Abstract P029: Diabetes Mellitus and Disabling Dementia among Japanese: The Circulatory Risk in Communities Study (CIRCS)

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Eri Eguchi ◽  
Kazumasa Yamagishi ◽  
Ai Ikeda ◽  
Choy-Lye Chei ◽  
Hiroyuki Noda ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Intolerance ◽  
Smoking Status ◽  
Asian Population ◽  
Serum Glucose ◽  
Fasting Serum ◽  
Hypertension Status ◽  
Fasting Serum Glucose ◽  
The Status ◽  
History Of

Introduction: The evidence for the relation between diabetes mellitus and risk of dementia in Asian population has been limited. This study investigated the association between diabetes mellitus and risk of dementia in community-based samples of Japanese. Hypothesis: There is an association between diabetes mellitus and risk of disabling dementia Methods: We performed a nested case-control study based on a cohort of about 6,000 Japanese aged 45-69 at baseline between 1984 and 1994. The information of the status of diabetes at baseline was collected for 174 disabling dementia cases incident between 1999 and 2004 and 348 controls matched with cases by age±3, sex and baseline-year. Incident disabling dementia was defined as dependent individuals who had moderate to severe dementia-related behavioral disturbance or cognitive impairment. This criterion was previously validated with 5-cog test. Dementia cases were further classified according to presence of history of stroke. The conditional odds ratio (OR) for dementia was calculated according to the status of (1) glucose intolerance; fasting serum glucose 110-125mg/dl or non-fasting serum glucose 140-199 mg/dl; and (2) diabetes; fasting serum glucose ≥126 mg/dl, non-fasting serum glucose ≥200 mg/dl, and/or the use of glucose-lowering medication or insulin therapy. Variables for multivariable adjustment were body mass index, smoking status, total cholesterol and hypertension status (140≤SBP<160 mmHg, 90≤DBP<95 mmHg for hypertension of grade 1, SBP ≥160 mmHg, DBP ≥95mmHg for hypertension of grade 2 and 3, and the treatment with an antihypertensive drug). Sex-specific analysis was also conducted as subanalysis. Results and Conclusions: Mean follow-up year was 11.4 years. The proportion of men was 32.8% and the prevalence of glucose intolerance and diabetes among controls were 16.7% and 5.8%, respectively. Of dementia cases, 44.8% had history of stroke. Compared with persons with normal glucose level, ORs (95%CI) for glucose intolerance and diabetes were 1.12 (0.68-1.84) and 2.18 (1.13-4.22), and multivariable ORs were 0.98 (0.58-1.65) and 2.04 (1.03-4.03), respectively. For sex stratified analysis, ORs for diabetes were 1.39 (0.45-4.31) for men, and 2.79 (1.20-6.50) for women. The association of diabetes was primarily observed in dementia cases with stroke history [OR=3.19 (1.04-9.82)], but not in those without it [OR=1.78 (0.78-4.07)]. In conclusion, we found an association between diabetes mellitus and risk of disabling dementia. The association was confined to women, and dementia with stroke history.

scholarly journals Serum Glucose Measurement after Five to Six Hours is Comparable to Eight Hours Overnight Fasting in Ramadan

2021 ◽  
Author(s):  
Ammar M.S. Almomin ◽  
Samih A. Odhaib ◽  
Mahmood T. Altemimi ◽  
Hussein A. Nwayyir ◽  
Ibrahim H. Hussein ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Serum Glucose ◽  
Glucose Measurement ◽  
Fasting Serum ◽  
Cross Sectional ◽  
Fasting Serum Glucose ◽  
Two Samples ◽  
Significant Difference ◽  
Overnight Fasting ◽  
Fasting Duration

Objectives: This study was done to evaluate whether a shorter fasting duration of five to six hours can be used as an alternative to the usually recommended eight hours fasting serum glucose measurement. Methods: An observational, cross-sectional study was conducted during Ramadan (May) 2019, on 200 individuals. Two fasting serum glucose (FSG) venous samples taken, the first after 5-6 hours after predawn meal (suhoor), and the second after 8 hours. Participants were divided into two groups; normal individuals, and those who have type 2 diabetes mellitus (T2DM). Patients with T2DM further subdivided into three groups: those without treatment, those on oral antidiabetic drugs (OAD), and those using insulin and OAD. Results: There was no significant difference between the mean FSG readings in mg/dL (mmol/L) between the first and second samples for healthy individuals, 104.5 ± 21.4 (5.79±1.18) and 104.8 ± 12.6 (5.82±0.7), respectively. Generally, the same is true for T2DM patients with FSG values of 235 ± 107 (13.04±5.94) and 230 ± 105 (12.77±5.83). Untreated T2DM patients have consecutive FSG readings of 194.0 ± 151.5 (10.77±8.41) and 193.9 ± 128.9 (10.76±7.15), respectively, in the two samples without significant difference. Patients using insulin and OAD showed similar pattern of FSG 268 ± 111 (14.87±6.16) and 269 ± 114 (14.93±6.33), respectively. The only significant difference was observed in patients on OAD which have 220 ± 78 (12.21±4.33) and 207 ± 77 (11.49±4.27) for their successive FSG samples. Conclusions: The overnight fasting duration of 5-6 hours, can give a comparable measurement of fasting serum glucose as that obtained by 8 hours. Keywords: Glucose; Fasting; Duration; Diabetes Mellitus

scholarly journals Early Postoperative Fasting Serum Glucose Levels are Useful in Depicting Future Diabetes Mellitus in Patients with Curative Insulinoma Surgery

2019 ◽  
Vol 128 (03) ◽  
pp. 158-163
Author(s):  
Aycan Akca ◽  
Achim A. R. Starke ◽  
Anna Dobek ◽  
Alexis Ulrich ◽  
Peter E. Goretzki
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Tumor Resection ◽  
Pancreatic Head ◽  
Serum Levels ◽  
Medical Intervention ◽  
Serum Glucose ◽  
Fasting Serum ◽  
Fasting Serum Glucose ◽  
Glucose Levels

Abstract Background Hyperglycemia has been reported in some patients after curative insulinoma resection but no systematic investigation of glucose metabolism has been shown in a larger cohort of these patients. Therefore, it is still unknown, whether long lasting hyperinsulinism in insulinoma patients induces insulin resistance, which may jeopardize the postoperative health status of these patients. Methods Early postoperative fasting serum glucose levels were measured in all insulinoma patients after curative tumor resection during the first 48 h, being operated between 2011 and 2018, retrospectively. Results Of 77 (100%) patients with benign, spontaneous occuring insulinoma 51 (66.2%) patients were operated on by tumor enucleation. In 15 (19.5%) patients a left pancreatic resection was performed and in 11 (14.3%) patients the pancreatic head or the middle console of pancreatic corpus were excised. In 32 (41.6%) cases the highest fasting postoperative glucose levels were measured between 140–200 mg/dl. In 16 (20.8%) patients the glucose serum levels reached values above 200 mg/dl and in 4 (5.2%) patients short term substitution with insulin was indicated. Only one (1.3%) of these patients developed diabetes mellitus with the need of ongoing insulin treatment. Major postoperative complications were registered in 31 of all 77 patients (40.3%) and in 9 of 16 patients (56.3%) with postoperative glucose levels above 200 mg/dl. This difference was not statistically significant. Conclusions Early postoperative (first 48 h) fasting serum glucose levels in insulinoma patients showed significant hyperglycemia above 200 mg/dl in only few patients (20.8%) and chronic postoperative Diabetes mellitus developed in only one of 77 patients (<2%). Therefore, recovery of glucose metabolism after insulinoma resection is fast and medical intervention is not mandatory in most of these patients.

scholarly journals Investigation of the progress in the women with gestational diabetes mellitus postpartum

2021 ◽  
pp. 45-51
Author(s):  
Thi To Nhu Phan ◽  
Trung Vinh Hoang
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Glucose Tolerance ◽  
Beta Cell ◽  
Glucose Intolerance ◽  
Beta Cell Function ◽  
Cell Function ◽  
Postpartum Women ◽  
Matsuda Index ◽  
History Of

Aims: Our aim was to evaluate the uptake of postpartum screening, the prevalence and the risk factors for glucose intolerance in women with a recent history of gestational diabetes mellitus (GDM). Methods: All women with a history of GDM are advised to undergo a 75g oral glucose tolerance test (OGTT) around 6 - 12 weeks postpartum. Indices of insulin sensitivity (the Matsuda index and the reciprocal of the homeostasis model assessment of insulin resistance, HOMA-IR) and an index of beta-cell function, the Insulin Secretion-Sensitivity Index-2 (ISSI-2) were calculated based on the OGTT postpartum. Multivariable logistic regression was used to some factors. Results: Of all women (135) who received an OGTT postpartum, 42.2% (57) had glucose intolerance (11.8% impaired fasting glucose, 24.4% impaired glucose tolerance and 6.0% both impaired fasting and impaired glucose tolerance) and 1.5% (2) had overt diabetes. Compared to women with a normal OGTT postpartum, women with glucose intolerance and diabetes were older (32.5 ± 4.3 vs. 30.8 ± 4.8 years, p = 0.049), were more often obese (34.5% vs. 17.3%, p = 0.023). In the multivariable logistic regression, an EM background [OR = 2.76 (1.15 - 6.62), p = 0.023] and the HbA1c level at the time of the OGTT in pregnancy [OR = 4.78 (1.19 - 19.20), p = 0.028] remained significant predictors for glucose intolerance postpartum. Women with glucose intolerance and diabetes postpartum had a similar insulin sensitivity [Matsuda index 0.656 (0.386 - 1.224) vs. 0.778 (0.532 - 1.067), p = 0.709; HOMA-IR 0.004 (0.002 - 0.009) vs. 0.064 (0.003 - 0.007), p = 0.384] but a lower beta-cell function compared to women with a normal OGTT postpartum, remaining significant after adjustment for confounders [ISSI-2 1.6 (1.2 - 2.1) vs. 1.9 (1.7 - 2.4), p = 0.002]. Conclusions: Glucose intolerance is very frequent in early postpartum in women with GDM these women have an impaired beta-cell function. Nearly one third of women did not attend the scheduled OGTT postpartum and these women have an adverse risk profile. More efforts are needed to engage and stimulate women with GDM to attend the postpartum OGTT.

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