The impact of dusk phenomenon on total glucose exposure in Chinese people with type 2 diabetes

We hypothesized that the relative contribution of fasting plasma glucose (FPG) versus postprandial plasma glucose (PPG) to glycated haemoglobin (HbA1c) could be calculated using an algorithm developed by the A1c-Derived Average Glucose (ADAG) study group to make HbA1c values more clinically relevant to patients. The algorithm estimates average glucose (eAG) exposure, which can be used to calculate apparent PPG (aPPG) by subtracting FPG. The hypothesis was tested in a large dataset (comprising 17 studies) from the vildagliptin clinical trial programme. We found that 24 weeks of treatment with vildagliptin monotherapy (n=2523) reduced the relative contribution of aPPG to eAG from 8.12% to 2.95% (by 64%,p<0.001). In contrast, when vildagliptin was added to metformin (n=2752), the relative contribution of aPPG to eAG insignificantly increased from 1.59% to 2.56%. In conclusion, glucose peaks, which are often prominent in patients with type 2 diabetes, provide a small contribution to the total glucose exposure assessed by HbA1c, and the ADAG algorithm is not robust enough to assess this small relative contribution in patients receiving combination therapy.

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Strong correlation between glycaemic variability and total glucose exposure in type 2 diabetes is limited to subjects with satisfactory glycaemic control

Diabetes & Metabolism ◽

10.1016/j.diabet.2014.01.006 ◽

2014 ◽

Vol 40 (4) ◽

pp. 272-277 ◽

Cited By ~ 20

Author(s):

S. Suh ◽

J.Y. Joung ◽

S.M. Jin ◽

M.Y. Kim ◽

J.C. Bae ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycaemic Control ◽

Strong Correlation ◽

Glycaemic Variability ◽

Glucose Exposure ◽

Total Glucose

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Abstract #781083: Statins Reduce Incident Hip Fractures Among Chinese People with Type 2 Diabetes: The Effect of Cumulative Daily Defined Dose

Endocrine Practice ◽

10.1016/s1530-891x(20)39419-2 ◽

2020 ◽

Vol 26 ◽

pp. 42-43

Author(s):

David Lui

Keyword(s):

Type 2 Diabetes ◽

Hip Fractures ◽

Chinese People

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The Impact of Obesity on Incidence of Type 2 Diabetes Mellitus (T2DM) among Women with Polycystic Ovary Syndrome (PCOS)

Diabetes ◽

10.2337/db18-1612-p ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 1612-P

Author(s):

NADIRA SULTANA KAKOLY ◽

ARUL EARNEST ◽

HELENA TEEDE ◽

LISA MORAN ◽

DEBORAH LOXTON ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

The Impact

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2436-PUB: Predicting Risk for New-Onset Type 2 Diabetes in Chinese People with Coronary Heart Disease and Impaired Glucose Tolerance

Diabetes ◽

10.2337/db19-2436-pub ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 2436-PUB

Author(s):

SHISHI XU ◽

CHARLES A. SCOTT ◽

RUTH L. COLEMAN ◽

JAAKKO TUOMILEHTO ◽

RURY R. HOLMAN

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Chinese People ◽

Onset Type ◽

New Onset

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116-LB: Evaluating the Impact of Glucommander on Improvement in Time-in-Range (TIR) in Type 2 Diabetes Using Continuous Glucose Monitoring

Diabetes ◽

10.2337/db20-116-lb ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 116-LB

Author(s):

BRUCE W. BODE ◽

JOHN G. CLARKE

Keyword(s):

Type 2 Diabetes ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Time In Range ◽

The Impact

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Model estimates of the results of diabetes patients using modern glucometers with tri-color technology for displaying test results

Medical Technologies Assessment and Choice (Медицинские технологии Оценка и выбор) ◽

10.31556/2219-0678.2019.37.3.081-089 ◽

2019 ◽

pp. 81-89

Author(s):

Larisa Dmitrievna Popovich ◽

Svetlana Valentinovna Svetlichnaya ◽

Aleksandr Alekseevich Moiseev

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Economic Benefits ◽

Test Results ◽

Self Monitoring ◽

Patients With Diabetes ◽

The Impact

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.

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The Impact of Bariatric Surgery in Patients with Type-2 Diabetes Mellitus

Current Diabetes Reviews ◽

10.2174/157339911795843087 ◽

2011 ◽

Vol 7 (3) ◽

pp. 185-189 ◽

Cited By ~ 6

Author(s):

Richdeep S. Gill ◽

Arya M. Sharma ◽

David P. Al-Adra ◽

Daniel W. Birch ◽

Shahzeer Karmali

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Type 2 Diabetes Mellitus ◽

The Impact

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Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001413 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001413

Author(s):

Jonathan Yap ◽

Kamalesh Anbalakan ◽

Wan Ting Tay ◽

Daniel Ting ◽

Carol Yim Cheung ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Glycemic Control ◽

Microvascular Complications ◽

Population Based ◽

Cardiovascular Outcomes ◽

Microvascular Complication ◽

The Impact ◽

Hba1c Levels

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

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