scholarly journals Use Of The GLYCEMIZER® Tool By General Practitioners To Meet Individual Glycated Hemoglobin Goals In Patients With Type 2 Diabetes Mellitus

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Nicolas Byron Hatziisaak ◽  
Telemachos Hatziisaak ◽  
Urs Keller
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
General Practitioners ◽  
Glycated Hemoglobin ◽  
Cross Sectional Survey ◽  
Significant Difference ◽  
The Individual ◽  
Hba1c Levels

Background — For general practitioners (GPs), it is often not easy to determine the individual glycated hemoglobin (HbA1c)-goal of patients with type 2 diabetes mellitus (T2DM) in order to offer them a tailored treatment and minimize side effects. Usually, they simply rely on their gut feeling. Objective — We assessed the usefulness of an easy-to-use algorithm (GLYCEMIZER®) to calculate individual HbA1c-goals and compared them with targeted (‘gut feeling’ of the GP’s) and achieved levels. Material and Methods — In this cross-sectional survey, general practitioners were asked to report anonymized data of at least 30 consecutive patients with T2DM presenting in their offices from May 1st to August 15th 2016 after obtaining informed consent. Demographic, clinical and biochemical data were used for the GLYCEMIZER® tool to calculate the individual HbA1c-goals. A statistical analysis was conducted in order to compare the calculated HbA1c-goals with targeted and achieved HbA1c-levels. Results — A total of 184 patients (mean age: 69y) were enrolled by 6 participating general practitioners from the Werdenberg-Sarganserland region in eastern Switzerland. Four patients did not meet the inclusion criteria. The overall median calculated HbA1c-goal did not differ from the targeted and achieved levels (7.1% vs. 7.0% vs. 7.1%, p=0.894). There was a significant difference between achieved and calculated HbA1c-levels in patients aged <50 (n=13, median 7.2% vs. 6.5%, p=0.014), goals not achieved) and patients aged >71 (n=85, median 6.9% vs. 7.5%, p=0.005), lower levels achieved in relation to calculated HbA1c-goals). Both in patients treated with insulin (n=44) and in patients without insulin (n=136) the achieved HbA1c-levels met the calculated goals (no insulin: 6.9% vs. 7.0%, ns; with insulin: 7.8% vs. 7.7%, ns). In regard to CKD-stages 3 and 4 the achieved HbA1c-levels were significantly lower than calculated (n= 41, median 6.9% vs. 7.6%, p=0.001). Conclusion — Calculating HbA1c-goals using the GLYCEMIZER tool is more accurate than relying on gut feeling alone, and is specifically useful in the treatment of patients with T2DM of less than 50, as well as more than 70 years of age. Furthermore, it is helpful to meet individual HbA1c-goals in patients with CKD-stages 3+.

scholarly journals The Role of Serum Angiopoietin-Like Protein 4 (ANGPTL-4) and its Gene in Iraq Patients with Type2 Diabetes Mellitus: Case-Control Study

2021 ◽  
Vol 24 (4) ◽  
pp. 7-14
Author(s):  
Aseel Ali Abd Ali Sahib ◽  
◽  
Mohammed I. Hamzah ◽  
Mahmood Shakir Khudhair ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Case Control Study ◽  
Glycated Hemoglobin ◽  
Control Group ◽  
Diabetes Group ◽  
Significant Difference ◽  
Control Study

Background Type 2 Diabetes Mellitus is produced by cell failure of pancreatic cells and insulin resistance and is a disorder in which the amount of sugar in the blood is elevated. Angiopoietin-like protein 4 (ANGPTL4) functions as an inhibitor of lipoprotein lipase, a critical enzyme in lipid metabolism. The aim of this study was to explore if the ANGPTL4 gene's E40K variant and ANGPTL4 serum levels are related to the Body mass index, fasting glucose levels, lipid levels, and glycated hemoglobin.Method75 people were enrolled in this case-control study, 25 of whom had type 2 diabetes mellitus while the other 50 were healthy control subjects. Fasting blood glucose, Lipid profile, Glycated hemoglobin were estimated by Cobas 111 analyzer, BMI (weight, height) was calculated, angiopoietin-like protein 4by anenzyme-linked immune sorbent test kit and TaqMan genotyping-based real-time PCR was used to ascertain ANGPTL4 genotypes. The variant was linked to the risk of Type 2 Diabetes Mellitus and parameters used to quantify the variant were identified. Result Patients in the 30-50 age range with type 2 diabetes and those in the same age group who serve as controls. The control group had a lower level of angiopoietin-like protein 4 (ANGPTL4) than the diabetes group. Patients with T2DM had a substantially (p< 0.0001) greater fasting serum Angiopoietin-like protein 4 level than the control group (135.1±6.70) ng/ml and (62.35±6.4) ng/ml, respectively. The diabetes group has significantly higher fasting serum glucose, lipid profile, and glycated hemoglobin compared with non-diabetics. Serum Angiopoietin-like protein 4 was correlated positively with body mass index. (CC,CT,TT) genotypes of the rs2010871 polymorphism There was a significant difference in frequency of the control group (p =0.0477); however, there was no significant difference in its level of (diabetics, newly diagnosed type 2 diabetic before treatment)p-value (0.7066, 0.5555) respectively Conclusion Serum Angiopoietin-like protein 4 levels are negatively correlated to cholesterol, positively correlated to triglyceride, negatively correlated to HDL, positively correlated to HbA1c, negatively correlated to LDL, negatively correlated to VLDL, negatively correlated to FBS, negatively correlated to BMI. The C>T allele at the ANGPTL4 gene's rs2010871polymorphic locus was linked to a decreased prevalence of Type 2 diabetes.

scholarly journals EFFECTIVENESS OF A MEDICATION BOOKLET AND COUNSELING ON TREATMENT ADHERENCE IN TYPE 2 DIABETES MELLITUS PATIENTS

2017 ◽  
Vol 9 ◽  
pp. 28 ◽  
Author(s):  
Iin Presetiawati ◽  
Retnosari Andrajati ◽  
Rani Sauriasari
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Significant Difference ◽  
Before And After ◽  
Adherence Scale ◽  
Hba1c Levels

Objective: This study aimed to evaluate the effectiveness of counseling and the use of a medication booklet on the level of treatment compliancethrough reduced levels of glycated hemoglobin (HbA1C) and Morisky Medication Adherence Scale (MMAS-8) scores in patients with type 2 diabetesmellitus.Methods: This pre-experimental prospectively study was conducted at Dr. Adjidarmo General Hospital, KabupatenLebak, Banten Province, Indonesia.The study sample consisted of 30 type 2 diabetic patients who met the inclusion and exclusion criteria and who underwent a counseling interventionsession and received a medication booklet. Compliance was measured against the MMAS-8 scores and HbA1C levels before the intervention and after10 weeks of administration of counseling and receipt of the booklet).Results: The MMAS-8 scores before and after the intervention were 2.63±1.50 and 0.7±1.18, respectively. The HbA1C levels before and after theintervention were 11.31±2.95 and 8.12±2.79, respectively. The measurement results for MMAS-8 and HbA1C were analyzed using the Wilcoxon test.Conclusions: The analysis showed a significant difference (p<0.001) between the HbA1Cvalues and MMAS-8 scores before and after the intervention.Therefore, this study’s finding indicate that the provision of counseling and an informational booklet can improve type 2 diabetes mellitus patientcompliance with treatment.

scholarly journals Impact of Diabetes Mellitus Type 2 in the Activity of Glucose-6-Phosphate Dehydrogenase in Human Erythrocyte

2018 ◽  
Vol 3 (1) ◽  
pp. 58-62 ◽  
Author(s):  
Salih Awla Hamzah ◽  
Luqman Awla Hamza ◽  
Heshu Sulaman Rahman
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Human Erythrocyte ◽  
Glycated Hemoglobin ◽  
G6pd Activity ◽  
Glucose Levels ◽  
Glucose 6 Phosphate Dehydrogenase ◽  
Hba1c Levels

Diabetes mellitus is a metabolic affliction saunter that is characterized by a nobler than normal blood glucose poise. Glucose-6-phosphate dehydrogenase (G6PD) enzyme code (E.C.1.1.1.49) is an underlying enzyme in the phosphogluconate pathway. In this study, G6PD vitality in the mortal erythrocyte of male and female patients with type 2 diabetes mellitus was assessed utilizing a spectrophotometer at 340 nm. The activity of the enzyme increased with elevated glycated hemoglobin (HbA1C) levels. G6PD activity was found to be significantly associated with type 2 diabetes mellitus. The association between G6PD and diabetes mellitus was significant (P < 0.001). Moreover, G6PD was positively correlated with HbA1C levels (r = 0.572). The following mean ± standard deviation values were obtained: G6PD activity (IU/g Hb), 3.1103 ± 0.79349; HbA1C (%), 8.6600 ± 1.63120; Hb (g/dL), 13.4933 ± 1.38836; platelet count (103/µl), 283.4667 ± 58.59312; WBC (103/µl), 7.4890 ± 1.49842; HCT (%), 45.0100 ± 2.63430; and BS (mg/dL), 230.2667 ± 75.67760. The results showed that an elevated HbA1C up leads to increased G6PD performance in the human erythrocyte, which is concerning to glucose levels in the special (blood).

scholarly journals rs622342 in SLC22A1, CYP2C9*2 and CYP2C9*3 and Glycemic Response in Individuals with Type 2 Diabetes Mellitus Receiving Metformin/Sulfonylurea Combination Therapy: 6-Month Follow-Up Study

2020 ◽  
Vol 10 (2) ◽  
pp. 53
Author(s):  
Khaled Naja ◽  
Ali Salami ◽  
Said El Shamieh ◽  
Rajaa Fakhoury
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Combination Therapy ◽  
Hybridization Probes ◽  
Significant Difference ◽  
Polymerase Chain ◽  
Hba1c Levels

Background and Objective: Since the treatment outcome with oral anti-diabetics differs between individuals, the objective of this study is to evaluate the significance of rs622342 in SLC22A1, CYP2C9*2 (rs1799853) and CYP2C9*3 (rs1057910) with regard to the efficacy of metformin/sulfonylurea combination therapy in individuals with type 2 diabetes mellitus (T2DM). Methods: Eighty-eight Lebanese individuals with T2DM received metformin/sulfonylurea combination therapy over 3 and 6 months. The clinical and biochemical characteristics were collected. Genotyping of rs622342 in SLC22A1, CYP2C9*2 and CYP2C9*3 was performed using hybridization probes on real-time polymerase chain reaction (PCR) instrument. Statistical analysis was performed using SPSS 22.0. Results: The levels of fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) showed a statistically significant reduction over 3 and 6 months of follow-up (p < 0.001). An interaction between rs622342 in SLC22A1, CYP2C9*2 and CYP2C9*3 (p = 0.035) was found associated with reduced levels of HbA1c levels after 3 and 6 months. A significant difference between the means of HbA1c was observed among the different groups after 3 and 6 months (p = 0.004 and p < 0.001, respectively). The most beneficial group was; AA and AC, *1*3, whereas the individuals that benefited the least were CC, *1*3 at 3 and 6 months. In contrast to HbA1c, no interaction was found between the three polymorphisms to affect FBS (p = 0.581). Conclusion: The combination of metformin/sulfonylurea therapy led to the maximum glycemic control in individuals with T2DM carrying AA or AC genotypes in SLC22A1 and *1*3 in CYP2C9.

scholarly journals A cross-sectional study: an assessment of low muscle mass and osteoporosis in type 2 diabetes mellitus patients with a high glycated hemoglobin level

2021 ◽  
Vol 12 ◽  
pp. 204062232110267
Author(s):  
Lingna Fang ◽  
Shao Zhong ◽  
Dan Ma ◽  
Chong Li ◽  
Yanmin Hao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Muscle Mass ◽  
Glycated Hemoglobin ◽  
Chinese Patients ◽  
Prevalence Rates ◽  
Osteoporosis In Men ◽  
Hba1c Levels

Background: Low muscle mass and osteoporosis are commonly observed in individuals with type 2 diabetes mellitus (T2DM). We investigated the prevalence of low muscle mass and osteoporosis in patients with T2DM who had high glycated hemoglobin (HbA1c) levels. Methods: We included 187 Chinese patients with T2DM who were aged ⩾50 years and evaluated their body composition using dual-energy X-ray absorptiometry. We measured levels of fasting blood glucose, HbA1c, B collagen-specific sequences (B-CTX), osteocalcin (OC), propeptide of type 1 procollagen (P1NP), and 25-hydroxy vitamin D. Results: Of the total patients, 82 were men and 105 were women. The prevalence rates of low muscle mass, osteopenia, and osteoporosis were 35.8%, 38.0%, and 31.0%, respectively. The prevalence rate of low muscle mass was significantly higher in women with HbA1c levels >9.0% than in those with HbA1c levels <9.0%. The prevalence rates of osteopenia and osteoporosis in men with HbA1c levels >9.0% differed significantly from those with HbA1c levels <9.0%. The appendicular skeletal muscle mass index (ASMI), trunk muscle mass, lumbar spinal bone mineral content (BMC), lumbar spine BMD, femoral BMC, and femoral BMD were significantly decreased, and the serum levels of B-CTX, OC, and P1NP were significantly increased in patients with T2DM who had osteoporosis. The ASMI was associated with osteopenia/osteoporosis in men and women with T2DM. Conclusions: In patients with T2DM, high HbA1c levels were associated with higher prevalence rates of low muscle mass in women and osteoporosis in men, and ASMI was a risk factor of osteoporosis.

scholarly journals Association between Glycated Hemoglobin with the Levels of Serum Proinflammatory Cytokines and Antioxidants in Patients with Type 2 Diabetes Mellitus in Universitas Sumatera Utara Hospital

2019 ◽  
Vol 7 (5) ◽  
pp. 715-720 ◽  
Author(s):  
Mutiara Indah Sari ◽  
Zaimah Z. Tala ◽  
Dian Dwi Wahyuni
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Proinflammatory Cytokines ◽  
Glycated Hemoglobin ◽  
Statistical Significance ◽  
Study Groups ◽  
Uncontrolled Diabetes ◽  
Significant Difference

BACKGROUND: Hyperglycemia condition in diabetes mellitus (DM) influences proinflammatory cytokine levels and disrupts antioxidant balances. Glycated Hemoglobin is used as a biomarker of glycemic control in DM. AIM: This study aimed to analyse the association between glycated Hemoglobin with the levels of serum proinflammatory cytokines (interleukin (IL)-6) and antioxidants (glutathione peroxidase (GPx) and glutathione (GSH)) in type 2 diabetes mellitus (T2DM) patients in Universitas Sumatera Utara (USU) Hospital. METHODS: A total of eighty-nine T2DM patients were recruited at USU Hospital. Glycated Hemoglobin levels were measured using routine laboratory tests at USU Hospital. The IL-6, GPx, and GSH levels were measured using enzyme-linked immunosorbent (ELISA) method. The statistical significance was determined using the Kruskal Wallis test, followed by Mann-Whitney test (p < 0.05). RESULTS: The mean of glycated hemoglobin (%), IL-6 (pg/ml), GPx (ng/ml), and GSH (ng/ml) levels in T2DM patients were 8.96 ± 2.28, 59.27 ± 16.04, 32.13 ± 12.10, and 7.42 ± 3.50, respectively. Regarding the glycated Hemoglobin levels, 28.09% of patients had controlled diabetes, 24.72% of patients had poorly controlled diabetes, and 47.19% of patients had uncontrolled diabetes. The IL-6 levels of the three study groups based on glycated Hemoglobin levels were related significantly (p < 0.05), but there was no statistically significant difference observed between the GPx and GSH levels (p > 0.05). CONCLUSION: The present study suggests that the glycated Hemoglobin was associated with the levels of serum IL-6 levels but not GPx and GSH levels in T2DM patients in USU Hospital.

scholarly journals Application value of combination therapy of periodontal curettage and root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yonghuan Bian ◽  
Changhao Liu ◽  
Zhaojiang Fu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Chronic Periodontitis ◽  
Root Planing ◽  
Tnf Α ◽  
Significant Difference ◽  
Hs Crp

Abstract Background Our study attempted to observe the value of periodontal curettage combined with root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. Methods There involved 72 patients with type 2 diabetes mellitus complicated with moderate-to-severe chronic periodontitis who were diagnosed and treated in our hospital from January 2019 to December 2019. The patients enrolled were randomly divided into four groups using a computer-generated table: root planing and periodontal curettage combined group (n = 18), root planning group (n = 18), periodontal curettage group (n = 18) and cleansing group (n = 18). Blood glucose, plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), serum levels of inflammatory factors (Tumor Necrosis Factor Alpha [TNF- α] and hypersensitive C-reactive protein [hs-CRP]) were observed before and after treatment. The collecting dates were analyzed by the chi-square χ 2 test, repeated measurement analysis of variance, or t-test according to different data types and research objectives. Results Before treatment, there was no significant difference in PI, GI, PD and AL among the four groups (P> 0.05), while after 3-month treatment, the levels of PI, GI, PD and AL in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, with both root planing group and periodontal curettage group significantly lower than cleansing group (P< 0.05). The fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin in the combined group, root planing group, periodontal curettage group and cleansing group were significantly lower than those before treatment (P < 0.05). Before treatment, there was no significant difference in TNF- α and hs-CRP among the four groups (P> 0.05), but the levels of TNF- α and hs-CRP in the four groups decreased significantly after 3-month treatment (P< 0.05). The levels of TNF- α and hs-CRP in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, and those in the root planing group and periodontal curettage group were significantly lower than those in the cleansing group (P< 0.05). Conclusion The combination therapy of periodontal curettage and root planing exerted beneficial effects on moderate-to-severe chronic periodontitis in patients with type 2 diabetes mellitus, which holds the potential to maintain the level of blood glucose and improve the quality of life of the patients.

scholarly journals TheType 2 Deiodinase Thr92Ala PolymorphismIs Associated with Worse Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Xiaowen Zhang ◽  
Jie Sun ◽  
Wenqing Han ◽  
Yaqiu Jiang ◽  
Shiqiao Peng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Meta Analysis ◽  
Increased Risk ◽  
Design And Methods ◽  
Hba1c Levels

Objective. Type 2 deiodinase (Dio2) is an enzyme responsible for the conversion of T4 to T3. The Thr92Ala polymorphism has been shown related to an increased risk for developing type 2 diabetes mellitus (T2DM). The aim of this study is to assess the association between this polymorphism and glycemic control in T2DM patients as marked by the HbA1C levels.Design and Methods.The terms “rs225014,” “thr92ala,” “T92A,” or “dio2 a/g” were used to search for eligible studies in the PubMed, Embase, and Cochrane databases and Google Scholar. A systematic review and meta-analysis of studies including both polymorphism testing and glycated hemoglobin (HbA1C) assays were performed.Results. Four studies were selected, totaling 2190 subjects. The pooled mean difference of the studies was 0.48% (95% CI, 0.18–0.77%), indicating that type 2 diabetics homozygous for the Dio2 Thr92Ala polymorphism had higher HbA1C levels.Conclusions. Homozygosity for the Dio2 Thr92Ala polymorphism is associated with higher HbA1C levels in T2DM patients. To confirm this conclusion, more studies of larger populations are needed.

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