scholarly journals Use of the Bayer DCA 2000+ for the measurement of glycated haemoglobin in a remote Australian Aboriginal community

2003 ◽  
Vol 40 (5) ◽  
pp. 566-568 ◽  
Author(s):  
T Shemesh ◽  
LS Piers ◽  
K O'Dea
Keyword(s):  
Glycaemic Control ◽  
High Performance ◽  
Glycated Haemoglobin ◽  
Remote Communities ◽  
Community Based ◽  
Aboriginal Community ◽  
Good Glycaemic Control ◽  
Australian Aboriginal Community ◽  
Sensitivity Specificity

Background: Good glycaemic control in type 2 diabetes can reduce both morbidity and mortality, and monitoring of glycated haemoglobin A1c (HbA1c) is currently recommended for this purpose. Methods: Haemoglobin A1c can be measured using the portable Bayer DCA 2000+. As part of a community-based screening project for chronic diseases, subjects with impaired fasting glucose concentrations or diabetes had their HbA1c concentration measured on the analyser. HbA1c measurements were also made in a laboratory using cation-exchange high-performance liquid chromatography. Results were then compared to those obtained in the field. HbA1c values were loge transformed to obtain a normal distribution. Results: Mean (95% confidence interval) HbA1c measured on the DCA 2000+ ( n = 39) was 6.3% (5.8, 6.9%), while that measured in the laboratory was 6.5% (6.0, 7.0%). The correlation coefficient ( r) between the measurements was 0.96 ( P < 0.01). Bland-Altman analysis revealed that the DCA 2000+ estimate of HbA1c could be used interchangeably with that from the laboratory (mean bias = 0.1%, limits of agreement - 1.1, 0.8%). The sensitivity, specificity and positive predictive value of the DCA 2000+ estimate of HbA1c using a cut-off value of <7% for adequate glycaemic control, were all 100%. Conclusions: The DCA 2000+ may be used to measure HbA1c in remote communities.

Can non-invasive features including limited joint mobility be used to predict glucose control?

2020 ◽  
Vol 7 (1) ◽  
pp. 26-32
Author(s):  
Sterling Ramroach ◽  
Andrew Dhanoo ◽  
Brian Cockburn ◽  
Ajay Joshi
Keyword(s):  
Glycaemic Control ◽  
Glucose Control ◽  
Glycated Haemoglobin ◽  
Diabetes Research ◽  
Joint Mobility ◽  
Limited Joint Mobility ◽  
Non Invasive ◽  
Full Dataset ◽  
Machine Learning Model

IntroductionLimited joint mobility (LJM) has been linked to deficient glycaemic control but is an understudied area of type 2 diabetes research. We set out to investigate the correlation between glycated haemoglobin (HbA1c) and the quantification of LJM of finger joints and non-invasive anthropometrics.MethodsBlood samples were taken from 170 participants at diabetes awareness drives in Trinidad. These participants were aged 59.61 ± 15.46, with a body mass index (BMI) of 29.73 ± 7.65 and HbA1c levels of 8.42 ± 2.22. There were 110 women and 60 men. Finger joint angles were recorded using a goniometer.ResultsThe K-Nearest Neighbour machine learning model was tested via 10-fold cross validation to differentiate good from poor glycaemic control (HbA1c ≤ 6.5%) using non-invasive features. There is some correlation between LJM and HbA1c. Our model scored a mean accuracy of 74.71% ± 1.81 (p=0.01) classifying the full dataset, 82.14% ± 2.20 (p=0.01) and 72.76% ± 1.41 (p=0.059) on the male/female subsets, respectively.DiscussionThe time since diagnosis, age and BMI were important features linked to glucose control. Our results support the notion that the first signs of LJM in the fingers occur in the first and fifth fingers as these particular angles were ranked highly in the list of most important features.ConclusionOur results show that LJM has some role to play in monitoring HbA1c, although not as important as more conventional anthropometrics. Our results support the idea that there should be a separate test for each sex.

Maintenance of good glycaemic control is challenging – A cohort study of type 2 diabetes patient in North Karelia, Finland

2019 ◽  
Vol 73 (4) ◽  
pp. e13313 ◽  
Author(s):  
Nazma Akter Nazu ◽  
Jaana Lindström ◽  
Päivi Rautiainen ◽  
Hilkka Tirkkonen ◽  
Katja Wikström ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Glycaemic Control ◽  
Diabetes Patient ◽  
Good Glycaemic Control

The overtreatment of type 2 diabetes in frail older people

2020 ◽  
Vol 2 (9) ◽  
pp. 496-502
Author(s):  
Hannah Syed
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Older People ◽  
Diabetes Management ◽  
Holistic Approach ◽  
Protective Effects ◽  
Frail Older People ◽  
Good Glycaemic Control

Intensive treatment with insulin and sulfonylureas in older people with low HbA1c (<53mmol/mol) can increase the risk of hypoglycaemia, morbidity and mortality. Older people, particularly those with frailty and/or comorbidities are less likely to benefit from the long-term protective effects of good glycaemic control and are often at risk of inappropriate polypharmacy. A person-centred holistic approach to diabetes management must be adapted for older people living with diabetes.

scholarly journals Impact of pharmacist-led care on glycaemic control of patients with uncontrolled type 2 diabetes: a randomised controlled trial in Nigeria

2021 ◽  
Vol 19 (3) ◽  
pp. 2402
Author(s):  
Emmanuel A. David ◽  
Rebecca O. Soremekun ◽  
Isaac O. Abah ◽  
Roseline I. Aderemi-Williams
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Usual Care ◽  
Usual Care Group ◽  
Intervention Group ◽  
Glycated Haemoglobin ◽  
Care Group ◽  
Laboratory Parameters ◽  
Randomised Controlled

Background: Diabetes mellitus is a chronic, degenerative disease, requiring a multi-dimensional, multi-professional care by healthcare providers and substantial self-care by the patients, to achieve treatment goals. Objective: To evaluate the impact of pharmacist-led care on glycaemic control in patients with uncontrolled Type 2 Diabetes Methods: In a parallel group, single-blind randomised controlled study; type 2 diabetic patients, with greater than 7% glycated haemoglobin (A1C) were randomised into intervention and usual care groups and followed for six months. Glycated haemoglobin analyzer, lipid analyzer and blood pressure monitor/apparatus were used to measure patients’ laboratory parameters at baseline and six months. Intervention group patients received pharmacist-structured care, made up of patient education and phone calls, in addition to usual care. In an intention to treat analysis, Mann-Whitney U test was used to compare median change at six months in the primary (A1C) and secondary outcome measures. Effect size was computed and proportion of patients that reached target laboratory parameters were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each arm. Mean age was 51 (SD 11.75) and majority were females (68.5%). Participants in the intervention group had significant reduction in A1C of -0.75%, compared with an increase of 0.15% in the usual care group (p<0.001; eta-square= 0.144). The proportion of those that achieved target A1C of <7% at 6 months in the intervention and usual care group was 42.6% vs 20.8% (p=0.02). Furthermore, intervention patients were about 3 times more likely to have better glucose control; A1C<7% (aOR 2.72, 95%CI: 1.14-6.46) compared to usual care group, adjusted for sex, age, and duration of diabetes. Conclusions: Pharmacist-led care significantly improved glycaemic control in patients with uncontrolled T2DM.

scholarly journals Lixisenatide – A New Glucagon-like Peptide 1 Receptor Agonist in the Treatment of Type 2 Diabetes

2010 ◽  
Vol 9 (2) ◽  
pp. 76 ◽  
Author(s):  
Josep Vidal ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Basal Insulin ◽  
Glycated Haemoglobin ◽  
Insulin Analogues ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Long Acting

Optimal glycaemic control is essential to managing risks in patients with type 2 diabetes. However, glycaemic control remains poor among type 2 diabetes patients, particularly the control of post-prandial glucose (PPG). Almost half of patients treated with basal insulin and oral anti-diabetic drugs (OADs) do not achieve their glycated haemoglobin (HbA1c) goals, despite achieving fasting plasma glucose (FPG) control. Glycaemic control targets have emphasised FPG targets, but PPG contributes significantly to overall glycaemic control in type 2 diabetes. Glucagon-like peptide 1 (GLP-1) receptor agonists have shown substantial efficacy in improving overall glycaemic control but have differing effects on PPG, which is a result of their different mechanisms of action. Lixisenatide is unique among existing GLP-1 receptor agonists in that it is short acting but given as a once daily dose, and exerts its main effects during the prandial period. It has demonstrated efficacy in an extensive clinical trial programme. In particular, it has shown a beneficial effect on PPG compared with existing GLP-1 receptor agonists, probably a result of its effect on slowing gastric emptying. This has provided a strong rationale for its use as add-on therapy to long-acting basal insulin analogues, in cases where the latter is not providing adequate glycaemic control. The additive effects on glycaemic control may lead to a new treatment approach to manage blood glucose and prevent long-term complications in patients with type 2 diabetes.

scholarly journals Dependence of Retinopathy (and other Complications) on Glycaemic Control and on Weight over 5/10 Years from Diagnosis of Type II Diabetes

1996 ◽  
Vol 89 (1) ◽  
pp. 27-30 ◽  
Author(s):  
B J Boucher ◽  
J Tsoumanis ◽  
K Noonan ◽  
J Holmes
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Type Ii Diabetes ◽  
Type Ii ◽  
Peripheral Vascular ◽  
Initial Weight ◽  
Weight Fluctuation ◽  
Good Glycaemic Control ◽  
Glycosylated Haemoglobins

Glycosylated haemoglobins and weights were recorded for 200 consecutive diabetic clinic attendere seen yearly for 5 years, 76 of whom were also seen up to 10 years from diagnosis of type 2 diabetes, representing 1380 patient years. Weight fluctuation (≥3 kg) was associated with increased final prevalence of hypertension, macroalbuminaemia and a raised creatinine (P≤ 0.002) but this relationship was abolished by correction for higher initial weight. Average giycaemia over 5/10 years [itself related to initial weight in women on tablets (N=53) but not others, and to waist but not waist/hip ratio], correlated with prevalence and severity of retinopathy (N=200; r=0.38, P≤0.0006) seen also in the subgroup of patients on tablets (N=145, P≤0.006). At HbA1 levels ≥10.5% an increased prevelance of retinopathy was seen in those on insulin (W=37, P≤0.001) and an increased prevalence of peripheral vascular disease was seen in men but not women (x2=2.87, P≤0.01) as well as in the prevalence of neuropathy. These findings suggest that good glycaemic control is of value in type 2 diabetes and less easily achieved in obesity.

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