Endocrinology-metabolism ; Association between blood glucose level derived using the oral glucose tolerance test and glycated hemoglobin level

( Hyoung Joo Kim ),( Young Geon Kim ),( Jin Soo Park ),( Young Hwan Ahn ),( Kyoung Hwa Ha ),( Dae Jung Kim ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.3

Background/Aims: Glycated hemoglobin (HbA1c) is widely used as a marker of glycemic control. Translation of the HbA1c level to an average blood glucose level is useful because the latter figure is easily understood by patients. We studied the association between blood glucose levels revealed by the oral glucose tolerance test (OGTT) and HbA1c levels in a Korean population. Methods: A total of 1,000 subjects aged 30 to 64 years from the Cardiovascular and Metabolic Diseases Etiology Research Center cohort were included. Fasting glucose levels, post-load glucose levels at 30, 60, and 120 minutes into the OGTT, and HbA1c levels were measured. Results: Linear regression of HbA1c with mean blood glucose levels derived using the OGTT revealed a significant correlation between these measures (predicted mean glucose [mg/dL] = 49.4 × HbA1c [%] . 149.6; R2 = 0.54, p < 0.001). Our linear regression equation was quite different from that of the Alc-Derived Average Glucose (ADAG) study and Diabetes Control and Complications Trial (DCCT) cohort. Conclusions: Discrepancies between our results and those of the ADAG study and DCCT cohort may be attributable to differences in the test methods used and the extent of insulin secretion. More studies are needed to evaluate the association between HbA1c and self monitoring blood glucose levels.

Various pain stimulations cause an increase of the blood glucose level

Sim, Yun-Beom,Park, Soo-Hyun,Kang, Yu-Jung,Jung, Jun-Sub,Ryu, Ohk-Hyun,Choi, Moon-Gi,Suh, Hong-Won The Korean Society for Integrative Biology 2012 Animal cells and systems Vol.16 No.5

The relationship between pain stimulation and the blood glucose level was studied in ICR mice. We examined the possible change of the blood glucose level after the pain stimulation induced by acetic acid injected intraperitoneally (i.p.),, formalin injected subcutaneously (s.c.) into the hind paw, or substance P (SP), glutamate, and proinflammatory cytokines (TNF-${\alpha}$ and IFN-${\gamma}$) injected intrathecally (i.t.). We found in the present study that acetic acid, formalin, SP, TNF-${\alpha}$, and IFN-${\gamma}$ increased the blood glucose level. The blood glucose level reached at maximal state 30 min and returned to normal level 2 h after the pain stimulation in a fasting group. Furthermore, acetic acid, formalin, SP, TNF-${\alpha}$, and IFN-${\gamma}$ caused the elevation of the blood glucose level in D-glucose-fed group only in an additive manner. However, i.t. injection of glutamate did not alter the blood glucose level in a fasting group. In contrast, i.t. injection of glutamate enhanced the blood glucose level in the D-glucose-fed group. Our results suggest that the blood glucose level appears to be differentially regulated by various pain stimulation induced by acetic acid, formalin, SP, glutamate, and pro-inflammatory cytokines.

마라톤선수의 葡萄糖攝取後 血中葡萄糖 및 인슐린濃度의 變化

李根大,黃樹寬,朴載植,朱永恩 慶北大學校 醫科大學 1987 慶北醫大誌 Vol.28 No.4

마라톤선수를 대상으로 하여 포도당 섭취후 血糖濃度 및 血中인슐린濃度의 變化를 究明하고자 19∼21세의 남자대학생 長距離選手 16명과 非選手 16명을 選定하여, 10% 및 20% 포도당 용액을 體重當 8㎖를 섭취시킨 후 時間 經過에 따라 血糖 및 인슐린濃度를 測定하여, 섭취한 포도당농도별로 비교하고, 또한 選手群과 非選手群을 비교하였다. 10% 및 20% 포도당용액을 섭취한 후 血糖濃度가 증가하기 시작하여 30분에 최고값이 각각 147.91㎎/dl 및 162.37㎎/dl에 이른 후 차차 감소하여 120분에 섭취전의 값으로 거의 돌아왔다. 10% 포도당용액 섭취후 10분에 134.40㎎/dl로 20%의 114.78㎎/dl에 비해 有意하게 높았으나, 그 이후는 낮은 값을 유지했다. 인슐린濃度는 포도당섭취후 血糖濃度의 증가에 비해 급증하였고, 20% 포도당용액 섭취후 인슐린농도가 10%포도당섭취에 비해 높았으며 특히 30분 및 60분에 각각 29.29uu/㎖ 및 31.21uu/㎖로 10%의 21.14uu/㎖ 및 18.75uu/㎖에 비해 有意하게 높았다. 選手群의 血糖濃度는 10% 포도당용액을 섭취한 30분에 최고치를 나타냈으며, 그후 감소하여 120분에 섭취전의 값으로 돌아온데 비해, 非選手群에서는 60분에 최고치를 나타낸 다음 차차 감소하여 150분에 섭취전의 값으로 돌아왔다. 20% 포도당용액을 섭취한 후에는 양군 모두 30분에 최고값을 나타내었으나 選手群이 더 빨리 증가하고 또한 더 빨리 감소하였다. 選手群의 인슐린濃度는 10%포도당용액 섭취후 30분부터 非選手群에 비해 낮았으며, 특히 60, 90 및 120분에 각각 18.75uu/㎖, 12.17uu/㎖ 및 7.74uu/㎖로 非選手群의 29.35uu/㎖, 28.21uu/㎖ 및 22.25uu/㎖에 비해 유의하게 낮았다. 20% 포도당용액 섭취후에는 選手群에서 非選手群에 비해 전실험기간중 유의하게 낮은 인슐린 값을 나타내었다. 血糖濃度와 인슐린濃度의 相關은 매우 높았으며, 이에 따라 推定式을 設定하였다. 이상의 結果를 綜合해 보면 葡萄糖攝取後 血糖濃度의 增加보다 인슐린濃度가 急增한 점과 섭취하는 포도당濃度가 增加함에 따라 血糖濃度는 다소 增加한데 반해 인슐린濃度는 有意한 差로 增加한 점은 注目할 만한 사실이며, 選手群이 非選手群에 비해 血糖濃度가 더 빨리 增加하고 또한 더 빨리 減少한 점과 인슐린濃度가 選手群에서 非選手群에 비해 有意하게 낮은 점은 또한 特記할 만한 사실이다. Effects of glucose ingestion on blood glucose and insulin levels in long-distance runners were studied to observe if there is any difference in glycolytic metabolism between the normal person and well-trained athletes like marathon runners. Sixteen long-distance runners were orally given either 10% (8 runners) or 20% (8 runners) of glucose solution after overnight fasting in a dose of 8㎖ per ㎏ of body weight. Blood concentrations of glucose and insulin were measured for 180 minutes at an interval of 5, 10 or 30minutes. Data obtained were compared with those from 16 healthy, non-athletic college students. After 10% glucose ingestion, the athletes showed an abrupt increase in blood glucose at 10 minutes and reached a peak at 30 minutes, whereas the non-athletes showed a much slower increase in blood and a peak at 60 minutes. In case of serum insulin, the concentration reached a peak at 10 minute; in athletes and at 30 minutes in non-athletes. The athletes showed significantly lower level of insulin than the non-athletes, but the maximum blood glucose level was similar in both groups. On the other hand, after 20% glucose ingestion, changes in blood glucose level was similar in both groups. On the other hand, after 20% glucose ingestion, changes in blood glucose level were not significantly different between the two groups. However, response in insulin release was significantly smaller in the athletes than the non-athletes. Comparing the response between 10% and 20% glucose group, maximal blood level of glucose was not different, but insulin release was much greater after 20% glucose ingestion than 10% glucose ingestion. Decrease in blood glucose was faster in the athletes than in the non-athletes after both 10% and 20% glucose ingestion. There was a highly significant linear correlation between blood glucose and insulin. The non-athletes showed a much steeper slope than the athletes. The results indicate that the athletes absorb and metabolize glucose faster than non-athletes with significantly lower serum insulin level.

Various pain stimulations cause an increase of the blood glucose level

심윤범,서홍원,박수현,강유정,정준섭,류옥현,최문기 한국통합생물학회 2012 Animal cells and systems Vol.16 No.5

The relationship between pain stimulation and the blood glucose level was studied in ICR mice. We examined the possible change of the blood glucose level after the pain stimulation induced by acetic acid injected intraperitoneally (i.p.),, formalin injected subcutaneously (s.c.) into the hind paw, or substance P (SP), glutamate, and proinflammatory cytokines (TNF-a and IFN-g) injected intrathecally (i.t.). We found in the present study that acetic acid, formalin, SP, TNF-a, and IFN-g increased the blood glucose level. The blood glucose level reached at maximal state 30 min and returned to normal level 2 h after the pain stimulation in a fasting group. Furthermore, acetic acid,formalin, SP, TNF-a, and IFN-g caused the elevation of the blood glucose level in D-glucose-fed group only in an additive manner. However, i.t. injection of glutamate did not alter the blood glucose level in a fasting group. In contrast, i.t. injection of glutamate enhanced the blood glucose level in the D-glucose-fed group. Our results suggest that the blood glucose level appears to be differentially regulated by various pain stimulation induced by acetic acid,formalin, SP, glutamate, and pro-inflammatory cytokines.

Noninvasive Blood Glucose Level Detection Based on Matrix Pencil Method and Artificial Neural Network

Li Qinwei,Xia Xiao,Kikkawa Takamaro 대한전기학회 2021 Journal of Electrical Engineering & Technology Vol.16 No.4

A method of improving the resolution of the detected blood glucose level by using the microwave detection technique is proposed in this paper. In this proposed method, the matrix pencil method and the artifi cial neural network are combined to help improve the resolution of the detected blood glucose level. The matrix pencil method is applied to extract the poles of the received microwave signals. And the artifi cial neural network which is very popular in the artifi cial intelligence fi eld in recent years is also utilized to help distinguish the blood glucose level by training the poles extracted from the received signals. The reliability of the method is checked by establishing an earlobe model which is more realistic than it is in the former research. The mean error between the real blood glucose level and the detected blood glucose can be 0.09957% which is minor than 0.1%. The correctness of the method is testifi ed by successfully detecting the blood glucose level with the precision of 1 mg/dl. The UWB microwave detection system can satisfy the detection of the normal range of the plasma glucose level 70–240 mg/dl.

Near-Drowning 환아의 예후 판정에 대한 초기 Glucose의 의의

차상원(Sang Won Cha),이건수(Keon Su Rhee) 대한소아신경학회 1993 대한소아신경학회지 Vol.1 No.2

To validate the prognostic significance of initial blood glucose level in near-drowning, we have researched the relationship between initial blood glucose level and complications of 21 patients under 15 years with near-drowning, who admitted to the Department of Pediatrics, Chungnam National University Hospital from Jan. 1985 to Dec. 1992. The results were as follows ; 1) In distribution of sex, male was 15 cases and female was 6 cases and male to female ratio was 2.5:1. 2) The most common age group of incidence was under 3 years(8 cases:38.0%) 3) The most common season of incidence was summer(16 cases:76.6%) 4) The mean blood glucose level of subjects was 198mg/dl. 5) The group of prolonged period of submersion was significantly higher initial blood glucose level than short period of submersion. 6) The initial blood glucose level of patients with complications(224.30mg/dl) was significantly higer than patients without complications(157.25mg/dl). The results suggest that initial blood glucose level is one of the important prognostic predictor of near-drowning patients.

Effects of Goat Milk Yogurt Supplemented with Citrus Concentrate on Blood Glucose and Serum Lipids in Diabetic Rats

함준상,신지혜,장애라,정석근,박광욱,김현욱,강수연,황혜중,이완규,Ham, Jun-Sang,Shin, Ji-Hye,Jang, Ae-Ra,Jeong, Seok-Geun,Park, Kwang-Wook,Kim, Hyun-Uk,Kang, Su-Yeon,Hwang, Hye-Joong,Lee, Wan-Kyu Korean Society for Food Science of Animal Resource 2008 한국축산식품학회지 Vol.28 No.4

The effects of fermented goat milk supplemented with citrus concentrate on blood glucose levels in streptozotocin-nicotinamide-induced diabetic rats were examined. Streptozotocin-nicotinamide-induced diabetic rats (type II) were divided into five experimental groups treated with metformin, goat milk, fermented goat milk, fermented goat milk containing citrus concentrate, or no supplementation (control). The rats in each group were examined weekly for blood levels of glucose, total cholesterol, triglyceride. HDL-cholesterol, LDL-cholesterol. and body weight. On the $24^{th}$ day of the experiment, an oral glucose tolerance test (OGTT) was carried out. Administration of fermented goat milk to the diabetic rats significantly decreased blood glucose and triglyceride levels, while administration of metformin (33.3 mg/kg body weight) did not significantly lower blood glucose levels. Fermented goat milk containing citrus concentrate caused a significant decrease in blood glucose levels in the OGTT at 30 min. This study shows that supplementation with fermented goat milk containing citrus concentrate may be a practical method of reducing blood glucose levels in type II diabetics.

제2형 당뇨병 환자에서 혈당강하제와 보중익기탕 병용 투여가 혈당 변화에 미치는 영향 및 안전성 연구

오승현,정우녕,송미령,노지원,안영민,안세영,이병철,Seung-hyun Oh,Woo-nyoung Jung,Mee-ryoung Song,Ji-won Noh,Young-min Ahn,Se-young Ahn,Byung-cheol Lee 대한한방내과학회 2023 大韓韓方內科學會誌 Vol.44 No.3

Objective: This study aimed to assess the safety and effect on glucose level of Bojungikgi-tang in patients with type 2 diabetes mellitus. Methods: To review patients' clinical characteristics and laboratory tests retrospectively, we investigated 15 hospitalized patients with type 2 diabetes mellitus who took Bojungikgi-tang at Kyung Hee University Korean Medical Hospital for at least one day between January 2012 and December 2022. The blood glucose levels, including fasting blood sugar (FBS), 2-hour postprandial glucose (PP2) levels, and glycated hemoglobin level, were collected to determine the effect of the Bojungikgi-tang on blood sugar changes. Furthermore, to evaluate the safety of Bojungikgi-tang, hepatic function and renal function tests were implemented, including aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, γ-glutamyltransferase, blood urea nitrogen, creatinine, and Modification of Diet in Renal Disease estimated glomerular filtration rate. Results: When Bojungikgi-tang and a standard treatment for diabetes were administered for patients with type 2 diabetes, it was confirmed that there were no statistically significant changes in FBS and PP2 levels in the analysis of each medication taken. There was no significant difference in the safety profile after taking Bojungikgi-tang. Conclusions: The combined administration of Bojungikgi-tang with standard hypoglycemic medication for patients with type 2 diabetes may not affect blood glucose levels and safety.

감(Diospyros kaki Thunb) 또는 감부산물에서 추출한 감시럽의 혈당수치에 미치는 영향

유기환(Ki-Hwan Yoo),김석진(Seok-Jin Kim),정종문(Jong-Moon Jeong) 한국식품영양과학회 2011 한국식품영양과학회지 Vol.40 No.5

본 연구에서는 한국의 주요 과실 중 하나인 감과 감의 부산물을 이용하여 추출한 시럽인 PSⅠ과 PSⅡ의 총 탄수화물 함량, 총 페놀성 화합물 함량 그리고 혈당반응에 의한 혈당지수를 측정하였다. PSⅠ과 PSⅡ의 총 탄수화물 함량측정결과 70.6±0.6, 66.6±1.6%로 나타났으며 시판중인 감미료인 설탕, 메이플 시럽, 꿀의 100.0±0.6, 80.0±0.8, 69.9±1.9% 탄수화물 함량보다 비교적 적은 함량의 탄수화물을 포함하고 있음을 확인하였다. 또한 총 페놀성 화합물은 포도당, 설탕, 메이플 시럽, 꿀이 0.1±0.1, 0.1±0.1, 0.5±0.1, 0.2±0.1 ㎎/g을 함유하고 있으며, PSⅠ과 PSⅡ는 0.3±0.1, 0.6±0.2 ㎎/g의 페놀성 화합물을 함유하는 것으로 나타나 시판중인 감미료와 비슷하거나 더 많은 양의 페놀성 화합물을 함유하는 것으로 확인되었다. 정상 혈당의 mouse에 대한 PSⅠ과 PSⅡ의 혈당반응을 측정한 결과 급격한 혈당 증가와 감소를 보인 대조군과는 다르게 PSⅠ과 PSⅡ는 적은 양의 혈당 증가와 완만한 혈당 감소를 보였다. 당뇨가 유발된 SD rat에 대한 혈당반응 역시 메이플 시럽의 실험군을 제외하고 다른 대조군과 비교하여 상대적으로 PSⅠ과 PSⅡ는 적은 혈당 증가를 보였다. 정상인을 대상으로 한 혈당반응 실험 결과 시료섭취 30분 이내에 모든 실험군의 혈당이 최고치를 나타냈으며, 가장 높은 혈당증가를 보인 꿀에 비해 PSⅠ과 PSⅡ의 혈당 증가가 유의적으로 적음을 확인하였다. 또한 이 혈당반응 면적을 통해 혈당지수를 구한 결과 PSⅠ과 PSⅡ의 혈당지수는 각각 51.9, 35.7로 나타났다. 감시럽은 당질 이외에 감에서 유래된 유용한 성분을 다량 함유하고 또한, 동일한 탄수화물 양을 섭취하여도 혈당의 상승폭이 크지 않았으므로 이는 혈당 증가의 부담 없는 천연 감미료의 개발 및 기존 감미료를 대체하는 천연 감미료의 가능성을 보여주는 것이라 사료된다. The purpose of this study was to measure the blood glucose level and glycemic index (GI) in response to persimmon (Diospyros kaki Thunb) syrup extracted from persimmon and extract of persimmon by-products. Major component analyses of persimmon syrup Ⅰ (PSⅠ, 95:5 mixture of purified persimmon syrup and non-purified persimmon syrup) and persimmon syrup Ⅱ (PSⅡ, 50:50 mixture ratio of purified persimmon syrup and non-purified persimmon syrup) were 0.3±0.1 and 0.6±0.2 ㎎/g for total polyphenolic compounds and 70.6±0.6 and 66.6±1.6% for total carbohydrates, respectively. Blood glucose responses of PSⅠ and PSⅡ were determined using both normal ICR mice and streptozotocin (STZ)-induced diabetic male Sprague-Dawley (SD) rats. Further, oral glucose tolerance test (OGTT) was performed on diabetic rats to assess the effects of the experimental diets. Blood glucose response and OGTT showed that blood glucose levels were significantly lower in mice and diabetic rats fed PSⅠ and PSⅡ compared to those fed diets of sugar, maple syrup, or honey. The GIs of healthy volunteers in response to PSⅠ and PSⅡ were calculated to be 51.9 and 35.7, respectively. On the contrary, the GIs of healthy volunteers fed diets including sugar, maple syrup, or honey were 52.6, 20.0, and 93.0, respectively. These results suggest that persimmon syrup can be used for both the treatment of diabetics and healthy people due to its beneficial effects on blood glucose level.

Fucosylated Chondroitin Sulfate From Sea Cucumber Improves Glucose Metabolism and Activates Insulin Signaling in the Liver of Insulin-Resistant Mice

Shiwei Hu,Ying-Ying Tian,Yao-Guang Chang,Zhao-Jie Li,Chang-Hu Xue,Yu-Ming Wang 한국식품영양과학회 2014 Journal of medicinal food Vol.17 No.7

This study investigated the effects of fucosylated chondroitin sulfate (CHS) isolated from sea cucumber on glucose metabolism and insulin signaling in the liver of insulin-resistant C57BL/6 mice fed a high-fat, high-sucrose diet (HFSD). Male C57BL/6J mice were randomly assigned into six groups: control; HFSD; 1mg RSG/kg$body weight (RSG); 80 mg CHS/kg$body weight (CHS); 20 mg CHS + 1mg RSG/kg$body weight (20 CHS + RSG); and 80 mg CHS + 1mg RSG/kg$body weight (80 CHS + RSG). Blood glucose, insulin parameters, glucose metabolism-related enzymes activities and insulin-signaling transducers in the liver were analyzed at 19 weeks. Results showed that CHS significantly decreased body weight gain, adipose tissue weight, and fasting blood glucose and serum insulin levels in insulin-resistant mice. Rosiglitazone (RSG) is an effective thiazolidinedione hypoglycemic agent, and CHS synergistically enhanced the effect of RSG. CHS feeding normalized the activities of hexokinase, pyruvate kinase, glycogen phosphorylase, glucose-6-phosphatase, and increased glycogen reserves in the liver. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis showed that CHS promoted the mRNA expression of insulin receptors (IR), insulin receptor substrate 2 (IRS-2), phosphatidylinositol 3 kinase (PI3K), protein kinase B (PKB), and glycogen synthase (GS) in the liver of insulin resistant mice, and inhibited glycogen synthase kinase-3 (GSK-3b) mRNA expression. The results suggested that CHS treatment improved glucose metabolism by modulating metabolic enzymes and promoting the PI3K/PKB/GSK-3b signaling pathway mediated by insulin at the transcriptional level. These results provided strong justification for the development of CHS as a functional food.