Browsing by Subject "Blood Glucose"
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Item Confirmation of Hypoglycemia in Goat -/- Mice When Total Body Fat Falls below 2% of Body Weight(2013-01-22) Singh, Ashish; Goldstein, Joseph L.; Zhao, Tongjin; Brown, Michael S.Ghrelin is an octanoylated peptide hormone first identified in stomach, with the octanoyl group being essential to its biological activity. The enzyme that attaches the octanoyl group to ghrelin is called Ghrelin-Oacyltransferase (GOAT). By studying mice that have the GOAT gene knocked out (GOAT KO mice), we have shown that these mice develop severe hypoglycemia under a 60% calorie restricted diet. In order for this hypoglycemia to occur, depletion of fat deposits is required. Specifically, GOAT knockout mice will not develop severe hypoglycemia until the total fat mass drops to 2% of the total body weight. These observations were made in 8-week-old mice with an average starting fat mass between 8-10% of total body weight. In our present work, we wanted to know whether we could reproduce the results using older mice with a higher percentage of fat mass. The mice used in this study were 32-34 week old male mice (wild type and GOAT knockout mice, n=8/group), and both groups had an average starting fat mass of 17% of total body weight. We then subjected these mice to a 60% calorie restriction and monitored their fat mass and blood glucose level everyone or two days. For the first 7 days of calorie restriction, both wild type and GOAT knockout mice were able to maintain their blood glucose around 60 mg/dl. After that, the GOAT knockout mice start to develop hypoglycemia when their body fat mass dropped below 2% of the body weight. However, the wild type mice were able to maintain their blood glucose level above 40 mg/dl throughout the course even when their fat mass dropped below 2% of their body weight. The results here further confirm that in order to develop hypoglycemia in the GOAT knockout mice, the fat mass needs to be depleted from these mice during calorie restriction , even in older mice (32-34 weeks versus 8 weeks).Item The deadly quadrangle: upper body obesity, glucose intolerance, hypertriglyceridemia and hypertension(1988-02-04) Kaplan, Norman M.Item Defining Practices, Outcomes, and Barriers to Gestational Diabetes Mellitus Screening at a Large, Urban Indian Community Hospital(2019-04-02) Balijepally, Ramya; Chang, Mary; Rajora, Nilum; McGarry, MaryBACKGROUND: Gestational diabetes mellitus (GDM) is defined as a glucose intolerance of varying severity with onset or first recognition during pregnancy. Uncontrolled GDM is linked to various pre-and postpartum complications and long term maternal health issues. Complications of pregnancy due to GDM include abortion, preterm labor, polyhydramnios, oligohydramnios, and fetal death. Complications to the fetus include fetal macrosomia, fetal malnutrition, defects of the neural tube, and cardiac anomalies such as ventricular septal defects and atrial septal defects. In 2010, the International Association of Diabetes and Pregnancy Study Groups (IADPSG) estimated that the prevalence of gestational diabetes mellitus (GDM) in Southeast Asia was 25%. Among the various populations globally, Indians have a higher frequency of GDM proving the need for an efficient screening process. This was an observational study conducted at large, urban community hospital in India. The purpose of this study was to define the patient population, GDM screening practices, and reasons why some women did not get screened for GDM. METHODS: This was an observational study conducted at a community hospital in south India. The timeframe of the study was from April 2017 to April 2018. The data was collected through patient interview and chart review. The patient's demographic information, risk factors for GDM, course during pregnancy, method of GDM screening used, mode of delivery, maternal, and neonatal outcomes were collected by a simple questionnaire. When accessible, data collected through patient interview was verified by the patient's chart. The inclusion criterion was post-partum women who delivered at Apollo General Hospital. The exclusion criterion for study participants was women with pre-GDM. FINDINGS: 55 interviews were conducted. The mean age at delivery was 24.5 years (n = 55). The mean gestational age that prenatal care was established was at 4.7 months (n = 54). Of the 42 of the 55 patients (76%) who were screened for GDM, 5 patients (9%) were diagnosed with GDM. All 42 patients were screened using the WHO 1999 criterion. Only 7 of the 42 patients were screened between 24 and 28 weeks. The mean gestational month that GDM screening occurred at the hospital was at 5.9 months (n = 40). Of the 13 patients who were not screened, 9 did not get screened because of physician recommendation. 4 were not screened because of lack of patient knowledge. INTERPRETATION: The incidence of GDM in this population was 9%. Although the screening method was standardized, the rate of screening was not universal (76%). Most women were not screened between 24 and 28 weeks, which is recommended by the American College of Obstetricians and Gynecologists (ACOG). Based on this study, future research should explore if there are any harmful consequences from not screening between 24 to 28 weeks in this population and consider educational outreach opportunities.Item From Feast to Famine: A Tale of Satiety and Hunger Hormones(2016-04-18) Zhang, Yuanyuan; Repa, Joyce J.; Horton, Jay D.; Chen, Zhijian J.; Goldstein, Joseph L.; Brown, Michael S.Ghrelin is a peptide hormone secreted mainly from the stomach. It has a unique octanoylation on Ser-3 by Ghrelin-O-Acyltransferase (GOAT). We have previously shown that Goat−/− mice developed severe hypoglycemia under 60% calorie restriction. Liver autophagy has been reported to play a crucial role in maintaining blood glucose during fasting. The present work was carried out to explore whether autophagy plays a role in the onset of hypoglycemia in Goat−/− mice. We observed a deficiency in autophagy in livers of calorie-restricted Goat−/− mice by showing lower expression level of LC3-II, an autophagy marker. This was further demonstrated by showing 10-fold fewer autolysosomes in livers of calorie-restricted Goat−/− mice as compared to the control mice (20 electron microscopic images analyzed for each group). We then went on to show that the deficiency in autophagy in Goat−/− mice can be restored by infusion of growth hormone. It can also be restored by injections of lactate, a gluconeogenic precursor, or octanoate, a fatty acid that spares the usage of glucose. Protein expression of p- STAT 5, a downstream target of growth hormone action, was significantly lower in livers of calorie-restricted Goat−/− mice, and was restored by infusion of growth hormone and by injections of lactate or octanoate. Protein expression levels of LC3-II and p-STAT 5 showed a strong correlation (r2=0.87, p<10-6) through the time course of calorie-restriction. Considered together, these data suggest that the onset of autophagy during calorie restriction is strongly correlated with the ghrelin-growth hormone axis, and that autophagy plays an important role in maintaining blood glucose homeostasis during chronic starvation.Item Insulin, glucose, and acute coronary syndromes: a spoonful of medicine helps the sugar go down(2010-04-09) McGuire, Darren K.Item Newer methods of blood glucose regulation(1978-06-08) Raskin, PhilipItem Oral hypoglycemic agents(1969-04-10) UnknownItem Rethinking diabetes screening and case finding strategies in clinical practice: who's really at risk?(2016-08-26) Bowen, MichaelItem Updates in diabetes technology(2023-06-30) Abreu, MarconiItem Where are we on "artificial pancreas"?(2014-12-19) Rhee, Chanhaeng