Is there an HbA1c Threshold for Symptoms of Chronic Hyperglycemia?

2021 ◽  
Author(s):  
Nicolle Müller ◽  
Thomas Lehmann ◽  
Ulrich Alfons Müller ◽  
Christof Kloos
Keyword(s):  
Diabetes Mellitus ◽  
Safety Margin ◽  
Well Being ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Chronic Hyperglycemia ◽  
Patients With Diabetes ◽  
The Mean

Abstract Aims of the study The minimum therapeutic goal regarding metabolic control for people with diabetes mellitus is the “absence of symptoms of hyperglycemia.” However, it is uncertain whether a level of HbA1c can be defined that guarantees the absence of these symptoms. The aim was to define an HbA1c threshold above which most patients show hyperglycemic symptoms. Methods In a multicenter cross-sectional study, 137 patients with type 1 and 285 with type 2 diabetes were asked about their symptoms during periods of hyperglycemia with a standardized questionnaire. Seventeen symptoms of hyperglycemia were summarized to the total hyperglycemia symptom score (THSS; min. 0; max. 68). The answers could be given according to the frequency and intensity in the last 4 – 6 weeks. Results The HbA1c threshold above which most patients showed hyperglycemic symptoms was 10.05% for patients with diabetes type 1 and 8.9%. for patients with type 2. Most confidence was reached on the symptoms of frequent urination” and “tiredness.” The mean THSS was 19.4 (±9.0) and showed a positive correlation with age (r=0.167; p<0.001) and HbA1c (r=0.254; p<0.001). Conclusions We identified an HbA1c threshold above which most patients show symptoms of hyperglycemia. In the treatment of people with diabetes mellitus, a safety margin to this threshold should be maintained to preserve well-being and avoid distress. However, since hyperglycemia symptoms are subject to many influencing factors, an adjustment of the therapy—both intensification and de-intensification—should always be carried out in combination with the requested hyperglycemia symptoms and HbA1c value.

scholarly journals Is There a HbA1c Threshold for Symptoms of Chronic Hyperglycaemia?

2020 ◽  
Author(s):  
Nicolle Müller ◽  
Thomas Lehmann ◽  
Ulrich A Müller ◽  
Christof Kloos
Keyword(s):  
Diabetes Mellitus ◽  
Safety Margin ◽  
Well Being ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Therapeutic Goals ◽  
Patients With Diabetes ◽  
Chronic Hyperglycaemia

Abstract Aims of the study: The minimum therapeutic goals regarding metabolic control for people with diabetes mellitus is “absence of symptoms of hyperglycaemia”. However, it is uncertain, if a level of HbA1c can be defined which guarantees the absence of these symptoms. The aim was to define an HbA1c threshold above which most patients show hyperglycaemic symptoms.Methods: In a multicenter cross-sectional study 137 patients with type 1 and 285 with type 2 diabetes were asked about their symptoms during periods of hyperglycaemia with a standardized questionnaire. Seventeen symptoms of hyperglycaemia were summarized to the total hyperglycaemia symptom score (THSS; min. 0; max. 68). The answers could be given according to the frequency and intensity in the last 4 to 6. Results: The HbA1c threshold above which most patients showed hyperglycaemic symptoms was for patients with diabetes type 1 10.05% and with type 2 8.9%. Most confidence was reached on the symptoms of frequent urination” and “tiredness”. The mean THSS was 19.4 (±9.0) and showed a positive correlation with age (r=0.167; p<0.001) and HbA1c (r=0.254; p<0.001).Conclusions: We identified a HbA1c threshold above which most patients show symptoms of hyperglycaemia. In the treatment of people with diabetes mellitus a safety margin to this threshold should be maintained to preserve well-being and avoid distress. However, since hyperglycaemia symptoms are subject to many influencing factors, an adjustment of the therapy, both intensification and de-intensification, should always be carried out in combination with the requested hyperglycaemia symptoms and HbA1c value.

scholarly journals Association between obesity and depression in patients with diabetes mellitus type 2; a study protocol

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 7 ◽  
Author(s):  
Eduardo De la Cruz-Cano ◽  
Carlos Alfonso Tovilla-Zarate ◽  
Emilio Reyes-Ramos ◽  
Thelma Beatriz Gonzalez-Castro ◽  
Isela Juarez-Castro ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Diabetes Mellitus Type 2 ◽  
Cross Sectional Study ◽  
Diabetes Mellitus Type ◽  
Sectional Study ◽  
Cross Sectional ◽  
The World ◽  
Patients With Diabetes

Background: Diabetes mellitus and depression are highly prevalent conditions throughout the world and have significant impact on health outcomes. It has been estimated that diabetes mellitus type 2 affects about 246 million people in the world; nevertheless, incidence varies among countries. There is evidence that depression is associated with a poor metabolic control in patients with type 2 diabetes mellitus that present other health problems (such as hypertension and obesity). The aim of this study protocol is to determine if obesity increases the risk for depression in patient with diabetes type 2.Methods: The analysis will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).The studies suitable for inclusion will be assessed by the Newcastle-Ottawa Scale (NOS) to determine their methodological quality. To identify the studies of interest, we will search on PubMed and EBSCO databases. We will use the following keyword combinations: "Diabetes Mellitus type 2 AND obesity AND depression", "depression AND Diabetes Mellitus type 2", "Diabetes Mellitus type 2 AND body mass index cross sectional study", "depression AND obesity cross-sectional study". Causes for exclusion will be publications that studied patients diagnosed with diabetes mellitus type 1; articles that focused on the treatment and complications of diabetes mellitus type 2; publications that have studied other clinical or psychiatric conditions (for instance, seizure disorder or history of schizophrenia, bipolar disorder, psychotic symptoms or dementia).Conclusion: The results of this study will form the basis for a better understanding of the association between obesity and depression in patients with diabetes mellitus type 2, and will allow development of prediction tools and better interventions. It is evident that several modifiable and non-modifiable risk factors play an important role in the pathogenesis of diabetes among population. Currently, evidence for the deleterious effects of diabetes mellitus type 2 are based on cross-sectional or other observational designs. Therefore, this study will have important implications for future research and public health guidance.

scholarly journals Thyroid hormones profile of patients with type 2 diabetes mellitus in Kano, Nigeria

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Mustapha Zainab Abubakar ◽  
Kabiru Abdulsalam ◽  
Isah A. Yahaya
Keyword(s):  
Diabetes Mellitus ◽  
Thyroid Dysfunction ◽  
Cross Sectional Study ◽  
Endocrine Disorders ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Type 2 Diabetics ◽  
Patients With Diabetes ◽  
Considerable Impact

Diabetes mellitus (DM) and thyroid disease are the two most common endocrine disorders in the general population. Several Studies have shown that thyroid dysfunction is common in patients with DM, and thyroid dysfunction have been found to have a considerable impact on the glycaemic control and often increases the risk of development of long-term complications in patients with diabetes mellitus. This study determined the prevalence of thyroid dysfunction in patients with type 2 DM in Kano, North-Western Nigeria. The study was a descriptive cross-sectional study conducted on 250 participants made up of 130 patients with type 2 DM and 120 apparently healthy non-diabetic controls. Questionnaires were used to collect information on bio data, medical history, duration of diagnosis of diabetes and type of treatment. Also, blood samples of the participants were collected and analyzed for fasting plasma glucose, fT3, fT4, and TSH. The results were interpreted using American Thyroid Associations’ criteria and the data was analyzed using the statistical software package, STATA version 20. Two hundred and thirty-four (93.6%) of the participants were euthyroid while sixteen (6.4%) were found to have various forms of thyroid dysfunction. The prevalence of thyroid dysfunction was 10% and 2.5% among type 2 diabetics and controls respectively. Among the type 2 DM patients with thyroid dysfunction, 38.5% had hypothyroidism. Thyroid dysfunction was found to be commoner among type 2 DM patients than non-diabetic individuals with hypothyroidism being the commonest disorder.

scholarly journals Manifestasi Penyakit Kulit pada Pasien Diabetes Melitus Tipe 2 di Rumah Sakit Dr. Pirngadi Medan

2021 ◽  
Vol 6 (2) ◽  
pp. 65-67
Author(s):  
Dione Larissa Simanjuntak
Keyword(s):  
Diabetes Mellitus ◽  
Skin Diseases ◽  
Disease Process ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Diabetic Ulcer ◽  
Skin Manifestations ◽  
Chronic Hyperglycemia ◽  
Steven Johnson Syndrome

Background: Diabetes mellitus (DM) is a metabolic group with characteristic hyperglycemia that occurs due toabnormal insulin secretion, insulin action, or both. DM is often called the silent killer because the patients knowthey has DM only after the patient experiencing complications and manifestations. It is estimated that 30-70% of DM patients experience skin manifestations during the disease process. The relationship between the appearance of skin manifestations with diabetes mellitus is not yet known, but it is suspected due to chronic hyperglycemia and abnormalities of the immune system.Objective: To determine skin diseases in patients with type 2 diabetes at General Hospital Dr. Pirngadi Medan.Methods: This research was a descriptive study with a cross-sectional study design conducted at Dr. GeneralHospital Pirngadi Medan. Data collection was carried out through 29 medical records of patients with diabetesmellitus from January 2018 to December 2018. Samples were selected by total sampling.Results: From 29 samples studied, there were six types of skin manifestations. The most common skinmanifestations are Diabetic Ulcer (62.07%), followed by Steven Johnson Syndrome and diabetic gangrene, which both are equally 13.80%. The other skin manifestations are herpes zoster, gluteal abscess, and bullous pemphigoid (3.44%).Conclusion: The most common manifestation of the skin in patients with type 2 DM is Diabetic Ulcer.

scholarly journals Dietary Attitude of Adults with Type 2 Diabetes Mellitus in the Kingdom of Saudi Arabia: A Cross-Sectional Study

Medicina ◽  
2020 ◽  
Vol 56 (2) ◽  
pp. 91 ◽  
Author(s):  
Waqas Sami ◽  
Khalid M Alabdulwahhab ◽  
Mohd Rashid Ab Hamid ◽  
Tariq A. Alasbali ◽  
Fahd Al Alwadani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Saudi Arabia ◽  
Dietary Behavior ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Patients With Diabetes

Background and Objectives: There is a paucity of literature on the dietary attitude (DA) of patients with type 2 diabetes in the Kingdom of Saudi Arabia (KSA). Although the prevalence of diabetes mellitus (DM) is high in Gulf countries, there remains a lack of understanding of the importance of dietary behavior in diabetes management among patients. Understanding the behavior of patients with diabetes towards the disease requires knowledge of their DA. Therefore, this study aimed to assess and evaluate the DA of type 2 diabetes patients, and it is the first of its kind in the KSA. Material and Methods: An analytical cross-sectional study was conducted among 350 patients with type 2 diabetes. A self-administered DA questionnaire was used to collect the data. Psychometric properties of the questionnaire were assessed by face validity, content validity, exploratory factor analysis, and internal consistency reliability. The data were collected using a systematic random sampling technique. Results: The overall DA of the patients was inappropriate (p = 0.014). Patients had an inappropriate DA towards food selection (p = 0.003), healthy choices (p = 0.005), food restraint (p < 0.001), health impact (p < 0.001), and food categorization (p = 0.033). A poor DA was also observed in relation to the consumption of red meat (p <0.001), rice (p < 0.001), soup and sauces (p = 0.040), dairy products (p = 0.015), and junk food (p < 0.001). Conclusions: It is highly recommended that patients with diabetes receive counseling with an empowerment approach, as this can bring about changes in their dietary behavior, which is deeply rooted in their daily routine. Healthcare providers should also be well-informed about patients’ attitudes and beliefs towards diabetes to design tailored educational and salutary programs for this specific community. Diabetes self-management educational programs should also be provided on a regular basis with a special emphasis on diet and its related components.

scholarly journals Glucometers for Patients with Type 2 Diabetes Mellitus: Are they helpful?

2021 ◽  
Vol 9 (2) ◽  
pp. 140-144
Author(s):  
Andrew Thomas ◽  
Mohan T. Shenoy ◽  
K.T. Shenoy ◽  
Nirmal George
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Glucose Levels ◽  
The Mean ◽  
Glycated Hemoglobin Level

Background: The effectiveness of self-monitoring of blood glucose (SMBG) in type 2 diabetes mellitus (T2DM) patients is debated in the literature. We aimed at elucidating the association and patterns of complications between SMBG use and plasma glucose values. Methods: This cross-sectional study comprised 303 participants from outpatient departments with T2DM for over 12 months. We analyzed sociodemographic and clinical variables including: anthropometry, SMBG use, disease duration, treatment modality, complications, plasma glucose level, and glycated hemoglobin level (%). Results: The mean duration of T2DM was 93±76 months. Participants were grouped into SMBG users (n=115, 38%) and non-SMBG users (n=188, 62%). The mean fasting plasma glucose levels of SMBG and non-SMBG users were 140.7±42.7 (95% Confidence Interval [95%CI]: 132.72;148.67) mg/dl and 145.4±50 (95%CI: 138.12;152.67) mg/dl (p=0.03), respectively. The mean post-prandial plasma glucose levels of the SMBG and non-SMBG groups were 202±63.42 (95%CI: 190.23;213.76) mg/dl and 209±84.54 (95%CI: 196.56;221.43) mg/dl (p=0.002), respectively. The mean difference in HbA1c among the groups were 8.14±1.69% (95%CI: 7.59;8.68) and 8.15±1.98% (95%CI: 7.27;9.02) (p=0.4), respectively. Hypoglycemia (n=50, 43.5%) was the most common complication. The prevalence of neuropathy (n=5, 4.3%, p=0.036) and cardiovascular disease (n=21, 18.3%, p=0.042) were significantly higher in the SMBG group. Conclusion: Although plasma glucose values were significantly lower in the SMBG group, its clinical significance remains questionable. Furthermore, many participants in both the groups had shortfalls in awareness, monitoring, and glycemic control. SMBG use needs to be evaluated in a cohort of patients with T2DM with adequate health awareness.

Is type 1 diabetes mellitus associated with ABO & Rh blood groups? A cross-sectional study

2022 ◽  
Author(s):  
Mahtab Ordooei ◽  
Nasim Namiranian ◽  
Saeedeh Jam-Ashkezari ◽  
Hadi Jalali ◽  
Azam Golzar
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Group ◽  
Cross Sectional Study ◽  
Blood Groups ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean

Background: This study was conducted to determine whether type 1 diabetes mellitus (T1DM) is associated with ABO & Rhesus (Rh) blood groups. Materials and Methods: This analytical cross sectional study was carried out on 77 patients suffering from T1DM and 96 healthy children less than 18 years old referring to Yazd Diabetes Research Center from April 2018 to May 2019. The ABO blood group and Rh factor in both groups were determined. Fasting blood sugar (FBS) and hemoglobin A1C (HbA1c) were measured at baseline, 12 weeks, and 24 weeks in these patients, and the mean of FBS and HbA1C in three-time assessments were considered as the FBS and HbA1C variables. The statistical analysis was performed by SPSS software version 22. Results: About 46.8% in T1DM and 36.5% in the control groups were male. There was a significant difference between groups regarding blood groups (p-value: 0.042). Although the frequency of B+ was 33.8% and 19.8% in the T1DM and controls, respectively, AB+ and O+ were more prevalent in the controls. The mean of FBS was significantly different between groups (p-value: 0.023). Conclusions: The findings revealed that patients with blood group B are more likely to develop T1DM whereas those with blood group O showed a lower tendency towards diabetes.

scholarly journals Adherencia terapéutica y control metabólico en pacientes con diabetes mellitus tipo 2 / adherence and metabolic control in patients with type 2 diabetes mellitus in a hospital of medellin (colombia), 2011

2014 ◽  
Vol 14 (1) ◽  
pp. 44-50
Author(s):  
Lina María Martínez Sánchez ◽  
Gloria Inés Martínez Domínguez ◽  
María de los angeles Rodríguez Gázquez ◽  
Camilo andrés Agudelo Vélez ◽  
Juan Guillermo Jiménez Jiménez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Therapeutic Adherence ◽  
Type 2 Dm ◽  
Patients With Diabetes ◽  
Apoyo Social ◽  
The Relationship

Objetivo:Explorar la relación entre la adherencia terapéutica y el control metabólicoen pacientes con Diabetes Mellitus tipo 2 (DM-2), que consultaron a una instituciónhospitalaria en Medellín-Colombia.Materiales y métodos:Estudio transversal. Lamuestra estuvo constituida por personas con 18 y más años, con diagnóstico de DM-2•PHVHVTXHILUPDURQHOFRQVHQWLPLHQWRLQIRUPDGR(OPXHVWUHRIXHQRSUREDELOtVWLFRmuestra por conveniencia. Se aplicaron las escalas Summary of Diabetes Self-CareActivities para valorar adherencia terapéutica y Duke-Unc para evaluar apoyo social.La hemoglobina glicosilada (HbA1c) fue procesada por el método inmunoturbidimé-trico de inhibición en el Equipo Cobas C-501. Se asumió como “control metabólicoadecuado” un valor de HbA1c < al 7%. Se utilizó el programa SPSS versión 19.0 parael análisis.Resultados:De los 70 pacientes estudiados: el 66% son mujeres, el 76%tiene Hipertensión arterial, el 70% tiene dislipidemias y el 16% fuma. Además, el 59%HVLQVXOLQRGHSHQGLHQWHHOWLHQH+E$F•HOQRWLHQHDSRRVRFLDO/RVfactores con mayor proporción de adherencia fueron: medicación (79%), cuidado depies (71%). Mientras que los más bajos fueron: autocontrol glicémico (32%) y ejercicio(28%). La HbA1c se correlacionó significativamente (p<0.05) con adherencia a dieta,autocontrol de glicemia, cuidado de pies, apoyo social y género.Conclusiones:Laadherencia terapéutica estuvo asociada al control metabólico en pacientes con DM-2. Objective: Explore the relationship between the therapeutic adherence and metaboliccontrol in patients with Diabetes Mellitus type 2 (DM-2), which consulted to a hospitalinstitution in Medellin-Colombia. Materials and Methods: Cross-sectional study. The

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