Significant Differences in the Prevalence of Elevated HbA1c Levels for Type I and Type II Diabetics Attending the Parirenyatwa Diabetic Clinic in Harare, Zimbabwe

Diabetics have chronically elevated glucose levels. High levels of glucose result in nonenzymatic formation of glycosylated haemoglobin (HbA1c). Therefore, elevated HbA1c is a good indicator of poorly controlled diabetes. We used the standard HbA1c method to determine glycemic control in diabetics attending a public health facility in Harare, Zimbabwe. Our study sought to assess the prevalence of elevated HbA1c amongst treated diabetics and compare the HbA1c levels by type of diabetes. The cross-sectional study was carried out at one of the main public health centres in Zimbabwe: the Parirenyatwa Group of Hospitals in Harare. Type I and type II diabetics were recruited and had their blood HbA1c levels measured. The standard one tailed proportion z test was used to test the hypothesis at 5% significance level. Combined prevalence of type I and type II diabetics with elevated HbA1c was 27%. There was no significant difference in levels of HbA1c by age and sex. Over half (54%) of Type I diabetics had elevated HbA1c, suggesting poor glycemic control. In contrast only 24% of the Type II diabetics studied had elevated HbA1c. The difference in proportion of Type I and Type II diabetics with elevated HbA1c suggestive of poor glycemic control was significant (P=0.0067).

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Predialysis Glycemic Control is An Independent Predictor of Clinical Outcome in Type Ii Diabetics on Continuous Ambula Tory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686089701700309 ◽

1997 ◽

Vol 17 (3) ◽

pp. 262-268 ◽

Cited By ~ 24

Author(s):

Chun-Chen Yu ◽

Mai-Szu Wu ◽

Ching-Herng Wu ◽

Chih-Wei Yang ◽

Jeng-Yi Huang ◽

...

Keyword(s):

Glycemic Control ◽

Patient Survival ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Type Ii ◽

Peritoneal Membrane ◽

Good Glycemic Control ◽

Cholesterol Levels ◽

Significant Difference ◽

Type Ii Diabetics

Objective To evaluate the correlation between predialysis glycemic control and clinical outcomes for type II diabetic patients on continuous ambulatory peritoneal dialysis (CAPD). Design Sixty type II diabetic patients on CAPD were classified into 2 groups according to the status of glycemic control. In group G (good glycemic control), more than 50% of blood glucose determinations were within 3.3 11 mmol/L and the glycosylated hemoglobin (HbA 1 C) level was within 5 -10% at all times. In group P (poor glycemic control), fewer than 50% of blood glucose determinations were within 3.3 -11 mmol/L or HbA 1 C level was above 10% at least once during the follow-up duration. In addition to glycemic control status, predialysis serum albumin, cholesterol levels, residual renal function, peritoneal membrane function, and the modes of glycemic control were also recorded. Setting Dialysis Unit, Department of Nephrology of a single university hospital. Patients From February 1988 to October 1995, 60 type II diabetic patients receiving CAPD for at least 3 months were enrolled. Main Outcome Measures Morbidities before and during the dialysis period, patient survival, and causes of mortality. Results The patients with good glycemic control had significantly better survival than patients with poor glycemic control (p < 0.01). There was no significant difference in predialysis morbidity between the two groups. No significant differences were observed in patient survival between the patients with serum albumin greater than 30 g/L and those with less than 30 g/L (p = 0.77), with cholesterol levels greater or less than 5.18 mmol/L (p = 0.73), and with different peritoneal membrane solutetrans port characteristics evaluated by peritoneal equilibration test (p = 0.12). Furthermore, there was no significant difference in survival whether the patients controlled blood sugar by diet or with insulin (p = 0.33). Cardiovascular disease and infection were the major causes of death in both groups. Although good glycemic control predicts better survival, it does not change the pattern of mortality in diabetics maintained on CAPD. Conclusions Glycemic control before starting dialysis is a predictor of survival for type II diabetics on CAPD. Patients with poor glycemic control predialysis are associated with increased morbidity and shortened survival.

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Pre-Dialysis Glycemic Control is An Independent Predictor of Mortality Intype Ii Diabetic Patients on Continuous Ambulatory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686089901902s29 ◽

1999 ◽

Vol 19 (2_suppl) ◽

pp. 179-183 ◽

Cited By ~ 15

Author(s):

Mai-Szu Wu ◽

Chun-Chen Yu ◽

Ching-Herng Wu ◽

Jeng Yi Haung ◽

Mei-Lin Leu ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Glycemic Control ◽

Serum Albumin ◽

Poor Glycemic Control ◽

Control Group ◽

Diabetic Patients ◽

Type Ii ◽

Good Glycemic Control ◽

Cholesterol Levels ◽

Significant Difference

Objective To evaluate the impact of pre-dialysis glycemic control on clinical outcomes for type II diabetic patients on continuous ambulatory peritoneal dialysis (CAPO). Materials and Methods One hundred and one type II diabetic patients receiving CAPO for at least 3 months were enrolled in a single institute. The patients were classified into two groups according to status of glycemic control. In the good glycemic control group, more than 50% of blood glucose determinations were within 3.3 11.0 mmol/L and glycosylated hemoglobin (HbA 1 C) levels were within 5% -10% at all times. In the poor glycemic control group, less than 50% of blood glucose determinations were within 3.3 -11.0 mmol/L, or HbA1C levels were above 10% at least 6 months before peritoneal dialysis was started. In addition to glycemic control status, pre-dialysis serum albumin, cholesterol levels, residual renal function, peritoneal membrane function, and modes of glycemic control were also recorded. Results The patients with good glycemic control had significantly better survival than those with poor glycemic control (p < 0.01). There was no significant difference in pre-dialysis morbidity between two groups. No significant differences were observed in patient survival between patients with serum albumin above 30 g/L and those with serum albumin under 30 g/L; between those with cholesterol levels above or below 5.2 mmol/L; and between those with different peritoneal membrane solute transport characteristics as evaluated by a peritoneal equilibration test (PET). Furthermore, there was no significant difference in survival between patients who controlled blood sugar by diet and those who controlled it by insulin. Cardiovascular disease and infection are the major causes of death in both groups. Although good glycemic control predicts better survival, it does not change the pattern of mortality in diabetic patients maintained on CAPO. Conclusions Glycemic control before starting dialysis is a predictor of survival for type II diabetic patients on CAPO. Patients with poor glycemic control predialysis are associated with increased morbidity and shortened survival.

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Diastolic dysfunction in cases with Type II diabetes mellitus.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.12.229 ◽

2019 ◽

Vol 26 (12) ◽

pp. 2040-2043

Author(s):

Munir Ahmed ◽

Abdul Hayee ◽

Shahla Afsheen Memon ◽

Ismail Salim Memon ◽

Abdul Qayoom Memon

Keyword(s):

Diabetes Mellitus ◽

Diastolic Dysfunction ◽

Type Ii Diabetes ◽

Female Gender ◽

Type Ii Diabetes Mellitus ◽

P Value ◽

Type I ◽

Type Ii ◽

Cross Sectional ◽

Significant Difference

Objectives: To determine the frequency of diastolic dysfunction in patients presenting with type II Diabetes Mellitus. Study Design: Cross sectional study. Setting: Sheikh Zayed Hospital, Rahim Yar Khan. Period: From 01-01-2017 to 30-06-2017. Material & Methods: In this study the cases were selected via non probability consecutive sampling of both male and female gender with age more than 40 years having type II DM of at least more than 2 years were included. The cases suffering from type I DM, gestational DM and those with HTN, end stage kidney and liver failure were excluded. Trans thoracic echocardiography was done to label diastolic dysfunction and was labelled as yes when the E/A ratio was <0.8. The data was analysed using chi square test and p value less than 0.05 was taken as significant. Results: In this study, 100 cases of type II DM were included with mean age of 51.31±7.89 years at presentation. There were 61% males and 39% females. Diastolic dysfunction was observed in 53% of the cases. There was no significant difference in terms of gender where it affected 56.41% of females with p= 0.92. Diastolic dysfunction was more in cases that had duration of DM more than 3 years affecting 48 (70.58%) cases with p= 0.001 and it was also significantly high in cases that had BMI more than 30 where it was seen in 40 (70.17%) of cases with p= 0.001. Conclusion: Diastolic dysfunction seen in half of the cases suffering from type II DM and it is significantly high in cases that had duration of DM more than 3 years and BMI more than 30.

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Identifying the Risk Factors and the Prevalence of Poor Glycemic Control among Diabetic Outpatients in a Rural Region in Saudi Arabia

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i24a31427 ◽

2021 ◽

pp. 15-23

Author(s):

Ziyad S. Almalki ◽

Nehad Jaser Ahmed ◽

Abdullah K. Alahmari ◽

Ahmed M. Alshehri ◽

Sheikah Abdullah Alyahya ◽

...

Keyword(s):

Risk Factors ◽

Saudi Arabia ◽

Glycemic Control ◽

Cross Sectional Study ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Cross Sectional ◽

Rural Region ◽

Increased Risk ◽

Hba1c Levels

Aim: This cross-sectional study aimed to assess the prevalence of poor glycemic control and risk factors associated with it among diabetic patients in the central rural region of Saudi Arabia. Methods: The study included a review of diabetic patients’ medical record in King Khaled Hospital in Al-Kharj from the beginning of January 2019 to the end of June 2019. Poor glycemic control was defined as the current use of diabetic-lowering medication associated with HbA1c levels ≥7%. Multivariate analysis was done to identify the associated factors of poor glycemic control. Results: Of 1,010 consecutive outpatients’ diabetic patients were involved in the study sample, poor glycemic control presented in 496 (49.1%). Individuals who were at risk to have poor glycemic control those between 45 and 65 years with odds ratio (OR) of 1.927 (95% CI: 1.143–3.248), obese 1.496 (95% CI: 1.085–2.063) and diagnosed with asthma 2.062 (95% CI: 1.637–3.504). Conclusion: The extent of poor glycemic control in the study sample was found high. Age, obesity, and having asthma are the most important factors of increased risk of poor glycemic control. Improving glycemic control would need rigorous efforts by addressing these factors.

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Diabetes-related knowledge in diabetic haemodialysis patients: a cross-sectional study from Palestine

Renal Replacement Therapy ◽

10.1186/s41100-019-0241-8 ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Mohammad K. Hemadneh ◽

Sohaib T. Khatib ◽

Samer A. Hasan ◽

Ihab N. Tahboub ◽

Emad Khazneh ◽

...

Keyword(s):

Glycemic Control ◽

Glycaemic Control ◽

Cross Sectional Study ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Diabetes Knowledge ◽

Sectional Study ◽

Cross Sectional ◽

Maintenance Haemodialysis ◽

Hba1c Levels

Abstract Background Diabetes mellitus is the leading cause of end-stage renal disease. Monitoring and controlling normal blood sugar levels play a critical role in slowing the progression of micro- and macrovascular complications of diabetes. This study was conducted to measure glycaemic control and diabetes-related knowledge in diabetic patients on maintenance haemodialysis and to assess any relationship between these two variables. Methods This cross-sectional study was conducted at six dialysis centres in the north of the West Bank. Blood samples were collected to measure glycated haemoglobin (HbA1c) levels, while the Michigan Diabetic Knowledge Test (MDKT) was employed as a measure tool of diabetes-related knowledge. Patients were also asked to fill in a questionnaire in order to determine their sociodemographic characteristics. Finally, univariate analyses were used to measure the associations between the clinical and sociodemographic data, and diabetes knowledge and glycaemic control. Results A total of 147 haemodialysis patients with diabetes were included in this study. The mean age of the cohort was 60.12 (SD = 10.28). Males accounted for 51.7% of the cohort. The HbA1c levels (%) and MDKT scores were 6.89 ± 1.72 and 9.19 ± 1.7 (mean ± SD), respectively. 36.1% of the patients had poor glycemic control. The study showed that residency and household income were associated with diabetes knowledge (P < 0.05). However, the study did not show a significant association between diabetes-related knowledge and glycaemic control overall, nor did it show a significant association between the clinical and sociodemographic factors and glycaemic control (P > 0.05). Conclusions This study showed that patients living in refugee camps as well as those with low income had low diabetes-related knowledge and needed extra care. This study also revealed that a relatively high proportion of diabetic patients on maintenance haemodialysis suffered from poor glycemic control. Here, we recommend to put greater emphasis on better diabetes-related knowledge as a means to achieve better diabetes care with improved glycemic control for all haemodialysis patients

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The Study of Sexual Dimorphism in Lip Print Patterns Among Igbos in Anambra State of Nigeria: A Cross-Sectional Study

Journal of Advanced Oral Research ◽

10.1177/2320206820919668 ◽

2020 ◽

Vol 11 (2) ◽

pp. 240-244

Author(s):

Chijioke Mmadueke Okeke ◽

Onyechege Ann ◽

Ukoha Ukoha Ukoha ◽

Uchechukwu Dimkpa ◽

Ijeoma Enemuo

Keyword(s):

Sex Determination ◽

Cross Sectional Study ◽

Frequent Pattern ◽

Type I ◽

Type Ii ◽

Sectional Study ◽

Cross Sectional ◽

Type Iii ◽

Type Iv ◽

Significant Difference

Aim: To characterize the lip print pattern in a study population and to ascertain its potential for sex determination. Materials and Methods: A cross-sectional study was conducted among 300 undergraduate students (144 males and 156 females). Simple random sampling was used. Lip prints were obtained with lipstick and were classified according to Suzuki and Tsuchihashi classification. Data were analyzed with the Statistical Package for Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY, USA). The prevalence of lip print patterns was presented as frequencies and percentages, and the test of significance of gender difference was done with chi-square at the 95 percent confidence interval. Result: No two lip print patterns were found to be the same. There was a significant difference in the lip print patterns of females and males. In females, the pattern with the highest frequency was type II (40.4%). This was followed by type I (36.5%), type III (13.5%), type V (7.1%), and type IV (2.6%). In males, the pattern with the highest frequency was type IV (28.5%). This was followed by type III (26.4%), types I and V (each 16.0%), and type II (13.2%). When both sexes were considered together, type II was the most frequent pattern. Conclusion: Lip print is unique to individuals and it has potential for sex determination. The most prevalent patterns in females and males were type II and type IV, respectively.

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Evaluation of HER2/neu Expression in High-Grade Endometrial Carcinoma and Its Clinicopathological Correlation

10.30699/ijp.2019.90831.1867 ◽

2019 ◽

Vol 14 (4) ◽

pp. 322-328

Author(s):

Soheila Sarmadi ◽

Narges Izadi-Mood ◽

Nazanin Mansourzadeh ◽

Dorna Motevalli

Keyword(s):

Endometrial Carcinoma ◽

Disease Free Survival ◽

Serous Carcinoma ◽

Low Grade ◽

Type I ◽

High Grade ◽

Type Ii ◽

Cross Sectional ◽

Ancillary Test ◽

Significant Difference

Background & Objective: Endometrial carcinoma (EC) has been traditionally classified into two distinct categories of low-grade and high-grade. Type I (low grade) EC, which constitutes the majority of cases, is linked to estrogen-related molecular pathways. But type II (high-grade) EC accounts for 10-20% of cases and behaves in an aggressive way. Pathologic and biological features of type II EC have not been fully elucidated yet. Several investigations have demonstrated HER2/neu expression and amplification in type II EC, especially papillary serous carcinoma (PSC).This study assessed HER2/neu expression in high-grade EC as well as its association with other clinical and histopathological prognostic factors. Methods: In this cross-sectional study, we performed HER2/neu immunohistochemical (IHC) staining in 37 high-grade EC cases with histological diagnostic categories of PSC (n=23), clear cell carcinoma (CCC) (n=9), and carcinosarcoma with high-grade carcinomatous component (PSC, CCC, grade 3 endometrioid carcinoma, or unclassified high-grade adenocarcinoma) (n=5). All patients were followed for 2-9 years in order to evaluate their disease-free survival (DFS) and overall survival (OS) during study period (2005-2014). Results: HER2/neu IHC staining was positive in 12 patients (32.4%) including 8/23 (34.8%) PSC, 2/9 (22.2%) CCC, and 2/5 (40%) carcinosarcoma cases. There was no statistically significant difference between HER2/neu expression and DFS or OS of the patients (P>0.05). Conclusion: We observed that HER2/neu is expressed in one-third of high-grade ECs. This ancillary test is supportive in follow-up of patients with high-grade ECs.

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Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

International Journal of Bioassays ◽

10.21746/ijbio.2016.05.006 ◽

2016 ◽

Vol 5 (05) ◽

pp. 4563

Author(s):

Tariq A. Zafar

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Glycated Haemoglobin ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Age Group ◽

Hba1c Test ◽

Significant Difference ◽

Tract Infections ◽

The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah. The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively. Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

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Analysis of sagittal profile and radiographic parameters in symptomatic thoracolumbar disc herniation patients

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04033-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ang Gao ◽

Yongqiang Wang ◽

Miao Yu ◽

Xiaoguang Liu

Keyword(s):

Disc Herniation ◽

Thoracic Spine ◽

Normal Population ◽

Sagittal Profile ◽

Sacral Slope ◽

Type I ◽

Type Ii ◽

Radiographic Parameters ◽

Significant Difference ◽

Thoracolumbar Region

Abstract Background Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH). The aim of study is to investigate sagittal alignment in TLDH and analyze sagittal profile with radiographic parameters. Methods Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameter values in each subtype. Results We found two subtypes differentiated by the apex of thoracic kyphotic curves. The sagittal profile was similar to that of the normal population in type I, presenting the apex of the thoracic kyphotic curve located in the middle thoracic spine. The well aligned thoracic-lumbar curve was disrupted in type II, presenting the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9 ± 24.8°, 8.2 ± 7.3° and 6.2 ± 4.9°, respectively. There was significant difference (p < 0.001) of thoracolumbar angle between type I (14.9 ± 7.9°) and type II patients (29.1 ± 13.7°). Conclusions We presented two distinctive sagittal profiles in TLDH patients, and a regional kyphotic deformity with a balanced spine was validated in both subtypes. In type I patients, disc degeneration was accelerated by regional kyphosis in the thoracolumbar junction and eventually caused disc herniation. In type II patients, excessive mechanical stress was directly loaded at the top of the curve (thoracolumbar apex region) rather than being diverted by an arc as in a normal population or type I patients. Mismatch between shape and sacral slope value was observed, and better agreement was found in Type II patients.

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Effect of Regular Khat Chewing on Serum Fasting Sugar Level in Diabetic patients versus Healthy Individuals; A comparative study

Nutrition and Metabolic Insights ◽

10.1177/11786388211035220 ◽

2021 ◽

Vol 14 ◽

pp. 117863882110352

Author(s):

Yordanos Mengistu ◽

Gobena Dedefo ◽

Mesay Arkew ◽

Gebeyehu Asefa ◽

Gutema Jebessa ◽

...

Keyword(s):

Risk Factors ◽

Blood Glucose ◽

Glycemic Control ◽

Glucose Oxidase ◽

Blood Sugar ◽

Poor Glycemic Control ◽

Fasting Blood Sugar ◽

Healthy Individuals ◽

Cross Sectional ◽

Khat Chewer

Background: Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat’s effect on blood glucose especially in our setting, Harar estern Ethiopia. Objective: Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects. Method: A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement. Result: (Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control. Conclusion: There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects. Recommendation: Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.

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