Notes

Swertiamarin mitigates nephropathy throughout high-fat diet/streptozotocin-induced person suffering from diabetes test subjects through inhibiting the organization involving sophisticated glycation finish items.
Previous meta-analysis investigating the incidence and prevalence of hypoglycaemia in both types of diabetes is limited. The purpose of this review is to conduct a systematic review and meta-analysis of the existing literature which investigates the incidence and prevalence of hypoglycaemia in individuals with diabetes.

PubMed, Embase and Cochrane library databases were searched up to October 2018. Observational studies including individuals with diabetes of all ages and reporting incidence and/or prevalence of hypoglycaemia were included. Two reviewers independently screened articles, extracted data and assessed the quality of included studies. Meta-analysis was performed using a random effects model with 95% confidence interval (CI) to estimate the pooled incidence and prevalence of hypoglycaemia in individuals with diabetes.

Our search strategy generated 35,007 articles, of which 72 studies matched the inclusion criteria and were included in the meta-analysis. The prevalence of hypoglycaemia ranged from 0.074% to 73.0%, comprising a total of 2,462,810 individuals with diabetes. The incidence rate of hypoglycaemia ranged from 0.072 to 42,890 episodes per 1,000 person-years stratified by type of diabetes, it ranged from 14.5 to 42,890 episodes per 1,000 person-years and from 0.072 to 16,360 episodes per 1,000-person years in type 1 and type 2 diabetes, respectively.

Hypoglycaemia is very common among individuals with diabetes. Further studies are needed to investigate hypoglycaemia-associated risk factors.
Hypoglycaemia is very common among individuals with diabetes. Further studies are needed to investigate hypoglycaemia-associated risk factors.
To test the performance of the cardiac vagal tone (CVT) derived from a 5-minute ECG recording compared with the standardized cardiovascular autonomic reflex tests (CARTs).

Cross-sectional study included 56 well-phenotyped adults with type 1 diabetes (19-71years, 2-54years disease-duration). Autonomic testing included standardized CARTs obtained with the VAGUS™, CVT, and indices of heart rate variability (HRV) obtained at 24- and 120-hour, and electrochemical skin conductance assessed with SUDOSCAN®. ROC AUC and cut-off values were calculated for CVT to recognize CAN based on≥2 (established CAN, n=7) or 1 (borderline CAN, n=9) abnormal CARTs and compared to HRV indices and electrochemical skin conductance.

Established CAN The cut-off CVT value of 3.2LVS showed 67% sensitivity and 87% specificity (p=0.01). Indices of HRV at either 24-hour (AUC>0.90) and 120-hour (AUC>0.88) performed better than CVT. Borderline CAN The cut-off CVT value of 5.2LVS indicated 88% sensitivity and 63% specificity (p=0.07). CVT performed better than HRV indices (AUC<0.72). Bemcentinib Electrochemical skin conductance (AUC0.63-0.72) had lower sensitivity and specificity compared with CVT.

Implementation of CVT with a clinically applicable cut-off value may be considered a quicker and accessible screening tool which could ultimately decrease the number of unrecognized CAN and initiate earlier prevention initiatives.
Implementation of CVT with a clinically applicable cut-off value may be considered a quicker and accessible screening tool which could ultimately decrease the number of unrecognized CAN and initiate earlier prevention initiatives.
This study aimed to assess whether body mass index (BMI), fasting plasma glucose (FPG) levels, blood pressure (BP), and kidney function were associated with the risk of severe disease or death in patients with COVID-19.

Data on candidate risk factors were extracted from patients' last checkup records. Propensity score-matched cohorts were constructed, and logistic regression models were used to adjust for age, sex, and comorbidities. The primary outcome was death or severe COVID-19, defined as requiring supplementary oxygen or higher ventilatory support.

Among 7,649 patients with confirmed COVID-19, 2,231 (29.2%) received checkups and severe COVID-19 occurred in 307 patients (13.8%). A BMI of 25.0-29.9 was associated with the outcome among women (aOR, 2.29; 95% CI, 1.41-3.73) and patients aged 50-69years (aOR, 1.64; 95% CI, 1.06-2.54). An FPG≥126mg/dL was associated with poor outcomes in women (aOR, 2.06; 95% CI, 1.13-3.77) but not in men. Similarly, estimated glomerular filtration rate (eGFR)<60ml/min/1.73m
was a risk factor in women (aOR, 3.46; 95% CI, 1.71-7.01) and patients aged<70years.

The effects of BMI, FPG, and eGFR on outcomes associated with COVID-19 were prominent in women but not in men.
The effects of BMI, FPG, and eGFR on outcomes associated with COVID-19 were prominent in women but not in men.
Nutritional composition and food patterns influence postprandial glycaemia in type 1 diabetes (T1D). For optimal glycaemic control, insulin dose and delivery pattern must be matched accordingly. This systematic review aimed to compare insulin dosing strategies for meals varying in fat, protein and glycaemic index (GI), and prolonged meals in T1D.

Studies in adults and/or children with T1D on insulin pump therapy comparing the glycaemic effects of different insulin pump bolus types for these meal types were identified from biomedical databases (MEDLINE, PREMEDLINE, Embase, CINAHL and Cochrane Central Register of Controlled Trials; March 1995-April 2020) and systematically reviewed.

All eleven publications investigating high-fat meals (234 participants) and all seven studies investigating high-protein meals (129 participants) showed a dual-wave bolus was superior. Additional insulin further improved postprandial glycaemia, although increasing risk of hypoglycaemia in 5 of 14 studies. One study investigating GI found a dual-wave bolus reduced postprandial glycaemia and risk of hypoglycaemia. No studies were identified for grazing/degustation-style meals. Due to heterogeneity, meta-analysis was not possible.

Dual-wave boluses improve postprandial glycaemia in high-fat, high-protein and low-GI meals. Further research is needed to identify optimal bolus delivery split, duration and optimal total dose adjustment.
Dual-wave boluses improve postprandial glycaemia in high-fat, high-protein and low-GI meals. Further research is needed to identify optimal bolus delivery split, duration and optimal total dose adjustment.
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