Glucose variability in maintenance hemodialysis patients with type 2 diabetes: Comparison of dialysis and nondialysis days

Introduction

Hemodialysis (HD) induces several physiological changes that can affect plasma glucose levels in patients with diabetes and in turn their glycemic control. Studies using continuous glucose monitoring (CGM) to assess glucose variations on dialysis days compared with nondialysis days report conflicting results. Here, we used CGM to examine glucose variations induced by HD in patients with type 2 diabetes.

Methods

Patients with type 2 diabetes undergoing maintenance HD were included. CGM (Ipro2®, Medtronic) was performed at baseline and Week 4, 8, 12, and 16 for up to 7 days at each visit. CGM profiles on days where participants received HD were compared with days without HD using a linear mixed model.

Findings

Twenty-seven patients were included. The median number of CGM days performed was 8 (interquartile range [IQR] 6–10) for dialysis days and 16 (IQR 12–17) for nondialysis days. The median sensor glucose was 9.4 (95% confidence interval [CI] 8.8–10.2) mmol/L on dialysis days compared with 9.5 (95% CI 8.9–10.2) mmol/L on nondialysis days (p = 0.58). Nocturnal mean sensor glucose was higher on dialysis days compared with nondialysis days: 8.8 (95% CI 8.0–9.6) mmol/L versus 8.4 (95% CI 7.7–9.2) mmol/L (p = 0.029).

Discussion

Similar median sensor glucose values were found for days on and off HD. Nocturnal glucose levels were modestly increased on dialysis days. Our findings indicate that antidiabetic treatment does not need to be differentiated on dialysis versus nondialysis days in patients with type 2 diabetes undergoing maintenance HD.     

Recyclability Studies on Poly(lactic acid)/Poly(butylene succinate-co-adipate) (PLA/PBSA) Biobased and Biodegradable Films

Poly(lactic acid)/poly(butylene succinate-co-adipate) (PLA/PBSA) blends are found promising for film packaging applications because of their flexibility, resistance, and compostability. Industrially extruded granules and films based on PLA and containing different amounts of PBSA are reprocessed through mini-extrusion, to simulate recycling, and tested in terms of their melt flow rate as a function of PBSA content. Moreover, pure PLA commercial granules and the film produced extruding the PLA/PBSA 60/40 blend are reprocessed several times by injection molding and characterized in terms of melt flow rate, mechanical properties, thermal properties, and color as a function of injection molding cycles. The variation in melt fluidity and thermo-mechanical properties is negligible up to 3 injection molding cycles for both pure PLA granules and PLA/PBSA blend. In the case of blend the change in color (yellowing and darkening) is more evident and slight local compositional change in injection molded items can be evidenced as well as a slight decrease in PBS crystallinity as a function of injection molding cycles. Nevertheless, in applications where these aspects are not critical, these materials can be recycled by extrusion or injection molding before being composted, thus prolonging their life cycle and storing carbon in them as longer as possible.     

A software-based measurement system for testing and analysis of automotive brake squeal

A software-based measurement system using both analogue data acquisition and digital communication via a general-purpose interface bus (GPIB) board has been developed for analysis and evaluation of disc brake squeal. The system is built around a computer and based on commercial software. Brake pressure and torque, rotational speed, five different temperatures, and sound emission are logged once a second. If the sound is characterised as a squeal it is saved to file together with the other parameters. The measurement system is very flexible, allowing for different types of instruments and sensors to be used by adapting the software. Furthermore, the same software is used for evaluation of the collected data. Mechanically, the equipment consists of a complete front wheel suspension where the original brake disc and caliper are mounted in a steel tube chassis. The brake disc is driven by a DC electric motor, while a hydraulic system provides the brake pressure. Brake pressure and rotational speed can be controlled independently.     

Magneto-hydrodynamic mixing: A new technique for preparing carbomer hydrogels

Magnetohydrodynamic mixing was evaluated as an alternative to conventional high shear mixing (HSM) in the preparation of carbomer hydrogels containing 1.22 wt% Carbopol® 980 NF. Neutralization of the carbomer dispersion (pH = 2.74) with triethanolamine (TEA) enabled to adjust the pH of the mixture and tune the viscosity of the hydrogel. Using HSM, this approach was limited to 0.2 wt% TEA (pH = 3.83) as the gel became too viscous and the recirculation flow dropped from 12 to 0.3 m³/h. Magnetohydrodynamic mixing enabled to reach TEA concentrations up to 1.0 wt% (pH = 5.31). Apparent viscosity measurements on samples having 0.2 wt% TEA revealed lower viscosities for carbomer hydrogels prepared with HSM, that is, 6800 mPa s versus 8800 mPa for magneto-hydrodynamic mixing. Based on ¹H NMR evidence, this decrease in apparent viscosity was attributed to structural damage to the carbomer backbone in combination with mechanochemical degradation of the added TEA.     

Molecular Architecture Effects on Bulk Nanostructure in Bis(Orthoborate) Ionic Liquids

A series of 19 ionic liquids (ILs) based on phosphonium and imidazolium cations of varying alkyl-chain lengths with the orthoborate anions bis(oxalato)borate [BOB]⁻, bis(mandelato)borate, [BMB]⁻ and bis(salicylato)borate, [BScB]⁻, are synthesized and studied using small-angle neutron scattering (SANS). All measured systems display nanostructuring, with 1-methyl-3-n-alkyl imidazolium-orthoborates forming clearly bicontinuous L₃ spongelike phases when the alkyl chains are longer than C₆ (hexyl). L₃ phases are fitted using the Teubner and Strey model, and diffusely-nanostructured systems are primarily fitted using the Ornstein-Zernicke correlation length model. Strongly-nanostructured systems have a strong dependence on the cation, with molecular architecture variation explored to determine the driving forces for self-assembly. The ability to form well-defined complex phases is effectively extinguished in several ways: methylation of the most acidic imidazolium ring proton, replacing the imidazolium 3-methyl group with a longer hydrocarbon chain, substitution of [BOB]⁻ by [BMB]⁻, or exchanging the imidazolium for phosphonium systems, irrespective of phosphonium architecture. The results suggest there is only a small window of opportunity, in terms of molecular amphiphilicity and cation:anion volume matching, for the formation of stable extensive bicontinuous domains in pure bulk orthoborate-based ILs. Particularly important for self-assembly processes appear to be the ability to form H-bonding networks, which offer additional versatility in imidazolium systems.     

Reciprocative sliding friction and wear properties of electrical discharge machined ZrO2‐based composites

Hot‐pressed, laboratory‐made, ZrO₂‐based composites with 40 vol. % WC, TiCN or TiN were surface finished by electrical discharge machining in order to compare their reciprocating sliding friction and wear response against WC–6wt%Co cemented carbide in unlubricated conditions. Sliding experiments were performed using a Plint TE77 pin‐on‐flat wear test rig, revealing a strong impact of the secondary phase on the tribological behaviour of the ZrO₂‐based composites. The worn surfaces and wear debris were characterised by scanning electron microscopy, energy dispersive X‐ray analysis and surface topography scanning, pointing out abrasion, polishing and adhesion as main wear mechanisms. The most favourable friction and wear characteristics were encountered with ZrO₂–WC composites compared to the other grades with equal amount of volumetric secondary phase. Copyright © 2009 John Wiley & Sons, Ltd.