Perinatal outcome in diabetic mothers with relation to glycemic control during pregnancy.

Objective: To determine the frequency of perinatal outcomes (macrosomia, large for gestational age, birth asphyxia) in pregnant diabetic women with low and high plasma glucose levels between 36-40 weeks. Study Design: Cross-sectional study. Setting: Department of Obstetrics & Gynaecology, DHQ Hospital, Lodhran. Period: 2017 to 2019. Material & Methods: Total 285 diabetic women of age 25-40 years with singleton pregnancy of gestational age 36-40 weeks were selected. Patients with multiple pregnancies, GDM, renal disease and hypertension were excluded. Plasma glucose levels (fasting & 2 hour post-prandial) measured and mean values (fasting + postprandial/2) calculated. The mean values falling between 100-139 mg/dl were taken as low plasma glucose level where as ≥140 mg/dl noted as high plasma glucose level. The perinatal outcomes (macrosomia, large for gestational age, birth asphyxia) were assessed at the time of delivery. Results: Mean age was 29.44 ± 6.01 years. Mean plasma glucose levels were 109.77 ± 6.81 mg/dl. Perinatal outcome i.e. macrosomia, large for gestational age infants and birth asphyxia was found in 7.72%, 27.37% and 22.81% respectively. In this study that pregnant women with mean plasma glucose of 100-139 mg/dl showed frequency of macrosomia by 3.59%, large for gestational age 16.17% and birth asphyxia 14.35% while women with mean plasma glucose of ≥140 mg/dl showed frequency of macrosomia by 13.56%, large for gestational Age 43.22% and birth asphyxia 34.75%. Conclusion: Pregnant diabetic women with high plasma glucose levels have significantly high percentage of large for gestational age, birth asphyxia and macrosomia as compared to diabetic mothers with low plasma blood glucose levels. Consider diabetic mothers at risk and implement efficacious treatment in order to reduce the perinatal complications.

Molecular Characterization and Identification of Facilitative Glucose Transporter 2 (GLUT2) and Expression of Related Glycometabolism in Response to Different Starch Levels in Blunt Snout Bream (Megalobrama amblycephala)

Facilitative glucose transporters (GLUT) are transmembrane transporter of proteins involved in glucose transport across the plasma membrane. To date, there is no information about glucose transporter 2 (GLUT2) in blunt snout bream (Megalobram aamblycephala). In this study, GLUT2 were cloned and characterized from blunt snout bream, and its-expression in response to diets with different carbohydrate levels (17.1%; 21.8%; 26.4%; 32.0%; 36.3% and 41.9% of dry matter). In this study, the full-length cDNA of GLUT2 was 2577 bp, including a 5’-untranslated region (UTR) of 73 bp, a 3’-UTR of 992 bp, and an open reading frame of 1512 bp, encoding a polypeptide of 503 amino acids with predicted molecular weight of 55.046 kDa and theoretical isoelectric point of 7.52. GLUT2 has twelve across the membrane area locating at 7-29; 71-93; 106-123; 133-155; 168-190; 195-217; 282-301; 316-338; 345-367; 377-399; 412-434; 438-460 aimo acids respectively. Conservative structure domains located at 12-477 aimo acids belonging to sugar porter family major facilitator superfamily (MFS) transporter. The blunt snout bream GLUT2 showed high identity to their orthologs in other fish species and mammals. Quantitative real-time (qRT)-PCR assays revealed that GLUT2 expression was high in the liver, intestine and kidney; highest in the liver. Compared with the control group (17.1%), high dietary carbohydrate levels (32.0%; 36.3% and 41.9%) resulted in high plasma glucose at 3h after feeding, but high plasma glucose were back to basal at 24h after feeding. Furthermore, high dietary carbohydrate levels significantly improved the glycolysis and inhibitied gluconeogenesis by augmentation of GK and PK expression, inhibition of PEPCK and G6P mRNA levels (P<0.05). However, GLUT2; GK; PK; PEPCK and G6P mRNA levels were back to basal.

The Spontaneously Diabetic Torii Rat: An Animal Model of Nonobese Type 2 Diabetes with Severe Diabetic Complications

The Spontaneously Diabetic Torii (SDT) rat is an inbred strain of Sprague-Dawley rat and recently is established as a nonobese model of type 2 diabetes (T2D). Male SDT rats show high plasma glucose levels (over 700 mg/dL) by 20 weeks. Male SDT rats show pancreatic islet histopathology, including hemorrhage in pancreatic islets and inflammatory cell infiltration with fibroblasts. Prior to the onset of diabetes, glucose intolerance with hypoinsulinemia is also observed. As a result of chronic severe hyperglycemia, the SDT rats develop profound complications. In eyes, retinopathy, cataract, and neovascular glaucoma are observed. Proliferative retinopathy, especially, resulting from retinal neovascular vessels is a unique characteristic of this model. In kidney, mesangial proliferation and nodular lesion are observed. Both peripheral neuropathy such as decreased nerve conduction velocity and thermal hypoalgesia and autonomic neuropathy such as diabetic diarrhea and voiding dysfunction have been reported. Osteoporosis is another complication characterized in SDT rat. Decreased bone density and low-turnover bone lesions are observed. Taking advantage of these features, SDT rat has been used for evaluating antidiabetic drugs and drugs/gene therapy for diabetic complications. In conclusion, the SDT rat is potentially a useful T2D model for studies on pathogenesis and treatment of diabetic complications in humans.

An educational tool for understanding the cardiovascular changes associated with diabetes.

Diabetes, a syndrome characterized by high plasma glucose and low plasma insulin concentrations, is associated with somatic and autonomic neuropadiabetes as well as cardiac and vascular disorders. These consequences of diabetes significantly affect the organism's ability to maintain homeostasis. To understand the changes associated with diabetes, we developed a laboratory exercise that compares and contrasts the cardiovascular responses to exercise in an individual with diabetes and in an individual without diabetes. This exercise provides a unique opportunity to analyze, integrate, and interpret the changes associated with diabetes, since more is learned about how a system operated when the system is forced to perform than when it is idle. In this laboratory, anatomical and physiological data concerning diabetes are provided. Subsequently, a figure that illustrates the response of a specific cardiovascular variable during exercise (e.g., heart rate, cardiac output, blood pressure) is presented. Students are challenged to analyze and assimilate information from figures, answer questions, make calculations, fill in tables, and plot graphs. The laboratory does not require equipment or software, only rulers and pencils. The answers to the questions and tables are provided in the APPENDIX. Students obtain experience in evaluating and understanding diabetes as well as applying basic cardiovascular concepts. The emphasis is on the application of basic cardiovascular principles, interpretation of pictorial or tabular material, and problem-solving skills.

Metabolic characteristics of cat kidney: failure to adapt to metabolic acidosis

During studies performed on domestic cats made acidotic with ammonium chloride, it was found that the cat kidney is unable to adapt to metabolic acidosis. Renal proximal tubules do not increase their production of ammonia or glucose from glutamine during acidosis. During in vivo studies, the renal excretion of ammonia did not change much during acidosis. Other metabolic parameters in the cat were not very different from those found in other animals such as rat or dog. However, it was found that cats may show a relatively high plasma glucose concentration compared with other animals. Plasma insulin concentration was normal, and the animals showed no evidence of diabetes mellitus. It is not known whether limitation of ammoniagenesis and elevated plasma glucose concentration also characterize larger felidae such as panthers and cougars.