 10 rats in the control group.The drug was administered for four weeks,and fasting blood glucose was monitored.After four weeks of treatment,oral glucose tolerance test experiments were carried out.Serum was collected for the detection of alanine aminotransferase,aspartate aminotransferase,creatinine,blood urea nitrogen,low density lipoprotein,high density lipoprotein,and total cholesterol,triglyceride.Hematoxylin-eosin staining was used to assess potential pathological changes in the liver,kidneys,and pancreas.Results:Results from fasting blood glucose monitoring and oral glucose tolerance test showed that modified Yu-Ye decoction could significantly improve the blood glucose concentration and insulin resistance,compared to the model group.In addition,modified Yu-Ye decoction could significantly reduce the serum levels of alanine aminotransferase,aspartate aminotransferase,creatinine,blood urea nitrogen,low density lipoprotein,total cholesterol,triglyceride,and increase the level of high density lipoprotein.At the same time,hematoxylin-eosin results exhibited that modified Yu-Ye decoction could increase the number of islet cells,reduce the volume of islet cells,improve liver edema and inflammation,and improve renal glomerular hypertrophy.Conclusion:This study shows that modified Yu-Ye decoction ameliorates T2DM because it can reduce fasting blood glucose concentration,improve glucose tolerance,protect liver and kidney function,and improve livers,kidneys,and pancreas tissue morphology.展开更多
Objective:To investigate the therapeutic effects of ethyl acetate extract of Mallotus repandus stem in α-amylase inhibitory activity(in vitro)and hypoglycemic activity in normal and glucose induced hyperglycemic rats...Objective:To investigate the therapeutic effects of ethyl acetate extract of Mallotus repandus stem in α-amylase inhibitory activity(in vitro)and hypoglycemic activity in normal and glucose induced hyperglycemic rats(in vivo).Methods:Ethyl acetate extract of Mallotus repandus stem was tested for the presence of phytochemical constituents,α-amylase inhibitory activity and hypoglycemic effect in normal rats and glucose induced hyperglycemic rats.Results:Presence of different types of phytochemicals was identified in the extract.The extract has moderate α-amylase inhibitory activity[IC_(50)=(2.038±0.033)mg/mL]as compared to acarbose.The does 1000 mg/kg significantly reduced(P<0.0100)fasting blood glucose level in normal rats.In oral glucose tolerance test,both 1000 and 2000 mg/kg doses showed good hypoglycemic activity(P<0.0001)like glibenclamide in each specific hour after administration.Overall time effect in oral glucose tolerance test was found extremely significant(P<0.0001)with F(3,48)value=202.4.Conclusions:These findings suggest that this plant may be a potential source for the development of new oral hypoglycemic agent.展开更多
Total macromolecule extract was obtained from the soft body of Mactra veneriformis by the coupling techniques of decoction and alcohol precipitation.The extract was deproteinized with an ion exchange column,and result...Total macromolecule extract was obtained from the soft body of Mactra veneriformis by the coupling techniques of decoction and alcohol precipitation.The extract was deproteinized with an ion exchange column,and resulted in the purifying of the crude polysaccharide fraction.It was found by chemical analysis that the crude polysaccharide part is composed of abundant polysacchar-ides(>95%)and few proteins(<1%).Furthermore,only one type of monosaccharide,glucose,was detected from its hydrolytes by thin-layer chromatography,indicating that the polysaccharides might be analogs of glucosan.The anti-hyperglycemia effects of the crude polysaccharide part were preliminarily investigated using several pharmacolo-gical methods in normal and diabetic mice.Animal experimental results showed that the crude polysaccharide fraction exhibited proper glycemia inhibition activity,and 300 mg/kg-weight dose has the optimal effect among all the studied doses.It is concluded that the crude polysaccharide fraction can be explored as a novel health product that possesses potential as an anti-hyperglycemic agent.展开更多
The aim of this paper is to investigate the clin-ical features and transformation of elderly male patients with normal blood glucose levels at fasting and 2 hours after glucose intake but with hyperglycemia(>11.1 m...The aim of this paper is to investigate the clin-ical features and transformation of elderly male patients with normal blood glucose levels at fasting and 2 hours after glucose intake but with hyperglycemia(>11.1 mmol/L)1 hour after oral glucose tolerance test(OGTT-1h HG).Seven years of follow-up visits were per-formed on 189 elderly male outpatients with OGTT-1h HG and data was recorded on their body mass index(BMI),blood pressure,serum cholesterol and triglyceride test results and on their glucose tolerance changes every 1–2 years after taking OGTT;their possible causes were analysed.Follow-up visits revealed that 19 patients with OGTT-1h HG were diagnosed with diabetes(10.1%),78 patients with impaired glucose tolerance(IGT,41.3%),2 patients transformed to normal glucose tolerance(NGT,1.1%)and the remaining 90 patients(47.6%)remained unchanged.Synchronized comparison with IGT patients showed that the ratio of OGTT-1h HG patients turning to diabetes was lower than that of IGT patients(21.1%,x2513.05,P,0.01),and the ratio of OGTT-1h HG patients transforming to NGT was slightly higher(0.4%,x252.46,P.0.05).The prevalence of complications of hypertension,coronary heart disease,cerebral vascular diseases and dyslipidemia in patients with OGTT-1h HG were higher than those with NGT(P,0.05)and were similar to that of IGT patients.As a special phenotype of OGTT and as part of an abnormal glucose tolerance con-formation,patients with OGTT-1h HG warrant special attention,since about half of them were found to have developed diabetes or IGT,and their risk of suffering from vascular diseases were also increased.展开更多
Diet plays an important role in diabetes development.The effect of ketogenic diet on type 2 diabetes remains elusive.In this study,we collect diabetes related physiological parameters and abdominal MRI images to evalu...Diet plays an important role in diabetes development.The effect of ketogenic diet on type 2 diabetes remains elusive.In this study,we collect diabetes related physiological parameters and abdominal MRI images to evaluate the effect of ketogenic diet after 3-months of consecutive treatment.Ketogenic diet mitigates the diabetes symptom inferring from the statistically significant reduction of key diabetic physiological parameters such as Hemoglobin A1c(HbA1c)concentration,Triglyceride(TG),Fasting blood glucose(FBG),Body Mass Index(BMI),and adipose tissue volume.Moreover,we propose a new parameter to quantify the treating effect of ketogenic diet since Slope and Offset of Oral Glucose Tolerance Test(SOOGTT)incorporate more sampling points by fitting OGTT(Oral Glucose Tolerance Test)curve.SOOGTT shows statistically significant(P<0.001)treating effect of ketogenic diet on type 2 diabetes.We use artificial intelligence to segment adipose tissue for treatment evaluation,which shows that ketogenic diet reduces the amount of adipose tissue.展开更多
文摘The oral glucose tolerance test(OGTT)has been widely used both in clinics and in basic research for a long time.It is applied to diagnose impaired glucose tolerance and/or type 2 diabetes mellitus in individuals.Additionally,it has been employed in research to investigate glucose utilization and insulin sensitivity in animals.The main aim of each was quite different,and the details are also somewhat varied.However,the time or duration of the OGTT was the same,using the 2-h post-glucose load glycemia in both,following the suggestions of the American Diabetes Association.Recently,the use of 30-min or 1-h post-glucose load glycemia in clinical practice has been recommended by several studies.In this review article,we describe this new view and suggest perspectives for the OGTT.Additionally,quantification of the glucose curve in basic research is also discussed.Unlike in clinical practice,the incremental area under the curve is not suitable for use in the studies involving animals receiving repeated treatments or chronic treatment.We discuss the potential mechanisms in detail.Moreover,variations between bench and bedside in the application of the OGTT are introduced.Finally,the newly identified method for the OGTT must achieve a recommendation from the American Diabetes Association or another official unit soon.In conclusion,we summarize the recent reports regarding the OGTT and add some of our own perspectives,including machine learning and others.
基金Supported by the Al Jalila Foundation,No.AJF201545.
文摘BACKGROUND Women with gestational diabetes mellitus(GDM)are at a seven-fold higher risk of developing type 2 diabetes(T2D)within 7-10 years after childbirth,compared with those with normoglycemic pregnancy.Although raised fasting blood glucose(FBG)levels has been said to be the main significant predictor of postpartum progression to T2D,it is difficult to predict who among the women with GDM would develop T2D.Therefore,we conducted a cross-sectional retrospective study to examine the glycemic indices that can predict postnatal T2D in Emirati Arab women with a history of GDM.AIM To assess how oral glucose tolerance test(OGTT)can identify the distinct GDM pathophysiology and predict possible distinct postnatal T2D subtypes.METHODS The glycemic status of a cohort of 4603 pregnant Emirati Arab women,who delivered in 2007 at both Latifa Women and Children Hospital and at Dubai Hospital,United Arab Emirates,was assessed retrospectively,using the International Association of Diabetes and Pregnancy Study Groups(IADPSG)criteria.Of the total,1231 women were followed up and assessed in 2016.The FBG and/or the 2-h blood glucose(2hrBG)levels after a 75-g glucose load were measured to assess the prevalence of GDM and T2D,according to the IADPSG and American Diabetes Association(ADA)criteria,respectively.The receiver operating characteristic curve for the OGTT was plotted and sensitivity,specificity,and predictive values of FBG and 2hrBG for T2D were determined.RESULTS Considering both FBG and 2hrBG levels,according to the IADPSG criteria,the prevalence of GDM in pregnant Emirati women in 2007 was 1057/4603(23%),while the prevalence of pre-pregnancy T2D among them,based on ADA criteria,was 230/4603(5%).In the subset of women(n=1231)followed up in 2016,the prevalence of GDM in 2007 was 362/1231(29.6%),while the prevalence of prepregnancy T2D was 36/1231(2.9%).Of the 362 pregnant women with GDM in 2007,96/362(26.5%)developed T2D;142/362(39.2%)developed impaired fasting glucose;29/362(8.0%)developed impaired glucose tolerance,and the remaining 95/362(26.2%)had normal glycemia in 2016.The prevalence of T2D,based on ADA criteria,stemmed from the prevalence of 36/1231(2.9%)in 2007 to 141/1231(11.5%),in 2016.The positive predictive value(PPV)for FBG suggests that if a woman tested positive for GDM in 2007,the probability of developing T2D in 2016 was approximately 24%.The opposite was observed when 2hrBG was used for diagnosis.The PPV value for 2hrBG suggests that if a woman was positive for GDM in 2007 then the probability of developing T2D in 2016 was only 3%.CONCLUSION FBG and 2hrBG could predict postpartum T2D,following antenatal GDM.However,each test reflects different pathophysiology and possible T2D subtype and could be matched with a relevant T2D prevention program.
文摘BACKGROUND Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive.Furthermore,limited data are available on the reproducibility of the oral glucose tolerance test(OGTT)in children and adolescents who are obese(OB).AIM To investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.METHODS Eighty-one children and adolescents,41 females,either overweight(OW),OB or normal weight(NW)but with a strong positive family history of type 2 diabetes mellitus(T2DM),were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece.One or two 3-h OGTTs were performed and glucose,insulin and Cpeptide concentrations were measured at several time points(t=0 min,t=15 min,t=30 min,t=60 min,t=90 min,t=120 min,t=180 min).RESULTS Good repetitiveness was observed in the OGTT response with regard to T2DM,while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance(IGT)and no repetitiveness with regard to impaired fasting glucose(IFG).In addition,no concordance was observed between IFG and IGT.During the 1st and 2nd OGTTs,no significant difference was found in the glucose concentrations between NW,OW and OB patients,whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs.Also,OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.CONCLUSION In mild or moderate disorders of glucose metabolism,such as IFG and IGT,a diagnosis may not be reached using only one OGTT,and a second test or additional investigations may be needed.When glucose metabolism is profoundly impaired,as in T2DM,one OGTT is probably more reliable and adequate for establishing the diagnosis.Excessive weight and/or a positive family history of T2DM possibly affect the insulin and C-peptide response in the OGTT from a young age.
文摘The possibility of the 2 h oral glucose tolerance test(OGTT)as an alternative to the 3 h OGTT was investigated based on data from a national survey on pregnancy-associated diabetes.Data were retrieved from 4179 pregnant women who had OGTT performed after an abnormal 50 g glucose challenge test(GCT).All of the 4 glucose levels during their OGTT were collected and analyzed.According to American Diabetes Association(ADA)gestational diabetes mellitus(GDM)diagnostic criteria,among the 4179 pregnant women who required OGTT,3429(82.1%)were normal and 750(17.9%)were diagnosed as GDM.If the 3rd h glucose levels were omitted from OGTT,79 cases of GDM(10.5%)would be overlooked.No trend was shown where women with more risk factors were more likely to be overlooked if the 3rd h test was omitted(χ^(2) for trend=0.038,P>0.05).No significant differences were found in the rate of cesarean section(CS),preterm births or macrosomia between the 79 cases and those with normal OGTT results and in the gestational weeks when OGTT was performed.It shows that in order to diagnose one woman with GDM,another 52 pregnant women would have an innocent 3rd h glucose test.Omission of the 3rd h glucose test in OGTT might be reasonable due to its convenience,better compliance and a small number of possibly miss-diagnosed cases,and their pregnancy outcomes have no significant difference from those of normal pregnant women.
文摘Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.
文摘Background:One-hour postprandial hyperglycemia is associated with increased risk of type 2 diabetes and cardiovascular disease.Physical activity(PA)has short-term beneficial effects on post-meal glucose response.This study compared the oral glucose tolerance test results of 3 groups of people with habitually different levels of PA.Methods:Thirty-one adults without diabetes(age 25.9±6.6 years;body mass index 23.8±3.8 kg/m^2;mean±SD)were recruited and divided into 3 groups based on self-reported PA volume and intensity:low activity<30 min/day of moderate-intensity activity(n=11),moderately active≥30 min/day of moderate-intensity PA(n=10),and very active≥60 min/day of PA at high intensity(n=10).Participants completed an oral glucose tolerance test(50 g glucose)with capillary blood samples obtained at baseline,15 min,30 min,45 min,60 min,90 min,and 120 min post-ingestion.Results:There were no significant differences between groups for age or body fat percentage or glycated hemoglobin(p>0.05).The groups were significantly different in terms of baseline glucose level(p=0.003)and,marginally,for gender(p=0.053)and BMI(p=0.050).There was a statistically significant effect of PA on the 1-h postprandial glucose results(p=0.029),with differences between very active and low activity groups(p=0.008)but not between the moderately active and low activity groups(p=0.360),even when baseline glucose level and gender differences were accounted for.For incremental area under the curve there was no significant effect of activity group once gender and body fat percentage had been accounted for(p=0.401).Those in the low activity group took 15 min longer to reach peak glucose level than those in the very active group(p=0.012).Conclusion:The results suggest that high levels of PA have a beneficial effect on postprandial blood glucose profiles when compared to low and moderate levels of activity.
基金supported by grants from the Collaborative Innovation Program of Shanghai Municipal Health Commission (2020CXJQ01)the National Natural Science Foundation of China (81873565 and 82100605)+2 种基金Shanghai Jiao Tong University Transmed Awards Research (20190104)Star Program of Shanghai Jiao Tong University (YG2021QN54)Hospital Funded Clinical Research,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (17CSK04 and 15LC06)。
文摘Background: Nonalcoholic fatty liver disease(NAFLD) was recently proposed to be renamed metabolic dysfunction-associated fatty liver disease(MAFLD) with the diagnostic criteria revised. We investigated the similarities and differences in the prevalence and clinical characteristics of MAFLD and NAFLD in Chinese adults. Methods: A cross-sectional study of 9980 Chinese individuals aged 40 years or older was performed between 2011 and 2012 using randomized, stratifed cluster sampling in Shanghai, China. A detailed questionnaire and the results of abdominal ultrasonography, a standardized 2-h 75-g oral glucose tolerance test and blood biochemical examinations were collected. Results: A total of 9927 subjects were included in this study. The prevalence of MAFLD(40.3%) was significantly higher than that of NAFLD(36.9%)( P < 0.05). MAFLD was highly prevalent in type 2 diabetes mellitus(T2DM)(53.8%), impaired fasting glucose(35.7%) and impaired glucose tolerance(40.9%). High risk of advanced fbrosis based on fbrosis-4 was highly prevalent(14.7%) in lean MAFLD with T2DM. Among 9927 subjects, 3481(35.1%) fulflled the diagnostic criteria for MAFLD and NAFLD(MAFLD + NAFLD +), 521(5.2%) MAFLD + NAFLD-, and 181(1.8%) MAFLD-NAFLD +. The MAFLD + NAFLD-group had more signifcant metabolic disorders than those in the MAFLD + NAFLD + group(all P < 0.05). Among MAFLD-NAFLD + subjects, 82.9% had metabolic disorders. Conclusions: The new defnition of MAFLD may better reflect the pathogenesis related to metabolism. Future research should focus on studying the natural history, pathogenesis and treatment effectivity of the overlap and non-overlap of NAFLD and MAFLD subjects.
文摘BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PAPP-A),triglyceride(TG),and 25-hydroxyvitamin D[25-(OH)D]with GDM in early pregnancy.METHODS A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included,and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy.Of these cases with GDM,51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B.Serum PAPP-A,TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed.In addition,their diagnostic value in GDM was determined using receiver operating characteristic(ROC)curve analysis.RESULTS Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B,with statistical significance(P<0.05).Furthermore,Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose(FBG)levels(r=-0.605,P<0.001),(r=-0.597,P<0.001),while TG and FBG levels were positively correlated(r=0.628,P<0.001).The sensitivity,specificity,area under the curve(AUC)and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%,82.35%,0.861 and 16.340,respectively,while the sensitivity of TG in diagnosing GDM was 86.27%,the specificity was 66.67%,the AUC was 0.813,with an optimal cut-off value of 1.796.The corresponding sensitivity,specificity,AUC and optimal cut-off value of serum 25-(OH)D were 64.71%,70.59%,0.721 and 23.140,respectively.Moreover,multivariate logistic regression analysis revealed that FBG,vascular endothelial growth factor,Flt-1,serum PAPP-A,TG,and 25-(OH)D were related risk factors leading to GDM in patients.CONCLUSION Serum PAPP-A,TG,and 25-(OH)D levels are all correlated with blood glucose changes in GDM,and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.
文摘Objective:To investigate the antidiabetic activity of Ocimum tenuiflorum L.(O.tenuiflorum) leaves used in the traditional medicine management of diabetes in Malaysia.Methods:O.tenuiflorum leaves were extracted sequentially with hexane,chloroform,ethyl acetate,methanol,and water.The extracts were evaluated in terms of antidiabetic activity by using acute,subcutaneous glucose tolerance,and sub-chronic tests in streptozotocininduced diabetic rats.The extracts were also subjected to phytochemical analyses.Results:With an acute dose(1 g/kg),the methanol extracts showed significant reduction(31%) in fasting blood glucose(FBG) of the streptozotocin-induced diabetic rats.The FBG-decreasing effect of ethyl acetate extract was more rapid than that of the other extracts;the decreasing rates were 20%after 2 h,21%after 3 h,and 8%after 5 and 7 h.After 7 h(31%),the effect of methanol extract on FBG was significantly lower than that of metformin.In the subcutaneous glucose tolerance test,only methanol and hexane extracts showed the similarity of metformin in diabetic rats.After 14 days,the effects of these extracts were similar to those of metformin(63.33%).The total flavonoid and phenolic contents of extracts decreased as the polarity of the extraction solvent increased.Conclusions:The results obtained provide support for a possible use of O.tenuiflorum leaves in managing hyperglycemia and preventing the complications associated with it in type 2 diabetic.
文摘AIM:To investigate the postprandial response of bone turnover markers in patients with Crohn’s disease(CD).METHODS:Fifty nine patients with CD aged 38±14years,and 45 healthy individuals matched for age and body mass index were included in the study.All participants underwent an oral glucose tolerance test(OGTT)after an overnight fast and serum levels of the bone resorption marker C-terminal crosslinking telopeptide of type?Ⅰ?collagen(CTX-Ⅰ)and the bone formation marker procollagen type?Ⅰ?N propeptide were measured.Activity of the disease was assessed by calculation of the Crohn’s disease activity index(CDAI).RESULTS:Serum CTX-I was significantly higher in patients compared to controls(CTX-I:453±21 pg/mL vs 365±25 pg/mL,P=0.008),and values were significantly correlated with the activity of the disease(r=0.435,P=0.001).Results from OGTT-induced suppression of CTX-I showed two different trends.Patients with more active disease(assessed as CDAI>150)had a more excessive suppression of CTX-I compared to controls(55%vs 43%P<0.001),while patients on remission(assessed as CDAI<150)demonstrated an attenuated CTX-I suppression(30%vs 43%P<0.001).In line with this,CTX-I suppression after oral glucose load was significantly correlated with the activity of the disease(r=0.913,P<0.001).CONCLUSION:The physiological skeletal response of postprandial suppression of bone resorption is maintained in patients with CD and is strongly dependent to the activity of the disease.
文摘BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly diagnosed.AIM To estimate the impact of the World Health Organization(WHO)2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy outcomes.METHODS We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically applied.Women were categorized into four groups:non-GDM by both criteria,GDM by WHO 1999 only(excluded from GDM),GDM by WHO 2013 only(newly diagnosed)and GDM by both criteria.We compared maternal characteristics,pregnancy outcomes and likelihood ratios for adverse pregnancy outcomes.RESULTS Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%,from 19.3%to 32.4%.Discordant diagnoses occurred in 21.3%;4.1%would no longer be labelled as GDM,and 17.2%were newly diagnosed.Compared to the non-GDM group,women newly diagnosed were older,had higher rates of obesity,higher diastolic blood pressure and higher rates of caesarean deliveries.Their infants were more often delivered preterm,large-for-gestational-age and were at higher risk of a 5 min Apgar score<7.Women excluded from GDM were older and had similar pregnancy outcomes compared to the non-GDM group,except for higher rates of shoulder dystocia(4.3%vs 1.3%,P=0.015).Positive likelihood ratios for adverse outcomes in all groups were generally low,ranging from 0.54 to 2.95.CONCLUSION Applying the WHO 2013 criteria would result in a substantial increase in GDM diagnoses.Newly diagnosed women are at increased risk for pregnancy adverse outcomes.This risk,however,seems to be lower than those identified by the WHO 1999 criteria.This could potentially influence the treatment effect that can be achieved in this group.Evidence on treatment effects in newly diagnosed women is urgently needed.
文摘<strong>Aim</strong>: Evaluation of the occurrence of glucose intolerance after 34 - 36 weeks in pregnant mothers attending the Teaching Hospital, Peradeniya. <strong>Materials & Method</strong>: This is a descriptive cross-sectional study carried out from October 2017 to March 2018 among 183 pregnant mothers attending antenatal clinic at Teaching Hospital Peradeniya. After informed consent a repeat Oral Glucose Tolerance Test (OGTT) was done among the pregnant mothers, at period of amenorrhoea of 34 - 36 weeks, whose initial OGTT values were normal. Gestational diabetes was diagnosed according to the NICE guideline cut off values and the percentage of late occurrence of Gestational diabetes (GDM) was analyzed. <strong>Results</strong>: Mean age of the population was 29.1 years and the age range in this group was 18 to 45 years and the majority (73.9%) of women were primipara. There were 3.3% of teenage pregnancies and 14% of mothers were over 35 years. Majority (59.7%) of mothers underwent repeat OGTT test at 34 weeks of gestation and the rest (40.3%) underwent test between 34 to 36 weeks of gestation. Although the mean BMI was 23.74, 9.7% of mothers were obese (>30 kg/m2), 30.3% of mothers were pre-obese (25.0 - 29.9 kg/m2). 8.2% of mothers were diagnosed with Gestational diabetes at 34 - 36 weeks whose initial OGTT values were normal.<strong> Conclusion</strong>: In view of reducing feto-maternal morbidity and mortality, considering a repeat OGTT at a later gestation (34 - 36 weeks of gestation) should be considered in mothers, whose initial OGTT values are normal as Sri Lanka is a high risk country for GDM. <strong>Clinical Significance</strong>: The study may play an important role in guideline alteration process and screening for gestational diabetes in Sri Lankan set-up.
文摘Background:Yu-Ye decoction is a classic prescription therapy that is widely used in the treatment of type 2 diabetes mellitus(T2DM).In this study,we evaluate and exhibit the protective effect of modified Yu-Ye decoction on T2DM rats.Methods:Sixty rats with T2DM were included in this study that was induced by high-fat high-glucose diet for 6 weeks.following 6 weeks later,1%streptozotocin 30 mg/kg was injected intraperitoneally,and the T2DM rats were randomly divided into the model group,the metformin(90 mg/kg)positive control group,and the modified Yu-Ye decoction(6.4 g/kg,12.7 g/kg,25.4 g/kg)group.In contrast,standard chow was provided to the 10 rats in the control group.The drug was administered for four weeks,and fasting blood glucose was monitored.After four weeks of treatment,oral glucose tolerance test experiments were carried out.Serum was collected for the detection of alanine aminotransferase,aspartate aminotransferase,creatinine,blood urea nitrogen,low density lipoprotein,high density lipoprotein,and total cholesterol,triglyceride.Hematoxylin-eosin staining was used to assess potential pathological changes in the liver,kidneys,and pancreas.Results:Results from fasting blood glucose monitoring and oral glucose tolerance test showed that modified Yu-Ye decoction could significantly improve the blood glucose concentration and insulin resistance,compared to the model group.In addition,modified Yu-Ye decoction could significantly reduce the serum levels of alanine aminotransferase,aspartate aminotransferase,creatinine,blood urea nitrogen,low density lipoprotein,total cholesterol,triglyceride,and increase the level of high density lipoprotein.At the same time,hematoxylin-eosin results exhibited that modified Yu-Ye decoction could increase the number of islet cells,reduce the volume of islet cells,improve liver edema and inflammation,and improve renal glomerular hypertrophy.Conclusion:This study shows that modified Yu-Ye decoction ameliorates T2DM because it can reduce fasting blood glucose concentration,improve glucose tolerance,protect liver and kidney function,and improve livers,kidneys,and pancreas tissue morphology.
基金Supported by Jahangirnagar University Annual Research Grant(Grant No.JU-ARG-2012-005).
文摘Objective:To investigate the therapeutic effects of ethyl acetate extract of Mallotus repandus stem in α-amylase inhibitory activity(in vitro)and hypoglycemic activity in normal and glucose induced hyperglycemic rats(in vivo).Methods:Ethyl acetate extract of Mallotus repandus stem was tested for the presence of phytochemical constituents,α-amylase inhibitory activity and hypoglycemic effect in normal rats and glucose induced hyperglycemic rats.Results:Presence of different types of phytochemicals was identified in the extract.The extract has moderate α-amylase inhibitory activity[IC_(50)=(2.038±0.033)mg/mL]as compared to acarbose.The does 1000 mg/kg significantly reduced(P<0.0100)fasting blood glucose level in normal rats.In oral glucose tolerance test,both 1000 and 2000 mg/kg doses showed good hypoglycemic activity(P<0.0001)like glibenclamide in each specific hour after administration.Overall time effect in oral glucose tolerance test was found extremely significant(P<0.0001)with F(3,48)value=202.4.Conclusions:These findings suggest that this plant may be a potential source for the development of new oral hypoglycemic agent.
基金supported by the National Natural Science Foundation of China(Grant No.30900293)the R&D Special Fund for Public Welfare Industry from State Ocean Administration of China(No.200709005)。
文摘Total macromolecule extract was obtained from the soft body of Mactra veneriformis by the coupling techniques of decoction and alcohol precipitation.The extract was deproteinized with an ion exchange column,and resulted in the purifying of the crude polysaccharide fraction.It was found by chemical analysis that the crude polysaccharide part is composed of abundant polysacchar-ides(>95%)and few proteins(<1%).Furthermore,only one type of monosaccharide,glucose,was detected from its hydrolytes by thin-layer chromatography,indicating that the polysaccharides might be analogs of glucosan.The anti-hyperglycemia effects of the crude polysaccharide part were preliminarily investigated using several pharmacolo-gical methods in normal and diabetic mice.Animal experimental results showed that the crude polysaccharide fraction exhibited proper glycemia inhibition activity,and 300 mg/kg-weight dose has the optimal effect among all the studied doses.It is concluded that the crude polysaccharide fraction can be explored as a novel health product that possesses potential as an anti-hyperglycemic agent.
文摘The aim of this paper is to investigate the clin-ical features and transformation of elderly male patients with normal blood glucose levels at fasting and 2 hours after glucose intake but with hyperglycemia(>11.1 mmol/L)1 hour after oral glucose tolerance test(OGTT-1h HG).Seven years of follow-up visits were per-formed on 189 elderly male outpatients with OGTT-1h HG and data was recorded on their body mass index(BMI),blood pressure,serum cholesterol and triglyceride test results and on their glucose tolerance changes every 1–2 years after taking OGTT;their possible causes were analysed.Follow-up visits revealed that 19 patients with OGTT-1h HG were diagnosed with diabetes(10.1%),78 patients with impaired glucose tolerance(IGT,41.3%),2 patients transformed to normal glucose tolerance(NGT,1.1%)and the remaining 90 patients(47.6%)remained unchanged.Synchronized comparison with IGT patients showed that the ratio of OGTT-1h HG patients turning to diabetes was lower than that of IGT patients(21.1%,x2513.05,P,0.01),and the ratio of OGTT-1h HG patients transforming to NGT was slightly higher(0.4%,x252.46,P.0.05).The prevalence of complications of hypertension,coronary heart disease,cerebral vascular diseases and dyslipidemia in patients with OGTT-1h HG were higher than those with NGT(P,0.05)and were similar to that of IGT patients.As a special phenotype of OGTT and as part of an abnormal glucose tolerance con-formation,patients with OGTT-1h HG warrant special attention,since about half of them were found to have developed diabetes or IGT,and their risk of suffering from vascular diseases were also increased.
基金Part of this work is supported by National Natural Science Foundation of China(31970752)Science and Technology Planning Project of Shenzhen Municipality(JSGG20191129110812708,JCYJ20190809180003689,JSGG20200225150707332)Shenzhen Bay Laboratory Open Funding(SZBL2020090501004).
文摘Diet plays an important role in diabetes development.The effect of ketogenic diet on type 2 diabetes remains elusive.In this study,we collect diabetes related physiological parameters and abdominal MRI images to evaluate the effect of ketogenic diet after 3-months of consecutive treatment.Ketogenic diet mitigates the diabetes symptom inferring from the statistically significant reduction of key diabetic physiological parameters such as Hemoglobin A1c(HbA1c)concentration,Triglyceride(TG),Fasting blood glucose(FBG),Body Mass Index(BMI),and adipose tissue volume.Moreover,we propose a new parameter to quantify the treating effect of ketogenic diet since Slope and Offset of Oral Glucose Tolerance Test(SOOGTT)incorporate more sampling points by fitting OGTT(Oral Glucose Tolerance Test)curve.SOOGTT shows statistically significant(P<0.001)treating effect of ketogenic diet on type 2 diabetes.We use artificial intelligence to segment adipose tissue for treatment evaluation,which shows that ketogenic diet reduces the amount of adipose tissue.
