scholarly journals The National Glycohemoglobin Standardization Program: Over 20 Years of Improving Hemoglobin A1c Measurement

2019 ◽  
Vol 65 (7) ◽  
pp. 839-848 ◽  
Author(s):  
Randie R Little ◽  
Curt Rohlfing ◽  
David B Sacks
Keyword(s):  
Blood Glucose ◽  
Hemoglobin A1c ◽  
Blood Glucose Concentration ◽  
Clinical Value ◽  
Patients With Diabetes ◽  
Substantial Progress ◽  
Hemoglobin Variants ◽  
The Mean ◽  
Mean Blood Glucose ◽  
Hba1c Measurement

Abstract BACKGROUND Measurement of hemoglobin A1c (HbA1c) in the blood is integral to and essential for the treatment of patients with diabetes mellitus. HbA1c reflects the mean blood glucose concentration over the preceding 8 to 12 weeks. Although the clinical value of HbA1c was initially limited by large differences in results among various methods, the investment of considerable effort to implement standardization has brought about a marked improvement in analysis. CONTENT The focus of this review is on the substantial progress that has been achieved in enhancing the accuracy and, therefore, the clinical value of HbA1c assays. SUMMARY The interactions between the National Glycohemoglobin Standardization Program and manufacturers of HbA1c methods have been instrumental in standardizing HbA1c. Proficiency testing using whole blood has allowed accuracy-based assessment of methods in individual clinical laboratories that has made an important contribution to improving the HbA1c measurement in patient samples. These initiatives, supported by the efforts of the IFCC network, have led to a continuing enhancement of HbA1c methods. Many of the factors that previously influenced HbA1c results independently of blood glucose have been eliminated from most modern methods. These include carbamylation, labile intermediates, and common hemoglobin variants. Nevertheless, some factors (e.g., race and aging) may alter HbA1c interpretation, but whether these differences have clinical implications remains contentious. HbA1c has a fundamental role in the diagnosis and management of diabetes. Ongoing improvements in HbA1c measurement and quality will further enhance the clinical value of this analyte.

scholarly journals Evaluation and follow up patients with diabetes mellitus who attended Sabratha diabetic center

2020 ◽  
Vol 8 (2) ◽  
pp. 340-343
Author(s):  
Khaled Ali ALawaini ◽  
Hanen Daw Sweed ◽  
Khalod Mohamed Sawesi ◽  
Fatma Abdusalam Kamoka ◽  
Sara Abugalel Alakrme ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Blood Glucose Concentration ◽  
Microvascular Disease ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Diabetes Incidence ◽  
Patients With Diabetes ◽  
Public Health Challenge ◽  
The Mean ◽  
Mean Blood Glucose

Background: Diabetes is a public health challenge facing the world. Awareness and long term diabetes have an enormous effect, including cardiovascular disease and microvascular disease. Objective: This study aimed to estimate diabetes incidence and it is complications. Methods: A hundred diabetic patients who attended Galil diabetic center in Sabratha city had participated in this study in May 2013. Results: The mean age was 56 years old. Diabetes was more prevalent in females than in males (62%vs38%). The mean blood glucose concentration was 168 mg/dl, reflecting poor glycemic control, as 16% of diabetic patients moved to treatment with insulin. Conclusion: Poor glycemic control means of fasting plasma glucose was 168 mg/dl, and 16% started to use insulin therapy, along with 15% had hypertension.

scholarly journals COMPARISON OF BLOOD GLUCOSE LEVELS OF PATIENTS WITH DIABETES MELLITUS ON UNPRESSED FINGERS AND GETTED TO THE TELAGA BIRU MEDICAL CENTER GORONTALO DISTRICT

2021 ◽  
Vol 2 (1) ◽  
pp. 1-10
Author(s):  
Nurain T. Ismail ◽  
La Ode Sultan ◽  
Adnan Malaha
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Health Center ◽  
Capillary Blood ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Patients With Diabetes ◽  
The Mean ◽  
Mean Blood Glucose

Abstract Examination of blood glucose levels using the POCT method using capillary blood helps diabetes mellitus patients monitor glucose levels. But often the insufficient stabbing causes the blood to come out a little so that the staff performs massage which can affect blood glucose levels. This study aims to determine the differences in the results of examination of blood glucose levels of patients with diabetes mellitus on fingers that are not massaged and massaged at Telaga Biru Public Health Center, Gorontalo District. This research is an experimental study with a Pre Experiment Design type One group Prettest-Postest Design with a total of 21 samples taken capillary blood to check blood glucose levels on the fingers that are not massaged and massaged. The results obtained were analyzed using the Faired Sample t-Test. The results showed that the mean blood glucose level on the fingers that was not massaged was 321 mg/dL, while the mean blood glucose level on the fingers that was massaged was 299 mg/dL. The results of the Faired Sample t-Test showed a significant value of 0.000 <0.05. There was a significant difference in the results of examining blood glucose levels on fingers that were not massaged and massaged by diabetes mellitus patients at Telaga Biru Health Center, Gorontalo District. Laboratory personnel are expected to perform deep punctures on the fingers so that the blood that comes out is enough for the POCT method of blood glucose testing.

scholarly journals Improved HbA1c and reduced glycaemic variability after 1-year intermittent use of flash glucose monitoring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wenhui Zhang ◽  
Yu Liu ◽  
Baosheng Sun ◽  
Yanjun Shen ◽  
Ming Li ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Insulin Dose ◽  
Glucose Monitoring ◽  
Final Visit ◽  
Glycaemic Variability ◽  
Self Monitoring ◽  
Flash Glucose Monitoring ◽  
Significant Difference ◽  
Mean Blood Glucose ◽  
Hba1c Measurement

AbstractFlash glucose monitoring (FGM) was introduced in China in 2016, and it might improve HbA1c measurements and reduce glycaemic variability during T1DM therapy. A total of 146 patients were recruited from October 2018 to September 2019 in Liaocheng. The patients were randomly divided into the FGM group or self-monitoring blood glucose (SMBG) group. Both groups wore the FGM device for multiple 2-week periods, beginning with the 1st, 24th, and 48th weeks for gathering data, while blood samples were also collected for HbA1c measurement. Dietary guidance and insulin dose adjustments were provided to the FGM group patients according to their Ambulatory Glucose Profile (AGP) and to the SMBG group patients according to their SMBG measurements taken 3–4 times daily. All of the participants underwent SMBG measurements on the days when not wearing the FGM device. At the final visit, HbA1c, time in range (TIR), duration of hypoglycaemia and the number of diabetic ketoacidosis (DKA) events were taken as the main endpoints. There were no significant difference in the baseline characteristics of the two groups. At 24 weeks, the HbA1c level of the FGM group was 8.16 ± 1.03%, which was much lower than that of the SMBG group (8.68 ± 1.01%) (p = 0.003). The interquartile range (IQR), mean blood glucose (MBG), and the duration of hypoglycaemia in the FGM group also showed significant declines, compared with the SMBG group (p < 0.05), while the TIR increased in the FGM group [(49.39 ± 17.54)% vs (42.44 ± 15.49)%] (p = 0.012). At 48 weeks, the differences were more pronounced (p < 0.01). There were no observed changes in the number of episodes of DKA by the end of the study [(0.25 ± 0.50) vs (0.28 ± 0.51), p = 0.75]. Intermittent use of FGM by T1DM patients can improve their HbA1c and glycaemic control without increasing the hypoglycaemic exposure in insulin-treated individuals with type 1 diabetes in an developing country.

Hypoglycaemia in the treatment of diabetes mellitus

2011 ◽  
pp. 1849-1861
Author(s):  
Pratik Choudhary ◽  
Stephanie A. Amiel
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Concentration ◽  
Cerebral Metabolism ◽  
Chronic Complications ◽  
Glucose Levels ◽  
Patients With Diabetes ◽  
Treatment Of Diabetes ◽  
Clinically Significant ◽  
The Brain

Hypoglycaemia (low blood glucose concentration) is the most important acute complication of the pharmacological treatment of diabetes mellitus. Low blood glucose impairs brain (and, potentially, cardiac) function. The brain has minimal endogenous stores of energy, with small amounts of glycogen in astroglial cells. The brain is therefore largely dependent on circulating glucose as the substrate to fuel cerebral metabolism and support cognitive performance. If blood glucose levels fall sufficiently, cognitive dysfunction is inevitable. In health, efficient glucose sensing and counterregulatory mechanisms exist to prevent clinically significant hypoglycaemia. These are impaired by diabetes and by its therapies. Patients with diabetes rank fear of hypoglycaemia as highly as fear of chronic complications such as nephropathy or retinopathy (1). Fear of hypoglycaemia, hypoglycaemia itself and attempts to avoid hypoglycaemia limit the degree to which glycaemic control can be intensified to reduce the risk of chronic complications of diabetes both for type 1 and type 2 diabetes.

scholarly journals The effects of starvation and experimental diabetes on phosphoenol-pyruvate carboxykinase in the guinea pig

1977 ◽  
Vol 164 (2) ◽  
pp. 357-361 ◽  
Author(s):  
K R F Elliott ◽  
C I Pogson
Keyword(s):  
Enzyme Activity ◽  
Guinea Pig ◽  
Phosphoenolpyruvate Carboxykinase ◽  
Blood Glucose Concentration ◽  
Mitochondrial Fraction ◽  
Kidney Cortex ◽  
Total Enzyme Activity ◽  
The Mean ◽  
Mean Blood Glucose ◽  
Total Enzyme

1. Approx. 85% of liver phosphoenolpyruvate carboxykinase is associated with the mitochondrial fraction in the fed guinea pig. Enzyme activity is unchanged in diabetes, but doubles during starvation. In contrast with earlier reports, both cytoplasmic and mitochondrial activities were found to be increased. 2. In kidney cortex, total enzyme activity is increased in both starved and diabetic animals. These changes are associated with increases in the cytoplasmic activity alone. 3. In diabetic animals the mean blood-glucose concentration was 23.1 mM. Other blood metabolites were lower than those in the rat, and the animals did not show significant ketosis. 4. Changes in the rates of gluconeogenesis from lactate and propionate paralleled those in phosphoenolpyruvate carboxykinase activity.

scholarly journals Seasonal variations in blood parameters of the Amazonian manatee, Trichechus inunguis

2000 ◽  
Vol 43 (2) ◽  
pp. 165-171 ◽  
Author(s):  
Elton P. Colares ◽  
Ioni G. Colares ◽  
Adalto Bianchini ◽  
Euclydes A. Santos
Keyword(s):  
Body Weight ◽  
Blood Glucose ◽  
Seasonal Variations ◽  
Crude Protein ◽  
Blood Parameters ◽  
Total Proteins ◽  
Daily Food ◽  
Males And Females ◽  
The Mean ◽  
Mean Blood Glucose

Seasonal variations in body weight, food consumption and blood glucose, total lipids, urea, total proteins, albumin and globulins of captive Amazonian manatees, Trichechus inunguis, were determined. Body weight changed significantly along the year, increasing from autumn to spring and decreasing in summer. The mean daily food intake of paragrass remained almost unchanged along the year. Paragrass administered to the manatees showed important variations in crude protein and lipid content along the year. No significant differences in blood parameters were registered between males and females in all seasons. Further, there were no significant differences in blood total proteins, albumin and globulins along the year. On the other hand, significant differences in the mean blood glucose, lipids and urea were registered. An increase in the blood glucose in the spring and summer was observed. Blood urea and lipids levels were positively related to paragrass protein and lipids content. These two correlations suggested that these blood parameters are good indicators of the animal nutritional status in the Amazonian manatee.

scholarly journals Differences in the Effects of Carbohydrate Food Form on Endurance Performance to Exhaustion

1993 ◽  
Vol 3 (1) ◽  
pp. 41-54 ◽  
Author(s):  
Scott D. Murdoch ◽  
Terry L. Bazzarre ◽  
Ian P. Snider ◽  
Allan H. Goldfarb
Keyword(s):  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Endurance Performance ◽  
Performance Effects ◽  
Endurance Tests ◽  
The Mean ◽  
And Performance ◽  
Mean Blood Glucose ◽  
Mean Glucose ◽  
Placebo Drink

This investigation examined the metabolic and performance effects of ingesting solid compared to slurried carbohydrate food (bananas) between two prolonged exhaustive exercise bouts. Eight highly trained bale triathletes performed four exhaustive endurance tests (ET), each separated by at least 2 weeks. Each ET consisted of a 90-min run followed by 90 min of cycling, both at 70%. Workloads were then gradually increased on the cycle, and subjects continued to cycle until exhausted. They then rested for 20 min and ingested one of the following: an artificially sweetened placebo drink (P), slurried bananas (SL), or solid bananas (SO). Bananas were given in equal portions relative to each subject's body weight. Subjects cycled to exhaustion a second time at 70% of their, at which point the mean blood glucose concentration for the combined carbohydrate treatments was significantly higher than that from the P treatment. The mean glucose concentration from the SL treatment did not differ significantly from the SO treatment. These data demonstrate that solid bananas are as effective as slurried bananas in maintaining plasma glucose and in enhancing endurance exercise performance.

scholarly journals A bőr-autofluoreszcencia és a konvencionális glykaemiás markerek kapcsolata diabeteses betegekben

2015 ◽  
Vol 156 (33) ◽  
pp. 1341-1347
Author(s):  
Emília Mácsai ◽  
Erika Rakk ◽  
Margit Miléder ◽  
Ágnes Fulcz
Keyword(s):  
Blood Glucose ◽  
Hemoglobin A1c ◽  
Fasting Blood Glucose ◽  
Glycemic Load ◽  
Vascular Complications ◽  
Rank Test ◽  
Accurate Estimation ◽  
Skin Autofluorescence ◽  
Before And After ◽  
Patients With Diabetes

Introduction: Skin autofluorescence has a well-known significance for screening diabetes and early diagnosis of vascular complications. It predicts cardiovascular events better than hemoglobin A1c, hence skin autofluorescence is a marker of cumulative tissue glycemic load whereas hemoglobin A1c reflects changes occurring in the previous 6–8 weeks. Aim: The aim of the authors was analyze the relationship between skin autofluorescence and conventional glycemic markers in patients with diabetes. Method: Skin autofluorescence measurements were performed in 2010 in 18 patients (10 men and 8 women with normal glomerular filtration rate; age, 61.4±13.8 years) with long term follow-up (2624 months, 476 laboratory results). Relationships between skin autofluorescence values and fasting blood glucose, hemoglobin A1c levels and metabolic parameters obtained before and after skin autofluorescence measurements were analysed using Spearman rank test. Results: The average skin autofluorescence value was 2.88±0.65 arbitrary units. There were no significant correlations between skin autofluorescence and hemoglobin A1c levels obtained before (7.84±1.08%, p = 0.07) and after the skin autofluorescence measurements (7.45±1.18%, p = 0.71). Skin autofluorescence values also failed to show relationship with fasting blood glucose obtained before (p = 0.09) and after (p = 0.29) the skin autofluorescence measurements. Conclusions: In patients with diabetes skin autofluorescence may provide novel information about glycemic burden. Skin autofluorescence values (which may presumably provide a more accurate estimation of the cardiovascular risk) do not correlate with hemoglobin A1c and fasting blood glucose. Orv. Hetil., 2015, 156(33), 1341–1347.

scholarly journals Glycemic Variability Impacted by SGLT2 Inhibitors and GLP 1 Agonists in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4078
Author(s):  
Heeyoung Lee ◽  
Se-eun Park ◽  
Eun-Young Kim
Keyword(s):  
Meta Analysis ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Randomized Controlled ◽  
Sodium Glucose Cotransporter ◽  
Patients With Diabetes ◽  
The Mean ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Mean Blood Glucose

To investigate the effect of sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) agonists on glycemic variability (GV), the mean amplitude of glucose excursion (MAGE), mean blood glucose (MBG) levels, and percentage of time maintaining euglycemia were evaluated. Randomized controlled trials evaluating the efficacy of SGLT-2 inhibitors and GLP-1 agonists for treating people with diabetes were selected through searches of PubMed, EMBASE, and other databases. Sixteen studies were finally analyzed. There were no differences in the reductions in MAGE after treatment with SGLT-2 inhibitors or GLP-1 agonists (standardized mean difference (SMD) = −0.59, 95% CI = −0.82 to −0.36 vs. SMD = −0.43, 95% CI = −0.51 to −0.35, respectively), and treatment with SGLT-2 inhibitors was associated with an increased reduction in MBG levels (SMD = −0.56, 95% CI = −0.65 to −0.48, p < 0.00001). Monotherapy and add-on therapy with medications were correlated with MAGE and MBG level reductions. In conclusion, SGLT-2 inhibitors and GLP-1 agonists were associated with a reduction in GV and could be alternatives for treating people with diabetes.

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