460 www.bsmiab.org/jabet Marzan et al., J Adv Biotechnol Exp Ther. 2024 Sep; 7(3): 460-471 Impact of betel quid on hyperglycemia among diabetes patients in Bangladesh Abdullah Al Marzan 1, † , Md. Soyib Hasan 1, † , Md. Rafiul Islam 1 , Miah Mohammad Sakib 1 , Md. Sifatul Islam 1 , Md Sakil Arman 1 , Md. Rakibul Islam 2 , Mohammad Abul Hasnat 1 , Zafrul Hasan 1, * 1 Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh 2 Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka-1000, Bangladesh ABSTRACT Betel quid (BQ), a prevalent social habit in Asia, is often used without awareness of its harmful effects. This study explored the impact of BQ chewing on hyperglycemia among diabetic patients in northeastern Bangladesh. Specifically, this study focused on the role of areca nut, a key addictive component in BQ, in influencing hyperglycemia. Random blood glucose (RBG) tests were conducted on 961 diabetic patients, alongside lifestyle data, from August 2018 to February 2019 at Sylhet Diabetic Hospital, Bangladesh. Statistical analyses, including t-tests, Analysis of the variance (ANOVA), Fisher's exact test, and Multivariate regression, were employed to assess RBG status in BQ chewer vs. non-chewer. BQ chewers had higher RBG levels than non-chewers (263.3 ± 4.768 vs. 251.0 ± 5.915). Notably, raw areca nut users in the BQ group had significantly higher RBG levels than dry nut users (278.0 ± 8.790 vs. 252.1 ± 6.835 mg/dl), with up to 50 times more hyperglycemic effect. BQ chewing was associated with elevated RBG levels across different demographic and lifestyle groups. Lack of awareness was also prevalent among BQ chewers while individuals with desk jobs showed higher RBG levels. In conclusion, diabetic BQ chewers experience elevated hyperglycemia levels, highlighting the. urgent need to discourage BQ use for effective diabetes management. INTRODUCTION Hyperglycemia, a hallmark of diabetes, exerts profound and multifaceted impacts on health. Elevated blood glucose levels result from insufficient insulin production or impaired insulin utilization, leading to both acute and chronic complications. Acutely, hyperglycemia manifests through symptoms like excessive thirst, frequent urination, fatigue, and blurred vision, disrupting daily life [1]. If unmanaged, it can escalate to life-threatening conditions such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) [2]. Furthermore, hyperglycemia impairs wound healing and heightens infection risk, while also being linked to higher rates of depression and anxiety [3]. These complications not only increase morbidity and mortality but also significantly diminish quality of life [4]. Herbal medicines combined with nanoparticles, such as Gynura procumbens ethanolic extract with chitosan nanoparticles, have shown significant efficacy in reducing hyperglycemia and improving metabolic parameters in diabetic models [5]. Additionally, type-2 diabetes mellitus (T2DM) exacerbates other diseases, notably cancer, underscoring the need for early detection biomarkers [6]. Effective management of blood glucose levels is paramount to preventing these adverse outcomes and improving the overall health and well-being of individuals with diabetes [7]. *Corresponding author Zafrul Hasan, PhD Department of Biochemistry and Molecular Biology Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh Email: zafrul-bmb@sust.edu † These authors contributed equally Academic editor Md Jamal Uddin, PhD ABEx Bio-Research Center, Dhaka Bangladesh Article info Received: 21 May 2024 Accepted: 12 June 2024 Published: 28 June 2024 Keywords Areca nut, Betel quid, Hyperglycemia, Random blood glucose, Type-2 diabetes. Copyright: © by the authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. ORIGINAL ARTICLE J Adv Biotechnol Exp Ther. 2024 Sep; 7(3): 460-471 eISSN: 2616-4760, https://doi.org/10.5455/jabet.2024.d40 Published by www.bsmiab.org