In the twentieth century, researchers developed the oral glucose tolerance test, or OGTT, as a method to diagnose different types of diabetes, a medical condition that causes blood sugar levels to become abnormally high. During the test, a healthcare provider measures a person’s blood sugar levels before and after the person consumes a predetermined amount of glucose solution. While not exclusively used for pregnant women, an OGTT may test for gestational diabetes which, according to the International Diabetes Federation, affected one in six pregnancies worldwide in 2019. Generally, the results from an OGTT can inform a patient and her physician how her body is responding to glucose during pregnancy, and high levels may increase her risk of developing adverse pregnancy outcomes such as heavy bleeding during delivery and a high blood pressure condition known as preeclampsia. An OGTT can help to accurately diagnose, treat, and monitor gestational diabetes in pregnant women, which can reduce health and pregnancy complications for the woman and the fetus.

Gestational diabetes is a medical condition that causes blood sugar levels to become abnormally high, which manifests for the first-time during pregnancy and typically disappears immediately after birth for around ninety percent of affected women. While many women with the condition do not experience any noticeable symptoms, some may experience increased thirst and urination. Although gestational diabetes is treatable, if left unmanaged, the resulting fetus is more likely to have elevated risks of increased birth weight, birth injuries, low blood sugar, stillbirth, and later development of type 2 diabetes. The International Diabetes Federation estimates that worldwide in 2019, gestational diabetes affected one in six pregnant women, with many cases occurring in women living in low and middle-income countries. Despite the prevalence and risks associated with gestational diabetes, as of 2020, researchers have yet to reach a unified consensus on the best guidelines for diagnosis and treatment.

Type II Diabetes Mellitus has detrimental effects on the human body. A1C levels reflect the attachment of glucose to hemoglobin-the protein in red blood cells that carries oxygen. Elevated A1C levels are an indicator of how controlled diabetes is. Uncontrolled diabetes not only affects glucose levels, but has detrimental repercussions in other organs of the body, causing peripheral vascular disease, risk of developing dementia, periodontal or gum disease, skin infections, neuropathy in lower and upper extremities, renal damage, erectile dysfunction, decreased blood flow, and cardiac conditions among others.

A diet low in calories positively affects glucose levels in the body. Type II Diabetes can be easily controlled when lifestyle modifications are included in the plan of care. Among those modifications, diet is an effective intervention for the management of this condition.
Establishing a diet among the patients that have an elevated A1C is the plan of care and ultimate goal for this project. The Mediterranean diet has demonstrated decreased blood glucose levels, improved weight control and enhanced quality of life.

Birds have been found to possess naturally high blood glucose levels compared to other mammals of similar sizes (Braun and Sweazea, 2008). Additionally, birds utilize lipids as their primary source of fuel yet continue to have high resting blood glucose levels (Landys et al., 2005). It has been hypothesized that the underlying cause of this is a preference to oxidize fatty acids rather than carbohydrates, which results in the production of glycerol (a precursor to gluconeogenesis). Thus, the role of gluconeogenesis in blood glucose regulation in birds was examined in this study. We captured seven mourning doves (Zenaida macroura) in Tempe, Arizona, and allowed them to acclimate to their new environment for two weeks. One bird was released prior to experimentation due to poor acclimation. Over a course of six weeks following this acclimation period, birds were administered either metformin (an inhibitor of gluconeogenesis that is commonly used in type 2 diabetes patients) at 150 mg/kg or 300 mg/kg, a compound called DAB (1,4-dideoxy-1,4-imino-D-arabinitol) at a dose of 2.5 mg/kg that acts to inhibit glycogenolysis (a potential compensatory mechanism that elevates blood sugar), or a control (water). Blood draws were conducted at 0, 5, and 15 minutes following each treatment. In this crossover design study, each bird received one treatment each week. In the first phase of this study, Kreisler et al. found that 150 mg/kg metformin significantly increased blood glucose whereas 300 mg/kg metformin did not increase over two hours. These observations held true in the current acute study as well. Additionally, Kreisler et al. observed no effect of METDAB (150 mg/kg metformin and 2.5 mg/kg DAB) on blood glucose compared to the control, indicating that DAB effectively inhibited glycogenolysis induced by metformin. Contrary to this, the current study observed a significant increase (p<0.05) in blood glucose over 15 minutes after administration of METDAB, suggesting that DAB does not act within a shorter period of time. While metformin increases blood glucose within only 5 minutes, the longer timeframe with which DAB acts was not sufficient to prevent the increase. Additionally, when administered alone, DAB had no effect on blood glucose concentrations over a 2-hour period. This suggests that glycogenolysis is most likely not activated in healthy mourning doves under fed conditions and that gluconeogenesis plausibly plays a much larger role.