scholarly journals Glycemic Variability Assessed by Continuous Glucose Monitoring and Short-Term Outcome in Diabetic Patients Undergoing Percutaneous Coronary Intervention: An Observational Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Annunziata Nusca ◽  
Angelo Lauria Pantano ◽  
Rosetta Melfi ◽  
Claudio Proscia ◽  
Ernesto Maddaloni ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Troponin I ◽  
Fasting Blood Glucose ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Percutaneous Coronary

Poor glycemic control is associated with unfavorable outcome in patients undergoing percutaneous coronary intervention (PCI), irrespective of diabetes mellitus. However a complete assessment of glycemic status may not be fully described by glycated hemoglobin or fasting blood glucose levels, whereas daily glycemic fluctuations may influence cardiovascular risk and have even more deleterious effects than sustained hyperglycemia. Thus, this paper investigated the effectiveness of a continuous glucose monitoring (CGM), registering the mean level of glycemic values but also the extent of glucose excursions during coronary revascularization, in detecting periprocedural outcome such as renal or myocardial damage, assessed by serum creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and troponin I levels. High glycemic variability (GV) has been associated with worse postprocedural creatinine and NGAL variations. Moreover, GV, and predominantly hypoglycemic variations, has been observed to increase in patients with periprocedural myocardial infarction. Thus, our study investigated the usefulness of CGM in the setting of PCI where an optimal glycemic control should be achieved in order to prevent complications and improve outcome.

The Effect of Glycemic Control on Outcomes of Percutaneous Coronary Intervention Among Diabetic Patients

2021 ◽  
Vol 242 ◽  
pp. 150
Author(s):  
Ziad M. Bukhari ◽  
Saad Albugami ◽  
Mohammed S. Alqarni ◽  
Abdulkarim W. Abukhodair ◽  
Malak A. BinShihon
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Glycemic Control ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Percutaneous Coronary

Abstract P338: Adverse Outcomes Following Percutaneous Coronary Intervention in Insulin Dependent and Non-Insulin Dependent Diabetes Mellitus

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Michael S Scholfield ◽  
Ragu Murthy ◽  
Burhan Mohamedali ◽  
Sloane McGraw ◽  
Anupama Shivaraju ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Glycemic Control ◽  
Coronary Intervention ◽  
Cardiovascular Outcomes ◽  
Adverse Outcomes ◽  
Diabetic Patients ◽  
Percutaneous Coronary ◽  
Insulin Dependent ◽  
The Impact ◽  
Niddm Patients

Background: ACC guidelines suggests late outcomes in diabetic patients after percutaneous coronary intervention (PCI) are similar to non-diabetics if the hgbA1C can be maintained less than 7.0%. To achieve this level of glycemic control many patients require the addition of insulin. The differences in outcomes amongst insulin dependent (IDDM) and non-insulin dependent (NIDDM) patients are not well known. We wish to analyze the cardiovascular (CV) outcomes and glycemic control of diabetic patients 6 months post PCI stratified by insulin usage. Methods: We conducted a retrospective cohort study investigating the impact of DM on clinical outcomes in patients who underwent a PCI at a Veterans Health Institution from September 2004 to March 2009. Adverse cardiovascular outcomes (death, myocardial infarct, revascularization, cardiac hospitalization, and combined outcomes) six months post-PCI were recorded and compared in IDDM and NIDDM patients. Data pertaining to glucose levels, HgbA1C, lipids, and blood pressure were also collected. Results: Of the 771 unique patients in our analysis, 302 had DM of which, 132(44%) were on insulin and 169(56%) were on oral medications. Although not statistically significant, in IDDM patients there was an increased rate of death, MI, cardiac hospitalization, and combined outcomes. HgbA1C and glucose values in IDDM were significantly higher pre and post-PCI. Conclusion: Our study suggested that both IDDM and NIDDM groups had poor glycemic control, however, IDDM patients were less controlled. Although lack of power in our study may have led to our inability to detect statistically significant differences in adverse CV outcomes we can see a trend toward worse outcomes in the IDDM group. Increased attention to promote tighter glycemic control particularly among IDDM veterans is warranted. We can conclude that more attention needs to be paid to diabetics patients, especially IDDM patients, to maintain a tighter glycemic control and hence reduce adverse cardiovascular outcomes post PCI.

scholarly journals The Impact of the Triglyceride-Glucose Index on Poor Prognosis in NonDiabetic Patients Undergoing Percutaneous Coronary Intervention

2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Yang ◽  
Yi-Da Tang ◽  
Yitian Zheng ◽  
Chen Li ◽  
Qing Zhou ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiovascular Risk ◽  
Poor Prognosis ◽  
Fasting Blood Glucose ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Tyg Index ◽  
Triglyceride Glucose Index ◽  
Percutaneous Coronary ◽  
The Impact

BackgroundThe triglyceride-glucose index (TyG index) is a valuable marker for predicting adverse cardiovascular events in diabetic patients. However, for nondiabetic patients, whether the TyG index is independently related to poor prognosis remains unclear. This cohort study assessed the association of the TyG index with future cardiovascular risk in nondiabetic subjects who received percutaneous coronary intervention (PCI).MethodsWe consecutively enrolled 5,489 nondiabetic patients who underwent PCI. All experimental subjects were divided into three groups based on their TyG index, which was determined by the equation ln (fasting triglyceride (mg/dl) × fasting blood glucose (mg/dl)/2). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and target vessel revascularization (TVR).ResultsA total of 386 MACCE were documented during a median 29-month follow-up. The Kaplan–Meier survival results indicated that among the three groups, there was no obvious difference in any endpoints. Further Cox regression analyses suggested that the TyG index was not independently related to adverse cardiovascular outcomes for nondiabetic patients who underwent PCI (HR: 0.77, 95% CI 0.56–1.16, P = 0.210 for MACCE). Subgroup analysis suggested that the TyG index was independently relevant to MACCE for patients with low-density lipoprotein cholesterol (LDL-C) lower than 1.8 mmol/L.ConclusionThe TyG index is not an effective predictive factor for adverse cardiovascular prognosis in nondiabetic patients who underwent PCI. However, in subjects with LDL-C lower than 1.8mmol/L, it may predict future cardiovascular risk.

scholarly journals Impact of Glycemic Control on the Clinical Outcome in Diabetic Patients With Percutaneous Coronary Intervention

2011 ◽  
Vol 75 (4) ◽  
pp. 791-799 ◽  
Author(s):  
Amane Ike ◽  
Hiroaki Nishikawa ◽  
Kazuyuki Shirai ◽  
Ken Mori ◽  
Takashi Kuwano ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Glycemic Control ◽  
Clinical Outcome ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Percutaneous Coronary

scholarly journals MON-653 The Effects of DPP IV Inhibitor on Glycemic Variability in Type 2 Diabetic Patients Treated with Twice Daily Premixed Human Insulin

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Florence Hui Sieng Tan ◽  
Chin Voon Tong ◽  
Yueh Chien Kuan ◽  
Bik Kui Lau ◽  
Huai Heng Loh
Keyword(s):  
Glycemic Control ◽  
Glycaemic Control ◽  
Human Insulin ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Diabetic Patients ◽  
Premixed Insulin ◽  
Dpp Iv

Abstract Glycemic variability (GV) is emerging as an exciting therapeutic target for diabetes mellitus (DM) with recent evidences showing association of GV with hypoglycemia risk as well as chronic complications.(1,2) Twice daily human premixed insulin is commonly used in developing countries and Asia for treatment of type 2 DM (T2DM). (3) While more convenient and cost saving, human premixed insulin regime may increase GV due to lesser flexibility and less physiological pharmacokinetic profile. Dipeptidyl peptidase IV inhibitors (DPPIV-I) have been shown to improve GV when used for treatment of T2DM but the effects of DPPIV-I when added on human premixed insulin is limited. We therefore evaluated the changes in GV following addition of DPP IV-I among T2DM patients treated with premixed human insulin with or without metformin therapy. This was a prospective study involving adult patients with T2DM on stable doses of premixed human insulin with or without metformin for at least 3 months from two state hospitals in Malaysia. Blinded continuous glucose monitoring (CGM) were performed at baseline and following 6 weeks of adding Vildagliptin to their insulin regime. A total of 12 patients were recruited (50% male). Mean (SD) age was 55.8 (13) years with mean duration of disease of 14 (6.6) years. The addition of Vildagliptin significantly reduced GV indexes including SD 2.98 (1.17) to 2.33 (0.82), p=0.017; MAGE 6.94 (2.61) to 5.72 (1.87), p=0.018; MAG 1.60 (0.76) to 1.23 (0.48), p=0.009 and M Value 13.96 (13.01) to 6.52 (7.45), p=0.037. In addition there were improvements in terms of parameters for glycemic control. Time spent in optimal glycemic range (4-8 mmol/l) improved from 38.33 (19.69) to 58.17 (5.95) %, p=0.001 with reduction in AUC for hyperglycemia from 2.09 (1.73) to 1.06 (1.09) mmol/day, p=0.010. Hypoglycemia events were infrequent and the reduction in time spent in hypoglycemia [5.92(9.74) to 1.91 (2.54)%, p=0.191] as well as AUC for hypoglycemia [0.03(0.54) to 0.01(0.02) mmol/day, p=0.163] were found although these did not reach statistical significance. We concluded that addition of DPP IV-I to commonly prescribed twice daily premixed human insulin regime in patients with T2DM may improve GV and glycemic control and warrant further exploration. References (1) Gerry Rayman. Glycaemic control, glucose variability and the triangle of diabetes care. Br J Diabetes 2016;16(Suppl1):S3-S6 (2) Boris P. Kovatchev. Metrics for glycaemic control - from HbA1c to continuous glucose monitoring. Nat Rev Endocrinol. 2017 Jul;13(7):425-436 (3) Kalra S, Balhara YP, Sahay BK, Ganapathy B, Das AK. Why is premixed insulin the preferred insulin? Novel answers to a decade-old question. J Assoc Physicians India. 2013 Jan;61(1 Suppl):9-11

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