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

1997 ◽  
Vol 17 (3) ◽  
pp. 262-268 ◽  
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.

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

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 179-183 ◽  
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.

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

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kurai Z. Chako ◽  
Heather Phillipo ◽  
Erisi Mafuratidze ◽  
Danai Tavonga Zhou
Keyword(s):  
Public Health ◽  
Glycemic Control ◽  
Public Health Facility ◽  
Poor Glycemic Control ◽  
Type I ◽  
Type Ii ◽  
Cross Sectional ◽  
Significant Difference ◽  
Type Ii Diabetics ◽  
Hba1c Levels

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).

Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

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.

Hypoglycemia in Elderly Diabetic Patients with Good Glycemic Control attending Cardiology Out Patient Department of a Superspeciality Hospital

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Deepika Mittal ◽  
Purushottam Mittal
Keyword(s):  
Glycemic Control ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Diabetic Patients ◽  
Precipitating Factors ◽  
Good Glycemic Control ◽  
Glucose Levels ◽  
Fasting Plasma ◽  
Significant Difference ◽  
Hba1c Levels

Objective-Clinical trials and observational studies have provided good evidence that early glycemic control leads to a reduction in complications and improved survival in diabetics. However, elevated risk of mortality has been reported at both the lower and upper ends of long-term glucose levels. Fear of hypoglycemia has been a significant factor in suboptimal glycemic control. In this retrospective analysis we aimed to identify the incidence of hypoglycemia and their precipitating factors in elderly diabetics on good glycemic control. Material and methods- Ninety seven elderly diabetic patients attending the cardiology Out-Patients Department of a super speciality private sector hospital from 1 December 2017 to 30 November 2018 were studied retrospectively. Their demographic profile, co-morbidities and pharmacological profile were recorded. Incidence of hypoglycemic episodes and their precipitating factor were then analyzed. Result-Mean age was 71.7± 6.3 years, and 64 (66%) were male. Mean duration of diabetes was 7.3± 1.3 years. All patients had type II diabetes mellitus. Mean fasting and random capillary blood glucose levels were 116.5 ±8.7 mg/dl and 169.5±13.5mg/dl, respectively. Mean HbA1c levels of the study population was 6.8±1.14. Over the study period, 23 (23.7%) patients experienced 39 episodes of any level of hypoglycemia. HbA1c Levels in the hypoglycemia group were not significantly different from those in no-hyperglycemia group (6.85±1.13 vs. 6.63±1.04). Mean random plasma glucose values were slightly higher in no-hypoglycemia group (170.9±14.5 vs 164.9±14.9), but the difference did not reach the statistical significance. There was a markedly significant difference in mean fasting plasma glucose values between hypoglycemia and no-hypoglycemia group (101.8±8.9 vs 116.5±12.7). Sulphonylurea and insulin use was more frequent in patients experiencing hypoglycemia (9.6% and 52.2% respectively) as compared with no-hypoglycemia group (33.8% and 39.1% respectively). The most common preceding event was either skipping a meal in 12(30.8%) patients or an unplanned change in diet in 23% patients. Conclusion- Patients with longstanding diabetes and loss of warning symptoms have increased risk of severe hypoglycaemic episodes. Risk of the hypoglycemic episode is better correlated with fasting plasma glucose levels and glycemic variability rather than with HbA1c Level. Sulphonylurea drug use was the only group associated with a statistically significant risk of hypoglycemia. Skipping of a meal or a sudden change in the diet and alteration in antidiabetic drug regimen are the most important precipitating factors for hypoglycemia.

Impact of glycemic control on treatment efficacy and safety during nabpaclitaxel plus gemcitabine therapy in unresectable pancreatic cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 337-337
Author(s):  
Junko Tauchi ◽  
Akira Shinohara ◽  
Ken Ohashi ◽  
Taro Shibuki ◽  
Gen Kimura ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Glycemic Control ◽  
Dose Intensity ◽  
Progression Free Survival ◽  
Poor Glycemic Control ◽  
Cancer Center ◽  
Control Group ◽  
Unresectable Pancreatic Cancer ◽  
Good Glycemic Control ◽  
Significant Difference

337 Background: Diabetes mellitus (DM) and hyperglycemia have been widely considered to be associated with the risk of pancreatic cancer. However, the aim of this study was to evaluate the relationship between glycemic control and the efficacy or safety in pancreatic cancer pts receiving treatment with nab-Paclitaxel (nab-PTX) plus Gemcitabine (GEM). Methods: We retrospectively reviewed 285 pts with unresectable pancreatic cancer with nab-PTX plus GEM as the first-line chemotherapy from December 2014 to March 2017 at the National Cancer Center Hospital East, Kashiwa, Japan. The pts were divided into two groups, average blood glucose level during the period of chemotherapy was less than 160 mg/dL (Group GC: Good glycemic control group) and more than 160 mg/dL (Group PC: Poor glycemic control group). Results: A total of 285 pts were enrolled. Median age was 66 years (range: 26-84) and males/females: 180/105, PS (0-1/2-3): 272/13, stage (III/IV): 77/208. There were 226 pts in GC group and 59 pts in PC group. No significant differences were seen in the overall survival between Group GC and PC (median: 16.1 months vs. 13.8 months, p = 0.344) and in the progression free survival between the two groups (median: 7.5 months vs. 8.2 months, p = 0.862). The incidence rate of grade 2-3 chemotherapy-induced peripheral neuropathy (CIPN) was significantly higher in Group PC compared with Group GC (Group GC 28.3%, Group PC 45.8%, p = 0.010). Univariate and multivariate analyses identified glycemic control as significant independent factors associated with the incidence of grade 2-3 of CIPN (Odds ratio 2.182, 95% CI 1.20-3.96, p = 0.010). There was no significant difference in the relative dose intensity of nab-PTX between two groups (median, 56.6% in group GC, 56.5% in group PC, p = 0.952). Conclusions: Glycemic control during the chemotherapy with nab-PTX plus GEM in unresectable pancreatic cancer was not associated with OS. The incidence of severe CIPN was higher in pts with poor glycemic control compared with good glycemic control.

scholarly journals IMPACT OF PHYSICIAN LED LIFE STYLE MODIFICATIONS (DIET AND DAILY STEP COUNT BY USING PEDOMETER) ON GLYCEMIC CONTROL OF PATIENTS WITH TYPE II DIABETIC

2021 ◽  
Vol 71 (2) ◽  
pp. 478-81
Author(s):  
Rimsha Azhar ◽  
Khurshid Uttra ◽  
Andaleeb Khan ◽  
Marriam Hussain Awan ◽  
Ayesha Anwer ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Life Style ◽  
Step Count ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type Ii ◽  
Daily Step ◽  
Significant Difference ◽  
Daily Step Count ◽  
The Impact

Objective: To determine the impact of physician led life style modifications (diet and daily step count by using pedometer) on glycemic control of type II diabetic patients Study Design: Quasi experimental study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi, Aug 2018 to Feb 2019. Methodology: The sample population comprised of 200 diabetic patients reporting for the routine follow-up at a tertiary care hospital in Rawalpindi. Patients were divided into two groups by random method. Group A had the patients with continuation of the routine anti-diabetic medication while group received the physician led life style modifications in addition to the routine anti diabetic medication. Values of HBA1c among the groups were compared three months after the start of study. Results: Mean age of the patients was 42.19 ± 6.175 years. Mean duration of DM in the study participants was 4.52 ± 4.166 years. Out of 115 patients were male while 85 were female. HBA1c in the intervention group was 7.96% ± 0.39 while in the control group was 7.04% ± 0.81. Difference between the two groups was statistically significant (p-value<0.01). Conclusion: This study showed a significant difference in glycemic control of patients who received physician led life style modification in addition to conventional biological treatment than those who only received the routine anti-diabetic medication. Physicians should be trained to impart this sort of education to the diabetic patients in routine diabetic clinics.

ASSOCIATION OF SERUM FERRITIN WITH GLYCEMIC CONTROLAMONG TYPE 2 DIABETIC PATIENTS

2021 ◽  
pp. 34-36
Author(s):  
Mallam Srikanth Goud ◽  
Sohil Sharda ◽  
Gangurde Bhushan Daulatrao
Keyword(s):  
Glycemic Control ◽  
Serum Ferritin ◽  
Blood Donation ◽  
Tertiary Care ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Strong Positive Correlation ◽  
Good Glycemic Control ◽  
Positive Correlation ◽  
Iron Stores

Introduction: Serum ferritin is a marker for iron stores and is an acute phase reactant. Its role in pathogenesis of Diabetes is suggested by improvement in insulin sensitivity and insulin secretion with frequent blood donation and decreased iron stores. Objective of the present study is to determine correlation of serum ferritin with glycemic control. Material and Methods: This analytical cross sectional study was conducted at a tertiary care centre of southern India, including 50 diabetic patients with good glycemic control and 50 patients with poor glycemic control. Results: Mean serum ferritin level of diabetics was signicantly lower in diabetics with good glycemic control (119.07±58.99 ng/ml) as compared to those with poor glycemic control (331.11±140.69 ng/ml). Serum ferritin showed strong positive correlation (p <0.001)with the duration of diabetes (r = 0.651) and HbA1C (r = 0.828). Conclusion: Serum ferritin levels were higher in diabetic individuals with poor glycemic control and serum ferrition showed strong positive correlation with glycemic control (HbA1C). Serum ferritin may be used as marker for screening poor glycemic control and patients at high risk of developing complications.

scholarly journals Level of Glycemic Control and Its Associated Factors among Type II Diabetic Patients in Debre Tabor General Hospital, Northwest Ethiopia

2020 ◽  
Keyword(s):  
Family History ◽  
Glycemic Control ◽  
Associated Factors ◽  
Educational Status ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Dietary Adherence ◽  
Type Ii ◽  
Debre Tabor ◽  
History Of

Introduction: Poor glycemic control is the major risk factor for the development of acute and chronic diabetes complications. There are limited studies on the level of glycemic control among diabetes and its associated factors. So, the aim of this study was to assess the level of glycemic control and its associated factors among type II DM patients in Debre Tabor General Hospital.Methods: An institution based cross-sectional study was conducted from November 1-30, 2017on 413 diabetic patients who were selected by systematic random sampling. The three months average fasting blood glucose was used to determine glycemic control. Regressions were fitted to identify associated factors. P-value <0.05 was used to declare statistical significance. Results: A total of 398 study participants were participated in the study with a response rate of 96.4%. Among 398 type II DM patients, 284 (71.4%) had poor glycemic control. patient’s educational status (AOR= 3.0, 95%CI (1.5, 5.7), (AOR= 4.5, 95%CI (1.8, 10.9), and (AOR= 5.7, 95% CI (2.9, 11.2)))), family history of DM (AOR= 2.3, 95%CI (1.4, 3.9)), Duration of DM since diagnosis (AOR= 0.3, 95% CI (0.1, 0.9)), and Dietary adherence(AOR= 2.4, 95% CI (1.4, 4.1)) were associated factors of glycemic control.Conclusion: Poor glycemic control was high. Educational status, family history of DM, duration of DM, and dietary adherence were independent predictors of glycemic control. Appropriate attention should be given for glycemic control especially for patients with a longer duration. Health promotion should be cross-cutting intervention for DM patients about medical recommendations.

scholarly journals Individual Lipids and Lipid Ratios in Type-2 Diabetic Patients: Association with Glycemic Control Status

2017 ◽  
Vol 03 ◽  
pp. 42
Author(s):  
Ni Putu Tesi Maratni ◽  
Dwijo Anargha Sindhughosa ◽  
I Gusti Ayu Mardewi ◽  
Ida Bagus Amertha Putra Manuaba ◽  
Made Ratna Saraswati ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Poor Glycemic Control ◽  
Control Group ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Good Glycemic Control ◽  
Lipid Ratios

The amount of glycosylated hemoglobin (HbA1c) reflects the long-term glycemic control of patients with diabetes. HbA1c also predicts the risk for the development of diabetic complications such as cardiovascular disease (CVD). Patients with type-2 diabetes and the characteristic of dyslipidemia are frequently found. Also, dyslipidemia plays as an independent risk factor for CVD. This study was aimed to evaluate the relationship between glycemic control status with serum individual lipid profiles and lipid ratios in patients with type-2 diabetes. This cross-sectional study consisted of 80 patients. Depending on the HbA1c level, the patients were divided into two groups, good glycemic control group (HbA1c < 7.0%, n = 15) and poor glycemic control group (HbA1c ≥ 7.0%, n = 65). The association of HbA1c with individual lipids (TC, TG, HDL-C, LDL-C, Non- HDL-C) and lipid ratios (TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, monocyte/HDL-C) were analyzed. The value of individual lipids and lipid ratios did not correlate with HbA1c level (p-value ≥ 0.05). Parameters of individual lipids and lipid ratios were not independently associated with poor glycemic control, which was analyzed by logistic regression. ROC analysis found both LDL-C and LDL-C/HDL-C were not accurate to be used as a prognostic indicator of poor glycemic control in patients with type-2 diabetes (p = 0.155, p = 0.297, respectively). The present study found that there was no association between individual lipids and lipid ratios with glycemic control status.

scholarly journals A cross-sectional study on the telemedicine usage and glycemic status of diabetic patients during the COVID-19 pandemic

2021 ◽  
Vol 30 (3) ◽  
pp. 215-20
Author(s):  
Novi Sulistia Wati ◽  
Pokkate Wongsasuluk ◽  
Pradana Soewondo
Keyword(s):  
Glycemic Control ◽  
Healthy Lifestyle ◽  
Blood Glucose Control ◽  
Cross Sectional Study ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Glycemic Status ◽  
Good Glycemic Control ◽  
Cross Sectional

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic disrupts selfmanagement in diabetic patients in Indonesia. This study aimed to determine the telemedicine usage and factors contributing to glycemic control in type 2 diabetes mellitus (T2DM) patients during the pandemic. METHODS A cross-sectional study was conducted in T2DM patients aged 25–54 years. The questionnaire included general characteristics, diabetes conditions, consultation factors, and self-care management. Glycemic status was evaluated using glycated hemoglobin (HbA1c) levels, which was categorized into poor (HbA1c≥7%) and good glycemic control (HbA1c<7%). Data were analyzed using chi-square and binary logistic regression. RESULTS Of 264 patients, only 19.2% used telemedicine and 60.2% had poor glycemic control during the pandemic. Overweight or obesity (odds ratio [OR] = 5.740 [95% confidence interval [CI] = 2.554–12.899]; p<0.001), insulin injection (OR = 3.083 [95% CI = 1.238–7.677]; p = 0.016), and frequent fried food consumption (OR = 5.204 [95% CI = 1.631–16.606]; p = 0.005) were the factors contributing to poor glycemic control. The risk is lower if exercised regularly (OR = 0.036 [95% CI = 0.007–0.195]; p<0.001) and consulted with a doctor using telemedicine (OR = 0.193 [95% CI = 0.044–0.846]; p = 0.029) or in-person visits (OR = 0.065 [95% CI = 0.016–0.260]; p<0.001). CONCLUSIONS Glycemic control was not optimal during the COVID-19 pandemic. Therefore, keeping a healthy lifestyle and staying connected with a doctor are important to ensure optimal blood glucose control and reduce the risk of diabetesrelated complications.

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