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

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.

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jen-Hung Huang ◽  
Yung-Kuo Lin ◽  
Ting-Wei Lee ◽  
Han-Wen Liu ◽  
Yu-Mei Chien ◽  
...  

Abstract Background Glucose monitoring is vital for glycemic control in patients with diabetes mellitus (DM). Continuous glucose monitoring (CGM) measures whole-day glucose levels. Hemoglobin A1c (HbA1c) is a vital outcome predictor in patients with DM. Methods This study investigated the relationship between HbA1c and CGM, which remained unclear hitherto. Data of patients with DM (n = 91) who received CGM and HbA1c testing (1–3 months before and after CGM) were retrospectively analyzed. Diurnal and nocturnal glucose, highest CGM data (10%, 25%, and 50%), mean amplitude of glycemic excursions (MAGE), percent coefficient of variation (%CV), and continuous overlapping net glycemic action were compared with HbA1c values before and after CGM. Results The CGM results were significantly correlated with HbA1c values measured 1 (r = 0.69) and 2 (r = 0.39) months after CGM and 1 month (r = 0.35) before CGM. However, glucose levels recorded in CGM did not correlate with the HbA1c values 3 months after and 2–3 months before CGM. MAGE and %CV were strongly correlated with HbA1c values 1 and 2 months after CGM, respectively. Diurnal blood glucose levels were significantly correlated with HbA1c values 1–2 months before and 1 month after CGM. The nocturnal blood glucose levels were significantly correlated with HbA1c values 1–3 months before and 1–2 months after CGM. Conclusions CGM can predict HbA1c values within 1 month after CGM in patients with DM.


2021 ◽  
Author(s):  
Jen-Hung Huang ◽  
Yung-Kuo Lin ◽  
Ting-Wei Lee ◽  
Han-Wen Liu ◽  
Yu-Mei Chien ◽  
...  

Abstract Background: Glucose monitoring is vital for glycemic control in patients with diabetes mellitus (DM). Continuous glucose monitoring (CGM) measures whole-day glucose levels. Hemoglobin A1c (HbA1c) is a vital outcome predictor in patients with DM. Methods: This study investigated the relationship between HbA1c and CGM, which remained unclear hitherto. Data of patients with DM (n = 91) who received CGM and HbA1c testing (1-3 months before and after CGM) were retrospectively analyzed. Diurnal and nocturnal glucose, highest CGM data (10%, 25%, and 50%), mean amplitude of glycemic excursions (MAGE), percent coefficient of variation (%CV), and continuous overlapping net glycemic action were compared with HbA1c values before and after CGM. Results: The CGM results were significantly correlated with HbA1c values measured 1 (r = 0.69) and 2 (r = 0.39) months after CGM and 1 month (r = 0.35) before CGM. However, glucose levels recorded in CGM did not correlate with the HbA1c values 3 months after and 2-3 months before CGM. MAGE and %CV were strongly correlated with HbA1c values 1 and 2 months after CGM, respectively. Diurnal blood glucose levels were significantly correlated with HbA1c values 1-2 months before and 1 month after CGM. The nocturnal blood glucose levels were significantly correlated with HbA1c values 1-3 months before and 1-2 months after CGM.Conclusions: CGM can predict HbA1c values within 1 month after CGM in patients with DM.


2019 ◽  
Vol 9 (9) ◽  
pp. 98 ◽  
Author(s):  
Kisokanth G. ◽  
Indrakumar J. ◽  
Prathapan S. ◽  
Joseph J. ◽  
Ilankoon I.M.P.S.

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.


2019 ◽  
Vol 10 (1) ◽  
pp. 77
Author(s):  
Febria Syafyu Sari ◽  
Ridhyalla Afnuhazi

ABSTRAK Diabetes Melitus merupakan penyakit yang paling menonjol yang disebabkan oleh gagalnya pengaturan gula darah. Lidah buaya berkhasiat untuk menurunkan kadar gula dalam darah bagi penderita diabetes dan dapat mengontrol tekanan darah. Tujuan penelitian untuk mengetahui pengaruh jus lidah buaya (AloeBarbadensis Miller) terhadap penurunan glukosa darah puasa GDP) dan 2 Jam PP (Post Prendial) pada penderita DM (Diabetes Melitus). Desain penelitian merupakan Quasi Eksperimental dengan pendekatan one group pretest – postest design. Sampel terbagi menjadi 14 responden. Data dianalisis dengan paired t-test. Hasil menunjukan rata-rata penurunan glukosa darah puasa pada intervensi (28,42 gr/dl) dan glukosa darah 2 jam pp pada intervensi (40,57 gr/dl). Untuk analisis bivariat terdapat perbedaan antara glukosa puasa dan 2 jam pp dengan glukosa darah puasa GDP) dan 2 Jam PP (Post Prendial) pada penderita DM (Diabetes Melitus). Kesimpulan didapatkanlidah buaya dapat menurunkan kadar glukosa darah.Berdasarkan hasil penelitian jus lidah buaya dapat menjadi salah satu alternatif keperawatan non farmakologi dalam penyakit diabetes melitus. Kata Kunci : Lidah Buaya ; Diabetes Mellitus THE EFFECT OF VEGETABLE VOCATIONAL JUICE ON FAST BLOOD GLUCOSE LEVELS AND 2 HOURS OF PP (Post Prandial) IN DIABETES MELLITUS  ABSTRACT Diabetes mellitus is the most prominent disease caused by the failure of blood sugar regulation. Aloe vera is efficacious can to  reduce blood sugar levels for diabetics and can control blood pressure. The purpose of this study was to determine the effect of Aloe Barbadensis Miller on the reduction of fasting blood glucose GDP and 2 hours of PP (post prendial) in patients with diabetes mellitus. The research design is Experimental Quasi with one group pretest - postest design approach. The sample is divided into 14 respondents. Data were analyzed by paired t-test. The results showed an average decrease in fasting blood glucose at intervention (28.42 gr / dl) and 2 hours pp blood glucose at intervention (40.57 gr / dl). For bivariate analysis there was a difference between fasting glucose and 2 hours pp with fasting blood glucose GDP) and 2 hours PP (Post Prendial) in patients with diabetes mellitus. The conclusion is that aloe vera can reduce blood glucose levels. Based on the results of research on aloe vera juice can be an alternative non-pharmacological nursing in diabetes mellitus. Keywords: Aloe Vera ; Diabetes Mellitus


Author(s):  
Berrak BASTURK ◽  
Zeynep KOC OZERSON ◽  
Aysun YUKSEL

Background: The positive effects of blood glucose levels should be demonstrated in healthy or type 2 diabetic individuals who can be recommended to consume macronutrients (protein + fat) with carbohydrates. Therefore, at the end of the research planned with the amount of carbohydrates and fats that can be consumed in a meal, we aimed to recommend the consumption of food with high protein content egg together with the carbohydrate source. Methods: The study was carried out from Nov 2017 to Apr 2018 by looking at fasting blood glucose levels using feeding 2 different test foods on a minimum of 8 h of fasting in the Haliç University Sutluce Campus, Istanbul, Turkey. Before and after the carbohydrate and carbohydrate + protein source, blood glucose was measured from the fingertip for 3 days in 30 min, 60 min and 120 min periods. The average of 3 days was used in the analysis. Results: Blood glucose values were compared after individuals were given carbohydrate and carbohydrate + protein source. The mean blood glucose value 60 min after the carbohydrate administration was significantly higher than the average blood glucose value 60 min after the carbohydrate + protein administration (P= 0.006). Conclusion: A protein-containing diet positively affects the glycemia response and can recommend it. In individuals with diabetes, they should focus on the effects of proteins to achieve glycemia control.


2018 ◽  
Vol 3 (1) ◽  
pp. e000130 ◽  
Author(s):  
Hiroki Mieno ◽  
Kazuhito Yoneda ◽  
Masahiro Yamazaki ◽  
Ryosuke Sakai ◽  
Chie Sotozono ◽  
...  

ObjectiveTo investigate the change of chronic diabetic macular oedema (DMO) in vitrectomised eyes when the administration of sodium–glucose cotransporter 2 (SGLT2) inhibitors is initiated as a systemic medical treatment.Methods and analysisThis study involved 10 eyes of five patients with chronic DMO lasting more than 6 months who had previously undergone vitrectomy and whose systemic medical treatments were newly changed to SGLT2 inhibitors. In this study, chronic DMO was defined as persistent diffuse macular oedema despite ophthalmic treatment in patients with diabetes. Patients who received antivascular endothelial growth factor therapy or steroids administration, or change of eye-drop medication from at 3 months before and after the initiation of SGLT2 inhibitors, were excluded. In this study, visual acuity (VA) and central retinal thickness (CRT, μm) prior to and at 3, 6 and 12 months after the initiation of SGLT2 inhibitors were retrospectively compared. The Wilcoxon signed-rank test was used for statistical analysis.ResultsIn the 10 treated eyes, from at baseline to at 3, 6 and 12 months after the initiation of SGLT2 inhibitor, median VA (logMAR) improved from 0.35 to 0.15 (p=0.038), 0.2 (p=0.157) and 0.2 (p=0.096), respectively, and median CRT significantly reduced from 500.5 µm to 410 µm (p<0.01), 378 µm (p<0.01) and 339 µm (p<0.01), respectively.ConclusionAlthough this study involved only five patients, our findings indicate that SGLT2 inhibitors might have structural efficacy for chronic DMO in vitrectomised eyes.


2015 ◽  
Vol 33 (2) ◽  
pp. 110-114 ◽  
Author(s):  
Maria Belivani ◽  
Thomas Lundeberg ◽  
Mike Cummings ◽  
Charikleia Dimitroula ◽  
Nicole Belivani ◽  
...  

Background Obesity is an increasing global health problem, and current methods of management are limited. Preliminary research data suggest that acupuncture may have an influence on metabolic parameters related to obesity. Objective To determine the electroacupuncture (EA) protocol to be used in a future clinical trial examining the effect of acupuncture on metabolic parameters related to obesity and to examine whether a single EA treatment can change fasting blood glucose in obese subjects. Methods 16 obese women aged 30–52 years with body mass index >30 kg/m2 were assigned consecutively into three groups and their fasting blood glucose was measured before and after administering a single session, lasting 30 min, of one of three EA treatment protocols. The Dorsal group received EA to dorsal segmental acupuncture points BL18–23 bilaterally (corresponding to the segmental levels innervating the pancreas); the Ear group received EA to ear points in the cavum conchae; and the Limb group received EA to points in the arms and legs (LI10–LI11, ST36– Zongping). Results After a single session of EA there was a statistically significant decrease in fasting blood glucose in the Dorsal and Limb groups, but there was no change and even a trend towards an increase in the glucose level in the Ear group. Conclusions The findings of this small pilot study suggest that EA to either dorsal segmental points corresponding to the pancreas or to muscle points in all four limbs may exert a beneficial effect on glucose metabolism in obese women.


2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Renying Xu ◽  
Ting Zhang ◽  
Yanping Wan ◽  
Zhuping Fan ◽  
Xiang Gao

Abstract Background Diabetes has been reported to be associated with carotid artery plaque (CAP). However, it remains unclear whether hemoglobin A1c (HbA1c) level, a marker for long-term glycemic status, is associated with altered CAP risk in individuals with fasting blood glucose (FBG) concentrations below the current cutoff for diabetes. Methods Included were 16,863 Chinese adults (aged 18 years or more; 9855 men and 7008 women) with fasting blood glucose < 7.0 mmol/L at baseline (2013). Both HbA1c level and CAP (assessed via ultrasound B-mode imaging) were annually assessed during 2014–2018. All the participants were further classified into three groups based on baseline HbA1c level: ≤ 5.6%, 5.7–6.4%, and ≥ 6.5%. We used Cox proportional-hazards model to evaluate the association between HbA1c level and incident CAP, adjusting for a series of potential confounders. Results During 5 years of follow up, 3942 incident CAP cases were identified. Individuals with higher baseline HbA1c had higher future risk of CAP (p-trend < 0.001). In the full-adjusted model, each percent increase of HbA1c was associated with a 56% (HR = 1.56, 95% CI 1.37, 1.78) higher risk of CAP. Excluding participants with chronic inflammation, as assessed by high-sensitivity C-reactive protein and white blood cell, and those with FBG ≥ 5.6 mmol/L at baseline generated similar results. Conclusions Elevated HbA1c level was associated with high risk of developing CAP in Chinese adults without FBG defined diabetes.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Ejigayehu G Abate ◽  
Amanda McKenna

Abstract The liver plays an important role in bone and mineral metabolism of patients with end-stage liver disease. These patients are known to have an increased risk of osteoporosis and fractures before liver transplant (LT) with reported fracture incidence of 10-56%. The cause is multifactorial, which includes their underlying liver disease, chronic illness, vitamin D deficiency, and hyponatremia. The impact of hyperglycemia and diabetes mellitus on bone health in liver transplant recipients is not known. Hypothesis: Hyperglycemia increases risk of fracture and osteoporosis in pre- LT patients undergoing LT. Methods: To answer this question, we did a retrospective chart review of consecutive first time, single organ LT recipients at our institution from 2011-2014, who had BMD performed prior to transplantation. We identified 393 patients but included only 209 patients who carried a diagnosis of hyperglycemia or diabetes (type 2 DM, type 1 DM, steroid induced DM and hyperglycemia). BMD was defined based on WHO criteria as Normal, osteopenia and osteoporosis. Hemoglobin A1C was divided into 4 quartiles (A1C ≤5.6%, 5.7-6.4%, 6.5-7.9%, and ≥8%); fasting blood glucose was defined as any venous glucose checked before 9am and labeled as a fasting lab in the chart. Fasting blood glucose was divided into those with BG&lt;100, 101-125, 126-200, &gt;200 mg/dL. We chose labs closest to the transplant date. Pre LT fracture was compared with hemoglobin A1C and BMD as well as fasting glucose. STATA statistical program was used to calculate Fisher T-test. Results: Baseline characteristics of our cohort were as follows. Median BMI was 27.9 (16.2, 45.6). Majority had hepatitis C (33%), NASH 12%, and alcoholic liver disease 23%. Average MELD score was 15 (6-40). Average wait time to transplant was 90 days. 29% of patients had normal BMD, 46% osteopenia and 25% osteoporosis. From the total 209 patients reviewed, 17 had a fracture prior to transplant of which 14/17 had vertebral fractures. The only variable that correlated with risk of fracture was hemoglobin A1C. Higher level of Hemoglobin A1C correlated with the presence of fracture p= 0.04. BMD did not correlate with fracture p= 0.28. There was no association between BMD and Fasting glucose level p=0.55. There was no correlation between fasting glucose and risk of fracture p=0.44. Discussion: This study suggests that a correlation between the presence of pre LT fracture and HgA1C exists. Other factors such as BMD and fasting BG did not correlate with fracture. Those with higher hemoglobin A1C prior to liver transplant might be at risk for fracture compared to those without diabetes or hyperglycemia (A1C &lt;5.7). Benefit of diabetes control for bone health in this population is not known, however we speculate that those with lower A1C, thus better glucose control, have a lower risk of fracture thus aggressive glucose control should be part of the pre transplant care.


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