ABSTRACT
OBJECTIVE: When glucose records from self blood glucose monitoring (SBGM) do not reflect estimated average glucose from glycosylated hemoglobin (HgBA1) or when patients' clinical symptoms are not explained by their SBGM records, clinical management of diabetes becomes a challenge. Our objective was to determine the magnitude of differences in glucose values reported by SBGM versus those documented by continuous glucose monitoring (CGM). METHODS: The CGM was conducted by a clinical diabetes educator (CDE)/registered nurse by the clinic protocol, using the Medtronic iPRO2™ system. Patients continued SBGM and managed their diabetes without any change. Data from 4 full days were obtained, and relevant clinical information was recorded. De-identified data sets were provided to the investigators. RESULTS: Data from 61 patients, 27 with type 1 diabetes (T1DM) and 34 with T2DM were analyzed. The lowest, highest, and average glucose recorded by SBGM were compared to the corresponding values from CGM. The lowest glucose values reported by SBGM were approximately 25 mg/dL higher in both T1DM ( P = .0232) and T2DM ( P = .0003). The highest glucose values by SBGM were approximately 30 mg/dL lower in T1DM ( P = .0005) and 55 mg/dL lower in T2DM ( P<.0001). HgBA1c correlated with the highest and average glucose by SBGM and CGM. The lowest glucose values were seen most frequently during sleep and before breakfast; the highest were seen during the evening and postprandially. CONCLUSION: SBGM accurately estimates the average glucose but underestimates glucose excursions. CGM uncovers glucose patterns that common SBGM patterns cannot. ABBREVIATIONS: CDE = certified diabetes educator; CGM = continuous glucose monitoring; HgBA1c = glycosylated hemoglobin; MAD = mean absolute difference; SBGM = self blood glucose monitoring; T1DM = type 1 diabetes; T2DM = type 2 diabetes.
Subject(s)
Blood Glucose Self-Monitoring/methods , Blood Glucose/metabolism , Diabetes Mellitus, Type 1/metabolism , Diabetes Mellitus, Type 2/metabolism , Hyperglycemia/diagnosis , Hypoglycemia/diagnosis , Monitoring, Ambulatory/methods , Adult , Aged , Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 2/drug therapy , Female , Glycated Hemoglobin/metabolism , Humans , Hyperglycemia/metabolism , Hypoglycemia/chemically induced , Hypoglycemia/metabolism , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Male , Middle Aged , Postprandial PeriodABSTRACT
PURPOSE: To evaluate the effect of slow and ultra-rapid freezing on biopsied blastocysts' DNA integrity. METHODS: Forty eight mouse blastocysts were biopsied of which 16 were cryopreserved by slowly freezing and 17 by vitrification. Fourteen intact blastocysts were slowly cryopreserved and 24 were vitrified. Eighteen fresh intact blastocysts and fifteen biopsied blastocysts served as controls. The DNA integrity index of all blastocysts was evaluated using (TUNEL) staining and confocal imaging RESULTS: Both slow freezing and vitrification of biopsied blastocysts induced apoptosis to a similar extent. Biopsying blastocysts before vitrification resulted in less apoptosis than vitrification of intact blastocysts. CONCLUSION: Slow freezing and vitrification are equal options for preservation of biopsied blastocysts as regards the DNA integrity index (DII). Biopsied blastocysts better tolerate vitrification than intact expanded blastocysts.
Subject(s)
Blastocyst , Cryopreservation/methods , Animals , Apoptosis , DNA Damage , Female , In Situ Nick-End Labeling , Male , Mice , Preimplantation DiagnosisABSTRACT
Maintaining the integrity of sperm DNA is vital to reproduction and male fertility. Sperm contain a number of molecules and pathways for the repair of base excision, base mismatches and DNA strand breaks. The presence of Poly (ADP-ribose) polymerase (PARP), a DNA repair enzyme, and its homologues has recently been shown in male germ cells, specifically during stage VII of spermatogenesis. High PARP expression has been reported in mature spermatozoa and in proven fertile men. Whenever there are strand breaks in sperm DNA due to oxidative stress, chromatin remodeling or cell death, PARP is activated. However, the cleavage of PARP by caspase-3 inactivates it and inhibits PARP's DNA-repairing abilities. Therefore, cleaved PARP (cPARP) may be considered a marker of apoptosis. The presence of higher levels of cPARP in sperm of infertile men adds a new proof for the correlation between apoptosis and male infertility. This review describes the possible biological significance of PARP in mammalian cells with the focus on male reproduction. The review elaborates on the role played by PARP during spermatogenesis, sperm maturation in ejaculated spermatozoa and the potential role of PARP as new marker of sperm damage. PARP could provide new strategies to preserve fertility in cancer patients subjected to genotoxic stresses and may be a key to better male reproductive health.