PSVI-9 Effects of dietary boron supplementation on growth performance, fasting and postprandial serum insulin, and glucose concentration of pigs

A 49-d experiment evaluated the effects of supplemental boron (B) on growth, and serum insulin and glucose concentration of pigs. Crossbred pigs [n = 48; initial body weight (BW) 19.18 ± 0.29 kg] were randomly allotted to 1 of 4 diets based on BW and sex. Diets were corn-SBM-based, formulated to meet NRC (2012) nutrient requirement estimates, and were supplemented with 0, 25, 50, or 100 mg B/kg diet as sodium tetraborate decahydrate. On d 20 and 41, blood samples were collected. Fasting samples were collected following an overnight fast; then a postprandial sample was taken approximately 50 minutes after the pigs had 10 minutes of ad libitum access to feed. Samples were processed and serum analyzed for insulin and glucose concentration. Increasing B levels resulted in a linear decrease for overall ADG (0.87, 0.86, 0.85, and 0.82 kg, P = 0.02). On d 20, supplemental B resulted in a quadratic response on fasting serum glucose concentration (5.25, 4.80, 4.65, and 5.01, P = 0.03) and a linear decrease in postprandial serum insulin concentration (29.1, 25.5, 18.2, and 18.1 µU/mL, P = 0.02). Furthermore, there was a tendency for a linear decrease in fasting insulin:glucose ratio (0.85, 0.84, 0.42, and 0.59, P = 0.08), which became more noticeable during the postprandial state (3.96, 3.63, 2.63, and 2.73, P = 0.02). Again on d 41, there was a quadratic response on fasting serum glucose concentration (4.32, 4.07, 3.91, and 4.68, P = 0.01) with supplemental B. Results suggest that supplemental boron may impact serum insulin and glucose concentrations by reducing the amount of insulin needed to maintain glucose concentrations. However, higher levels of supplemental boron did result in suppressed growth performance. Thus, additional research is warranted to determine the optimum level of supplemental B.

Serum Glucose Measurement after Five to Six Hours is Comparable to Eight Hours Overnight Fasting in Ramadan

Objectives: This study was done to evaluate whether a shorter fasting duration of five to six hours can be used as an alternative to the usually recommended eight hours fasting serum glucose measurement. Methods: An observational, cross-sectional study was conducted during Ramadan (May) 2019, on 200 individuals. Two fasting serum glucose (FSG) venous samples taken, the first after 5-6 hours after predawn meal (suhoor), and the second after 8 hours. Participants were divided into two groups; normal individuals, and those who have type 2 diabetes mellitus (T2DM). Patients with T2DM further subdivided into three groups: those without treatment, those on oral antidiabetic drugs (OAD), and those using insulin and OAD. Results: There was no significant difference between the mean FSG readings in mg/dL (mmol/L) between the first and second samples for healthy individuals, 104.5 ± 21.4 (5.79±1.18) and 104.8 ± 12.6 (5.82±0.7), respectively. Generally, the same is true for T2DM patients with FSG values of 235 ± 107 (13.04±5.94) and 230 ± 105 (12.77±5.83). Untreated T2DM patients have consecutive FSG readings of 194.0 ± 151.5 (10.77±8.41) and 193.9 ± 128.9 (10.76±7.15), respectively, in the two samples without significant difference. Patients using insulin and OAD showed similar pattern of FSG 268 ± 111 (14.87±6.16) and 269 ± 114 (14.93±6.33), respectively. The only significant difference was observed in patients on OAD which have 220 ± 78 (12.21±4.33) and 207 ± 77 (11.49±4.27) for their successive FSG samples. Conclusions: The overnight fasting duration of 5-6 hours, can give a comparable measurement of fasting serum glucose as that obtained by 8 hours. Keywords: Glucose; Fasting; Duration; Diabetes Mellitus

Selar (Selar crumenophthalmus) Fish Protein Hydrolysate Has an Antidiabetic Properties Possibly through GLP-1

Background : Enzymatic hydrolysis of fish protein using protease or fish protein hydrolysate can form bioactive peptides that has antidiabetes activity. One potential mechanism of fish protein hydrolysate in reducing blood glucose is through increased endogenous glucagon like peptide (GLP)-1 production. Tempeh is soy fermented food that has protease which is potential as biocatalyst in producing fish protein hydrolysate. Objective: To evaluate the antidiabetic properties of Selar (Selar crumenophthalmus) fish protein hydrolysate using tempeh protease as biocatalyst and duodenal gene expression of GLP-1. Methods: Selar fish protein isolate was digested for 8 hours at 37° C using crude tempeh protease. Diabetes mellitus was induced in rats by intraperitoneal injection of streptozotosin (65 mg/kg bw) and nicotinamide (230 mg/kg bw). Fish protein isolate and hydrolysate in dose of 300 mg/ bw and 500 mg/ bw were orally administered daily for 4 weeks. Blood was drawn for fasting serum glucose and lipid profile analysis. Total RNA were isolated from duodenum and quantitative real time PCR was performed to quantify mRNA expression of GLP-1. Data were analyzed using one way ANOVA and gene expression analysis were performed using Livak. Results and Discussion: There is a significant difference on fasting serum glucose, total cholesterol, triglyceride, LDLcholesterol, HDL-cholesterol and duodenal GLP-1 mRNA expression level between groups (p<0.05). The duodenal GLP1 mRNA expression was the highest in rats received hydrolyzed fish protein 500 mg/ bw.

Indicators of Adrenal Insufficiency in TB-suspect Patients Presenting with Signs and Symptoms of Adrenal Insufficiency at Three South African Hospitals in Pretoria

Background: Primary adrenal insufficiency occurs when the function of the adrenal cortex to produce cortisol is impaired. Infections, such as disseminated Tuberculosis (TB) and malignancies, are the major causes of Adrenal Insufficiency (AI) in developing countries. AI is characterized by specific symptoms, signs, and laboratory findings. Objective: To determine indicators of AI in TB-suspect patients presenting with signs and symptoms of AI. Methods: A cross-sectional study was conducted at the primary health care ward of Dr. George Mukhari Academic Hospital, Jubilee District Hospital, and Odi District Hospital. The population comprised all TB-suspects, from whom a sample of 75respondents was obtained. A researcher administered questionnaire was used to collect data related to their signs, symptoms, and laboratory findings. Results: Of the 75 respondents, 47 (62.37) and 28 (37.3%) were classified as Adrenal Sufficiency (AS) and AI, respectively. The most occurring symptoms were craving for salt, dry, itchy skin, and vomiting (prevalence: 79.7%, 68.1%, and 69.0%, respectively). Signs or symptoms by themselves did not discriminate persons with a high likelihood of AI. However, a fasting serum glucose (≤ 5.25 mmol/L), a positive GeneXpect, a low CD4 count (≤ 274.5 cells/ml), with a combination of signs and symptoms (9.5) constituted a discriminator for AI in TB-suspect patients (87.5% likelihood). Conclusion: A low fasting serum glucose, a positive GeneXpect, a low CD4 count with a minimum of ten signs and symptoms constitute a discriminator for AI in TB-suspect patients, necessitating treatment initiation to save patient lives in laboratory resource-limited settings.

5879Coronary microvascular dysfunction is associated with poor glycemic control in women with diabetes presenting with chest pain and non-obstructive coronary artery disease

Background Patients with type 2 diabetes are at an increased risk of cardiovascular events compared to individuals without diabetes. The role glycemic control plays in reducing cardiovascular risk remains uncertain. Coronary microvascular dysfunction (CMD) is more frequent in women compared to men, is prevalent in patients with type 2 diabetes and is linked to adverse cardiovascular events. We compared the association between CMD and glycemic control across sexes in patients with chest pain and non-obstructive coronary artery disease (CAD). Methods Patients with chest pain who were found to have non-obstructive CAD (stenosis <40%) at angiography underwent an invasive assessment of endothelial-independent and endothelial–dependent coronary microvascular function. Using a Doppler guidewire, endothelial-independent microvascular function was assessed by measuring the coronary flow velocity in response to intracoronary adenosine and comparing this to baseline to calculate the coronary flow reserve ratio (CFRAdn). A CFRAdn ≤2.5 was considered abnormal. Endothelial-dependent microvascular function was assessed by measuring the percent change in coronary blood flow in response to intracoronary infusions of acetylcholine (%ΔCBFAch), with a %ΔCBFAch ≤50% considered abnormal. Patients were classified as having normal versus abnormal CFRAdn and %ΔCBFAch. Measurements of HbA1c and fasting serum glucose were obtained at the time of catheterization and compared between groups after stratification by sex. Results Between 1993 and 2012, 1,469 patients (mean age 50.4 years, 35% male) underwent coronary angiography and invasive testing for CMD, of which 129 (8.8%) had type 2 diabetes. Fifty one (39.5%) had an abnormal %ΔCBFAch and 49 (38.0%) had an abnormal CFRAdn. Conventional cardiovascular risk factors did not vary significantly between groups. Females with an abnormal CFRAdn or abnormal %ΔCBFAch had a significantly higher HbA1c compared to those with a normal CFRAdn or %ΔCBFAch respectively: HbA1c % (standard deviation) 7.4 (2.1) vs. 6.5 (1.1), p=0.035 and 7.3 (1.9) vs. 6.4 (1.2), p=0.022, respectively. Females with an abnormal CFRAdn had significantly higher fasting serum glucose concentrations compared to those with a normal CFRAdn: fasting serum glucose mg/dL (standard deviation) 144.4 (55.6) vs. 121.9 (28.1), p=0.035. These effects were not observed in men. Amongst female diabetics, a higher HbA1c was significantly associated with any CMD after adjusting for covariates: odds ratio (95% confidence interval) 1.69 (1.01 – 2.86) p=0.049; and a fasting serum glucose >140 mg/dL was significantly associated with an abnormal CFRAdn, 4.28 (1.43–12.81). Conclusion Poor glycemic control is associated with CMD in females with diabete who present with chest pain and non-obstructive CAD. These findings highlight the importance of sex-specific risk stratification models and treatment strategies when managing cardiovascular risk in diabetics. Acknowledgement/Funding Mayo Foundation