scholarly journals Individualised targets for insulin initiation in type 2 diabetes mellitus—the influence of physician and practice: a cross-sectional study in eight European countries

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e032040 ◽  
Author(s):  
Anne Meike Boels ◽  
Elwin Koning ◽  
Rimke C Vos ◽  
Kamlesh Khunti ◽  
Guy EHM Rutten
Keyword(s):  
Hba1c Level ◽  
Cross Sectional Study ◽  
Insulin Initiation ◽  
Related Factors ◽  
Cross Sectional ◽  
Or Practice ◽  
Patient Vignette ◽  
The Uk ◽  
Hba1c Levels

ObjectivesTo determine at what glycated haemoglobin (HbA1c) level physicians from eight European countries would initiate insulin in type 2 diabetes, which physician or practice related factors influenced this level and whether physicians would differentiate between a younger uncomplicated patient and an older patient with comorbidities.DesignCross-sectional study with data from the Guideline Adherence to Enhance Care study.Setting and participants410 physicians from both primary and secondary care from Belgium, France, Germany, Italy, Ireland, Sweden, the Netherlands and the UK.Outcome measuresPhysicians were asked at which HbA1c level they would initiate insulin for a young, uncomplicated patient (vignette 1) and for an older, complicated patient (vignette 2). We evaluated differences in HbA1c levels between physicians from different countries using analysis of variance. To identify physician and practice related factors associated with HbA1c level at initiation of insulin, we performed multivariable linear regression. Multiple imputation was used to deal with missing data.ResultsIn Germany, Ireland, Sweden, the Netherlands and the UK, the HbA1c levels for initiating insulin in vignette 2 (range: 60.0 to 66.0 mmol/mol; 7.6% to 8.2%) were higher than for vignette 1 (range: 57.2 to 64.2 mmol/mol; 7.4% to 8.0%). In multivariable analysis, the HbA1c level at which insulin was initiated only differed between countries (vignette 1): Dutch physicians initiated insulin at a lower HbA1c level compared with Belgium, France and the UK. No physician or practice factors were independently associated with HbA1c level at insulin initiation.ConclusionsWhen deciding on individualised HbA1c targets for insulin initiation, physicians from five countries took patient’s age and comorbidity into account. The HbA1c level at which physicians would initiate insulin therapy differed between countries.

scholarly journals Relationship between Blood HbA1c Level and Decayed Teeth in Patients with Type 2 Diabetes: A Cross-sectional Study

2018 ◽  
Vol 60 (2) ◽  
pp. 89-96
Author(s):  
Seitaro Suzuki ◽  
Koichi Yoshino ◽  
Atsushi Takayanagi ◽  
Yoichi Ishizuka ◽  
Ryouichi Satou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Hba1c Level ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

HBA1C IS ASSOCIATED WITH FRAILTY IN A GROUP OF ABORIGINAL AUSTRALIANS

2018 ◽  
pp. 1-4
Author(s):  
Z. Hyde ◽  
K. Smith ◽  
L. Flicker ◽  
D. Atkinson ◽  
S. Fenner ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Hba1c Level ◽  
Binary Logistic Regression ◽  
Glycated Haemoglobin ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Aboriginal Australians ◽  
Obesity And Diabetes ◽  
Hba1c Levels

In this cross-sectional study of 141 Aboriginal Australians aged ≥45 years living in the remote Kimberley region of Western Australia, we explored whether glycated haemoglobin (HbA1c) levels were associated with frailty. Sixty-four participants (45.4%) had a HbA1c level ≥6.5% and 84 participants (59.6%) were frail. A significant trend was observed with regard to HbA1c levels and frailty, with those having HbA1c levels ≥6.5% having the greatest prevalence of frailty (70.3%). In binary logistic regression analyses, having a HbA1c level ≥6.5% was associated with being frail after adjustment for age, sex, and education. This association was attenuated after further adjustment for body mass index (BMI). Poorer glycaemic control is very common and a potential risk factor for frailty in remote-living Aboriginal Australians, and appears to be partly mediated by BMI, a known risk factor for diabetes mellitus. Obesity and diabetes mellitus are potentially important modifiable risk factors for frailty.

scholarly journals Inconvenient relationship of haemoglobin A1c level with endothelial function in type 2 diabetes in a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045415
Author(s):  
Takayuki Yamaji ◽  
Takahiro Harada ◽  
Yu Hashimoto ◽  
Yuji Takaeko ◽  
Masato Kajikawa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Hba1c Level ◽  
Cross Sectional Study ◽  
Antidiabetic Drugs ◽  
Haemoglobin A1c ◽  
Sectional Study ◽  
Cross Sectional ◽  
Relationship Of ◽  
Shaped Pattern

ObjectiveThe aim of this study was to determine the relationship of haemoglobin A1c (HbA1c) level with flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) in patients with type 2 diabetes.DesignCross-sectional study.Setting22 university hospitals and affiliated clinics in Japan.Participants1215 patients with type 2 diabetes including 349 patients not taking antidiabetic drugs.MeasuresWe evaluated FMD and HbA1c level. All patients were divided into four groups based on HbA1c level: <6.5%, 6.5%–6.9%, 7.0%–7.9% and ≥8.0%.ResultsAn inverted U-shaped pattern of association between HbA1c level and FMD was observed at the peak of HbA1c of about 7%. FMD was significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5%–6.9% group and HbA1c 7.0%–7.9% group (p<0.001 and p<0.001), and FMD values were similar in the HbA1c <6.5% group and HbA1c ≥8.0% group. There were no significant differences in NID values among the four groups. After adjustments for confounding factors, FMD was significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5%–6.9% and HbA1c 7.0%–7.9% group (p=0.002 and p=0.04). In patients not taking antidiabetic drugs, FMD was also significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5%–6.9% group and HbA1c 7.0%–7.9% group (p<0.001 and p=0.02), and there were no significant differences in NID values among the four groups.ConclusionsThese findings suggest that there is an inverted U-shaped pattern of association between FMD and HbA1c and that a low HbA1c level of <6.5% is associated with endothelial dysfunction.Trial registration numberUMIN000012950, UMIN000012951, UMIN000012952 and UMIN000003409.

scholarly journals The Correlation between the levels of HbA1c with Ureum and Creatinine in Patient with Type 2 Diabetes Mellitus

2019 ◽  
Vol 7 (5) ◽  
Author(s):  
Tri Prasetyorini ◽  
Karningsih Sudiro ◽  
Bagya Mujianto ◽  
Rus Martini
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Kidney Failure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Type 2 Dm ◽  
Hba1c Levels

Introduction and Aims : Untransmitted diseases is the leading cause of death globally. Diabetes mellitus is one of the four priorities of untransmitted diseases. This disease is a chronic disease characterized by blood glucose levels that exceed normal values. High blood sugar levels (hyperglycemia) will cause various complications, one of which is chronic complications that can attack various organs such as eyes, kidneys, nerves and blood vessels. This study aims to find out the correlation between the results of the examination of HbA1c, urea and creatinine levels which is an indicator of complications of Chronic Kidney Failure in Type 2 DM patients. Methods : This research is a survey research using cross-sectional study design. The respondents in this study are Type 2 DM patients who filled out the questionnaire and examined levels of HbA1c, ureum, and creatinine. Analysis of the data performed by using the SPEARMEN test SPSS for Windows 17. Result : The result of the SPEARMEN analysis is p = 0,016 (p < 0.05) which means there is a relationship between the levels of HbA1c with age of respondent. Meanwhile, p = 0,84 (p>0,05) which means there is no relationship between HbA1c levels of type 2 DM with urea levels of type 2 DM patients. While, there is no relationship between HbA1c levels of type 2 DM with creatinine levels of type 2 DM with p = 0.693 (p > 0,05). Conclusions : There is a correlation between HbA1c levels of type 2 diabetes mellitus with the age of the respondent, but there is no correlation between HbA1c levels of type 2 diabetes mellitus with ureum levels of type 2 diabetes mellitus and there is no correlation between HbA1c levels with Creatinine levels of  type 2 diabetes mellitus patients.

scholarly journals Hasil BERA & TEOAE dengan kadar HbA1c pada pasien Diabetes Melitus tipe-2

2019 ◽  
Vol 49 (1) ◽  
pp. 12
Author(s):  
Novi Primadewi ◽  
Hadi Sudrajad ◽  
Eka Prasetya
Keyword(s):  
Hearing Loss ◽  
Significant Relationship ◽  
Hba1c Level ◽  
Cross Sectional Study ◽  
T Test ◽  
Sectional Study ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Diabetes Melitus

Latar belakang: Neuropati adalah salah satu komplikasi yang paling sering dari Diabetes Melitus(DM) tipe 2. Disamping neuropati perifer dan otonom, pasien dengan DM tipe 2 juga dapat menderitagangguan pendengaran tipe sensorineural hearing loss (SNHL) pada frekuensi tinggi. Pada studi inihubungan HbA1c dengan hasil pemeriksaan brainstem evoked response audiometry (BERA) dan transient evoked otoacoustic emissions (TEOAE) digunakan untuk mendeteksi neuropati akustik dan sentral pada pasien DM tipe 2. Tujuan: Untuk mengetahui hubungan kadar HbA1c pada DM tipe 2 dengan masa laten gelombang BERA dan respon TEOAE. Metode: Desain penelitian cross sectional study, dilakukan dari Maret 2018 hingga jumlah sample terpenuhi. Penelitian dimulai dengan mengidentifikasi pasien DM tipe 2 dengan profil kadar HbA1c, kemudian dilanjutkan dengan pemeriksaan TEOAE dan BERA. Hasil: Dari hasil pemeriksaan BERA terdapat hubungan signifikan antara HbA1c dengan masa laten gelombang BERA di intensitas 70 dB dan 80 dB kecuali latensi antar-puncak I-V, tetapi tidak berhubungan signifikan pada intensitas 90 dB. Didapatkan pada pemeriksaan TEOAE di telinga kanan kadar HbA1c berhubungan dengan hasil pemeriksaan TEOAE kategori refer rata-rata 8,67+1,14%, sedangkan pasien dengan hasil pemeriksaan TEOAE kategori pass rata-rata 7,73+0,95%. Hasil uji t test didapatkan nilai p=0,021 (p<0,05). TEOAE di telinga kiri kategori refer rata-rata 8,82+1,09%, sedangkan pasien dengan hasil pemeriksaan TEOAE kategori pass rata-rata 7,66+0,88%. Hasil uji t test didapatkan nilai p=0,003 (p<0,05). Kesimpulan: Terdapat hubungan yang signifikan secara statistik antara kadar HbA1c dengan hasil pemeriksaan gelombang BERA dan TEOAE. Background: Neuropathy is complication of type 2 diabetes mellitus (DM). Besides peripheraland autonomic neuropathy, patients with type 2 DM may also have sensorineural hearing loss at highfrequency. In this study the association of HbA1c level with the results of BERA and TEOAE tests was used to detect acoustic and central neuropathy in type 2 DM patients. Objective: To find out the relationship of HbA1c level in type 2 DM with BERA and TEOAE. Method: Research design cross sectional study, conducted from March 2018 until the number of samples fulfilled. The study began by identifying patients with type 2 DM with the HbA1c profile, followed by TEOAE and BERA examinations. Result: There was a significant relationship between HbA1c and the latent period of waves at the intensity of 70 dB and 80 dB except on the interpeak I-V latency, but not significantly related to the 90 dB intensity. Results of TEOAE test in the right ear: the average levels of HbA1c with refer category results on TEOAE test was 8.67+1.14 %, whereas patients with pass category results on TEOAE was 7.73+0.95 %. The result of t test value was p=0.021 (p<0.05). TEOAE on the left ear: average refer category 8.82+1.09%, whereas patients with TEOAE examination results in the mean pass category 7.66+0.88%. The result of t test value was p=0.003 (p<0.05). Conclusion: There was a statistical significant relationship between HbA1clevel and BERA and TEOAE.

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