scholarly journals Variation of HbA1c with Hemoglobin level: A comparative study betweenD10 Biorad (HpLC) and Nycocard (Immunochromatography) analyser.

2021 ◽  
Author(s):  
Arabinda Mohan Bhattarai ◽  
Sulochana Parajuli ◽  
Salina Pradhananga
Keyword(s):  
Glycemic Control ◽  
High Performance ◽  
Glycosylated Hemoglobin ◽  
Cross Sectional Study ◽  
Hplc Method ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Background Measurement

Abstract Background Measurement of Glycosylated Hemoglobin (HbA1c) is an established procedure in evaluating long-term glycemic control in diabetic patients. It is an index of glycemic control which is not affected by diurnal glucose fluctuations. Methods A retrospective cross sectional study was performed in the Biochemistry department of Shree Birendra Hospital, Kathmandu, Nepal involving 100 known cases of type 2 diabetes mellitus. This study was designed to study the variation of HbA1c with hemoglobin levels. HbA1c was measured by Bio-Rad D10 (HPLC method) and Nycocard (Immunochromatography method). Linear regressive analysis with correlation coefficient was used to compare HbA1c with hemoglobin levels and a p-value < 0.05 is considered statistically significant. Results There was a strong correlation of HbA1c values with Hemoglobin levels in HPLC methods p = 0.001, r = 0.6, however no such correlation was seen in Nycocard method p = 0.6, r = 0.08. Conclusion Cation-exchange high performance liquid chromatography (HPLC) is the latest method introduced in our country Nepal. Therefore, interference caused by Hemoglobin variants needs to be evaluated by methods such as HPLC. In such situations, we may consider fructosamine, glycated serum albumin or self-monitoring of blood glucose as an adjunct to HbA1C measurements.

scholarly journals Stringent glycemic control is still the key to evade diabetic retinopathy.

2020 ◽  
Vol 27 (05) ◽  
pp. 1011-1016
Author(s):  
Syed Munawar Alam ◽  
Sagheer Ahmed ◽  
Shazia Bano ◽  
Shahneela Perveen
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Proliferative Diabetic Retinopathy ◽  
Study Groups ◽  
Hplc Method ◽  
P Value ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Institutional Review

Objectives: The aim of this study was to evaluate the major determinants of diabetic retinopathy. Study Design: Cross sectional, case control study. Setting: Department of Biochemistry, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi. Period: March 2015 to April 2016. Material & Methods: Ethical approval was taken from the Institutional Review Board of JPMC. A total of 208 people including type 2 diabetic patients and healthy control subjects; of male gender, aged between ≥30 years and ≤ 60 years were recruited and assigned to four study groups. Each group comprise of 52 individuals, depending on the ophthalmoscopy findings, i.e. healthy controls, diabetic without retinopathy (NDR), diabetic with non-proliferative diabetic retinopathy (NPDR) and diabetic with proliferative diabetic retinopathy (PDR). Fasting blood sugar was estimated using GOD-PAP method, while HbA1c was estimated by HPLC method. Data was analyzed on SPSS software version 16. Results: Diabetics with Diabetic Retinopathy had a poor glycemic control as compare to Diabetics without Diabetic Retinopathy (FBS; 109.12 ± 13.81 vs. 184.29 ± 40.07 vs. 188.6 ± 47.68 vs. 217.06 ± 62.33; p-value = 0.001) (HbA1c; 6.73 ± 0.56 vs. 8.40 ± 1.77 vs. 9.71 ± 1.85 vs. 14.91 ± 3.87; p-value = 0.001). For Diabetic Retinopathy the odds ratio of glycemic control i.e. FBS was observed as 1.019 & HbA1c was recorded as 1.561; which was statistically significant. Conclusion: Glycemic indicators; including FBS and HbA1c, are found to be the major determinants of Diabetic Retinopathy in our study.

scholarly journals The relationship between high-density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin in diabetic patients aged 20 or above: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rui Huang ◽  
Li Yan ◽  
Yuhua Lei
Keyword(s):  
Glycemic Control ◽  
Interaction Analysis ◽  
Glycosylated Hemoglobin ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Cerebrovascular Diseases ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Race Ethnicity ◽  
The Relationship

Abstract Aim The incidence rate of diabetes is increasing year by year, seriously threatening human health. As a predictor of glycemic control, glycated hemoglobin is reported to be related to various complications and prognoses of diabetes. Besides, HDL-C dyslipidemia is a component of metabolic syndrome and may be related to various cardiovascular and cerebrovascular diseases. The principal objective of this project was to investigate the relationship between HDL-C and glycosylated hemoglobin in adult diabetic patients. Methods A total of 3171 adult diabetic patients aged 20 years and above were included in the present study from the National Health and Nutrition Examination Survey (NHANES). HDL-C and glycosylated hemoglobin were regarded as independent and dependent variables, respectively. EmpowerStats software and R (version 3.4.3) were used to examine the association between HDL-C and glycosylated hemoglobin. Results HDL-C was inversely associated with glycohemoglobin after adjusting for other covariates (β = − 0.004, 95% CI:− 0.008 to − 0.000, p = 0.044). Race/ethnicity and age were considered the most prominent interactive factors that affect the relationship between HDL and glycosylated hemoglobin by the interaction analysis. A U-shaped association was detected between HDL-C and glycosylated hemoglobin for people of other race/ethnicity or aged 60 and above, which had an inflection point of HDL-C at 60 mg/dL. In contrast, we observed an inverted U-shaped distribution between HDL-C and glycosylated hemoglobin in people under 40 with point of inflection located at 60 mg/dL as well. Conclusions HDL-C in diabetic patients is inversely associated with glycosylated hemoglobin and may be relevant to glycemic control. However, a U-shaped relationship was also observed in a certain kind of people, which implied that, though HDL-C is considered as metabolism and anti-atherogenic property, for diabetics, it is not the higher, the better.

Glycemic control and its associated factors among patients with diabetes mellitus: a cross-sectional study in Bangladesh

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hasan Mahmud Reza ◽  
Towhid Hasan ◽  
Marjia Sultana ◽  
Md. Omar Faruque
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Cross Sectional Study ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Content Type

Purpose Diabetes mellitus is becoming a growing concern worldwide. Hence, the purpose of this study is to assess the magnitude of poor glycemic control and to identify the determinants of poor glycemic control among diabetic patients attending a tertiary care hospital in Bangladesh. Design/methodology/approach This cross-sectional study was conducted among 732 diabetes patients seeking care at the outpatient department of Bangladesh Institute of Health Sciences Hospital, Dhaka, Bangladesh. Information, including glycemic status, was collected from patients’ medical records using a structured questionnaire. Findings About 87.6% of the patients were found to have poor glycemic control (glycosylated hemoglobin = 7%). Variables that were significant in bivariate analysis were put into a multivariate model where the factors associated with poor glycemic control were patients aged 41–60 years (odds ratio (OR)=2.26; 95% confidence interval (CI): 1.19–4.32, p = 0.013), suffering from diabetes for > 7 years (OR = 1.84; 95% CI: 1.12–2.99, p = 0.015), using insulin (OR = 2.34; 95% CI: 1.23–4.47; p = 0.010) or diet alone (OR = 0.20; 95% CI: 0.05–0.80, p = 0.023) as a type of diabetes treatment and proper use of medicine (OR = 0.37; 95% CI: 0.17–0.82, p = 0.015). Originality/value The high prevalence of poor glycemic control among diabetic patients is evident; therefore, strategic management and proper attention focusing on the predictors of poor glycemic control are necessary to reduce the long-term complications of diabetes.

scholarly journals Lipid profile pattern in controlled and uncontrolled diabetic patients in a tertiary care centre

2020 ◽  
Vol 8 (4) ◽  
pp. 1528
Author(s):  
Smita Gupta ◽  
Rajat Mangal ◽  
Ankit Grover
Keyword(s):  
Glycemic Control ◽  
Total Cholesterol ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Good Glycemic Control ◽  
Cross Sectional ◽  
Lipid Panel

Background: Diabetes Mellitus is a metabolic disorder characterized by hyperglycemia with disturbances of carbohydrate, lipid as well as protein metabolism virtually affecting every organ in the human body. Dyslipidemia is a group of biochemical disorders, which is frequently seen in diabetic individuals. Dyslipidemia associated with diabetes has a major role in atherosclerosis and cardiovascular complications.Methods: This cross-sectional study was conducted in diabetic patients visiting OPD of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly over a period of 6 months. A total of 320 patients were randomly selected for the study and divided into 2 groups depending on HbA1c levels.Results: BMI of controlled diabetics was 26.2±1.91 kg/m2 and of uncontrolled was 27.56±4.36 kg/m2 respectively with a statistically significant p value. Total Cholesterol levels in controlled group was 185.63±52.32 mg% and 217.83±61.33 mg% in uncontrolled group with a p value of 0.0005 which is highly significant. Same was seen in triglyceride and VLDL levels in controlled group which was 173.88±101.77 mg% and 31.5±12 mg% respectively and 203.33±83.7 mg% and 40.67±17.66 mg% in uncontrolled group respectively.Conclusions: The diabetic patients with poor glycemic control had statistically significant high values of Total Cholesterol, Triglycerides, VLDL levels and significant low HDL Levels. Good glycemic control can result in improvement in the lipid panel and the patients can be prevented from the high cardiovascular and neurological risk.

scholarly journals FVC, FEV1 And FEV1/FVC% In Type-1 Diabetic Male And Their Relationships With HbA1c

2012 ◽  
Vol 7 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Khan Mohammad Arif ◽  
Nasim Jahan ◽  
Nayma Sultana ◽  
Rezina Akter
Keyword(s):  
Glycemic Control ◽  
Economic Status ◽  
Glycosylated Hemoglobin ◽  
Study Groups ◽  
Cross Sectional Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Apparently Healthy

Background: Diabetes mellitus is a chronic and debilitating disease. Its complications give rise to micro and macrovascular diseases which affect eyes, kidneys, heart, blood vessels, nerves and also lungs. There may be a relationship between type-1 diabetes and reduced lung function.Objectives: To observe FVC, FEV1, FEV1/FVC % and their relationship with HbA1C in type-1 diabetic male in   Bangladesh.Methods: This cross-sectional study was carried out in the Department of Physiology, Sir Salimullah Medical College, Dhaka from January to December 2009. A total number of 60 male   subjects, from 18-30 years of age was taken and was divided into control and study groups. Among them study group was consisted of 30 type-1 diabetic male patients. Control group was consisted of 30 apparently healthy age, sex, BMI and socioeconomic status matched non-diabetic subjects. All the subjects belonged to lower socio-economic status. For assessment of lung function, FVC, FEV1, FEV1/FVC % of all the subjects were measured. All of theses tests were done by spirometric method by using a digital Spirometer. Again, to observe glycemic control of blood, glycosylated hemoglobin (HbA1c) levels of diabetic patients were also measured by usual laboratory technique. Data were analyzed by Independent-Samples ‘t’ test and Pearson’s correlation coefficient test as applicable.Results: FVC (p <0.001), FEV1 (p < 0.001), and FEV1/FVC% (p < 0.05) were significantly lower in type-1 diabetic patients in comparison to those of apparently healthy non-diabetic male. Again FVC and FEV1 had significant (p < 0.001) negative correlation but FEV1/FVC% had non-significant positive correlation with HbA1c.Conclusion: Impairment of some lung functions may be found in type-1 diabetic male which may be due to poor glycemic control. DOI: http://dx.doi.org/10.3329/jbsp.v7i1.11156 J Bangladesh Soc Physiol. 2012, June; 7(1): 23-28

scholarly journals PEFR, FEF25-75 and MVV In Type-1 Diabetic Male And Their Relationships With HbA1c

2013 ◽  
Vol 8 (1) ◽  
pp. 16-20
Author(s):  
Khan Mohammad Arif ◽  
Nasim Jahan ◽  
Nayma Sultana
Keyword(s):  
Glycemic Control ◽  
Lung Function ◽  
Glycosylated Hemoglobin ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Medical College ◽  
Control Serum ◽  
Apparently Healthy

Background: Diabetes mellitus is a chronic and debilitating disease. Its complications give rise to microvascular, macrovascular and neuropathic diseases which affect eyes, kidneys, heart, blood vessels and also lungs. So, there may be a relationship between type-1 diabetes and reduced lung function. Objectives: To observe PEFR, FEF25-75 and MVV and their relationship with HbA1c in type- 1 diabetic male in Bangladesh. Methods: This cross-sectional study was carried out in the Department of Physiology, Sir Salimullah Medical College, Dhaka between 1st January and 31st December 2009. A total 30 type-1 diabetic male subjects, age 18-30 years were taken as study group. Another 30 apparently healthy age, sex, BMI and socioeconomic status matched non-diabetic persons were also included as control. For assessment of lung function PEFR, FEF25-75 and MVV of all the subjects were measured by a digital spirometer. Again, to observe glycemic control serum blood glucose and glycosylated hemoglobin (HbA1c) levels of diabetic patients were also measured by usual laboratory technique. Data were analyzed by unpaired‘t’ test and Pearson’s correlation coefficient test. Results: PEFR (p<0.001), FEF25-75 (p<0.001), and MVV (p <0.001) were significantly lower in type-1 diabetic patients in comparison to those of apparently healthy non-diabetic male. Again, their PEFR (p < 0.05), FEF25-75 (p>0.05), and MVV (p<0.05) were negatively correlated with HbA1c. Conclusion: The lung functions were lower in type-1 diabetic male in comparison to those of non-diabetic counterpart and this reduction is mainly due to poor glycemic control. DOI: http://dx.doi.org/10.3329/jbsp.v8i1.16642 J Bangladesh Soc Physiol. 2013, June; 8(1): 16-20

scholarly journals Assessment of Vitamin D3 Levels and Metabolic Profile in Pre-diabetic and Type 2 Diabetes Mellitus Patient of Kanpur City- A Cross Sectional Study

2020 ◽  
Author(s):  
Prashant Tripathi ◽  
Malvika Mishra ◽  
Kirti Amresh Gautam ◽  
Arisht Jain ◽  
Saurabh Agarwal
Keyword(s):  
Vitamin D ◽  
Glycemic Control ◽  
Vitamin D3 ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Good Glycemic Control ◽  
Cross Sectional ◽  
Hba1 C ◽  
Sufficient Vitamin

Objective: It has been explored that Vitamin D play role in various non-skeletal disorders including Diabetes Mellitus. The present study was designed with the aim to assess association among control, pre-diabetic and diabetic with vitamin D and association between lipid profile and vitamin D. Materials and Methods: A total of 109 subjects were recruited for the cross-sectional study including 37 as control, 41 pre-diabetic and 31 diabetic. A clinical examination was done for all the groups including fasting samples (12hrs) for lipid parameters, serum 25 (OH) vitamin D level and (HbA1/C). Results: It was found that in control subjects 37.9% have the sufficient vitamin D3 level whereas 17.1% subjects in pre-diabetic, 16.6% in diabetic with good glycemic control and no subject was found to have sufficient vitamin D3 level in diabetic with poor glycemic control. The mean vitamin D3 levels was highest in control i.e. -26.53±11.99 ng/ml followed by 20.23±4.12ng/ml in prediabetics,19.07±8.01ng/ml in diabetics with good glycemic control and 12.92±6.77ng/ml in diabetics with poor glycemic control. HBA1/c and serum vitamin D3level share a significant association (P-value< 0.01).Total cholesterol (P-value< 0.0), serum triglyceride (P-value< 0.01), serum LDL cholesterol (P-value< 0.01) and serum VLDL (P-value< 0.01) had inverse association with vitamin D levels. HDL cholesterol has no effect with vitamin D. Conclusion: The present study showed vitamin D3 deficiency as a risk factor for worsening glycemic control and dyslipidemia.

scholarly journals Usage of diuretics among diabetic-hypertensive patients

2014 ◽  
Vol 6 (2) ◽  
pp. 14-17
Author(s):  
Rajeshwari Shastry ◽  
M.R. Prabha Adhikari ◽  
Sheetal D. Ullal ◽  
Shashidhar Kotian
Keyword(s):  
Glycemic Control ◽  
Tertiary Care ◽  
Vascular Complications ◽  
Cross Sectional Study ◽  
Drug Combinations ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Aggressive Approach ◽  
Hypertensive Patients ◽  
Treatment Of Hypertension

Background: Hypertension is more common in diabetics than in non-diabetic patients. An aggressive approach to the diagnosis and treatment of hypertension in patients with diabetes is required in order to substantially reduce the incidence of both macro-vascular and micro-vascular complications. The role of diuretics in the treatment of hypertension as first line or second line drugs is a provoking debate, hence we studied the usage of diuretics and their effects on BP and glycemic control among diabetic-hypertensive patients.Methods: This cross sectional study was carried out for a period of six months in a tertiary care teaching hospital. Patients’ details such as age, gender, height, weight, comorbid diseases, blood pressure, eGFR along with duration of diabetes and hypertension and drugs prescribed for hypertension were noted. Data were analyzed using descriptive statistics.Results: A total of 336 diabetic-hypertensiveswith a mean age of 64.55±9.51 years were included. Fortyfive patients were on diuretics,two (4.4%) of whom were on diuretic monotherapy, 16 (35.6%) on two drug combinations (Diuretic + ACEI or ARB), 21 (46.7%) on three drug combinations (diuretics + ARB & BBs or diuretic + ACEI & BB or diuretic + ARB &CCB) and six (13.3%) were on four drug combinations (diuretics + ARB, CCB & BB). Among the patients on diuretic combination therapy BP was well controlled in 23 (51%) patients and the glycemic control was comparable to those not on diuretics.Conclusion: In the present study the usage of diuretics was consistent with the guidelines. About 13% of diabetic-hypertensive patients were on diuretic treatment. The control of BP in patients on diuretics was not satisfactory, but there was no worsening of glycemic control compared to other antihypertensive therapy. This shows that low dose thiazides in combination with other antihypertensives can be safe in diabetic-hypertensive patients however their efficacy needs further scrutiny. DOI: http://dx.doi.org/10.3126/ajms.v6i2.10582Asian Journal of Medical Sciences Vol.6(2) 2015 15-18

scholarly journals THE IMPACT OF MEDICATION ADHERENCE ON HEALTH-RELATED QUALITY OF LIFE OF DIABETIC PATIENTS IN THE KINGDOM OF SAUDI ARABIA: FINDINGS FROM A CROSS-SECTIONAL STUDY

2020 ◽  
Vol 17 (34) ◽  
pp. 867-873
Author(s):  
Dhfer ALSHAYBAN ◽  
Royes JOSEPH
Keyword(s):  
Quality Of Life ◽  
Medication Adherence ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Health State ◽  
Cross Sectional ◽  
Related Quality ◽  
The Impact

Diabetes is a common chronic disease that is considered as one of the fastest-growing health problems in the world. Adherence to medications could be an important factor in reducing these complications and improving the quality of life. The purpose of this research was to assess the impact of treatment adherence on health-related quality of life in patients with type 2 diabetes. A multicenter cross-sectional study was carried out among 368 diabetes patients. General Medication Adherence Scale was used to assess the adherence level and EuroQol-5D to assess the quality of life. The results show that 19%, 21%, and 23% of patients had maintained low medication adherence due to patient’s intentional or unintentional behavior due to additional diseases or pills burden and due to financial constraints, respectively. Overall, 43% (n=162) participants had maintained high medication adherence, and 37% (n=138) had maintained low medication adherence to antidiabetic drugs. Nearly one-third (31%) of patients with high overall adherence had perfect health state in comparison with 4% among patients with low adherence. Further, the lower proportion (21%) of patients with high overall adherence had perfect health state in comparison with that among patients with low adherence (34%). In addition to the overall adherence, the association was statistically significant for the domains related to non-adherence due to the patient’s intentional or unintentional behavior (p-value 0.001) and non-adherence due to additional diseases or pills burden (p-value 0.001) after taking into account of socio-demographic and clinical characteristics. In conclusion, the findings suggest that the policymakers should establish an intervention to improve adherence to diabetic treatment, and thus improve the quality of life for the type 2 diabetic patients.

scholarly journals Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals

2018 ◽  
Vol 35 (1) ◽  
Author(s):  
Iqra Arshad ◽  
Sara Mohsin ◽  
Sana Iftikhar ◽  
Tahseen Kazmi ◽  
Luqman F. Nagi
Keyword(s):  
Insulin Therapy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Early Initiation ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Creative Commons ◽  
Oral Medications ◽  
Tertiary Care Hospitals

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.237 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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