Fasting plasma glucose (FPG) is useful for routine following up of the diabetic patients. Here, the author reported an interesting mortal case due to the fasting plasma glucose blood collection. In this case, it can be a good case study on the complication of fasting procedure for blood collection of FPG determination. However, the precautions for the diabetic patients whose the history of blood glucose control is fluctuated should be specially set.

There is as yet no consensus as to the effect of Ramadan fasting on fasting blood glucose. We carried out a study to help clarify the situation. This was a semi-experimental (pre- and post-) study of 115 healthy volunteers (67 men and 48 women), who fasted for at least 25 days during Ramadan. Blood samples were taken 7 days before Ramadan (at 7am after a 8-hour overnight fast), and on the 14th and 28th days of Ramadan (1 hour before sundown). The mean duration of daily fasting was 11.5±0.5 hours. Plasma glucose was measured by an enzymatic assay. Statistical analysis was by the paired-t and ANOVA functions on SPSS10.0 software. Fasting plasma glucose in the group as a whole decreased from 88.4±9.0mg/dl pre-Ramadan to 75.4±15.3mg/dl on day 14 and 62.9±7.7mg/dl on day 28 (p<0.001). Both men [87.5±8.8mgdl (pre-Ramadan)  60.8±6.4mg/dl (day 28)] and women [89.7±9.3mgdl (pre-Ramadan)  65.7±8.4mg/dl (day 28)] experienced a significant decrease in fasting plasma glucose levels (p<0.001 in both). There was a reduction in calorie intake during Ramadan in every volunteer (p<0.001), and there was a direct correlation between reduction in calorie intake and fasting plasma glucose (p<0.01). Fasting plasma glucose decreases with Ramadan fasting and is associated with a reduction in calorie intake. The decrease in plasma glucose does not seem to be accompanied by any serious adverse effects in healthy volunteers, however.

Cataract is a leading cause of vision loss in the world. Several factors are involved in the development of cataracts, of them; diabetes and uncontrolled plasma glucose have great importance. Therefore, controlling glycemic reduces the risk of related to microvascular complications of diabetes diseases such as cataract. This study aimed to compare fasting plasma glucose (FPG), HgbA1c, and oral glucose tolerance test (OGTT) between Diabetic patients with and without cataract in comparison with the healthy group as control. Among 150 subjects, 50 diabetic patients, 50 diabetic cataracts, and 50 healthy individuals without a history of specific disease were compared with each other. Fasting plasma glucose, OGTT, and HgbA1c were measured by colorimetric methods. SPSS23 software was used to analyze data. P-values ​​less than 5% or lower were considered to be statistically significant. In this study, the mean fasting plasma glucose, HgbA1c, and OGTT in the group of diabetic patients, diabetic with cataract, and healthy groups fasting plasma glucose were as follow, 162.46 mg dL-1 and 184.76 mg dL-1, 92.88 mg dL-1 (P˂0.05), HgbA1c: 7.8, 8.0, 5.8% (P˂0.05) and OGTT: 228 mg dL-1, 246.12 mg dL-1 and 114.32 mg dL-1 (P˂0.05) respectively. Our findings showed that in diabetic patients with and without cataract, fasting plasma levels, HgbA1C, and OGTT are higher than the healthy group. There was a significant relationship between the studied factors and cataracts. As a result, high blood glucose has a definitive role in the development of cataracts.

The aim of this study was to determine the effect of legume intake in therapeutic lifestyle change (TLC) on fasting insulin, fasting blood glucose, HbA1c and homeostasis model assessment insulin resistance (HOMA-IR) in patients with type 2 diabetes. In this randomized crossover trial, 31 subjects with type 2 diabetes in the age range of 50 to 80 years were selected. The subjects were randomly assigned to two groups receiving diets of therapeutic lifestyle change or the therapeutic lifestyle change with legumes (replacing meat with 2 servings of legumes in their therapeutic lifestyle change diet, three days a week). Period of each diet was 8 weeks with a 4 week washout period. Fasting blood samples were taken to measure the fasting insulin, fasting plasma glucose, HbA1c HOMA-IR. After 8 weeks of intervention, fasting plasma glucose, fasting insulin and HOMA-IR in both diets significantly reduced compared with baseline values (P<0.05). Compared with the TLC diet, in TLC diet with legumes, fasting insulin, fasting plasma glucose, and HOMA-IR was significantly decreased (P<0.05). No significant change was observed in HbA1c concentration. Replacement of 2 servings of legumes instead of meat 3 days a week in the TLC diet resulted in improved glycemic control and insulin resistance among type 2 diabetic patients.

There is evidence implying the influence of vitamin C on prevention of hemoglobin glycation. The aim of the present study was to investigate the effect of vitamin C on the level of glycosylated hemoglobin (HbA1c) in patients with type 2-diabetes. 18 patients with type 2 diabetes (14 females, 4 males) were enrolled in a clinical trial study. 1000 mg of supplemental vitamin C (divided into 4 doses) per day was given to the subjects for 6 weeks. Body mass index (BMI), a 3-day diet recall, fasting plasma glucose and glycosylated hemoglobin were measured beforeand after the administration of supplemental vitamin C. Data were analyzed by paired ttest. Body weight and BMI were slightly higher at the end of study, as compared to before. Glycosylated hemoglobin level decreased significantly at the end of study 11.8±1.48 vs, 10.2±1.28%, (p<0.015). Fasting plasma glucose did not change. Our findings indicate that vitamin C as a result of its structural similarity to glucose can compete with it to reduce hemoglobin glycosylation in patients with type 2-diabetes.

There is as yet no consensus as to the effect of Ramadan fasting on fasting blood glucose. We carried out a study to help clarify the situation.
This was a semi-experimental (pre- and post-) study of 115 healthy volunteers (67 men and 48 women), who fasted for at least 25 days during Ramadan. Blood samples were taken 7 days before Ramadan (at 7am after a 8-hour overnight fast), and on the 14th and 28th days of Ramadan (1 hour before sundown). The mean duration of daily fasting was 11.5±0.5 hours. Plasma glucose was measured by an enzymatic assay. Statistical analysis was by the paired-t and ANOVA functions on SPSS10.0 software.
Fasting plasma glucose in the group as a whole decreased from 88.4±9.0mg/dl pre-Ramadan to 75.4±15.3mg/dl on day 14 and 62.9±7.7mg/dl on day 28 (p Fasting plasma glucose decreases with Ramadan fasting and is associated with a reduction in calorie intake. The decrease in plasma glucose does not seem to be accompanied by any serious adverse effects in healthy volunteers, however.

Hyperglycemia is a known a risk factor for cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke. This risk is continuous and graded across the distributions of fasting plasma glucose (FPG), and levels of plasma glucose after an oral glucose challenge. Both fasting and 2-h postchallenge glucose (2hpg) levels contribute to average glycemia, but the relative contributions of fasting and postchallenge hyperglycemia to CVD risk remain uncertain. Considering the high prevalence of cardiovascular disease (CVD) in Tehran, this study was designed to evaluate the effects of difference levels of fasting and postchallenge hyperglycemia in prediction of cardiovascular disease. In this cohort study, all participants of the Tehran Lipid And Glucose Study (TLGS) (3694 subjects), aged over 40years, free from clinical CVD (coronary heart disease, stroke) or medication-treated diabetes were assessed for prediction of incident CVD events. We used the interquartile range (IQR) as a unit of exposure for continuously distributed glycemic measures in predicting CVD risk. Also, the Framingham Risk Score (FRS) was determined in this population at baseline. We recorded the cardiovascular events in 6.1±0.6 years of follow up for all subjects. Finally, we assessed ability of fasting and postchallenge hyperglycemia in prediction of cardiovascular disease. Mean age of the study population was 53.9 years undiagnosed diabetes in this population was present in 346 (9.3%) of the 346 subjects 172 (49.7%) had 2hPG ≥ 200mg/dL without FHG. There were 148 CVD events. In separate sex- and CVD risk–adjusted models,) hazard ratio (HR) for CVD with fasting plasma glucose (per [14 mg/dL] increase) was 1.15 (95% CI: 1.08–1.22) and HR for CVD per 49 mg/dL increase in 2hPG was 1.23 (95% CI: 1.14–1.33). When modeled together, the HR for FHG decreased to 1.03 (95% CI: 0.93–1.13) and for 2hPG remained significant (95% CI: 1.20, 1.05–1.38). In this study, postchallenge hyperglycemia was an independent risk factor for CVD.

There is no solid evidence of aluminium (Al3+) toxicity resulting from the Al3+ present in foods or from aluminium utensils used to prepare or contain foods. However recent studies have strongly emphasized Al3+ toxicity in chronic renal failure patients and patients administered aluminium containing antacids. In this study the effect of high doses of Al3+ on glucose metabolism in rats has been investigated. Six groups of male and female albino rats within a weight range of 180-220 grams were fed with food containing Al3+ (75, 212.5, 312.5, 625, 1250, 2500 mg/kg food) for two months. During this time, at 15-day intervals, measurements of plasma glucose concentrations, both while fasting - Fasting Blood Sugar (F.B.S) - and after Glucose Tolerance Test (G.T.T) were taken from the test and control groups. The results indicate that Al3+ can increase fasting plasma glucose and impair glucose tolerance in a dose and time dependent manner. Fasting plasma glucose of the control group at the end of the 60 day- intervention (113.8±4 mg/dl) was significantly less than the case-group, which consumed food containing Al3+ (2500 mg/kg) (165.9±10 mg/dl). In general the results of this study reveal for first time, that the toxic effect of aluminium on glucose metabolism must be considered, particularly in individuals with frequent exposure to the element.

Diabetes mellitus is one of the most common metabolic diseases in the world. Recently, willingness to use alternative treatments to control and reduce blood sugar levels has noticeably increased. The general objective of this study is to investigate the hypoglycemic effect of the active ingredient of Berberis (Berberine) in patients with type 2 diabetes.
In this double-blind randomized controlled placebo trial, 84 patients with type 2 diabetes were evaluated. The patients were divided in 2 groups (42 each). In addition to their previous drugs, new diet, and life style each group received Berberine capsules 500 mg or placebo twice daily for 4 weeks. At baseline, weight, height, blood pressure, and BMI were calculated for all patients. Fasting plasma glucose, post- meal plasma glucose, fructosamine, lipid profile, fasting blood insulin levels, BUN, creatinine, and liver enzymes were taken from all patients before the study and after 4 weeks. HOMA-IR and HOMA-β% were calculated.
After administration of Berberine for a month, average blood sugar (FBS) in the Berberine group decreased from 192 ± 59.6 to 167.7 ± 51.8, which was statistically significant compared with the results of the placebo group (P = 0.036). There was a significant decrease from 266.1 ± 93.7 mg dl to 222.5 ± 76 in 2HPP in the Berberine group compared with the placebo group (P = 0.001). There was also a significant decrease from 425.7 ± 139.7 micromoles per liter to 344.9± 126.1 micromoles per liter in fructoseamine in the Berberine group compared with the placebo group (P = 0.014). In addition, fasting insulin, HOMA-β%, and HOMA-IR increased in the Berberine group compared with the placebo group, however, this increase was not statistically significant. There was a significant decrease in LDL, TG, VLDL in the Berberine group, however, it was not lower than that in the placebo group. Also, total cholesterol in the Berberine group decreased insignificantly compared to the placebo group. There was no significant difference between the 2 groups in terms of BMI, systolic, and diastolic blood pressure.
The results showed taking Berberine in patients with type 2 diabetes for 1 month significantly reduces the fasting plasma glucose, post- meal blood glucose, and fructosamine. No signification changes were found in lipid profiles, fasting insulin, HOMA-IR, and HOMA-β%.

Many studies have shown that oxidative stress is increased in diabetes and may accelerate the development of complications through the metabolism of excessive glucose and free fatty acids. In the present study, the effects of two well-known antioxidative nutrients, vitamin E and selenium, on the oxidative stress and antioxidative systems in streptozotocin (STZ) induced diabetic rats have been investigated. Thirty two adult female Sprague Dawley rats were randomly divided into three groups of normal control, diabetic control and diabetic vitamin E+selenium-supplemented groups. Diabetes was induced in the second and third group by STZ (60 mg/kg, i.p) and third group received both vitamin E (300 mg/kg/day) and selenium (0.5 mg/kg/day) for a period of 30 days. Fasting serum glucose concentration, malondialdehyde (MDA) level, glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities, plasma total antioxidant status (TAS) and lipid profile were measured. In diabetic rats, a significant increase in the levels of fasting plasma glucose (p 0.001) and MDA (p<0.05) was observed, whereas plasma TAS (p<0.01) and erythrocyte SOD activity (p<0.05) significantly decreased with no change in the GPX activity (p>0.05). Oral administration of vitamin E and selenium led to a significant decrease in the fasting plasma glucose levels (p<0.05). It also improved the antioxidant status of diabetic rats possibly through decreasing lipid peroxidative products and increasing enzymatic antioxidants. According to the results obtained vitamin E and selenium supplementation has antioxidant effect in STZ-induced experimental diabetes and may have beneficial protective effects in diabetic oxidative damage.