Results of a Study Comparing Glycated Albumin to Other Glycemic Indices

Abstract Context Intermediate-term glycemic control metrics fulfill a need for measures beyond hemoglobin A1C. Objective Compare glycated albumin (GA), a 14-day blood glucose measure, with other glycemic indices. Design 24-week prospective study of assay performance. Setting 8 US clinics. Participants Subjects with type 1 (n = 73) and type 2 diabetes (n = 77) undergoing changes to improve glycemic control (n = 98) or with stable diabetes therapy (n = 52). Interventions GA, fructosamine, and A1C measured at prespecified intervals. Mean blood glucose (MBG) calculated using weekly self-monitored blood glucose profiles. Main Outcome Measures Primary: Pearson correlation between GA and fructosamine. Secondary: magnitude (Spearman correlation) and direction (Kendall correlation) of change of glycemic indices in the first 3 months after a change in diabetes management. Results GA was more concordant (60.8%) with changes in MBG than fructosamine (55.5%) or A1C (45.5%). Across all subjects and visits, the GA Pearson correlation with fructosamine was 0.920. Pearson correlations with A1C were 0.655 for GA and 0.515 for fructosamine (P < .001) and with MBG were 0.590 and 0.454, respectively (P < .001). At the individual subject level, Pearson correlations with both A1C and MBG were higher for GA than for fructosamine in 56% of subjects; only 4% of subjects had higher fructosamine correlations with A1C and MBG. GA had a higher Pearson correlation with A1C and MBG in 82% and 70% of subjects, respectively. Conclusions Compared with fructosamine, GA correlates significantly better with both short-term MBG and long-term A1C and may be more useful than fructosamine in clinical situations requiring monitoring of intermediate-term glycemic control (NCT02489773).

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Modern technologies in diabetes management - continuous glucose monitoring and insulin pump therapy

Public health of the Far East Peer-reviewed scientific and practical journal ◽

10.33454/1728-1261-2021-1-50-55 ◽

2021 ◽

Vol 87 (1) ◽

pp. 50-55

Author(s):

E.Yu. Pyankova ◽

◽

L.A. Anshakova ◽

I.A. Pyankov ◽

S.V. Yegorova ◽

...

Keyword(s):

Blood Glucose ◽

Diabetes Management ◽

Insulin Pump ◽

Glucose Monitoring ◽

Insulin Pump Therapy ◽

Pump Therapy ◽

Glucose Levels ◽

Blood Glucose Levels ◽

The Individual ◽

Glucose Lowering Therapy

The problems of complications of diabetes mellitus cannot be solved without constant monitoring of blood glucose levels. The evolution of additional technologies for the determination of glucose in the blood of the last decades makes it possible to more accurately predict the risks of complications, both in the individual and in the patient population as a whole. The article provides an overview of the methods used in modern diabetology, facilitating control over the variability of blood glucose levels and helping in a more accurate selection of glucose-lowering therapy. All presented methods are currently working in real clinical practice in the Khabarovsk Krai

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IMPACT OF NUTRITION EDUCATION AND DIET THERAPY ON GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES

10.36106/ijar/5215908 ◽

2020 ◽

pp. 1-2

Author(s):

B. Premagowri

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Nutrition Education ◽

Diabetes Management ◽

Fasting Blood Glucose ◽

Diet Therapy ◽

Information Communication ◽

Type 2 Diabetics ◽

Post Test

Lifestyle modications including alteration of diet and physical activity are the rst lines of management during diabetes. The objective of the study was to evaluate the effects of nutrition education on glycemic control in type 2 diabetics. Around 410 newly detected type 2 diabetics were selected and socio-economic, anthropometric, dietary survey and biochemical data were collected by using the standard interview schedule. Programmed nutrition education using Information Communication Technology (ICT) were conducted to all the selected subjects. Using questionnaire, pre and post test was conducted to nd the knowledge improvement on diabetes management. The mean scores 9.90±1.60 obtained in pre-test were increased to 17.85 ±1.15 after nutrition education. For the selected subjects without hypoglycemic drugs, fasting blood glucose reduced by 27.92mg/dl (t= 8.612), post prandial blood glucose reduced by 53.94mg/dl (t= 14.442) and HbA1c reduced by 0.55% (t= 13.987). Thus, imparting nutrition education through ICT tools was found to be effective in improving the level of nutrition knowledge.

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Impact of Community Pharmacy Diabetes Care Program on Knowledge and Glycemic Control: An Unexplored Opportunity for Community Pharmacists in Pakistan

International Journal of Diabetes & Metabolic Disorders ◽

10.33140/ijdmd.05.05.02 ◽

2020 ◽

Vol 5 (5) ◽

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Glycemic Control ◽

Diabetes Management ◽

Patient Adherence ◽

Intervention Group ◽

Community Pharmacists ◽

Sampling Technique ◽

Community Pharmacies ◽

Post Intervention

Background: Effective management of diabetes mellitus depends on efficacy of therapy as well as patient adherence to medication therapy and non-pharmacological approaches. One of the most important tools to improve patient adherence is counseling. Community pharmacists can effectively contribute to patient care as they have the expertise and accessibility to do the task appropriately. Objective: The objective of the study was to evaluate the impact of pharmacist counseling on glucose control and medication adherence of diabetic patients attending community pharmacies in Pakistan. Method: A randomized, controlled, single blinded, pre-post intervention study design was used. The respondents included patients diagnosed with both diabetes mellitus (Type I or II) visiting community pharmacies for purchasing their regular medicine. Simple random sampling technique by lottery method was used to select community pharmacies to be included in-group A (intervention n=4) and group B (control n=4). The total number of patients were 40 in each group while estimating a drop-out rate of 25%. Convenience sampling technique was used to select patients visiting community pharmacies. Patients in the intervention group received special counseling. Blood glucose was checked after every 15 days for a period of six months. Pre-validated tools such as diabetes knowledge questionnaire 24 and brief medication questionnaire were used. Data was cleaned, coded and analyzed in SPSS 21. Wilcoxon test (p≥0.05) was used to compare pre-post intervention knowledge regarding diabetes and. Mann-Whitney test (p≥0.05) was used to find differences among medication adherence among control and intervention groups as well as pre and post intervention. Results: The results of the present study showed that respondents having diabetes since the past 1-3 years had comparatively better knowledge scores (18.8, 3±2.04) after intervention. Mean knowledge scores regarding diabetes mellitus among intervention group at baseline was (16.02, ±2.93) which was improved after six months (19.97, ±2.66). Significant difference was observed (p≤0.05) in pre-post intervention knowledge regarding diabetes management. Knowledge of patients was improved regarding different aspects of diabetes management after counseling by community pharmacists. The fasting blood glucose improved at three months (9.32, ±1.92) and after six months (8.95, ±1.45) in intervention group. Conclusion: The results of the current study concluded that counseling by community pharmacist has a positive impact on blood glucose management among diabetic and patients. Educational programs should be initiated by community pharmacists as this can lead to improvement in glycemic control and enhance the image of pharmacist as a key health care member in management of chronic diseases.

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Glycemic impact of intensified self monitoring of blood glucose in insulin treated subjects with type 2 diabetes mellitus

Journal of Social Health and Diabetes ◽

10.1055/s-0038-1676194 ◽

2018 ◽

Vol 06 (01) ◽

pp. 027-033

Author(s):

Ejiofor Ugwu ◽

Ibrahim Gezawa ◽

Olufunmilayo Adeleye

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Glucose ◽

Glycemic Control ◽

Hba1c Level ◽

Insulin Dosage ◽

Self Monitoring ◽

Glycemic Indices

Objective:The aim of this study was to evaluate if intensified self-monitoring of blood glucose (SMBG) improves glycemic control in insulin-treated subjects with type 2 diabetes mellitus (T2DM). Methods:Ninety-six adults with stable but poorly controlled [glycated hemoglobin (HbA1c) level >7.5%] T2DM receiving twice-daily biphasic insulin were randomly assigned to either of the two groups: intensive monitors (IM) that performed SMBG at least twice daily or conventional monitors (CM) that performed SMBG at their discretionary frequency for 12 weeks. Demographic, clinical, and glycemic indices, including fasting blood glucose (FBG), postprandial glucose (PPG), and HbA1c, were compared at baseline and week 12. Results:A total of 71 subjects (25 IM and 46 CM) completed the study. Both groups had similar HbA1c at baseline. From baseline to week 12, the IM group had higher mean daily test strip usage (P <0.001), engaged in more frequent insulin dose adjustments (P <0.001), and attained greater daily insulin dosage (P = 0.002). All glycemic indices including FBG, PPG, and HbA1c improved significantly from baseline to week 12 in the IM but not in the CM group. HbA1c level declined by −1.2 ±0.4% in the IM group (P = 0.002). There was no difference in the frequency of hypoglycemia in both groups. The monthly cost of intensified SMBG was nearly four times that of conventional monitoring (P <0.001). Conclusion:Both short- and long-term glycemic control significantly improved by intensified SMBG in stable but poorly controlled insulin-treated adults with T2DM. Intensified SMBG enabled better self-titration of insulin and probably other self-care practices. This benefit, however, occurred at the expense of costs that may be difficult to sustain in resource-poor countries.

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Glycemic Monitoring in Diabetics with Sickle Cell Plus β-Thalassemia Hemoglobinopathy

Annals of Pharmacotherapy ◽

10.1345/aph.1g010 ◽

2005 ◽

Vol 39 (9) ◽

pp. 1557-1560 ◽

Cited By ~ 27

Author(s):

Sheri M Kosecki ◽

Philip T Rodgers ◽

Martha B Adams

Keyword(s):

Type 2 Diabetes ◽

Blood Glucose ◽

Sickle Cell Disease ◽

Glycemic Control ◽

Sickle Cell ◽

Diabetes Management ◽

Glycosylated Hemoglobin ◽

Fasting Blood Glucose ◽

Cell Disease

OBJECTIVE: To report a case of diabetes management in a patient with a hemoglobinopathy that caused her clinician to seek a different measure of glycemic control, fructosamine, rather than glycosylated hemoglobin (HbA1c). CASE SUMMARY: A 53-year-old African American woman presented with a past medical history of type 2 diabetes, hypertension, seizure disorder, rheumatoid arthritis, and sickle cell disease plus β-thalassemia. She reported fasting blood glucose values ranging broadly from 50 to 320 mg/dL, yet her HbA1c result remained steady in a low range of >6%. A measure of fructosamine returned elevated at 340 μmol/L (reference range 200–300%). DISCUSSION: We believe that this patient's hemoglobinopathy resulted in falsely low levels of HbA1c, and we substantiate this interpretation with the patient's self-monitored blood glucose values from home that appeared higher and inconsistent with the HbA1c results. Although few reports on using the measure of fructosamine appear in the literature, this patient's high fructosamine result supports fructosamine as the more appropriate measure of glycemic control. CONCLUSIONS: Serum fructosamine levels may be considered as an appropriate laboratory measurement when monitoring long-term glycemic control in patients with type 2 diabetes mellitus and sickle cell disease.

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Brief communication (Original). Correlation of glycated albumin with self blood glucose monitoring in diabetic patients on hemodialysis taking erythropoietin

Asian Biomedicine ◽

10.5372/1905-7415.0803.304 ◽

2014 ◽

Vol 8 (3) ◽

pp. 387-392

Author(s):

Khalidah M. Bador ◽

Sharifah K.A. Kamaruddin ◽

Norita T. Yazid

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Glycated Albumin ◽

Glucose Monitoring ◽

Blood Glucose Monitoring ◽

Bromocresol Green ◽

Diabetic Patients ◽

Cross Sectional ◽

Albumin Ratio ◽

Significant Difference

AbstractBackground: Serum glycated albumin (GA) is a marker of glycemic control in diabetic renal patients, but studies were limited by the use of few random glucose values to define glycemic control.Objectives: To determine whether GA correlated with self blood glucose monitoring is better than HbA1c in hemodialyzed diabetic patients taking erythropoietin.Methods: This was a cross-sectional study of diabetic patients on hemodialysis with and without erythropoietin. GA was measured by ELISA and HbA1c by ion-exchange HPLC. GA was reported as the GA/albumin ratio where albumin was measured using bromocresol green. The average capillary blood glucose level over the preceding three months (CBG) was calculated from self-reported daily prebreakfast, prelunch, and prebed glucose meter readings.Results: Thirty-four patients were recruited; 18 were taking erythropoietin (6000 units per week) and 16 had never received erythropoietin. HbA1c correlated poorly with CBG in patients taking erythropoietin (r = -0.014, P = 0.96) compared with patients without erythropoietin (r = 0.579, P = 0.02). The correlation of GA/albumin ratio with CBG in the erythropoietin group (r = 0.612, P = 0.007) was similar to the nonerythropoietin group (r = 0.854, P < 0.001). The slope for HbA1c versus CBG was 2.8-fold greater in patients without erythropoietin compared with those taking erythropoietin. There was no significant difference in the slopes for GA/albumin ratio versus CBG between the two patient groups (P > 0.05).Conclusion: In diabetic patients on hemodialysis and taking low doses of erythropoietin, GA/albumin is a better marker of glycemic control than HbA1c.

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Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.4.4112 ◽

2021 ◽

Vol 37 (4) ◽

Author(s):

Hyder Osman Mirghani

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Glycemic Control ◽

Plasma Glucose ◽

Meta Analysis ◽

Postprandial Plasma Glucose ◽

Creative Commons ◽

Patients With Diabetes ◽

Glycemic Indices ◽

Open Access Article

Background & Objective: Dates fruit is known for its great nutritional value and two to three servings of dates fruit/day are beneficial for patients with diabetes. However, some may advice against this cheap and widely available fruit consumption. Besides, 12% of the population Worldwide are either suffering or are at risk of developing diabetes, but no previous meta-analysis has assessed this important issue. Thus, the study aimed to investigate the effects of date’s fruit on glycemia among patients with diabetes. Methods: A systematic literature search was conducted in PubMed, Medline, EBSCO, Cochrane, and Google Scholar databases for trials published in English from the first published article up to December 2020. The following keywords were used: “dates fruit and glycemic control”, “dates fruit and blood glucose”, “dates fruit and HbA1c” without limitations regarding the date of publication. Results: Out of the 942 references identified, only 10 cohorts from five full texts were included, a reduction of Fasting plasma glucose (FPG), odd ratio, -24.79, 95% CI=-34.75, -14.83 P =0.002. I2 for heterogeneity=79%, P <0.00001 and postprandial plasma glucose (PPPG), odd ratio -28.19, 95% CI=-60.66-4.29, P =<0.0001. I2 for heterogeneity=92%, P=0.09) was observed. While the effect on HbA1c was neutral, odd ratio, -.20, 95% CI=-.46 -.06, P=0.13. I2 for heterogeneity=0. %, P=0.55. Conclusion: Dates fruit was beneficial regarding glycemic control among patients with diabetes, physician may not need to restrict its use among patients with diabetes. The small number of the included studies and the heterogeneity observed in PPPG and FPG sub-analysis limited the current results. Further trials assessing the glycemic indices of various types of dates fruit are needed. doi: https://doi.org/10.12669/pjms.37.4.4112 How to cite this:Mirghani HO. Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.4112 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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DIABETES MANAGEMENT AND CURRENT PROSPECTS FOR SELF-MONITORING OF BLOOD GLUCOSE

Medical Council ◽

10.21518/2079-701x-2017-3-17-21 ◽

2017 ◽

pp. 17-21

Author(s):

E. V. Goncharova ◽

N. A. Petunina

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Glycemic Control ◽

Diabetes Management ◽

Diabetes Treatment ◽

Self Monitoring ◽

Essential Component ◽

Attending Physician

Diabetes mellitus implies the need for self-monitoring under the supervision of the attending physician. In the conditions of increasing prevalence of diabetes, the physician’s key task is to properly educate the patient in applying the main principles of self-monitoring. Learning the principles of glycemic control with a portable glucometer is an essential component of diabetes treatment.

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Potential Markers of Dietary Glycemic Exposures for Sustained Dietary Interventions in Populations without Diabetes

Advances in Nutrition ◽

10.1093/advances/nmaa058 ◽

2020 ◽

Vol 11 (5) ◽

pp. 1221-1236 ◽

Cited By ~ 3

Author(s):

Edith Feskens ◽

Lorraine Brennan ◽

Pierre Dussort ◽

Matthieu Flourakis ◽

Lena M E Lindner ◽

...

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Dietary Intervention ◽

Glycated Albumin ◽

Dietary Interventions ◽

Patients With Diabetes ◽

Potential Applicability ◽

Intervention Trials ◽

Blood Glucose Concentrations ◽

Range Of Variation

ABSTRACT There is considerable interest in dietary and other approaches to maintaining blood glucose concentrations within the normal range and minimizing exposure to postprandial hyperglycemic excursions. The accepted marker to evaluate the sustained maintenance of normal blood glucose concentrations is glycated hemoglobin A1c (HbA1c). However, although this is used in clinical practice to monitor glycemic control in patients with diabetes, it has a number of drawbacks as a marker of efficacy of dietary interventions that might beneficially affect glycemic control in people without diabetes. Other markers that reflect shorter-term glycemic exposures have been studied and proposed, but consensus on the use and relevance of these markers is lacking. We have carried out a systematic search for studies that have tested the responsiveness of 6 possible alternatives to HbA1c as markers of sustained variation in glycemic exposures and thus their potential applicability for use in dietary intervention trials in subjects without diabetes: 1,5-anhydroglucitol (1,5-AG), dicarbonyl stress, fructosamine, glycated albumin (GA), advanced glycated end products (AGEs), and metabolomic profiles. The results suggest that GA may be the most promising for this purpose, but values may be confounded by effects of fat mass. 1,5-AG and fructosamine are probably not sensitive enough to the range of variation in glycemic exposures observed in healthy individuals. Use of measures based on dicarbonyls, AGEs, or metabolomic profiles would require further research into possible specific molecular species of interest. At present, none of the markers considered here is sufficiently validated and sensitive for routine use in substantiating the effects of sustained variation in dietary glycemic exposures in people without diabetes.

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Assessing quality of glycemic control: Hypo- and hyperglycemia, and glycemic variability using mobile self-monitoring of blood glucose system

Health Informatics Journal ◽

10.1177/1460458218824756 ◽

2019 ◽

Vol 26 (1) ◽

pp. 287-297 ◽

Cited By ~ 1

Author(s):

Sophie Huey-Ming Guo

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Health Care Providers ◽

Mobile Applications ◽

Diabetes Management ◽

Glycemic Variability ◽

Care Providers ◽

Self Monitoring ◽

Patients With Diabetes ◽

Glucose System

Although mobile applications bring potential benefits of metabolic control for patients with diabetes, their effect on glycemic fluctuation has been less widely explored. The goal of this study was to utilize data from the Mobile Self-Monitoring of Blood Glucose System to obtain a picture of the metabolic progression. Twenty-seven adults with type 2 diabetes mellitus were recruited to receive a mobile diabetes self-care system for a six-week period. The approach to the interpretation of glycemic control patterns, utilizes the following methods: 1) Graphical displays of the percentage of hyper-and-hypoglycemia episodes; 2) Pattern recognition of glycemic variability based on a simple equation involving both the standard deviation and the mean. Analytical results reveal that short-term usage of the developed system stabilizes the week-by-week glycemic fluctuations. Four categories were established to distinguish different patterns of patients’ glycemic variation. If patterns of glycemic control can be recognized or interpreted by newly designed mobile applications, then the collection and analysis of metabolic variation will greatly help both health care providers and patients in effective diabetes management.

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