scholarly journals Demographic Associations of Diabetes Status by Both Fasting Plasma Glucose Concentration and Glycated Hemoglobin in a Community Survey in Galle District, Sri Lanka

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Keddagoda Gamage Piyumi Wasana ◽  
Anoja Priyadarshani Attanayake ◽  
Thilak Priyantha Weerarathna ◽  
Kamani Ayoma Perera Wijewardana Jayatilaka
Keyword(s):  
Sri Lanka ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glycated Hemoglobin ◽  
Diagnostic Tools ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
Fasting Plasma ◽  
Diabetes Status ◽  
Significant Difference

Diagnostic tools used in detecting individuals with diabetes mellitus (DM) include fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), and oral glucose tolerance test (OGTT). The present study was aimed to determine the demographic associations of diabetes status by both tests (FPG and HbA1C) in Galle district, Sri Lanka. 147 adults (30–60 years) who are having FPG ≥ 126 mg/dL underwent demographic evaluations and testing for HbA1C. Group 01 (diabetes status diagnosed by both tests) and group 2 (diabetes status diagnosed only by FPG) were compared using independant sample t-test and chi-square test. Logistic regression was used to study the association between the demographic factors and the diabetes status by both tests. Of the 147 study subjects, 38.1% were males, 61.9% were females, and 63.3% had a family history of diabetes among first-degree relatives (FDR). Mean age, body mass index (BMI), waist circumference (WC), FPG, and HbA1C of the participants were 48.4 ± 7.2 years, 25.1 ± 4.0 kg/m2, 88.8 ± 9.0 cm, 139.4 ± 30.1 mg/dL, and 6.4 ± 0.7%, respectively. The prevalence of diabetes based on both tests was 55.1%. There is a significant difference in mean BMI and WC while no significant differences in mean age between groups 01 and 02. No association was seen between gender and diabetes status (X2(1) = 0.086, p=0.770), while a significant difference was observed between DM among FDR and diabetes status (X2(1) = 33.215, p<0.001). Significance of odds of having diabetes by both tests with rising BMI (OR = 1.97, CI 1.15–3.36, p=0.013) and DM among FDR (OR = 7.95, CI 3.54–17.88, p=0.000) was seen. We conclude rising BMI and having DM among FDR are strongly associated with diabetes status diagnosed by both tests of FPG and HbA1C in community screening.

scholarly journals Altered levels of fructosamine and glycated haemoglobin (HbA1c) in thyroid disorder patients without diabetes mellitus-A cross sectional study

Biomedicine ◽  
2021 ◽  
Vol 41 (1) ◽  
pp. 46-51
Author(s):  
G.Sajjan Sangamma ◽  
S. Sonoli Smita ◽  
Naveen Angadi
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glycated Hemoglobin ◽  
Thyroid Disorder ◽  
Newly Diagnosed ◽  
Fasting Plasma ◽  
Significant Difference ◽  
The Mean ◽  
Hba1c Levels

Introduction and Aim:Co-existence of thyroid disorder and Diabetes Mellitus is no more a coincidence. The cause and impact of thyroid disorder on glucose levels or vice versa is a well -established fact.Hence in this study we wanted to know the glycemic status by estimating fructosamine and glycated hemoglobin of the newly diagnosed thyroid patients without diabetes mellitus. The aim of the study was to estimatefructosamine and glycated hemoglobin levels in newly diagnosed subclinical hypothyroid, clinical hypothyroid and hyper thyroid patients without diabetes mellitus. Material and Methods:Twenty cases of subclinical hypothyroid,30 cases of hypothyroid,30 cases of hyperthyroid  and 30 healthy participantswere included in the study. Fasting plasma glucose and thyroid profile was estimated in suspected cases of thyroid disorder and participants with fasting plasma glucose (FPG) more than 110 mg/dL were excluded from the study.The participants who were eligible for an inclusion criterion were estimated for fructosamine by nitro bluetetrazolium, (NBT) method andion-exchange high performance liquid chromatography was for glycated hemoglobin. Results:In Subclinical hypothyroid group there was a statistically significant increase in the mean fasting plasma glucose, fructosamine and glycated hemoglobin levels when compared with the controls.There was a significant increase in the mean fasting plasma glucose,fructosamine and glycated hemoglobin(HbA1c) levels in clinical hypothyroid group when compared with the controls.Pairwise comparison of FPG (p=0.001), fructosamine (p=0.001) and HbA1c (p=0.001) levels with controls showed a statistically significant difference.In clinical hyperthyroid group the mean FPG and HbA1c levels were high and low fructosamine levels when compared with the controls by one way ANOVA.Pairwise comparison of FPG (p=0.001), fructosamine levels (p=0.001) and HbA1c (p=0.001) levels (p=0.001) with controls showed a statistically significant difference. Conclusion: Unidentified hyperglycemia could have an impact on thyroid disorder leading to its complication.Hence a systematic approach to fructosamine testing(monitor the plasma glucose concentration over 2–3 weeks) as a routine test in thyroid disorder patients, needs to be considered.Also the management of hyperglycemia in thyroid patients without diabetes mellitus may prove  to be beneficial.  

scholarly journals Evaluation of Fasting Capillary Glucose and Fasting Plasma Glucose as Screening Tests for Diabetes and Prediabetes among Adults in a Semi-Urban Area in the Kathmandu District, Nepal

2019 ◽  
Vol 21 (4) ◽  
pp. 265-275
Author(s):  
V Silvanus ◽  
PP Kafle ◽  
A Pokhrel ◽  
B K Baral ◽  
BR Pokhrel
Keyword(s):  
Glucose Tolerance ◽  
Sensitivity And Specificity ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Oral Glucose ◽  
Strong Positive Correlation ◽  
Positive Correlation ◽  
Fasting Plasma ◽  
Significant Difference ◽  
Capillary Glucose

The natural history of type 2 diabetes includes a preceding period of impaired fasting glucose or impaired glucose tolerance which is referred to as prediabetes. During the asymptomatic phase of prediabetes, an estimated 20-30% of persons may develop complications like retinopathy, cardiovascular disease, neuropathy and nephropathy. Screening and lifestyle management may help to delay or arrest progression to diabetes. In primary care settings, point of care devices that measure glucose in capillary blood can be used for diagnosis of diabetes. This study was carried out to evaluate the performance of fasting capillary glucose (FCG) and fasting plasma glucose (FPG) measurement in screening for diabetes and prediabetes among adults in a semi-urban community in the Kathmandu district of Nepal. An observational, cross-sectional study design was used and FCG, FPG performance was evaluated by the 2-hour plasma glucose levels (2-hr PG) following Oral glucose tolerance test (75g glucose) using WHO 1998 criteria. Linear regression was performed to assess correlation co-efficient (r) between FPG, FCG and 2 hr PG. Bland Altman plot and Receiver operator characteristic (ROC) curves were constructed to assess concordance, measure ROC AUC and determine sensitivity and specificity of the measurements at recommended cut-off values for identifying diabetes and prediabetes. Among the study participants (n=162), 104 were female and 58 were male. Prevalence of undiagnosed diabetes and prediabetes was 4.32% (95% CI 1.75% to 8.70%) and 7.14% (95% CI 3.89% to 12.58%). Strong positive correlation was seen between FPG and FCG (Spearman’s r 0.67). FPG & FCG had a moderate positive correlation (r = 0.49 & 0.45) with 2 hr PG levels (p<0.0001). FCG and FPG ROC AUC was 0.91 (95% CI 0.85 to 0.97) and 0.87 (95% CI 0.78 to 0.97) in comparison to 0.98 (95% CI 0.97 to 1.0) for the gold standard 2 hr PG. At 110 mg/dl and above, FCG had an optimal sensitivity and specificity of 84.21% and 81.12% in comparison to 47.37% and 100% for FPG. At 100 mg/dl, the sensitivity and specificity of FCG was 100% and 51.75% in comparison to 57.89% and 97.20% for FPG. In conclusion, at each recommended cut-off value, FCG was more sensitive than FPG with no significant difference between ROC AUCs of the two tests. Hence, FCG may be a suitable, sensitive, and convenient screening tool for diabetes and prediabetes in community-based settings. Larger prospective studies may validate the cost-effectiveness and efficiency of similar screening strategies in the Nepalese community.

scholarly journals Detecting Prediabetes and Diabetes: Agreement between Fasting Plasma Glucose and Oral Glucose Tolerance Test in Thai Adults

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Wichai Aekplakorn ◽  
Valla Tantayotai ◽  
Sakawduan Numsangkul ◽  
Wilarwan Sripho ◽  
Nutchanat Tatsato ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Diabetes Prevention Program ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Kappa Statistics ◽  
Family History Of Diabetes ◽  
Fasting Plasma

Aim. To evaluate an agreement in identifying dysglycemia between fasting plasma glucose (FPG) and the 2 hr postprandial glucose tolerance test (OGTT) in a population with high risk of diabetes.Methods. A total of 6,884 individuals aged 35–65 years recruited for a community-based diabetes prevention program were tested for prediabetes including impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), and diabetes. The agreement was assessed by Kappa statistics. Logistic regression was used to examine factors associated with missed prediabetes and diabetes by FPG.Results. A total of 2671 (38.8%) individuals with prediabetes were identified. The prevalence of prediabetes identified by FPG and OGTT was 32.2% and 22.3%, respectively. The proportions of diabetes classified by OGTT were two times higher than those identified by FPG (11.0% versus 5.4%, resp.). The Kappa statistics for agreement of both tests was 0.55. Overall, FPG missed 46.3% of all prediabetes and 54.7% of all diabetes cases. Prediabetes was more likely to be missed by FPG among female, people aged <45 yrs, and those without family history of diabetes.Conclusion. The detection of prediabetes and diabetes using FPG only may miss half of the cases. Benefit of adding OGTT to FPG in some specific groups should be confirmed.

Association of Triglyceride-glucose Index and the Risk of Incident Diabetes: a Secondary Analysis Based on a Chinese Cohort Study

2020 ◽  
Author(s):  
Xiaoli Li ◽  
Guilong Li ◽  
Tiantian Cheng ◽  
Jing Liu ◽  
Guangyao Song ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Incident Diabetes ◽  
Family History Of Diabetes ◽  
Tyg Index ◽  
Fasting Plasma ◽  
Increased Risk ◽  
The Relationship

Abstract BackgroundTriglyceride-glucose index (TyG index) has been regarded as a reliable alternative marker of insulin resistance. However, study on the relationship between TyG index and incident diabetes remains limited. This study aimed to investigate the association between TyG index and incident diabetes in a large cohort of Chinese population.MethodsThe present study was a retrospective cohort study using healthy screening programme data in China. A total of 201,298 subjects free of baseline diabetes were included who received a health check with all medical records from 2010 to 2016. TyG index was calculated as Ln[fasting triglyceride level (mg/dl) x fasting plasma glucose (mg/dl)/2]. Diagnosis of diabetes was based on fasting plasma glucose ≥ 7.00 mmol/L and/or self-reported diabetes. Cox proportion-hazard model was used to assess the relationship between TyG index at baseline and the risk of incident diabetes. It should be noted that the data was uploaded to the DATADRYAD website, and we only used this data for secondary analysis.ResultsDuring a mean follow-up of 3.12 years of 201,298 individuals aged ≥ 20 years old, 3389 subjects developed diabetes. After adjusting for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, low density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, serum creatinine, smoking, drinking and family history of diabetes, multivariate cox hazards regression analysis indicated that TyG index was positive correlation with the risk of developing diabetes in Chinese population (HR, 3.34; 95% CI, 3.11 to 3.60). The risk of incident diabetes increased with increasing TyG index. Subjects with TyG index in the fourth quartile were 6.26 times more likely to develop diabetes than the lowest quartile (P trend < 0.001). Subgroup analysis showed the stronger association was observed in the population with age < 40, BMI (≥ 18.5, < 24 kg/m2), SBP < 140 mmHg or females (all P for interaction < 0.0001).Conclusions TyG index was independently correlated with the increased risk of diabetes in Chinese adults, suggesting that TyG index may be a useful marker for identifying individuals at high risk of developing diabetes.

scholarly journals Randomized, Double-Blinded, Double-Dummy, Active-Controlled, and Multiple-Dose Clinical Study Comparing the Efficacy and Safety of Mulberry Twig (Ramulus Mori, Sangzhi) Alkaloid Tablet and Acarbose in Individuals with Type 2 Diabetes Mellitus

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Mengyi Li ◽  
Xuemin Huang ◽  
Hui Ye ◽  
Yao Chen ◽  
Jing Yu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Efficacy And Safety ◽  
Postprandial Plasma Glucose ◽  
Glucose Levels ◽  
Fasting Plasma ◽  
Significant Difference

Aims. To evaluate the efficacy and safety of mulberry twig alkaloid (SZ-A) tablet compared with acarbose in patients with type 2 diabetes.Methods. This clinical trial enrolled 38 patients who were randomized into two groups (SZ-A: 23; acarbose: 15) and were treated for 24 weeks. Patients and clinical trial staffs were masked to treatment assignment throughout the study. The primary outcome measures were glycated hemoglobin (HbA1c) and 1-hour and 2-hour postprandial and fasting plasma glucose levels from baseline to the end of treatment. Analysis included all patients who completed this study.Results. By the end of this study, HbA1c level in SZ-A group was decreased from baseline significantly (P<0.001). No significant difference was found when compared with acarbose group (P=0.652). Similarly, 1-hour and 2-hour postprandial plasma glucose levels in SZ-A group were decreased from baseline statistically (P<0.05), without any significant differences compared with acarbose group (P=0.748and 0.558, resp.). The fasting plasma glucose levels were not significantly changed in both groups. One of 23 patients in SZ-A group (4.76%) and 5 of 15 patients in acarbose group (33.33%) suffered from gastrointestinal adverse events.Conclusions. Compared with acarbose, SZ-A tablet was effective and safe in glycemic control in patients with type 2 diabetes.

scholarly journals Effect of Exenatide on Splanchnic and Peripheral Glucose Metabolism in Type 2 Diabetic Subjects

2011 ◽  
Vol 96 (6) ◽  
pp. 1763-1770 ◽  
Author(s):  
E. Cersosimo ◽  
A. Gastaldelli ◽  
A. Cervera ◽  
E. Wajcberg ◽  
A. Sriwijilkamol ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Gastric Emptying ◽  
Glucose Uptake ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Plasma Insulin ◽  
Hepatic Insulin Resistance ◽  
Oral Glucose ◽  
Fasting Plasma

Objective: Our objective was to examine the mechanisms via which exenatide attenuates postprandial hyperglycemia in type 2 diabetes mellitus (T2DM). Study Design: Seventeen T2DM patients (44 yr; seven females, 10 males; body mass index = 33.6 kg/m2; glycosylated hemoglobin = 7.9%) received a mixed meal followed for 6 h with double-tracer technique ([1-14C]glucose orally; [3-3H]glucose iv) before and after 2 wk of exenatide. In protocol II (n = 5), but not in protocol I (n = 12), exenatide was given in the morning of the repeat meal. Total and oral glucose appearance rates (RaT and RaO, respectively), endogenous glucose production (EGP), splanchnic glucose uptake (75 g − RaO), and hepatic insulin resistance (basal EGP × fasting plasma insulin) were determined. Results: After 2 wk of exenatide (protocol I), fasting plasma glucose decreased (from 10.2 to 7.6 mm) and mean postmeal plasma glucose decreased (from 13.2 to 11.3 mm) (P &lt; 0.05); fasting and meal-stimulated plasma insulin and glucagon did not change significantly. After exenatide, basal EGP decreased (from 13.9 to 10.8 μmol/kg · min, P &lt; 0.05), and hepatic insulin resistance declined (both P &lt; 0.05). RaO, gastric emptying (acetaminophen area under the curve), and splanchnic glucose uptake did not change. In protocol II (exenatide given before repeat meal), fasting plasma glucose decreased (from 11.1 to 8.9 mm) and mean postmeal plasma glucose decreased (from 14.2 to 10.1 mm) (P &lt; 0.05); fasting and meal-stimulated plasma insulin and glucagon did not change significantly. After exenatide, basal EGP decreased (from 13.4 to 10.7 μmol/kg · min, P = 0.05). RaT and RaO decreased markedly from 0–180 min after meal ingestion, consistent with exenatide's action to delay gastric emptying. Conclusions: Exenatide improves 1) fasting hyperglycemia by reducing basal EGP and 2) postmeal hyperglycemia by reducing the appearance of oral glucose in the systemic circulation.

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