Objetivo: Avaliar o efeito do exercício muscular inspiratório (EMI) nos níveis de glicose, variabilidade glicêmica e controle autonômico cardiovascular em pacientes com diabetes tipo 2. Métodos: Quatorze indivíduos foram randomizados para realizar EMI com carga de 2% ou 60% da pressão inspiratória máxima (PImax). Durante o EMI, os níveis de glicose e a variabilidade glicêmica foram avaliados por monitorização contínua da glicose. O controle autonômico foi avaliado no domínio do tempo e da freqüência. Resultados: Os níveis de glicose e variabilidade glicêmica reduziram após o EMI com ambas as cargas. O EMI com carga de 60% PImax determinou redução no componente de alta frequência da variabilidade da frequência cardíaca e maior variabilidade da pressão arterial. Conclusões: O EMI com carga de 60% da PImax não demonstrou melhoras nos níveis de glicose e variabilidade glicêmica, quando comparado com à carga 2% da PImax. Entretanto, o EMI com carga de 60% da PImax levou a alterações na modulação vagal cardíaca e maior variabilidade da pressão arterial / Objective: To evaluate the effect of inspiratory muscle exercise (IME) on glucose levels, glycemic variability and cardiovascular autonomic control in patients with type 2 diabetes. Methods: Fourteen subjects were randomized to perform IME with a of maximum inspiratory pressure (PImax) load of 2% or 60%. During IME, glucose levels and glycemic variability were assessed through continuous glucose monitoring. Autonomic control was evaluated in the domain of time and frequency. Results: Glucose levels and glycemic variability decreased after IME with both loads. IME with a load of 60% PImax resulted in a reduction in the high frequency component of heart rate variability and greater variability of blood pressure. Conclusions: IME with loads of 60% PImax fails to demonstrate improvement in glucose levels and glycemic variability, when compared to loads of 2% PImax. However, IME with 60% loading of PImax led to changes in vagal cardiac modulation and greater variability of blood pressure.

This thesis investigates the effects of alanine on rainbow trout’s glucose metabolism at the organismal and molecular levels. Rainbow trout is an important aquaculture species that belongs to the salmonid family. As a carnivorous fish, the requirement of protein/amino acids in trout’s diet is high. In contrast, rainbow trout are poor utilizers of carbohydrates. One prevalent hypothesis suggests that high levels of dietary amino acids could indeed contribute to the poor utilization of carbohydrates in this species. In mammals, there is evidence supporting the importance of alanine as a gluconeogenic precursor. However, a recent study found that alanine stimulates hepatic AMP-activated protein kinase (AMPK) to lower circulating glucose levels in mice. Alanine levels are high in all tissues in rainbow trout. The role of alanine in gluconeogenesis is less clear in trout and there is no evidence, to our knowledge, regarding its effects on glucose kinetics. Therefore, the main goal of the study was to investigate the impact of the continuous infusion of exogenous alanine for 4h on glucose fluxes and to identify potential mechanisms in tissues that could interpret the observed changes in glucose fluxes in vivo. Glucose turnover, appearance and disposal, Rt, Ra and Rd, respectively, were measured to determine the impact of alanine on glucose fluxes. The expression and/or activity of key genes in glucose transport, utilization and gluconeogenesis were assessed in liver and muscle. An additional goal was to assess whether alanine activates AMPK in trout. The levels of phosphorylated AMPK and other signaling proteins known to interact with the latter were quantified. Results show that alanine reduced plasma glucose levels and inhibited Ra and Rd glucose, consistent with previously observed effects of insulin in rainbow trout. The reduction in the expression of a paralogue of glut4, a key gene in glucose transport, and the activity of hexokinase (HK), a key enzyme in glucose utilization, in muscle can partially explain the observed reduction in Rd glucose. Together, these results suggest that glucose was not a preferred substrate under conditions of increased alanine availability and that alanine was probably oxidized to provide energy. Alanine failed to activate AMPK in trout, contrary to mammalian findings. However, it increased AKT (also known as protein kinase B) phosphorylation in muscle, similar to the effect of insulin in trout. In conclusion, my results suggest that alanine mediated at least some of the observed effects by stimulating insulin secretion given the similarities between the effects of exogenous alanine and insulin in rainbow trout as discussed above. Future studies are warranted to investigate the hypothesis that alanine is an insulin secretagogue in rainbow trout.

Spin-lattice relaxation in the rotating frame (T1ρ) is a relaxation parameter measured in nuclear magnetic resonance studies. This parameter has been found to be sensitive to chemical exchange processes occurring in diseased tissue associated with abnormal metabolism when measured in magnetic resonance imaging (MRI). Metabolic changes in tissue affected by abnormal metabolism can be quantified with good spatial and temporal resolution using T1ρ, better than a similar method of assessment known as CEST and current methods such as spectroscopic (1H- and 31P-MRS) and nuclear medicine (PET) methods used in clinical settings. Though T1ρ has these advantages, there is no consensus as to which metabolic changes T1ρ is most sensitive. The metabolic changes may be pH related, or due to changes in concentration of metabolites like glucose and glycogen. This work is tries to identify which metabolite evokes the greatest change in T1ρ by studying the response of three spin relaxation measures (T1ρ, T2 and T1) at different temperatures. It was found that T1ρ is more sensitive to pH changes than glucose and lysine at 3T. Also at body temperature, the pH results showed an exponential decay trend for T1ρ signifying the limited range of sensitivity in the pH range of 6.9 to 7.5. The T2 results can be used to explain this trend.

Background. Diabetes mellitus (DM) is a common condition. The high burden of undiagnosed DM and lack of large population studies make accurate prevalence estimations difficult, especially in the surgical environment. Furthermore, poorly controlled DM is associated with an increased risk of perioperative complications and mortality. Objectives. The primary objective was to establish the prevalence of DM in elective adult non-cardiac, non-obstetric surgical patients in Western Cape hospitals. The secondary objectives were to assess the glycaemic control and compliance with treatment of known diabetics. Methods. This was a five-day, multicentre, prospective observational study performed at six government-funded hospitals in the Western Cape. Screening for DM was done using fingerprick capillary blood glucose (CBG) testing. Patients found to have a CBG of ≥ 6.5 mmol/L had an HbA1c level done. DM was diagnosed based on the Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA) diagnostic criteria. Patients known with DM had an HbA1c performed and Morisky Medication Adherence Scale (MMAS-4) questionnaires completed, to assess glycaemic control and compliance with treatment. Results. Of the 379 participants, 61 were known diabetics (16.15%; 95% CI 12.4-19.8%). After exclusion of eight patients with incomplete results, a new diagnosis of DM was made in five out of 310 patients (1.6%; 95% CI 0.2-3.0%). Overall prevalence of DM was 17.8% (66/371; 95% CI 13.9-21.7%). HbA1c results were available in 57 (93.4%) of the 61 known diabetics. Of these 27 (47.4%; 95% CI 34.4-60.3%) had an HbA1c level≥8.5% and 14 (24.6%; 95% CI 13.4 - 35.8%) had an HbA1c ≤7%. Based on positive responses to two or more questions on their MMAS-4 questionnaires, 12 out of 60 participants (20%) were deemed non-compliant. Conclusion. There is a low rate of undiagnosed DM in our elective surgical population; however there is a large proportion of poorly controlled DM. Since poorly controlled DM is known to increase postoperative complications, this likely increases the burden of perioperative care. Resources should be focused on improvement of long-term glycaemic control in patients presenting for elective surgery.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21959号 / 医博第4501号 / 新制||医||1037(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 横出 正之, 教授 小杉 眞司, 教授 長船 健二 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Objetivo: Determinar el índice glicémico de Pouteria lúcuma (lúcuma), Annona cherimola (chirimoya) y Mauritia flexuosa (aguaje). Materiales y métodos: el estudio fue de tipo experimental. Se reunió a 9 sujetos que fueron seleccionados tras una serie de pruebas, se les extrajo muestras de sangre venosa mediante la colocación de un catéter venoso, ello para determinar la glucosa en los tiempos 0, 15, 30, 60, 90 y 120 minutos. Dichas muestras se tomaron tras la ingesta de los alimentos en estudio, lúcuma, chirimoya y aguaje, empleando como patrón referencial a la glucosa anhidra. Una vez obtenidos los resultados de la glucosa por cada tiempo, se determinó el índice glicémico mediante la sumatoria del área bajo la curva de cada alimento. Resultados: Se obtuvo un índice glicémico de 68 para la lúcuma, 58 para la chirimoya y 35 para el aguaje. Considerándose para la dos primeras un índice glicémico medio y para el último, un índice glicémico bajo. Conclusión: En el estudio presentado se determinó el índice glicémico de tres frutas nativas peruanas: la lúcuma, chirimoya y aguaje, que fueron 68%, 58% y 35%; respectivamente, empleando como alimento referencial la glucosa anhidra. / Objective: To determine the glycemic index of Pouteria lucuma (lúcuma), Annona cherimola (cherimoya) y Mauritia flexuosa (aguaje). Materials and methods: The study was experimental. It met 9 subjects that were selected after a serie of tests. They were extracted venous blood samples by placing a venous catheter, thereby to determine glucose at times 0, 15, 30, 60, 90 and 120 minutes. These samples were taken after food intake (lucuma, cherimoya and aguaje), using anhydrous glucose as reference. After obtaining the results of glucose per time, the glycemic index was determined by the sum of the area under the curve of each food. Results: The glycemic index obtained was 68 for lucuma, 58 for cherimoya and 35 for aguaje. Considered for the first two medium glycemic index and for the latter, a low glycemic index. Conclusion: In the presented study, the glycemic index of three peruvian native fruits was determined: lucuma, cherimoya and aguaje, which were 68%, 58% and 35%; respectively, using as a reference food anhydrous glucose. / Tesis

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Background: Carcinoembryonic antigen (CEA) in the pancreatic cystic fluid is the most important biomarker for differentiating mucinous from non-mucinous pancreatic cystic lesions (PCLs). However, recent studies have shown that glucose levels in pancreatic cystic fluid can discriminate mucinous from non-mucinous cysts. Aims: To perform a meta-analysis to determine the utility of intracystic fluid glucose of pancreatic mucinous cysts compared with intracystic CEA. Methods: We conducted a systematic review of the literature in the PubMed, OVID Medline, and Cochrane databases. This meta-analysis considers studies published up to October 2020. Results: Six studies comprising 506 patients were selected; 61.2% of the population was female. Of the 480 PCLs, 287 (59.7%) were mucinous. Pooled sensitivity and specificity of cystic fluid glucose levels for mucinous PCLs were 91% and 85%, respectively. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 6.33 and 0.11, respectively. Pooled diagnostic odds ratio (DOR) was 60.94. The pooled area under the summary receiver operating characteristic (SROC) curve was 0.959. Pooled sensitivity and specificity of pancreatic cystic fluid CEA levels were 61% and 93%. The PLR and NLR were 8.51 and 0.40, respectively. Pooled DOR was 23.52, and the pooled area under the SROC curve was 0.861. Conclusion: Glucose has become a useful method and appears to be better than CEA for differentiating between mucinous PCLs and non-mucinous PCLs. We suggest that the analysis of glucose in PCLs be routinely performed for the differential diagnosis of these lesions. / Revisión por pares

Acetone in exhaled breath is gaining attention as a non-invasive means of quantifying blood glucose levels in Diabetics. This calls for development of novel biosensors for the detection of trace concentrations of acetone present in human breath. Traditional gas detection systems, such as GC/MS and chemiresistive sensors, are currently used for this purpose. However, these systems have limitations with regards to size, cost, and operating temperature. This work presents the K2W7O22/Ti3C2 nanocomposite sensor as breath acetone sensor that overcomes the limitations in traditional detection systems. Sensing experiments were conducted using 5 different sensor materials in varying ratios. KWO/Ti3C2 - ratio 2:1 (annealed) and KWO/Ti3C2 - ratio 2:1 (Unannealed) showed excellent sensitivity to 2.85ppm and 5.4ppm acetone concentration. These materials were then implemented in a prototype device. Material and device test results confirm the potentials of the novel KWO/Ti3C2 nanocomposite as a good sensor for breath acetone detection.

This work discusses the mean of blood glucose in human body. Determination of glucose and held it in the physiological range.

This master's thesis deals with the optimalization of HPLC-ELSD method for the determination of carbohydrates in food. The theoretical part focuses on the classification and characterization of carbohydrates, the occurrence of carbohydrates in food and their physiological importance. There was targeted mainly glucose, fructose, sucrose and maltose. There is a brief summary of the analytical methods that can be used to determine carbohydrates. Experimental part is based on a literary review. It also deals with high performance liquid chromatography with evaporative light scattering detector. The main content in this part is the optimalization of condition for reliable and rapid separation of the most frequently occurring carbohydrates in foods. The carbohydrates were identified and quantified under optimum condition in real samples specifically in fruit juice, beer, ketchup and red pepper powder. The result is commented in conclusion.