Decreased sarcoplasmic reticulum phospholipids in human skeletal muscle are associated with metabolic syndrome.

Metabolic syndrome affects more than one in three adults and is associated with increased risk of diabetes, cardiovascular disease, and all-cause mortality. Muscle insulin resistance is a major contributor to the development of the metabolic syndrome. Studies in mice have linked skeletal muscle sarcoplasmic reticulum (SR) phospholipid composition to sarcoplasmic/endoplasmic reticulum Ca2+-ATPase activity and insulin sensitivity. To determine if the presence of metabolic syndrome alters specific phosphatidylcholine (PC) and phosphatidylethanolamine (PE) species in human SR, we compared SR phospholipid composition in skeletal muscle from sedentary subjects with metabolic syndrome and sedentary control subjects without metabolic syndrome. Both total PC and total PE were significantly decreased in skeletal muscle SR of sedentary metabolic syndrome patients compared with sedentary controls, particularly in female participants, but there was no difference in the PC:PE ratio between groups. Total SR PC levels, but not total SR PE levels or PC:PE ratio, were significantly negatively correlated with BMI, waist circumference, total fat, visceral adipose tissue, triglycerides, fasting insulin, and homeostatic model assessment for insulin resistance. These findings are consistent with the existence of a relationship between skeletal muscle SR PC content and insulin resistance in humans.

Interruption of CGM: Frequency and Adverse Consequences.

BACKGROUND: Removal of diabetes devices, including insulin pumps and continuous glucose monitoring (CGM), is a common practice due to hospital policies, interference with imaging studies, medications, and surgical interventions. Furthermore, these devices are inherently prone to malfunction, adhesive failure, and issues with insertion that can lead to a reduction in wear time. Prescription and dispensing practices provide an exact number of sensors per month without redundancy to account for the realities of daily CGM use. METHODS: A RedCap survey was completed by adult patients with type 1 or type 2 diabetes (T1D or T2D) who utilize CGM followed in the Diabetes Center at Washington University in St Louis. RESULTS: Of 384 surveys sent, 99 were completed. Participants had a mean age of 54 years, T1D 69%, female 70%, White 96%, non-Hispanic 96%, and a mean duration of diabetes mellitus (DM) 28 years. Of the cohort, 100% used CGM (80.2% Dexcom, 13.5% Freestyle Libre, 6.3% Medtronic), 61% insulin pump, and 41% Hybrid closed-loop (HCL) systems. CGM-related disruption events included device malfunction (in 85.4% of participants), insertion problems (63.5%), and falling off (61.4%). Medical care-related disruption occurred most frequently in the setting of imaging (41.7%), followed by surgery/procedures (11.7%) and hospitalization (4.4%). Adverse glycemic events attributed to CGM disruption, including hyperglycemia and hypoglycemia, occurred ≥4 times in 36.5% and 12.4% of the cohort, respectively. CONCLUSIONS: Disruption in CGM use is common. Lack of redundancy of CGM supplies contributes to care disruption and adverse glycemic events.

Review of Active Extracorporeal Medical Devices to Counteract Freezing of Gait in Patients with Parkinson Disease.

Parkinson Disease (PD) primarily affects older adults. It is the second-most common neurodegenerative disease after Alzheimer's disease. Currently, more than 10 million people suffer from PD, and this number is expected to grow, considering the increasing global longevity. Freezing of Gait (FoG) is a symptom present in approximately 80% of advanced-stage PD's patients. FoG episodes alter the continuity of gait, and may be the cause of falls that can lead to injuries and even death. The recent advances in the development of hardware and software systems for the monitoring, stimulus, or rehabilitation of patients with FoG has been of great interest to researchers because detection and minimization of the duration of FoG events is an important factor in improving the quality of life. This article presents a review of the research on non-invasive medical devices for FoG, focusing on the acquisition, processing, and stimulation approaches used.