Tuberculosis (TB) treatment success rates are high in China, but there are still a considerable number of cases who have unfavourable treatment outcomes (UTO). We aimed to determine the proportion of TB patients with UTO and to assess whether baseline characteristics that included glycaemic status [normal fasting blood glucose (FBG), transient hyperglycaemia and diabetes mellitus (DM)] and vitamin D status were associated with UTO.
Prospective cohort study conducted between November 2015 and July 2016 at six clinics within routine TB services in Jilin province, where persons with TB were consecutively recruited. Data analysis was performed using the chi-squared test and multivariate logistic regression.
Of the 306 recruited TB patients, 96 (31.4%) had smear-positive pulmonary TB, 187 (61.1%) had smear-negative pulmonary TB and 23 (7.5%) had extrapulmonary TB (EPTB). Of these, 95 (31.1%) had normal blood glucose, 83 (27.1%) had transient hyperglycaemia and 128 (41.8%) had DM. 227 (74.2%) patients had vitamin D deficiency/severe deficiency. There were 125 (40.8%) patients with UTO of whom the majority were lost to follow-up (57.6%) or not evaluated (28.8%). UTO was significantly associated with smear-negative pulmonary TB (P = 0.009), EPTB (P < 0.001) and DM (P = 0.007).
The proportion of TB patients with UTO increased with smear-negative pulmonary TB, EPTB and DM. TB programmes need to pay more attention to these issues and ensure intensive patient support to those at risk and early detection of DM.
Les taux de succès du traitement de la tuberculose (TB) sont élevés en Chine, mais il existe encore un nombre considérable de cas avec des résultats de traitement défavorables (RTD). Nous avons cherché à déterminer la proportion de patients TB avec un RTD et d\'évaluer si les caractéristiques de base comprenant le statut glycémique [glycémie normale à jeun (GJ), hyperglycémie transitoire et diabète sucré (DS)] et le statut en vitamine D étaient associés à un RTD. MÉTHODE: Etude de cohorte prospective réalisée entre novembre 2015 et juillet 2016 dans six cliniques des services anti-TB de routine de la province de Jilin, où des personnes atteintes de TB ont été recrutées consécutivement. L\'analyse des données a été réalisée à l\'aide du test du chi carré et de la régression logistique multivariée. RÉSULTATS: Sur 306 patients TB recrutés, 96 (31.4%) avaient une TB pulmonaire à frottis positif, 187 (61.1%) avaient une TB pulmonaire à frottis négatif et 23 (7.5%) avaient une TB extra pulmonaire (TBEP). Parmi ceux-ci, 95 (31.1%) avaient une glycémie normale, 83 (27.1%) avaient une hyperglycémie transitoire et 128 (41.8%) avaient un DS. 227 (74.2%) patients avaient une déficience/déficience sévère en vitamine D. Il y avait 125 (40.8%) patients avec un RTD dont la majorité (57.6%) ont été perdus de vue ou ont été non évalués (28.8%). Le RTD était significativement associé à la TB pulmonaire à frottis négatif (p = 0.009), la TBEP (P < 0.001) et le DS (P = 0.007).
La proportion de patients TB avec un RTD augmentait avec la TB pulmonaire à frottis négatif, la TBEP et le DS. Les programmes anti-TB devraient accorder plus d\'attention à ces problèmes et assurer un soutien intensif au patient pour les personnes à risque et une détection précoce du DS.

This randomized crossover study assessed the acute effects of almonds on postprandial glycemic, hormonal, and appetite responses in a sample of 7 men with type 2 diabetes (T2D). Participants completed 2 experimental visits during which a control (white bread, butter, cheese) and a test (white bread, almonds) meal were ingested. Energy, available carbohydrate, total lipid, and protein content were the same in both meals. Blood samples were collected in fasting state as well as 15, 30, 60, 90, 120, and 240 min postprandially for quantifying blood glucose, as well as insulin and glucagon-like peptide-1 (GLP-1) serum concentrations. Subjective appetite sensations were assessed using visual analog scales at the same time-points. Within this sample of participants, the test meal was found to be associated with lower postprandial glycemia and insulinemia, higher GLP-1 serum concentrations, decreased hunger and desire to eat, and increased fullness. The test meal was also associated with an increased estimated glucose metabolic clearance rate, indicating higher postprandial insulin sensitivity. Overall, results suggest that almonds\' macronutrient subtype profile could have a beneficial impact on postprandial glycemic, hormonal, and appetite responses in men with T2D. Studies with larger sample sizes are warranted to confirm these findings. Novelty A meal containing almonds (vs. isocaloric macronutrient-matched control) induced lower glycemic and insulinemic responses. A meal containing almonds (vs. isocaloric macronutrient-matched control) induced a greater elevation in postprandial GLP-1 serum concentrations. A meal containing almonds (vs. isocaloric macronutrient-matched control) induced more favourable postprandial appetite responses.

Diabetes mellitus and complications arising from the disease are a leading cause of morbidity and mortality worldwide. With increasing prevalence over the past 50 years and an estimated 20% of health-care spending dedicated to the disease, diabetes is considered by many to be a true public health emergency. Several protocols and management options exist to maximize glycemic control in the ambulatory setting, but the optimal glucose level in critically and noncritically ill inpatients is still debated. This review examines the evidence behind differing degrees of glycemic control across a variety of hospital settings and clinical scenarios. Patients presenting to the emergency department who are found to be hyperglycemic pose additional management challenges for clinicians. In this setting, no consensus exists for optimal serum glucose level and safe discharge parameters.

Postprandial hyperglycemia increases arterial stiffness. Arterial stiffness and insulin resistance are lower in exercise-trained humans than in untrained humans. However, the effect of exercise on arterial stiffness after glucose ingestion in young adults remains unknown. The present study investigates the effect of regular aerobic exercise on arterial stiffness after glucose ingestion in young males. Ten exercise-trained males (age, 20.8 ± 0.2 years; ETR) and 9 healthy untrained males (age, 22.2 ± 0.7 years; UTR) participated in this study. Carotid-femoral (aortic) pulse wave velocity (PWV), femoral-ankle (leg) PWV, carotid augmentation index (AIx) (applanation tonometry), brachial and ankle blood pressure (BP), heart rate (oscillometric device and electrocardiography), and blood glucose (glucose oxidase method) were measured at 30 min before (baseline) and 30, 60, and 120 min after a 75-g oral glucose tolerance test. Leg PWV at 30 min after glucose ingestion was significantly higher (P < 0.01) in the UTR group than in the ETR group. Ankle systolic BP at 30 min after glucose ingestion was also significantly higher in the UTR group than in the ETR group (P < 0.05). Blood glucose increased from baseline at 30 min (P < 0.01) and 60 min (P < 0.05) after glucose ingestion in both groups. Aortic PWV, carotid AIx, and brachial systolic BP did not change from baseline after glucose ingestion in both groups. The present findings indicate that leg PWV and ankle systolic BP after glucose ingestion were significantly lower in the ETR group than in the UTR group.

Observational studies support that dairy product intake is associated with a reduced risk of developing type 2 diabetes; however, several clinical studies report conflicting results on the association between dairy product consumption and metabolic parameters. The aim of this study was to determine associations between dairy product consumption and metabolic profile. Dietary data, using a validated food frequency questionnaire, and fasting blood samples were collected from 233 French Canadians. Plasma phospholipid (PL) fatty acids (FA) concentrations were determined by gas chromatography. Subjects consumed 2.5 ± 1.4 portions of dairy products daily, including 1.6 ± 1.3 portions of low-fat (LF) and 0.90 ± 0.70 portions of high-fat (HF) dairy products. Trans-palmitoleic acid level in plasma PL was related to HF dairy consumption (r = 0.15; p = 0.04). Total (r = -0.21; p = 0.001) and LF dairy (r = -0.20; p = 0.003) intakes were inversely correlated with fasting plasma glucose level. Total dairy intake was inversely associated to systolic blood pressure (r = -0.17; p = 0.008) and diastolic blood pressure (r = -0.14; p = 0.03). LF dairy intake was also inversely correlated with systolic blood pressure (r = -0.17; p = 0.009). Total dairy intake was correlated with plasma C-reactive protein (CRP) (r = 0.15; p = 0.03). No association was found between HF dairy consumption and the risk factors studied. In conclusion, dairy intake is inversely associated with glycaemia and blood pressure; yet, it may modify CRP levels. Moreover, trans-palmitoleic FA levels in plasma PL may be potentially used to assess full-fat dairy consumption.

This study investigated whether pulses (chickpeas, yellow peas, navy beans, lentils) have an effect on blood glucose (BG) and appetite following a fixed-size meal 2 h later. Over the following 2 h, all pulses lowered BG area under the curve (AUC) and lentils reduced appetite AUC compared with white bread (p < 0.05). Following the meal, BG was lower after lentils and chickpeas at 150 and 165 min, and AUC was lower after lentils compared with white bread (p < 0.05).