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Overnutrition during before and pregnancy can cause maternal obesity and raise the risk of maternal metabolic diseases during pregnancy, and in offspring. Lentinus edodes may prevent or reduce obesity. This study aimed to to assess Lentinus edodes fermented products effects on insulin sensitivity, glucose and lipid metabolism in maternal and offspring, and explore its action mechanism. A model of overnutrition during pregnancy and lactation was developed using a 60 % kcal high-fat diet in C57BL6/J female mice. Fermented Lentinus edodes (FLE) was added to the diet at concentrations of 1 %, 3 %, and 5 %. The results demonstrated that FLE to the gestation diet significantly reduced serum insulin levels and homeostatic model assessment for insulin resistance (HOMA-IR) in pregnant mice. FLE can regulate maternal lipid metabolism and reduce fat deposition. Meanwhile, the hepatic phosphoinositide-3-kinase-protein kinase (PI3K/AKT) signaling pathway was significantly activated in the maternal mice. There is a significant negative correlation between maternal FLE supplementation doses and offspring body fat percentage and visceral fat content. Furthermore, FLE supplementation significantly increased offspring weaning litter weight, significantly reduced fasting glucose level, serum insulin level, HOMA-IR and serum glucose level, significantly activated liver PI3K/AKT signaling pathway in offspring, and upregulated the expression of liver lipolytic genes adipose triglyceride lipase, hormone-sensitive lipase and carnitine palmitoyltransferase 1 mRNA. Overall, FLE supplementation can regulate maternal lipid metabolism and reduce fat deposition during pregnancy and lactation, and it may improve insulin sensitivity in pregnant mothers and offspring at weaning through activation of the PI3K/AKT signaling pathway.
Edited by
Rebecca Leslie, Royal United Hospitals NHS Foundation Trust, Bath,Emily Johnson, Worcester Acute Hospitals NHS Trust, Worcester,Alex Goodwin, Royal United Hospitals NHS Foundation Trust, Bath,Samuel Nava, Severn Deanery, Bristol
Here we cover topics including glucose metabolism, the citric acid or Krebs cycle, starvation and the stress response to surgery, highly relevant to anaesthesia and postoperative care. We examine the major endocrine systems, their physiology in health and in disease states. These include the pituitary gland and hypothalamus, the adrenals and the thyroid gland. There is material on the liver and blood clotting, and basic protein structure with focus on haemoglobin.
Adolescent girls often skip breakfast due to time constraints and reduced morning appetite. This study examined the acute impact of breakfast consumption timing v. breakfast omission (BO) on glycaemic and insulinaemic responses to lunch in infrequent breakfast-consuming girls. Fifteen girls (13·1 (sd 0·8) years) completed three conditions in a randomised crossover design: early-morning breakfast consumption (EM-BC; 08.30), mid-morning breakfast consumption (MM-BC; 10.30) and BO. A standardised lunch was provided at 12.30, followed by a 2-h post-lunch observation period. Blood and expired gas samples were collected periodically. Linear mixed models with Cohen’s d effect sizes compared outcomes between conditions. Pre-lunch glucose and insulin incremental AUC (iAUC) were higher in the breakfast conditions v. BO (P ≤ 0·009), with no differences between breakfast conditions. MM-BC reduced post-lunch glucose iAUC by 36 % and 25 % compared with BO and EM-BC, respectively (P < 0·001, d = 0·92–1·44). A moderate, non-significant 15 % reduction in post-lunch glucose iAUC was seen with EM-BC v. BO (P = 0·077, d = 0·52). These reductions occurred without changes in post-lunch insulinemia (P ≥ 0·323) and were accompanied by increased post-lunch carbohydrate oxidation compared with BO (P ≤ 0·018, d = 0·58–0·75); with no differences between EM-BC and MM-BC. MM-BC lowered glycaemic response over the experimental period compared with BO (P = 0·033, d = 0·98) and EM-BC (P = 0·123, d = 0·93), with no difference between EM-BC and BO. Compared with BO, both breakfast conditions lowered post-lunch glycaemic responses with mid-morning breakfast eliciting a greater second-meal effect than early-morning breakfast. These findings indicate the breakfast-to-lunch meal interval may be a crucial factor affecting postprandial glycaemia in infrequent breakfast-consuming girls.
The potential threshold for dietary energy intake (DEI) that might prevent protein-energy wasting (PEW) in chronic kidney disease (CKD) is uncertain. The subjects were non-dialysis CKD patients aged ≥ 14 years who were hospitalised from September 2019 to July 2022. PEW was measured by subjective global assessment. DEI and dietary protein intake (DPI) were obtained by 3-d diet recalls. Patients were divided into adequate DEI group and inadequate DEI group according to DEI ≥ 30 or < 30 kcal/kg/d. Logistic regression analysis and restricted cubic spline were used in this study. We enrolled 409 patients, with 53·8 % had hypertension and 18·6 % had diabetes. The DEI and DPI were 27·63 (sd 5·79) kcal/kg/d and 1·00 (0·90, 1·20) g/kg/d, respectively. 69·2 % of participants are in the inadequate DEI group. Malnutrition occurred in 18·6 % of patients. Comparing with patients in the adequate DEI group, those in the inadequate DEI group had significantly lower total lymphocyte count, serum cholesterol and LDL-cholesterol and a higher prevalence of PEW. For every 1 kcal/kg/d increase in DEI, the incidence of PEW was reduced by 12·0 % (OR: 0·880, 95 % CI: 0·830, 0·933, P < 0·001). There was a nonlinear curve relationship between DEI and PEW (overall P < 0·001), and DEI ≥ 27·6 kcal/kg/d may have a preventive effect on PEW in CKD. Low DPI was also significantly associated with malnutrition, but not when DEI was adequate. Decreased energy intake may be a more important factor of PEW in CKD than protein intake.
The main aim of a perioperative fluid therapy is to maintain or normalize the patient’s homeostasis. Small children have higher fluid volumes, metabolic rates and fluid needs than adults. Therefore, short perioperative fasting periods (formula milk 4 hours, breast milk 3 hours, clear fluids 1 hour) are important to avoid iatrogenic dehydration, hypotension, ketoacidosis and uncooperative behavior. Balanced electrolyte solutions with 1–2.5% glucose are favored for intraoperative maintenance infusion. Glucose- free balanced electrolyte solutions should then be added as needed to replace intraoperative fluid deficits or minor blood loss. Gelatin solutions or hydroxyethyl starch are useful in hemodynamically unstable patients or those with major blood loss, especially when crystalloids alone are not effective and blood products are not indicated. The monitoring should focus on the maintenance or restoration of a stable tissue perfusion.In nonsurgical or postoperative children, balanced electrolyte solutions should be used instead of hypotonic solutions, both with 5% glucose, as recent clinical studies and reviews showed a lower incidence of hyponatremia.
Medical emergencies occur rarely in dental practice. When they do occur, however, they can be both dangerous for the patient and unnerving for the clinician. If these events have been planned for, staff will be adequately trained, the correct medications on hand and their method of use easily recalled, so these rare and disturbing events can be managed with good outcomes. It has been reported that only one resuscitation event occurs for every 250 years of dental practice (1). Although this may seem rare, when it does occur, the event can be life threatening. Therefore, staff training in cardiopulmonary resuscitation (CPR) with regular updates is mandatory. Previous studies have reported very high uptake of CPR training, yet about 20% of dentists felt inadequately prepared and were less likely to have the necessary drugs and equipment in their practice (2). The single most important factor for prevention of medical emergencies in dental practice is the taking of a thorough medical history for each patient.
Cardiovascular disease (CVD) is one of the most important diseases which controlling its related risk factors, such as metabolic and inflammatory biomarkers, is necessary because of the increased mortality risk of that. The aim of our meta-analysis is to reveal the general effect of vitamin K supplementation on its related risk factors. Original databases were searched using standard keywords to identify all randomized clinical trials (RCTs) investigating the effects of vitamin K on CVD. Pooled weighted mean difference (WMD) and 95 % confidence intervals (95 % CI) were achieved by random-model effect analysis for the best estimation of outcomes. The statistical heterogeneity was determined using the Cochran's Q test and I2 statistics. Seventeen studies were included in this systematic review and meta-analysis. The pooled findings showed that vitamin K supplementation can reduce homeostatic model assessment insulin resistance (HOMA-IR) (WMD: −0⋅24, 95 % CI: −0⋅49, −0⋅02, P = 0⋅047) significantly compared to the placebo group. However, no significant effect was observed on other outcomes. Subgroup analysis showed a significant effect of vitamin K2 supplementation compared to vitamin K1 supplementation on HOMA-IR. However, no significant effect was observed on other variables. Also, subgroup analysis showed no potential effect of vitamin K supplementation on any outcome and omitting any articles did not affect the final results. We demonstrated that supplementation with vitamin K has no effect on anthropometrics indexes, CRP, glucose metabolism, and lipid profile factors except HOMA-IR.
The polyphenol theory of humic-substance formation has been studied extensively; however, an alternative theory, that humic substances are formed through the condensation of amino acids and reducing sugars (Maillard reaction), has not been explored to the same extent. The general objectives of this study were to determine whether smectites and goethites catalyze the abiotic polymerization of arginine and glucose to form humic-like compounds. The effects of smectite type, saturating cation, and the degree of Al substitution in goethites on the polymerization reaction were also studied. Four cation-saturated smectites and four Al-substituted goethites were incubated abiotically with solutions containing a mixture of arginine + glucose for 21 days at 37°C. After the incubations, total C recovered ranged from 80.6 to 123.8% and from 100.5 to 105.1% for the smectite and goethite systems, respectively. At the end of the incubations, 21.4–50.3% of the added C and 16.5–90% of the added N were sorbed on the various smectites, and 6.2–9.0% of the added C and 2.3–4.6% of added N was sorbed on the goethites in a form that could not be desorbed by washing with 100 mM CaCl2. X-ray diffraction analysis indicated that some of the sorbed C was intercalated in the smectites and FTIR analysis provided evidence of new absorption bands at 1650 and 1668 cm−1, which are consistent with Maillard reaction products. Thus, it is concluded that smectites catalyze the condensation of arginine and glucose to form humic-like products. Goethites, however, have little or no ability to catalyze this reaction.
Diabetic ketoacidosis (DKA) is a critical state of hyperglycemia that results in both hyperketonemia and acidosis. Despite elevated serum glucose in DKA, the cells are “starving” due to the lack of insulin to facilitate glucose uptake. Therefore, fatty acids are utilized, which produce ketones and an anion gap ketoacidosis.
Hyperglycemia causes glucose to spill into the urine, resulting in an osmotic diuresis that leads to dehydration and electrolyte derangements. The acidosis causes K+ to shift out of cells, leading to serum hyperkalemia. K+ and bicarbonate are lost in the urine, depleting whole body potassium. The loss of bicarbonate further exacerbates the acidosis.
To evaluate the relationships of fibre intake with subsequent BMI sd-score, waist-to-height ratio and serum fasting glucose levels among school-age Japanese children.
Design:
This is a prospective study of school-age Japanese children. Participants were followed from 6–7 to 9–10 years of age (follow-up rate: 92·0 %). Fibre intake was assessed using a validated FFQ. Serum fasting glucose was measured by a hexokinase enzymatic method. Using a general linear model, the associations between dietary fibre intake at baseline and BMI sd-score, waist-to-height ratio, and serum levels of fasting glucose at follow-up were evaluated after considering potential confounding factors.
Setting:
Public elementary schools in a city in Japan
Participants:
A total of 2784 students.
Results:
The estimated means for fasting glucose at 9–10 years of age were 86·45, 85·68, 85·88 and 85·58 mg/dl in the lowest, second, third and highest quartile of fibre intake at 6–7 years of age, respectively (P = 0·033, trend P = 0·018). Higher fibre intake at 6–7 years of age was associated with lower waist-to-height ratio at 9–10 years of age (trend P = 0·023). The change in fibre intake was inversely associated with concurrent change of BMI sd-score (trend P = 0·044).
Conclusion:
These results suggest that dietary fibre intake may be potentially effective to limit excess weight gain and lower glucose levels during childhood.
Breast milk leptin plays a potential role in preventing childhood obesity. However, the associations of breast milk leptin with maternal metabolism in pregnancy and dietary patterns during lactation are still unclear. We aimed to explore associations of breast milk leptin with maternal metabolic profiles in pregnancy and dietary patterns during lactation. A total of 332 participants were recruited for this retrospective cohort study. Breast milk samples were collected at approximately 6 weeks postpartum. Breast milk leptin and twenty-three metabolic profiles in pregnancy were measured in this study. A semi-quantitative FFQ was used to gather dietary information during lactation. Both principal component analysis and the diet balance index were used to derive dietary patterns. Among twenty-three maternal metabolic profiles, maternal serum glucose (β = 1·61, P = 0·009), γ-glutamyl transferase (β = 0·32, P = 0·047) and albumin (β = −2·96, P = 0·044) in pregnancy were correlated with breast milk leptin. All dietary patterns were associated with breast milk leptin. Given the joint effects of maternal metabolism in pregnancy and dietary patterns during lactation, only diet quality distance was significantly associated with leptin concentrations in breast milk (low level v. almost no diet problem: β = −0·46, P = 0·011; moderate/high level v. almost no diet problem: β = −0·43, P = 0·035). In conclusion, both maternal metabolism in pregnancy and dietary patterns during lactation were associated with breast milk leptin. Maternal diet balance during lactation was helpful to improve breast milk leptin concentration.
The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting.
Study Objective:
The aim of this study was to test the hypothesis that the elevation of POC plasma glucose and serum lactate levels may help to predict Sepsis-3 in the AS.
Methods:
A prospective observational study was performed in the AS setting of Gothenburg in Sweden from the beginning of March 2018 through the end of September 2019. The criteria for sampling POC plasma glucose and serum lactate levels in the AS setting were high or intermediate risk according to the Rapid Emergency Triage and Treatment System (RETTS), as red, orange, yellow, and green if the respiratory rate was >22 breaths/minutes. Sepsis-3 were identified retrospectively. A primary and secondary analyses were carried out. The primary analysis included patients cared for in the AS and emergency department (ED) and were hospitalized. In the secondary analysis, patients who were only cared for in the AS and ED without being hospitalized were also included. To evaluate the predictive ability of these biomarkers, the area under the curve (AUC), sensitivity, specificity, and predictive values were used.
Results:
A total of 1,057 patients were included in the primary analysis and 1,841 patients were included in the secondary analysis. In total, 253 patients met the Sepsis-3 criteria (in both analyses). The AUC for POC plasma glucose and serum lactate levels showed low accuracy in predicting Sepsis-3 in both the primary and secondary analyses. Among all hospitalized patients, regardless of Sepsis-3, more than two-thirds had elevated plasma glucose and nearly one-half had elevated serum lactate when measured in the AS.
Conclusions:
As individual biomarkers, an elevated POC plasma glucose and serum lactate were not associated with an increased likelihood of Sepsis-3 when measured in the AS in this study. However, the high rate of elevation of these biomarkers before arrival in hospital highlights that their role in clinical decision making at this early stage needs further evaluation, including other endpoints than Sepsis-3.
Male African cichlids (Oreochromis mossambicus) establish territories on the substrate upon which spawning pits are dug, thus attracting females. The substrate, therefore, plays a very significant role in its lifecycle. The effects of substrate access on behaviour and physiology in captivity were assessed. Mixed-sex, all-male and all-female groups were observed for five days, with and without substrate. Social patterns, behaviour directed towards the substrate, locomotor activity and spatial behaviour were recorded, and haematocrit, plasma cortisol and glucose levels were measured. Substrate inclusion saw a significant increase in behavioural diversity, sexual behaviour of dominant males in mixed groups, pit digging and territoriality whereas a lack of substrate was characterised by increased chafing and inactivity. Vacuum-pit digging was also observed. Frequency of aggression did not differ significantly and female behaviour was not affected by the presence of substrate. For both sexes, no differences in cortisol and glucose levels were found between the two treatments, but haematocrit increased with substrate. The key role played by substrate in territorial males is consistent with the behavioural and physiological data reported. In the absence of substrate, decreased territorial behaviour is contrasted with similar levels of aggression, cortisol and glucose; all of which are suggestive of a stress-related context. Moreover, the exhibition of vacuum activities is a signal that behavioural needs are not being met and may be some form of coping mechanism. These findings, taken in conjunction with the variations in behavioural diversity and inactivity, suggest that the welfare of male cichlids may be adversely affected by the absence of substrate.
Participants drank either regular root beer or sugar-free diet root beer before working on a probability-learning task in which they tried to predict which of two events would occur on each of 200 trials. One event (E1) randomly occurred on 140 trials, the other (E2) on 60. In each of the last two blocks of 50 trials, the regular group matched prediction and event frequencies. In contrast, the diet group predicted E1 more often in each of these blocks. After the task, participants were asked to write down rules they used for responding. Blind ratings of rule complexity were inversely related to E1 predictions in the final 50 trials. Participants also took longer to advance after incorrect predictions and before predicting E2, reflecting time for revising and consulting rules. These results support the hypothesis that an effortful controlled process of normative rule-generation produces matching in probability-learning experiments, and that this process is a function of glucose availability.
Does eating more carbohydrates, or fats, cause one to put on more weight? Are ketone bodies toxins or vital products that keep us alive during starvation? Does the concept of 'fat-burning exercise' hold true? In this game-changing book, Keith Frayn, an international expert in human metabolism and nutrition, dispels common misconceptions about human metabolism, explaining in everyday language the important metabolic processes that underlie all aspects of our daily lives. Illustrated throughout with clear diagrams of metabolic processes, Frayn describes the communication systems that enable our different organs and tissues to cooperate, for instance in providing fuel to our muscles when we exercise, and in preserving our tissues during fasting. He explores the impressive adaptability of human metabolism and discusses the metabolic disorders that can arise when metabolism 'goes wrong'. For anyone sceptical of information about diet and lifestyle, this concise book guides the reader through what metabolism really involves.
People with psychosis are at higher risk of cardiovascular events, partly explained by a higher predisposition to gain weight. This has been observed in studies on individuals with a first-episode psychosis (FEP) at short and long term (mainly up to 1 year) and transversally at longer term in people with chronic schizophrenia. However, there is scarcity of data regarding longer-term (above 3-year follow-up) weight progression in FEP from longitudinal studies. The aim of this study is to evaluate the longer-term (10 years) progression of weight changes and related metabolic disturbances in people with FEP.
Methods
Two hundred and nine people with FEP and 57 healthy participants (controls) were evaluated at study entry and prospectively at 10-year follow-up. Anthropometric, clinical, and sociodemographic data were collected.
Results
People with FEP presented a significant and rapid increase in mean body weight during the first year of treatment, followed by less pronounced but sustained weight gain over the study period (Δ15.2 kg; SD 12.3 kg). This early increment in weight predicted longer-term changes, which were significantly greater than in healthy controls (Δ2.9 kg; SD 7.3 kg). Weight gain correlated with alterations in lipid and glycemic variables, leading to clinical repercussion such as increments in the rates of obesity and metabolic disturbances. Sex differences were observed, with women presenting higher increments in body mass index than men.
Conclusions
This study confirms that the first year after initiating antipsychotic treatment is the critical one for weight gain in psychosis. Besides, it provides evidence that weight gain keep progressing even in the longer term (10 years), causing relevant metabolic disturbances.
Impaired brain metabolism may be central to schizophrenia pathophysiology, but the magnitude and consistency of metabolic dysfunction is unknown.
Methods
We searched MEDLINE, PsychINFO and EMBASE between 01/01/1980 and 13/05/2021 for studies comparing regional brain glucose metabolism using 18FDG-PET, in schizophrenia/first-episode psychosis v. controls. Effect sizes (Hedges g) were pooled using a random-effects model. Primary measures were regional absolute and relative CMRGlu in frontal, temporal, parietal and occipital lobes, basal ganglia and thalamus.
Results
Thirty-six studies (1335 subjects) were included. Frontal absolute glucose metabolism (Hedge's g = −0.74 ± 0.54, p = 0.01; I2 = 67%) and metabolism relative to whole brain (g = −0.44 ± 0.34, p = 0.01; I2 = 55%) were lower in schizophrenia v. controls with moderate heterogeneity. Absolute frontal metabolism was lower in chronic (g = −1.18 ± 0.73) v. first-episode patients (g = −0.09 ± 0.88) and controls. Medicated patients showed frontal hypometabolism relative to controls (−1.04 ± 0.26) while metabolism in drug-free patients did not differ significantly from controls. There were no differences in parietal, temporal or occipital lobe or thalamic metabolism in schizophrenia v. controls. Excluding outliers, absolute basal ganglia metabolism was lower in schizophrenia v. controls (−0.25 ± 0.24, p = 0.049; I2 = 5%). Studies identified reporting voxel-based morphometry measures of absolute 18FDG uptake (eight studies) were also analysed using signed differential mapping analysis, finding lower 18FDG uptake in the left anterior cingulate gyrus (Z = −4.143; p = 0.007) and the left inferior orbital frontal gyrus (Z = −4.239; p = 0.02) in schizophrenia.
Conclusions
We report evidence for hypometabolism with large effect sizes in the frontal cortex in schizophrenia without consistent evidence for alterations in other brain regions. Our findings support the hypothesis of hypofrontality in schizophrenia.
Extracts of mulberry have been shown to reduce post-prandial glucose (PPG) and insulin (PPI) responses, but reliability of these effects and required doses and specifications are unclear. We previously found that 1·5 g of a specified mulberry fruit extract (MFE) significantly reduced PPG and PPI responses to 50 g carbohydrate as rice porridge, with no indications of intolerance. The trials reported here aimed to replicate that work and assess the efficacy of lower MFE doses, using boiled rice as the carbohydrate source. Two separate randomised controlled intervention studies were carried out with healthy Indian males and females aged 20–50 years (n 84 per trial), with PPG area under the curve over 2 h as the primary outcome. Trial 1 used doses of 0, 0·37, 0·75, 1·12 and 1·5 g MFE in boiled rice and 0 or 1·5 g MFE in rice porridge. Trial 2 used doses of 0, 0·04, 0·12, 0·37 g MFE in boiled rice. In trial 1, relative to control, all MFE doses significantly decreased PPG (–27·2 to −22·9 %; all P ≤ 0·02) and PPI (–34·6 to −14·0 %, all P < 0·01). Breath hydrogen was significantly increased only at 1·5 g MFE (in rice porridge), and self-reported gastrointestinal symptoms were uniformly low. In trial 2, only 0·37 g MFE significantly affected PPG (–20·4 %, P = 0·002) and PPI (–17·0 %, P < 0·001). Together, these trials show that MFE in doses as low as 0·37 g can reliably reduce PPG and PPI responses to a carbohydrate-rich meal, with no apparent adverse effects.
Hyperglycemia is reported to predict worse outcome in patients with stroke, including intracerebral hemorrhage (ICH). In 83 consecutive cases of ICH at a tertiary stroke center, hyperglycemia (serum glucose >7 mmol/L) compared to normoglycemia at presentation was associated with higher rates of in-hospital mortality (51.2% vs. 26.2%, OR 2.3, CI 1.2–7.6, p = 0.02). The association with in-hospital mortality withstood adjustment for age, ICH volume, intraventricular hemorrhage, and infratentorial ICH location, but not baseline Glasgow Coma Scale. Acute hyperglycemia is associated with in-hospital mortality in spontaneous ICH patients, though this may be an indirect, rather than a causal relationship.
Paramedics commonly administer intravenous (IV) dextrose to severely hypoglycemic patients. Typically, the treatment provided is a 25g ampule of 50% dextrose (D50). This dose of D50 is meant to ensure a return to consciousness. However, this dose may cause harm and lead to difficulties regulating blood glucose levels (BGLs) post-treatment. It is hypothesized that a lower concentration, such as 10% dextrose (D10), may improve symptoms while minimizing harm.
Methods:
PubMed, Embase, CINAHL, and Cochrane Central were systematically searched on September 15, 2020. The PRISMA guidelines were followed. GRADE and risk of bias were applied to determine the certainty of the evidence. Primary literature investigating the use of IV dextrose in hypoglycemic diabetic patients presenting to paramedics or the emergency department was included. Outcomes of interest included safety, efficacy (symptom resolution), and BGL.
Results:
Of 680 abstracts screened, 51 full-text articles were reviewed, with eleven studies included. Data from three randomized controlled trials (RCTs) and eight observational studies were analyzed. A single RCT comparing D10 to D50 was identified. The primary significant finding of the study was an increased post-treatment glycemic profile by 3.2mmol/L in the D50 group; no other outcomes had significant differences between groups. When comparing pooled data from all the included studies, there was greater symptom resolution in the D10 group (95.9%) compared to the D50 group (88.8%). However, the mean time to resolution was approximately four minutes longer in the D10 group (4.1 minutes [D50] versus 8.0 minutes [D10]). There was a greater need for subsequent doses with the use of D10 (19.5%) compared to D50 (8.1%). The post-treatment glycemic profile was lower in the D10 group at 6.2mmol/L versus 8.5mmol/L in the D50 group. Both treatments had nearly complete resolution of hypoglycemia: 98.7% (D50) and 99.2% (D10). No adverse events were observed in the D10 group (0/1057) compared to 13/310 adverse events in the D50 group.
Conclusion:
Studies show D10 may be as effective as D50 at resolving symptoms and correcting hypoglycemia. Although the desired effect can take several minutes longer, there appear to be fewer adverse events. The post-D10-treatment BGL may result in fewer untoward hyperglycemic episodes.