Prevalence and risk factors of undiagnosed diabetes mellitus among gastroenterological patients: a HbA1c-based single center experience

2021 ◽  
Author(s):  
Thorben Fründt ◽  
Niko Schröder ◽  
Angelique Hölzemer ◽  
Hans Pinnschmidt ◽  
Jocelyn de Heer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Liver Cirrhosis ◽  
Risk Factor ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Medication Use ◽  
Undiagnosed Diabetes ◽  
Diabetes Screening ◽  
Fasting Plasma

Abstract Background Diabetes mellitus is a major risk factor for microvascular disease, leading to chronic kidney injury or cardiovascular disease, but there is a tremendous proportion of patients worldwide who suffer from undiagnosed diabetes. Until now, little is known about the prevalence of undiagnosed diabetes in gastroenterology inpatients. Objective To improve detection of undiagnosed diabetes, a routine screening procedure for gastroenterology inpatients, based on hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) measurement, was established. Methods We conducted a retrospective analysis of the implemented diabetes screening. Diabetes mellitus was diagnosed according to the guideline of the German Diabetes Association in patients with an HbA1c of ≥6.5% anld/or fasting plasma glucose (FPG) ≥126 mg/dL. Univariate and multivariate analyses were performed to identify independent risk factors for undiagnosed diabetes. Results Within a 3-month period, 606 patients were eligible for a diabetes screening. Pre-existing diabetes was documented in 120 patients (19.8 %), undiagnosed diabetes was found in 24 (3.9%), and 162 patients (26.7%) met the definition for prediabetes. Steroid medication use, age, and liver cirrhosis due to primary sclerosing cholangitis (PSC) were identified as risk factors for undiagnosed diabetes. Conclusion The prevalence of undiagnosed diabetes in gastroenterology inpatients is markedly elevated in comparison to the general population, and a substantial number of inpatients are in a prediabetic status, underlining the need for diabetes screening. In addition to previously described risk factors of patient age and steroid medication use, we identified PSC-related liver cirrhosis (but not liver cirrhosis due to another etiology) as an independent risk factor for undiagnosed diabetes.

scholarly journals Risk factors for Type 2 Diabetes Mellitus in college students: association with sociodemographic variables

2014 ◽  
Vol 22 (3) ◽  
pp. 484-490 ◽  
Author(s):  
Adman Câmara Soares Lima ◽  
Márcio Flávio Moura Araújo ◽  
Roberto Wagner Júnior Freire de Freitas ◽  
Maria Lúcia Zanetti ◽  
Paulo César de Almeida ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
College Students ◽  
Type 2 Diabetes ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Central Obesity ◽  
Fasting Plasma ◽  
High Fasting Plasma Glucose

OBJECTIVE: identify the modifiable risk factors for type 2 diabetes mellitus in college students and associate these factors with their sociodemographic variables.METHOD: cross-sectional study, involving 702 college students from Fortaleza-CE, Brazil. Sociodemographic, anthropometric, physical exercise data and blood pressure and fasting plasma glucose levels were collected.RESULTS: the most prevalent risk factor was sedentariness, followed by overweight, central obesity, high fasting plasma glucose and arterial hypertension. A statistically significant association was found between overweight and sex (p=0.000), age (p=0.004) and marital status (p=0.012), as well as between central obesity and age (p=0.018) and marital status (p=0.007) and between high fasting plasma glucose and sex (p=0.033).CONCLUSION: distinct risk factors were present in the study population, particularly sedentariness and overweight.

scholarly journals Oral glucose tolerance outcomes among pregnant women receiving antenatal care in Calabar and environs – A pilot study

2021 ◽  
Vol 4 ◽  
pp. 71-78
Author(s):  
Kenneth Ogar Inaku ◽  
Boniface Uji Ago ◽  
Asuquo Bassey Ene ◽  
Eyam Sunday Eyam ◽  
Lawson Ekpeni Ekpe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Venn Diagram ◽  
Glucose Load ◽  
Degree Relative ◽  
Fasting Plasma

Objectives: Dysglycemia is a common metabolic alteration during pregnancy with adverse effects on both mother and fetus. This is related to the fact that pregnancy is associated with insulin resistance which is a harbinger for hyperglycemia. This study was carried out to find out the prevalence of gestational diabetes mellitus (GDM) among pregnant women in Calabar area using International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic values. Material and Methods: This was a prospective, observational, cross-sectional study among pregnant women attending antenatal care in four health facilities in Calabar and adjoining areas conducted from September 2018 to August 2019. All consenting pregnant women were given 75 g glucose in 250–300 mL of water after 8–10 h overnight fast, without regard to the presence or absence of GDM risk factors. GDM diagnosis was made if any of the following glucose values were met or exceeded: (1) Fasting >92 mg/dl, (2) 1 h post-glucose load >180 mg/ dl, and (3) 2 h post-glucose load >153 mg/dl. Data were analyzed using IBM Statistical Package for the Social Sciences version 20.0 and results were presented using tables and a Venn diagram. Results: There were 345 pregnant women aged 18–50 (28.7 ± 6.3) years at 24–41 (29.6 ± 4.1) completed weeks of gestation. GDM was diagnosed in 48 (13.9%) women. Fasting plasma glucose cutoff diagnosed 81% while 37.5% and 50.0% met the diagnostic cutoff for 1 h and 2 h, respectively, and 15 (31.3%) women were positive for all three diagnostic cutoffs. Diabetes mellitus in a first-degree relative was the most common risk factor identified while hypertension in a first-degree relative and history of GDM was the least. Some 36.5% of women had no identifiable risk factors. Those who had positive fasting plasma glucose only (6.1%) were more than twice those diagnosed by 1 and 2 h only (2.6%) combined. The number of women with glucose values in the diabetic range was 6 (1.72%) but was classified as GDM since they were not previously known diabetics. Conclusion: This study has shown that the prevalence of GDM is 13.9% among women in Calabar and environs using the IADPSG criteria. Fasting plasma glucose can identify more than twice GDM patients than 1 and 2 h values combined. GDM still remains a major health issue among pregnant women hence there should be a national policy on routine screening for GDM with more studies being encouraged to determine the preferred glucose cutoff among Nigerians.

scholarly journals High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
E. Cosson ◽  
L. Carbillon ◽  
P. Valensi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Hypoglycemic Agents ◽  
Early Management ◽  
Fasting Plasma

Fasting plasma glucose (FPG) is nowadays routinely measured during early pregnancy to detect preexisting diabetes (FPG ≥ 7 mmol/L). This screening has concomitantly led to identify early intermediate hyperglycemia, defined as FPG in the 5.1 to 6.9 mmol/L range, also early gestational diabetes mellitus (eGDM). Early FPG has been associated with poor pregnancy outcomes, but the recommendation by the IADPSG to refer women with eGDM for immediate management is more pragmatic than evidence based. Although eGDM is characterized by insulin resistance and associated with classical risk factors for type 2 diabetes and incident diabetes after delivery, it is not necessarily associated with preexisting prediabetes. FPG ≥ 5.1 mmol/L in early pregnancy is actually poorly predictive of gestational diabetes mellitus diagnosed after 24 weeks of gestation. An alternative threshold should be determined but may vary according to ethnicity, gestational age, and body mass index. Finally, observational data suggest that early management of intermediate hyperglycemia may improve prognosis, through reduced gestational weight gain and potential early introduction of hypoglycemic agents. Considering all these issues, we suggest an algorithm for the management of eGDM based on early FPG levels that would be measured in case of risk factors. Nevertheless, interventional randomized trials are still missing.

scholarly journals GLYCATED HEMOGLOBIN (HbA1c)

2015 ◽  
Vol 22 (02) ◽  
pp. 208-214
Author(s):  
Saeed Akram Bhatti ◽  
Abdul Haseeb Khan ◽  
Naeem Yaqoob
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Detection Rate ◽  
Large Scale ◽  
Glycated Hemoglobin ◽  
Undiagnosed Diabetes ◽  
Pakistani Population ◽  
Chronic Hyperglycemia ◽  
Fasting Plasma

HbA1c gives an integrated index of glycemia over the entire 120 days lifespan of red blood cells. Therefore, measuring HbA1c would be appropriate in diagnosing adisease characterized by chronic hyperglycemia and a gradual progression to complications.Objectives: our primary objective was to evaluate the use of HbA1c as screening test forundiagnosed diabetes (WHO criteria of Fasting plasma glucose (FPG) of ≥ 7mmol/l (126mg/dl))in healthy asymptomatic individuals in Pakistani population. Study Design and Methodology:A cross sectional population survey was carried on asymptomatic, healthy individuals withoutpast history of diabetes. Venous blood was obtained to measure fasting plasma glucose(fasting > 8 hours) and Hb A1c. Place and Duration of Study: Khan lab Sargodha from July2013 to March 2014. The test: It was performed by using NycoCard HbA1c in vitro diagnosticmedical device for quantitative determination of glycated hemoglobin in whole blood. Results:In our sample size of 775, the lowest HbA1c was found to be 5% and Highest 13.2%. Arithmeticmeans was 6.7565%, while the median value was 6.2% and standard deviation 1.3323. Whenusing FPG only, the detection rate of diabetes was 32.65% (female, 14.71%; male, 17.94%).When HbA1c was included as a diagnostic test, the detection rate increased to 40% (female,18.84%; male, 21.16 %). An additional 7.6% of participants were diagnosed with diabetes whenusing HbA1c criteria. ROC (A receiver operating characteristic) curve was used for analysis.At HbA1c cutoff of ≥6.5% it demonstrated sensitivity of 98.02% (95% CI) and specificity of88.12% (95% CI) for detection of undiagnosed diabetes mellitus in healthy asymptomaticindividuals in Pakistani population. Area under the ROC curve was 0.981354 with significancelevel P (Area=0.5) 0.0001. Conclusions: Our study reveals that HbA1c is a highly specific andconvenient alternative to fasting plasma glucose for screening of diabetes mellitus in Pakistanipopulation. A large scale survey should be carried out to set our own national standardizations.

scholarly journals Hemoglobin A1c in combination with fasting plasma glucose trumps fasting plasma glucose alone as predictive indicators for diabetes mellitus: an ambidirectional cohort study of Thai people with impaired fasting glucose

2021 ◽  
Vol 9 (2) ◽  
pp. e002427
Author(s):  
Sangsulee Thamakaison ◽  
Thunyarat Anothaisintawee ◽  
Kanokporn Sukhato ◽  
Nattawut Unwanatham ◽  
Sasivimol Rattanasiri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cohort Study ◽  
Impaired Fasting Glucose ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Hemoglobin A1c ◽  
Fasting Glucose ◽  
Cox Regression Analysis ◽  
Fasting Plasma

IntroductionThis ambidirectional cohort study aimed to assess the performance of combining hemoglobin A1c (HbA1c) to fasting plasma glucose (FPG) for estimation of progression rate to diabetes mellitus (DM) and to explore the risk factors of DM in patients with impaired fasting glucose (IFG).Research design and methodsPatients with IFG were eligible for this study. IFG was defined as FPG of 100–125 mg/dL. Progression rates to DM were estimated using Kaplan-Meier analysis. Risk factors of DM were explored by Cox regression analysis.Results3011 patients were enrolled with median follow-up time of 8 years (range: 6 months–29 years). Progression rates to DM in patients with FPG 100–109 mg/dL and 110–125 mg/dL were 2.64 and 4.79 per 100 person-years. After adjusting covariables, compared with patients with FPG 100–109 mg/dL plus normal HbA1c (<5.7%), hazard ratios (95% CI) of patients with FPG 110–125 plus normal HbA1c, FBG 100–109 plus abnormal HbA1c (5.7%–6.49%), and FPG 110–125 plus abnormal HbA1c were 5.89 (2.37 to 14.63), 16.30 (8.59 to 30.92), and 33.84 (16.41 to 69.78), respectively. Body mass index ≥27.5 kg/m2, serum triglyceride level ≥150 mg/dL, family history of DM, and low level of high-density lipoprotein-cholesterol were independently associated with risk of DM in patients with IFG.ConclusionsPatients with both IFG and abnormal HbA1c had higher risk of DM than patients with IFG alone. Therefore, performing HbA1c in combination with FPG helps to identify subgroups of people with IFG at highest risk of DM. These patients should have the highest priority in diabetes prevention programs, especially in countries with low and limited resources.

Association between Visit-to-Visit Fasting Plasma Glucose Variability and Osteoporotic Fractures in nondiabetic subjects

2021 ◽  
Author(s):  
Jung A Kim ◽  
Ji Sung Lee ◽  
Eyun Song ◽  
Eun Roh ◽  
Ji Hee Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Plasma Glucose ◽  
Vertebral Fractures ◽  
Fasting Plasma Glucose ◽  
Osteoporotic Fractures ◽  
Glucose Variability ◽  
Fasting Plasma ◽  
The Mean ◽  
The Impact

Abstract Context Although long-term glucose variability has been reported to be a risk factor associated with osteoporosis, there have been no previous studies between the relationship of glucose variability and fractures in people without diabetes. Objective We assessed visit-to-visit variations in fasting plasma glucose (FPG) as a prognostic factor in predicting osteoporotic fractures in individuals without diabetes. Design, Setting, and Subjects Using a nationwide cohort database, we examined the impact of FPG on the development of osteoporotic fractures in men and women (aged ≥50 years). Main Outcomes The primary outcomes were the number of total fractures and vertebral fractures. FPG variability was measured using standard deviation (FPG-SD), coefficient of variation (FPG-CV), and variation independent of the mean (FPG-VIM). Results Of the 92,929 participants, 5,262 (5.7%) developed osteoporotic fractures during the mean follow-up of 8.4 years. Individuals in the highest quartile of FPG-SD showed an 11% and 16% increase in risk of total and vertebral fractures, respectively, compared with those in the lowest quartile after adjustment for mean FPG and other risk factors. Analyses using FPG-CV and FPG-VIM demonstrated similar results. Subgroup analyses and sensitivity analyses to explore potential heterogeneity showed consistent results. Conclusions FPG variability may be a novel risk factor for osteoporotic fractures independent of risk factors in the general population without diabetes.

Sign in / Sign up

Export Citation Format

Share Document