Hyperglycemia effect on red blood cells indices.

OBJECTIVE: Hyperglycemia has an effect on all body tissues; one of them is the bone marrow. This effect is related to protein glycation and other chemical and physiological changes of red blood cells (RBCs). The aim of this study was to assess the effect of hyperglycemia on different RBCs indices along with evaluating these changes in the normal physiology and chronic diabetes complication pathology. PATIENTS AND METHODS: This is a cross-sectional hospital-based study of 1000 type 2 Saudi diabetic patients without any hematological diseases. Patients were fully evaluated clinically and biochemically with full blood hematological parameters assessment. The studied cohort matched the general characteristics of Saudi type 2 diabetic patients. RESULTS: This study shows that hyperglycemia increases the red blood cells count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC). Red blood cell distribution width (RDW) was negatively correlated with poor glycemic control. Concurrently, the presence of micro and macroangiopathies with hyperglycemia shortens the lifespan of RBCs. CONCLUSIONS: We conclude that hyperglycemia has an imposing effect on RBCs count and its physiological function, which can be normalized effectively with good glycemic control.

Bioequivalence of Jusline following subcutaneous administration in healthy subjects.

OBJECTIVE: The aim of the current work is to evaluate the pharmacokinetic and pharmacodynamic profile of a new human insulin preparation (jusline) following subcutaneous administration in healthy subjects, and to compare this profile with Humulin insulin. METHODS: 20 healthy male subjects received a single dose of 0.2 U/kg of test (Jusline) or reference insulin (Humulin) during an euglycemic clamp keeping blood sugar constant (90 +/- 5 mg/dl) by changing the glucose infusion rate. Pharmacokinetic and pharmacodynamic measurements were taken from blood measurements of glucose, insulin, and C-peptide levels for tested insulin formulations. RESULTS: The mean values of the individual AUC ratios were well within the 90% confidence interval (100.5% for Regular, 101.9% for NPH, and 100.0% for Premixed Regular/NPH (30/70)). Similarly, Cmax and tmax were within the bioequivalence limit (80 - 125%). The maximum GIR were 10.20 mg/kg/min and 9.72 mg/kg/min for Jusline Regular and Humulin Regular, respectively. The maximum GIR were 7.09 mg/kg/min and 7.91 mg/kg/min for Jusline NPH and Humulin NPH, respectively. The maximum GIR and tGIRmax were 6.39 mg/kg/min and 6.63 mg/kg/ min for Jusline Premixed Regular/NPH (30/70) and Humulin Premixed Regular/NPH (30/70), respectively. Both insulin products produced similar suppression of endogenous C-peptide level (-29.76% to -50.22%). CONCLUSION: The present study demonstrated that after subcutaneous administration, there are no significant differences between Jusline and Humulin to promote peripheral glucose uptake.