Search Results (7)

Background: Diabetes mellitus is a well-established risk factor for surgical site infections (SSIs), particularly periprosthetic joint infections (PJIs) following joint arthroplasty. Although strict glycemic control in the early postoperative period is critical, few studies have evaluated glycemic dynamics using continuous glucose monitoring (CGM) in this setting. This study aimed to characterize early postoperative glycemic patterns using CGM in patients with type 2 diabetes mellitus undergoing lower extremity arthroplasty and to identify factors associated with postoperative hyperglycemia. Methods: We retrospectively analyzed 41 patients with type 2 diabetes who underwent total hip or knee arthroplasty. CGM was used to monitor glucose levels continuously for 48 h after surgery. All patients received standard glycemic management based on a sliding-scale insulin protocol. Patients were classified into two groups: normoglycemia (glucose consistently < 200 mg/dL) and hyperglycemia (glucose ≥ 200 mg/dL at least once within 48 h). Univariable and multivariable logistic regression analyses were conducted to identify predictors of postoperative hyperglycemia. Results: Hyperglycemia occurred in 65.9% of all patients. Univariable analysis identified fasting plasma glucose (FPG), mean postoperative glucose, number of antidiabetic medications, and glucose variability as significant predictors (p < 0.05). In multivariable analysis adjusted for HbA1c, glycoalbumin, and glucose variability, FPG [odds ratio (OR): 1.07; 95% confidence interval (CI): 1.01–1.14; p = 0.024], mean glucose (OR: 1.12; 95% CI: 1.02–1.23; p = 0.017), and glucose variability (OR: 1.19; 95% CI: 1.05–1.35; p = 0.008) remained independently associated with hyperglycemia. Conclusions: CGM revealed a high incidence of early postoperative hyperglycemia despite conventional sliding-scale insulin therapy. These findings highlight the limitations of current glycemic protocols and underscore the potential of CGM as a diagnostic tool to guide individualized glucose management. Future studies should evaluate whether CGM-guided interventions can improve surgical outcomes, particularly in reducing SSI risk among high-risk diabetic patients. Full article

This study aimed to examine the chronic effect of a stair climbing–descending exercise (ST-EX) program on glycemic control in individuals with type 2 diabetes (T2D). Sixteen T2D participants were randomly divided into two groups and followed up over 12 weeks: they either performed regular ST-EX after meals at home (n = 8) or maintained their daily routine (CON; no training) (n = 8). The participants in the ST-EX group were instructed to perform a minimum of 12 sessions/week of ST-EX for more than three days/week. One session of ST-EX consisted of two repetitions of 3 min bouts of climbing to the second floor, followed by walking down to the first floor. Fourteen participants completed the study (seven for each group). The decrease in glycoalbumin levels was significantly greater in the ST-EX group (mean value: −1.0%) than in the CON group (+0.4%). Moreover, the knee extension force increased greatly in the ST-EX group (+0.2 Nm/kg) compared with that in the CON group (−0.1 Nm/kg), with no significant change in the skeletal muscle mass. Performing regular ST-EX after meals may be an effective strategy to improve glycemic control and lower-extremity muscle strength in individuals with T2D. Full article

This preliminary study aimed to investigate physical activity (PA) and glycemic control changes in Japanese adult females with type 1 diabetes (T1D) before the COVID-19 pandemic and one year later. Twelve females with T1D who used continuous glucose monitoring devices and initially volunteered for the study between February and March 2020 were included. PA data, obtained using a triaxial accelerometer, and glycemic control, including glycated hemoglobin (HbA1c), glycoalbumin (GA), mean 24-h sensor glucose (SG), time above range (TAR > 180 mg/dL), time in range (TIR 70–180 mg/dL), and time below range (TBR < 70 mg/dL), were analyzed. One year later, long (≥10 min) bouts of moderate-to-vigorous-intensity PA and daily steps decreased by 35.1% and 6.0%, respectively, and TAR increased from 23.5% to 29.0%. Additionally, an increase in prolonged (≥30 min) sedentary behavior correlated with a decrease in TBR and an increase in mean 24-h SG, GA, and the GA/HbA1c ratio. Furthermore, a decrease in daily energy consumption correlated with a decrease in TIR. These results indicate that some forms of PA in Japanese T1D adults have not returned to their pre-pandemic status, even in the same season one year later, which could worsen glycemic control. Full article

Hemodialysis patients with diabetic kidney disease (DKD) experience blood glucose fluctuations owing to insulin removal. We evaluated the effects of single and long-term application of neuromuscular electrical stimulation (NMES) during hemodialysis on glycemic control. This trial was conducted in two stages: Stage 1, following a crossover design and 4 week washout period, eleven outpatients with DKD either underwent a single bout of NMES for 30 min (NMES period) or rested (control period) after receiving nutritional support during hemodialysis; Stage 2, following a crossover design and 4 week washout period, each participant received the intervention for 12 weeks. NMES was administered for 30 min at the maximum tolerable intensity. The mean subcutaneous glucose concentration and mean amplitude of glycemic excursion (MAGE) were determined by flash glucose monitoring for 24 h. Changes in glycoalbumin and MAGE before and after NMES initiation were evaluated. The mean blood glucose level and MAGE after a single bout of NMES were significantly lower than those after rest. Glycoalbumin levels and echo intensity of the rectus femoris tended to decrease, but not significantly by ANOVA due to a lack in statistical power after the dropout of three patients. NMES in end-stage DKD decreased blood glucose levels during and after hemodialysis. Full article

The correlation between diabetes-related biomarkers and quality of life (QOL) remains unclear. In this cross-sectional study, we investigated the correlation between diabetes-related biomarkers and QOL in a general Japanese population who underwent health checkups as a part of the Iwaki Health Promotion Project. Male and female participants aged ≥ 20 years from Iwaki District, Hirosaki City, Aomori Prefecture who participated in the 2019 medical evaluation were recruited. QOL was evaluated using the Short Form Health Survey 36 (SF-36). Fasting blood glucose, homeostatic model assessment-estimated insulin resistance (HOMA-IR), hemoglobin A1c (HbA1c), glycoalbumin, and plasma pentosidine were also evaluated as diabetes-related markers. Of the 1065 recruited participants, 1053 completed the clinical and QOL evaluations. Multivariate regression analysis revealed that upregulated diabetes-related markers levels were correlated with decreased SF-36 scores. Blood glucose, HOMA-IR, HbA1c, glycoalbumin, and plasma pentosidine levels were correlated with general health. Moreover, plasma pentosidine levels were correlated with role physical, social functioning, and role emotional in addition to general health. These results indicated that the levels of diabetes-related biomarkers, particularly the levels of plasma pentosidine, a glycation marker, were associated with QOL in our cohort. Full article

Although many studies have reported factors associated with reduced heart rate variability (HRV) in Western populations, evidence is limited among Asian populations. Therefore, we investigated the factors associated with reduced HRV values in a general Japanese population by measuring HRV among the participants of the Iwaki Health Promotion Project who underwent medical examination in 2019. We performed 90-s HRV measurements in 1065 participants. Of these, we evaluated the coefficient of variation in R–R intervals (CVRR) and standard deviation in R–R intervals (SDNN). Blood was collected under a fasting condition, and investigations of glucose metabolism, lipid metabolism, renal function, liver function, advanced glycation end products, and blood pressure were performed. A multivariate regression analysis of the association between CVRR or SDNN and blood test parameters and blood pressure in 987 participants with adequately completed HRV assessments showed that reduced CVRR or SDNN was associated with higher levels of glycated hemoglobin (HbA1c), glycoalbumin, blood glucose, triglycerides, creatinine, plasma pentosidine, and diastolic blood pressure. In the general Japanese population, higher levels of HbA1c, glycoalbumin, blood glucose, triglycerides, creatinine, plasma pentosidine, and diastolic blood pressure are associated with reduced CVRR or SDNN, which are typical HRV parameters. Full article

The aim of this study was to compare the kinetics of the glycoxidation of bovine serum albumin (BSA) as a model protein by three sugars: glucose, fructose and ribose, using fluorometric measurements of the content of advanced glycation end products (AGEs), protein-bound fructosamine, dityrosine, N'-formylkynurenine, kynurenine, tryptophan, the content of advanced oxidation protein products (AOPP), protein carbonyl groups, as well as thiol groups. Moreover, the levels of glycoalbumin and AGEs were determined by using an enzyme-linked immunosorbent assay. Based on the kinetic results, the optimal incubation time for studies of the modification of the glycoxidation rate by additives was chosen, and the effects of 25 compounds of natural origin on the glycoxidation of BSA induced by various sugars were examined. The same compounds were found to have different effects on glycoxidation induced by various sugars, which suggests caution in extrapolation from experiments based on one sugar to other sugars. From among the compounds tested, the most effective inhibitors of glycoxidation were: polyphenols, pyridoxine and 1-cyano-4-hydroxycinnamic acid. Full article