Glycosylated Haemoglobin as an Alternative to the Glucose Tolerance Test for the Diagnosis of Diabetes Mellitus

Author(s):  
Eva Lester ◽  
A D Frazer ◽  
Carole A Shepherd ◽  
F J Woodroffe

A comparison was made between the results of a standard 75 g oral glucose tolerance test and total haemoglobin A1 in 168 subjects referred by their general practitioners for the diagnosis of diabetes mellitus. The subjects were classified as having normal, impaired or diabetic glucose tolerance using WHO criteria. Of 108 subjects with normal glucose tolerance only three had haemoglobin A1 concentrations over 8%. Of 10 with impaired glucose tolerance two had haemoglobin A1 concentrations over 8%. Of 47 with diabetic responses, eight had haemoglobin A1 concentrations below 9%. There was a significant difference between the haemoglobin A1 concentration when fasting and that 2 hours after the glucose load in the subjects with a diabetic glucose tolerance response, but no significant difference between the two values in the other subjects.

Author(s):  
Oana Albai ◽  
Romulus Timar

The Relationship Between 1 Hour Glycemia, During Oral Glucose Tolerance Test and Cardiometabolic RiskBackground Diabetes mellitus is a very common disease, worldwide there are currently over 366 million diabetics. It seems that people with normal glucose tolerance and blood glucose at 1 hour during OGTT ≥200mg% represent an intermediate phenotype of abnormal glucose metabolism, another disturbance of carbohydrate metabolism that is associated with increased cardiometabolic risk. Objectives Starting from these premises, we decided to analyze the subjects with glucose at 1 hour during OGTT ≥200mg%, but with normal values for fasting glucose and 2 hours glucose. In this subgroup of subjects some parameters of CMR were analyzed. We also performed a comparison of this subgroup of subjects with both normal glucose tolerance and 1-hour glucose <200mg%, and with those with abnormal glucose tolerance. Results According to currently used recommendations to diagnose diabetes mellitus, from the 778 people included in this study, 167 (21.5%) had disturbances of carbohydrate metabolism, being classified as patoglycemic and 611 persons (78.5%) had normal values of fasting glucose and 2 hours glucose during OGTT, being considered normoglycemic. From the 611 people who were classified as normal glucose tolerance, based on the currently used criteria for diagnosis of diabetes mellitus, a total of 44 persons (7.2%) had, however, the value of 1-hour glucose during OGTT ≥200mg%, which represents 5.6% of the entire group studied. Conclusions Patients with normal glucose tolerance and glucose ≥200mg% at 1 hour during OGTT represent a new subgroup of impaired glucose tolerance, which requires strict lifestyle advice and possibly pharmacological measures to prevent or delay progression to abnormal glucose tolerance.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3848-3848
Author(s):  
Anupam Sachdeva ◽  
Satya Prakash Yadav ◽  
Subash C. Arya ◽  
Virender K. Khanna ◽  
Archana D. Arya

Abstract Abnormalities of the glucose metabolism are well documented in patients with Thalassemia Major who are frequently transfused and receiving therapy for chelation, due to excess iron deposition in the pancreas. The incidence of abnormalities in the glucose metabolism increase with age, with peak incidence between 16–20 years. The Indian (Asian) population is genetically predisposed to developing type 2 diabetes mellitus which is an additional risk factor for our Thalassemic population. Chelation is suboptimal in most of the patients due to economic reasons and ignorance. Impaired glucose tolerance (IGT) usually precedes the development of frank diabetes mellitus and intensive chelation in those with impaired glucose tolerance test may delay/prevent the onset of diabetes mellitus. Hence it is important to know the glyco-metabolic status of these children. At our Thalassemia endocrinology clinic, glucose tolerance test (GTT) is performed routinely in all subjects with Thalassemia major who have not already developed diabetes to identify the “at risk” population.GTT is performed by drawing a baseline fasting sample for blood glucose, oral glucose was given in a dose of 1.75mg/kg upto a maximum of 75 gms. Blood glucose level is measured 2 hours after oral glucose. According to the WHO criteria, Fasting plasma glucose between 110–126mg/dl is classified as impaired fasting and above 126mg/dl as diabetes. 2-hour plasma glucose value between 140–200mg/dl is classified as impaired glucose tolerance and above 200 mg/dl as diabetes. The purpose of this study was to analyze the status of the glucose metabolism of children and young adults with Thalassemia major who were attending our Thalassemia endocrinology clinic and to compare the factors affecting subjects with an abnormal glucose metabolism with those who have a normal glucose metabolism. The parameters compared were: effect of mean S. ferritin levels, age of onset of chelation and genetic predisposition. Retrospective analysis of our case records was done to determine the prevalence of diabetes and impaired glucose tolerance in children and young adults between 13 and 25 years of age. Of the 33 subjects evaluated, 16 out of 33 (48.5%) subjects had an abnormality of the glucose metabolism. 14/33 subjects (42.4%) had developed diabetes mellitus and 2 had an impaired GTT. Of the 16 affected subjects 9 were males and 7 were females (M:F = 1.28:1). The mean serum ferritin for this group was 5464ng/ml, 5503ng/ml for the diabetic group and 5425 for those with impaired GTT. (Range 2523–10904ng/ml). History of diabetes in a first or second degree relative was positive in 9 subjects(56.25%), negative in 2 and unknown in 5 subjects. Average age of onset of chelation was 8 years in this group. Oral glucose tolerance test was normal in 17/33(51.5%) subjects of which 10 were males and 7 were females (1.42:1). Average serum ferritin was 4747.4ng/ml in the group with a normal glucose tolerance. (1600–8294ng/ml). Family history of diabetes in a first or second degree relative was positive in 8 subjects(47%), negative in 4 and unknown in 5 subjects. Average age of onset of chelation was 6.5 years in the group with normal glucose metabolism. In conclusion of the 33 subjects evaluated, 48.5% had an abnormal glucose metabolism.


Author(s):  
Tahmineh Ezazi Bojnordi ◽  
Sedigheh Hantoushzadeh ◽  
Masomeh Sabzevary ◽  
Zahra Heidari

Background: Gestational diabetes mellitus (GDM) deserves proper prevention, diagnosis, and management due to healthcare implications from both maternal and fetal concerns. Objective: To evaluate the rate and investigate the risk factors for developing GDM. Materials and Methods: In this case-control, universal screening for GDM between 24 and 28 wk of gestation was performed in 613 pregnant women attending a prenatal clinic in Tehran who were followed-up until delivery between March 2017 to March 2018. Of the 613 women, 143 had GDM and 470 had normal glucose tolerance test as the primary diagnosis. Some GDM risk factors were compared in two groups. Results: Impaired glucose tolerance test was detected in 143 (23.3%) patients. Prevalence of GDM was higher in the first-trimester fasting blood sugar (FBS) > 90 qmg/dl group (p < 0.001). Comparison of the GDM and the normal glucose tolerance test groups demonstrated significant differences in maternal age, first-trimester FBS, third-trimester vitamin D level, maternal platelet count, maternal body mass index (BMI) (before 12 wk of gestation), weight gain during pregnancy, and the history of gestational complications in previous pregnancy (p < 0.01). In logistic regression, GDM was independently associated with older maternal age, higher first-trimester FBS, the history of gestational complications in previous pregnancy, lower third-trimester vitamin D level, and higher maternal platelet count (p < 0.01). Conclusion: Both patients with higher initial FBS and the history of gestational complications in previous pregnancy should be considered high risk for GDM and screened earlier. Key words: Diabetes Mellitus, Gestational, Blood glucose, Risk factor.


2017 ◽  
Vol 49 (06) ◽  
pp. 434-439 ◽  
Author(s):  
Sibel Ozyazgan ◽  
Burak Onal ◽  
Eda Kurtulus ◽  
Hafize Uzun ◽  
Gokhan Akkan ◽  
...  

AbstractThis study was aimed to investigate whether betatrophin shows glucose intolerance or not. To access the plasma betatrophin levels after basal and glucose load, groups were classified as normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetic glucose tolerance (DGT) according to WHO 2012 criteria. An oral glucose tolerance test was performed on age-matched subjects (n=220) with a body mass index (BMI)<27 kg/m2. Subjects were categorized as normoglycemic (n=55), IFG (n=50), IGT (n=60), and DM (n=55) according to the WHO criteria. Baseline betatrophin levels in DGT are significantly higher than in NGT (p<0.005), IFG (p<0.004), and IGT (p<0.001). Male subjects have significantly higher betatrophin levels than female subjects (p<0.01). In DGT, betatrophin of male subjects was found to be significantly higher than the betatrophin of male subjects in NGT (p<0.04), IFG (p<0.01), and IGT (p<0.01). Significant relationship between betatrophin and both ages and HbA1c in all groups were observed. When ages were accepted as an independent factor, significant correlation between betatrophin and ages were found. Betatrophin is increased and associated with age and HbA1c in DGT. Males had higher betatrophin levels compared with females in DGT group. As no obvious betatrophin deficiency to substitute in IFG and IGT individuals were observed, betatrophin levels appeared to be related to the pathogenesis of the diabetic stages rather than prediabetic stages.


Sign in / Sign up

Export Citation Format

Share Document