Severe hyperglycemia: a determinant factor for hypofiltration in alloxan diabetic rats

Abstract. The relationships among glomerular filtration rate, renal plasma flow and extracellular fluid volume were investigated in control and severely hyperglycemic (442±33 mg/dl) untreated, alloxan diabetc rats. Most of diabetic animals showed significant lower values of inulin clearance (diabetics, 0.55±0.07 ml/min·100 g; controls, 0.97±0.04) and p-aminohippurate clearance (diabetics, 2.11±0.39 ml/min·100 g; controls, 3.93±0.25). Diabetic rats exhibited reduced efficiency in tubular Na⁺ reabsorption, increased urinary Na⁺ excretion (diabetics, 3.12±0.27 mEq/day; controls, 1.25±0.14) and diminished values of plasma renin activity (diabetics, 3.34±0.44 ng/ml·h; controls, 8.64±0.79). Significant negative correlations were found between glycemia and renal hemodynamic variables. Acute overload with glucose further decreased these variables in both groups: inulin clearance in diabetics vs. controls, 0.26±0.04 vs. 0.44±0.05 ml/min·100 g; p-aminohippuric acid clearance in diabetics vs. controls, 1.09±0.20 vs. 1.55±0.21 ml/min·100 g. We conclude that chronically hyperglycemic alloxan diabetic rats showed diminished glomerular filtration rates (inulin clearance), renal plasma flow (p-aminohippurate clearance) and extracellular fluid volume associated with urinary Na⁺ losses and alterations in the renin-angiotensin system. Decreased reninangiotensin system activity might reduce aldosterone secretion, which in turn could result in (succesively) urinary sodium loss, extracellular fluid volume contraction and reductions in glomerular filtration and renal plasma flow.     

颈椎脊髓损伤患者血糖的变化及影响因素

目的探讨颈椎脊髓损伤患者高血糖的发生率及导致高血糖的因素。方法检测53例颈椎外伤伤后7 d内空腹血糖浓度。结果53例颈椎外伤患者空腹血糖值(7．82±2．84)mmol／L。36例出现高血糖(血糖值大于6．4 mmol／L)。患者颈椎外伤后高血糖的发生率与脊髓损伤程度和年龄有关,与外伤原因和损伤病程长短无关。结论颈椎脊髓损伤后7 d内约有68％患者出现高血糖反应。脊髓损伤程度越重,患者血糖浓度越高。年龄大、完全性瘫痪的患者发生高血糖的概率较高。     

Association of glycated hemoglobin at an early stage of pregnancy with the risk of gestational diabetes mellitus among non‐diabetic women in Japan: The Japan Environment and Children’s Study

Aims/IntroductionGestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with adverse pregnancy outcomes. This study aimed to explore the associations between glycated hemoglobin (HbA1c) levels at the early stage of pregnancy and the GDM risk among non‐diabetic women in a nationwide study in Japan. In addition, the relationship between GDM and adverse pregnancy outcomes was also analyzed.Materials and MethodsThis cohort study (n = 89,799) used data from the Japan Environment and Children’s Study. We stratified the participants into four groups according to HbA1c levels at an early stage of pregnancy. We investigated the association of HbA1c at an early stage of pregnancy with the risk of GDM, and of GDM with the risk of some representative adverse pregnancy outcomes, using the multiple logistic regression model with adjustment for potential confounders.ResultsThe adjusted odds ratio for GDM per 0.1 percentage point increase in HbA1c (%) was 1.20. The adjusted odds ratio for developing GDM was significantly increased in women from the HbA1c 5.0–5.4% category. GDM significantly increased the adjusted odds ratio for adverse pregnancy outcomes, such as hypertensive disorders of pregnancy, polyhydramnios and premature birth.ConclusionsHigh‐normal HbA1c levels at the early stage of pregnancy are significantly associated with GDM risk in women in Japan. GDM was significantly associated with adverse pregnancy outcomes.     

超负荷血糖对鼠局灶性脑缺血侧皮质内皮抑素表达的影响

目的观察超负荷血糖对鼠局灶性脑缺血侧皮质区内皮抑素(endostatin)表达的影响,进一步探讨超负荷血糖加重脑缺血损伤的分子机制。方法用SD大鼠腹腔内注射链脲佐菌素首先建立糖尿病高血糖大鼠模型,继而应用栓线法建立永久性局灶性脑缺血模型。随机分为3大组:假手术组、脑缺血组和糖尿病脑缺血组。于缺血24h时间点行神经功能评分、TTC染色测梗死面积、TUNEL法检测细胞凋亡数目、免疫组化及Western blot检测ES表达,并进行图像分析。结果糖尿病脑缺血组的神经功能评分为(4.73±0.35)、梗死面积为(50.12±3.54)、细胞凋亡数为(26.22±2.35)、免疫组化检测ES为(99.35±3.25)及Western blot检测ES为(1.193±0.045)。脑缺血组的神经功能评分为(3.18±0.65)、梗死面积为(39.98±2.02)、细胞凋亡数为(17.28±1.01)、免疫组化检测ES为(113.17±1.35)及Western blot检测ES为(1.033±0.032)。与脑缺血组相比,糖尿病脑缺血组的神经功能评分、梗死面积、细胞凋亡数、ES蛋白表达均明显增加(P<0.05)。结论血管再生可能参与了超负荷血糖加重脑缺血损伤的过程,上调ES表达可能是超负荷血糖加重脑缺血损伤的机制之一。     

Novel appearance of hyperglycemia/diabetes,associated with COVID-19

In a recent meta-analysis the prevalence of coronavirus disease 2019 (COVID-19)-associated hyperglycemia was 25%, and that of COVID-19-associated new-onset diabetes was 19%. An association between hyperglycemia or new-onset diabetes and COVID-19 has been suggested. In a recent relevant study of critically and non-critically ill patients with COVID-19, we found that indeed beta-cell function was compromised in critically ill patients with COVID-19 and that these patients showed a high glycemic gap. Nevertheless, one quarter of critically ill patients with no history of diabetes have stress hyperglycemia, a finding which could obscure the prevalence of hyperglycemia or new-onset diabetes that could be attributed to COVID-19 per se.     

Chronopharmacology of dapagliflozin-induced antihyperglycemic effects in C57BL/6J mice

Chronopharmacology is the study of the varying responses of drugs to changes in biological timing and endogenous periodicities. The selective sodium-glucose cotransporter 2 inhibitor, dapagliflozin, is a globally prescribed antihyperglycemic drug. Although dapagliflozin is usually administered once a day, the specific intake time is generally not mentioned. Therefore, this study aimed at investigating the diurnal effects of dapagliflozin on high-fat diet (HFD)-induced obesity in mice. Five-week-old male C57BL/6J mice were fed a normal (control) diet or HFD for 10 weeks. During the last 2 weeks, the mice were administered olive oil/ethanol emulsion or dapagliflozin (1 mg/kg, p.o.) in the light or dark phase. At the end of the experiment, the mice were euthanized after an 18 h fasting period, and plasma and tissue samples (epididymal white adipose tissues, liver, and kidney) were collected. Dapagliflozin administration in the light phase significantly decreased plasma glucose levels, insulin levels, adipose adipokines, and decreased the size of adipocytes, compared with the HFD group. In contrast, these parameters remained unchanged in the mice treated during the dark phase. Our data therefore suggests that dapagliflozin portrays definite chronopharmacology, which may provide valuable information on the importance of drug administration timing for maximal pharmacological effects.     

Hyperglycemia in COVID-19 infection without diabetes mellitus: Association with inflammatory markers

BACKGROUND New onset hyperglycemia is common in patients with severe coronavirus disease 2019(COVID-19) infection. Cytokine storm due to COVID-19 infection is an essential etiology for new-onset hyperglycemia, but factors like direct severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)-induced pancreatic β-cell failure have also been postulated to play a role.AIM We plan to investigate further the mechanisms underlying SARS-CoV-2 infectioninduced hyperglycemia, particularly the rationale ...