A prospective observational prevalence study of elevated HbA1c among elective surgical patients

Abstract Type 2 Diabetes Mellitus (DM) is a chronic disease with high prevalence worldwide. Using glycated haemoglobin (HbA1c) as a surrogate for potential pre-DM and DM conditions, our primary objective was to determine the HbA1c epidemiology in non-cardiac elective surgical patients in Singapore. Our secondary aim was to identify risk factors associated with elevated HbA1c. We conducted a prospective, observational single-centre study in adult patients. HbA1c screening was performed. Patient demographics and comorbidities were recorded. Patients were divided into those with HbA1C ≤ 6.0% and HbA1C ≥ 6.1%. Regression analyses were performed to identify associated factors. Subgroup analysis was performed comparing patients with HbA1C ≥ 6.1% and HbA1C ≥ 8.0%. Of the 875 patients recruited, 182 (20.8%) had HbA1c ≥ 6.1%, of which 32 (3.7%) had HbA1c ≥ 8%. HbA1C ≥ 6.1% was associated with Indian ethnicity [1.07 (1.01–1.13), p = 0.023], BMI > 27.5 [1.07 (1.02–1.11), p = 0.002], higher preoperative random serum glucose [1.03 (1.02–1.04), p < 0.001], pre-existing diagnosis of DM [1.85 (1.75–1.96), p < 0.001] and prediabetes [1.44 (1.24–1.67), p < 0.001], and peripheral vascular disease [1.30 (1.10–1.54), p = 0.002]. HbA1c ≥ 8% had an additional association with age > 60 years [0.96 (0.93–0.99), p = 0.017]. The prevalence of elevated HbA1c is high among the surgical population. Targeted preoperative HbA1c screening for at-risk elective surgical patients reduces cost, allowing focused use of healthcare resources.

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Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study

BMJ Open ◽

10.1136/bmjopen-2014-004794 ◽

2014 ◽

Vol 4 (4) ◽

pp. e004794 ◽

Cited By ~ 34

Author(s):

Kurubaran Ganasegeran ◽

Pukunan Renganathan ◽

Rizal Abdul Manaf ◽

Sami Abdo Radman Al-Dubai

Keyword(s):

Type 2 Diabetes ◽

Anxiety And Depression ◽

Single Centre ◽

Cross Sectional ◽

Centre Study ◽

Factors Associated ◽

Single Centre Study

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Predictors of new-onset diabetic ketoacidosis in patients with moderate to severe COVID-19 receiving parenteral glucocorticoids: A prospective single-centre study among Indian type 2 diabetes patients

Diabetes & Metabolic Syndrome Clinical Research & Reviews ◽

10.1016/j.dsx.2021.03.022 ◽

2021 ◽

Author(s):

Sunetra Mondal ◽

Riddhi DasGupta ◽

Moushumi Lodh ◽

Ramprasad Gorai ◽

Brojen Choudhury ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Ketoacidosis ◽

Single Centre ◽

Centre Study ◽

Single Centre Study ◽

New Onset ◽

Diabetes Patients

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Vein cannulation success rates by German paramedics: a single-centre study

International Paramedic Practice ◽

10.12968/ippr.2021.11.2.35 ◽

2021 ◽

Vol 11 (2) ◽

pp. 35-39

Author(s):

Paulina Naklicka ◽

Luis Möckel ◽

Thomas Hofmann

Keyword(s):

Vascular Access ◽

Night Shift ◽

Federal State ◽

Success Rates ◽

Single Centre ◽

Exact Test ◽

Factors Associated ◽

Risk Of Failure ◽

Single Centre Study ◽

Cannulation Success

Introduction: Gaining intravenous (IV) access is vulnerable to errors and failure, and this study analysed IV procedures by paramedics in the federal state of Hesse in Germany to examine these. Methods: This was a single-centre, observational, pilot study survey on gaining vascular access. As well as identifying the success and failure rate of IV attempts, factors associated with a higher risk of failure were analysed using logistic regression, Χ2 or Fisher's exact test. Results: A total of 207 vascular access attempts were included in the analysis, of which 90.34% were successful. Significantly associated with higher risk of failure were patients' age (OR 1.05; 95% (CI 1.02–1.10); p=0.041), or when two (OR 3.94; 95% CI (2.39–6.20); p≤0.001) or more than three attempts (OR: 3.26 [95% CI: 1.35; 5.17]; p=0.003) were needed rather than one. In contrast, risk of failure was significantly lower when patients indicate a good (OR 0.02; 95% CI (0.00–0.15); p≤0.001) or moderate (OR 0.04 (95% CI 0.01–0.17); p≤0.001) vein status compared to a bad vein status. Failure rates were higher when paramedics were working a night shift (OR 0.06; 95% CI (0.00–0.98); p=0.005) rather then during the day. Conclusion: A proportion of IV access attempts by paramedics are unsuccessful and, if paramedics are to provide invasive interventions, non-IV options for drug administration should be available.

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Risk factors for the development of micro-vascular complications of type 2 diabetes in a single-centre cohort of patients

Diabetes and Vascular Disease Research ◽

10.1177/1479164118780808 ◽

2018 ◽

Vol 15 (5) ◽

pp. 424-432 ◽

Cited By ~ 12

Author(s):

Marsida Teliti ◽

Giulia Cogni ◽

Lucia Sacchi ◽

Arianna Dagliati ◽

Simone Marini ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Risk Factor ◽

Peripheral Neuropathy ◽

Vascular Complications ◽

Glycated Haemoglobin ◽

Vascular Complication ◽

Single Centre ◽

Vascular Events

Aims: In type 2 diabetes, we aimed at clarifying the role of glycated haemoglobin variability and other risk factors in the development of the main micro-vascular complications: peripheral neuropathy, nephropathy and retinopathy. Methods: In a single-centre cohort of 900 patients, glycated haemoglobin variability was evaluated as intra-individual standard deviation, adjusted standard deviation and coefficient of variation of serially measured glycated haemoglobin in the 2-year period before a randomly selected index visit. We devised four models considering different aspects of glycated haemoglobin evolution. Multivariate stepwise logistic regression analysis was performed including the following covariates at the index visit: age, disease duration, body mass index, total cholesterol, high-density lipoprotein cholesterol, triglycerides, sex, smoking habit, hypertension, dyslipidemia, treatment with anti-diabetic drugs, occurrence of macro-vascular events and the presence of another micro-vascular complication. Results: Males with high mean glycated haemoglobin, long duration of diabetes, presence of macro-vascular events and retinopathy emerged at higher risk for peripheral neuropathy. Development of nephropathy was independently associated with higher glycated haemoglobin variability, older age, male sex, current smoking status, presence of retinopathy, of peripheral neuropathy and of hypertension. Higher mean glycated haemoglobin, younger age, longer duration of diabetes, reduced estimated glomerular filtration rate and the presence of peripheral neuropathy were significantly associated with increased incidence of retinopathy. Conclusion: Glycated haemoglobin variability was associated with increased incidence of nephropathy, while mean glycated haemoglobin emerged as independent risk factor for the development of retinopathy and peripheral neuropathy. The presence of macro-vascular events was positively correlated with peripheral neuropathy. Finally, the occurrence of another micro-vascular complication was found to be a stronger risk factor for developing another micro-vascular complication than the mean or variability of glycated haemoglobin.

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P77 Type II PEG fractures: collar or no collar

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-abn.136 ◽

2019 ◽

Vol 90 (3) ◽

pp. e42.2-e42 ◽

Cited By ~ 1

Author(s):

L Harris ◽

S Arif ◽

Z Brady ◽

M Elliot ◽

CH Lee ◽

...

Keyword(s):

Major Trauma ◽

Trauma Centre ◽

The Body ◽

Bony Union ◽

Supporting Evidence ◽

Single Centre ◽

Patient Demographics ◽

Major Trauma Centre ◽

Fracture Management

ObjectivesType 2 peg fractures are known to have low fusion rates but most are elderly with comorbidities and not fit for surgery. Increasingly, clinicians want to stop using hard collars due to its complications, but with little supporting evidence. We aim to provide data to add to this debate.DesignSingle centre cohort study.Subjects145 consecutive patients referred to a Major Trauma Centre as type 2 peg fracture.MethodsAll patients referred with a suspected peg fracture between March 2015 and December 2017 were included. All imaging were assessed and case notes reviewed for patient demographics, fracture management, complications and outcomes.Results102 cases were peg fractures (mean age=80 years). 92 (90.2%) were managed conservatively with a hard collar (mean of 87 days). 37% developed symptoms from the collar, namely pain, stiffness and non-tolerance. Bony union was achieved in only 39.1% of patients with increasing age being an independent risk factor (p<0.001). Of the 56 patients who did not have bony union, there were no reported symptoms and 90% were discharged without a collar. 2 patients were offered but declined fixation and neither reported any on-going symptoms.ConclusionsThis study adds to the body of evidence that fusion rates are low, and collar complications are not insignificant when type 2 peg fractures are treated in a hard collar. However, outcomes are good regardless of union, potentially rendering the collar unnecessary. We aim to conduct a randomised prospective study to further investigate.

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