Diabetes Mellitus and Hyperglycemia Management in the Hospitalized Patient

Roasting treatments affect oil extraction rate, fatty acids, oxidative stability, antioxidant activity, and flavor of walnut oil

Introduction

The quality of pressed walnut oil can be improved by moderate roasting treatment.

Methods

This study compared physicochemical characteristics and antioxidant ability of walnut oils pressed from differently roasted pretreated walnuts, analyzed the correlation among these indicators by using Pearson correlation coefficient and correlation coefficient heatmap, and evaluated the volatile organic compounds (VOCs) of walnut oil under optimal pretreatment roasting conditions using headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS).

Results

Hierarchical cluster analysis (HCA) and principal component analysis (PCA) were able to remarkably distinguish walnut oil produced by different roasting processes. In addition, correlation analysis showed that there was a significant impact among indicators. There were 73 VOCs were identified in the optimum roasted treated walnut oil, consisting of 30 aldehydes, 13 alcohols, 11 ketones, 10 esters, 5 acids, 2 oxygen-containing heterocycles, 1 nitrogen-containing heterocycle and 1 other compound. GC-IMS results showed that aldehydes contributed significantly to the volatile flavor profile of walnut oil, especially (E)-2-heptenal, (E)-2-pentenal and hexenal.

Discussion

The properties of walnut oil based on varying roasting pretreatment of walnut kernels were significantly differentiated. Roasting at 120°C for 20 min is a suitable pretreatment roasting condition for pressing walnut oil. Roasting at 120°C for 20 min is a suitable pretreatment roasting condition for pressing walnut oil.

Glycated Hemoglobin as a Marker for Predicting Outcomes of Patients With Stroke (Ischemic and Hemorrhagic): A Systematic Review and Meta-Analysis

Background: Glycated hemoglobin (HbA1c) has emerged as a useful biochemical marker reflecting the average glycemic control over the last 3 months, and the values are not affected by short-term transient changes in blood glucose levels. However, its prognostic value in the acute neurological conditions such as stroke is still not well-established. The present meta-analysis was conducted to assess the relationship of HbA1c with outcomes such as mortality, early neurological complications, and functional dependence in stroke patients.

Methods: A systematic search was conducted for the PubMed, Scopus, and Google Scholar databases. Studies, either retrospective or prospective in design that examined the relationship between HbA1c with outcomes of interest and presented the strength of association in the form of adjusted odds ratio/hazard ratios were included in the review. Statistical analysis was done using STATA version 13.0.

Results: A total of 22 studies (15 studies on acute ischemic stroke and seven studies on hemorrhagic stroke) were included in the meta-analysis. For patients with acute ischemic stroke, each unit increase in HbA1c was found to be associated with an increased risk of mortality within 1 year, increased risk of poor functional outcome at 3 months, and an increased risk of symptomatic intracranial hemorrhage (sICH) within 24 h of admission. In those with HbA1c ≥ 6.5%, there was an increased risk of mortality within 1 year of admission, increased risk of poor functional outcomes at 3 and 12 months as well as an increased risk of symptomatic intracranial hemorrhage (sICH) within 24 h of admission. In patients with hemorrhagic stroke, each unit increase in HbA1c was found to be associated with increased risk of poor functional outcome within the first 3 months from the time of admission for stroke. In those with HbA1c ≥ 6.5%, there was an increased risk of poor functional outcome at 12 months.

Conclusions: The findings indicate that glycated hemoglobin (HbA1c) could serve as a useful marker to predict the outcomes in patients with stroke and aid in the implementation of adequate preventive management strategies at the earliest.

Prevalence of diabetes and its effects on stroke outcomes: A meta-analysis and literature review

AIMS/INTRODUCTION

Diabetes mellitus is an established risk factor for stroke and maybe associated with poorer outcomes after stroke. The aims of the present literature review were to determine: (i) the prevalence of diabetes in acute stroke patients through a meta-analysis; (ii) the association between diabetes and outcomes after ischemic and hemorrhagic stroke; and (iii) to review the value of glycated hemoglobin and admission glucose-based tests in predicting stroke outcomes.

MATERIALS AND METHODS

Ovid MEDLINE and EMBASE searches were carried out to find studies relating to diabetes and inpatient stroke populations published between January 2004 and April 2017. A meta-analysis of the prevalence of diabetes from included studies was undertaken. A narrative review on the associations of diabetes and different diagnostic methods on stroke outcomes was carried out.

RESULTS

A total of 66 eligible articles met inclusion criteria. A meta-analysis of 39 studies (n = 359,783) estimated the prevalence of diabetes to be 28% (95% confidence interval 26-31). The rate was higher in ischemic (33%, 95% confidence interval 28-38) compared with hemorrhagic stroke (26%, 95% confidence interval 19-33) inpatients. Most, but not all, studies found that acute hyperglycemia and diabetes were associated with poorer outcomes after ischemic or hemorrhagic strokes: including higher mortality, poorer neurological and functional outcomes, longer hospital stay, higher readmission rates, and stroke recurrence. Diagnostic methods for establishing diagnosis were heterogeneous between the reviewed studies.

CONCLUSIONS

Approximately one-third of all stroke patients have diabetes. Uniform methods to screen for diabetes after stroke are required to identify individuals with diabetes to design interventions aimed at reducing poor outcomes in this high-risk population.