Glycosylated Hemoglobin Levels Among Non-Diabetic Children With Sickle Cell Anemia At Muhimbili National Hospital. A Case For Establishing Normal Values

2021 ◽  
Author(s):  
Nancy M Mugyabuso ◽  
Kandi Muze ◽  
Karim Manji
Keyword(s):  
Diabetes Mellitus ◽  
Hba1c Level ◽  
Reference Range ◽  
Glycosylated Hemoglobin ◽  
Reference Ranges ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Normal Ranges ◽  
Diabetic Children ◽  
Hba1c Levels

Abstract BackgroundImprovement in the management of children with SCA, has led to increase in their lifespan. However, the increased lifespan, has been accompanied with emergence of various endocrinopathies such as Diabetes mellitus (DM).Glycosylated Hemoglobin (HbA1c) levels have been found to be lower in children with SCA compared to children without SCA in various studies. This can lead to missed children with DM hence delaying their treatment. There is a need to establish normal ranges of HbA1c levels corresponding to children with SCA.ObjectiveTo determine normal range of HbA1c levels among non-diabetic children with SCA attending clinics at Muhimbili National Hospital in Dar-es-salaamMethodologyThis was a hospital-based cross sectional study conducted at Paediatric clinics in Muhimbili National Hospital involving children from 9 months to 14 years. The study was approved by Institutional review Board of MUHAS. A written informed consent was obtained.120 children with SCA and 40 children without SCA were recruited. Data was reported as median and IQR or as mean ± standard deviation. Chi-square was used for categorical data while independent t-test and Mann Whitney test were used for continuous data. ResultsThe reference range of HbA1c levels in children with SCA was from 3.4% to 5.2%. Median HbA1c level in children with SCA was 4.2% with IQR of (4.1% - 4.6%) while for children without SCA median HbA1c levels was 5.3% with IQR of (4.9% - 5.5%). The median HbA1c level was significantly lower in children with SCA than children without SCA.Conclusion and RecommendationThe reference range of HbA1c levels in children with SCA was from 3.4% to 5.2%. Children with SCA had lower levels of HbA1c compared to children without SCA. Health personnel are advised to use HbA1c reference ranges obtained from this study when screening for Diabetes mellitus in children with SCA.

scholarly journals Effects of Sitagliptin on HbA1c levels in uncontrolled hyperglycemia in diabetics using conventional OAD’s.

2020 ◽  
Vol 27 (05) ◽  
pp. 963-967
Author(s):  
Amar Nazir ◽  
Fida Muhammad Sheikh ◽  
Sheraz Saleem
Keyword(s):  
Diabetes Mellitus ◽  
Hba1c Level ◽  
Glycosylated Hemoglobin ◽  
Type Ii Diabetes Mellitus ◽  
Cross Sectional ◽  
Entire Study ◽  
Dipeptidyl Peptidase 4 ◽  
Diagnostic Center ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Hba1c Levels

Objectives: The study anticipates to appraise HbA1c levels after three months of sitagliptin addition (100mg/day) to patients already using conventional oral antidiabetics in patients of type II diabetes mellitus who have a meager retort to these existing anti diabetics. Study Design: Mainly cross sectional prospective multicenter, open labeled study. Setting: Department of Medicine University medical diagnostic center & District Head Quarter Hospital Sargodha. Period: January 2017 to June 2017. Material & Methods: 100 inadequately controlled diabetics using different types of oral anti diabetics were chosen and an especially designed performa was accomplished. In our study we gave preference to those patients who were on preexisting oral anti diabetics and now dipeptidyl peptidase 4 inhibitors were added for the first time. The patients were instructed (at the baseline visit) to report during the subsequent visit about glycemic control. Patients were not clued-up that glycosylated hemoglobin control was the main seek of the study, so there was no chance for Pygmalion effect. Results: Levels of glycosylated hemoglobin were significantly reduced after three months of treatment compared to baseline, with a mean alteration in HbA1c level from baseline of −0.77% (range, −0.68 to − -0.86%) in the entire study population at three months. The percentage of patients who achieved an HbA1c level of <6.9% significantly increased after three months of treatment, reaching 58.1%. Conclusion: HbA1c significantly lowered in patients with type 2 diabetes mellitus on conventional OADs after adding sitagliptin.

scholarly journals The Effect of Oat Bran Supplement on Fasting Blood Sugar and Glycosylated Hemoglobin in Patients with Gestational Diabetes Mellitus: Single-blind Randomized Clinical Trial

2019 ◽  
Author(s):  
Maedeh Shahzeidi ◽  
Azadeh Nadjarzadeh ◽  
Masoud Rahmanian ◽  
Amin Salehi Abarghuoei ◽  
Hossein Fallahzadeh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trial ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Blood Sugar ◽  
Glycosylated Hemoglobin ◽  
Oat Bran ◽  
Single Blind ◽  
Hba1c Levels

Background: Gestational diabetes mellitus (GDM) is known as a degree of glucose intolerance that occurs for the first time during pregnancy. There is paucity of evidence regarding the effect of oat bran on GDM. Oat as a source of β-glucan can be effective in reducing the blood sugar levels. This study aimed to investigate the effect of oat bran on fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c) in patients with GDM. Method: This single-blind clinical trial was conducted on 90 pregnant women with GDM. The experimental group (EG) consumed 30 g of oat bran daily with 100 g of low-fat yogurt before lunch and dinner for 4 weeks. The control group (CG) consumed only low-fat yogurt and both groups received nutrition counseling. The present study investigated the FBS, HbA1c, and weight gain at the beginning and after four weeks of intervention. Results: Out of 90 patients, 80 completed the study. FBS decreased in the EG (P = 0.04, -2.75 ± 8.22), whereas, it increased in the CG (P = 0.003, 4.37 ± 8.72). No significant difference was observed between the two groups in terms of HbA1c levels. Weight gain was controlled more efficiently in the EG than the CG (P = 0.001). Conclusion: The use of oat bran for four weeks decreased the FBS,; whereas, it did not affect HbA1c levels. Weight gain was controlled better in the EG than the CG.

Effect of Different Factors on Glycosylated Hemoglobin (HbA1c) Levels Among Diabetes Mellitus Patients

2021 ◽  
Vol 15 (12) ◽  
pp. 3513-3515
Author(s):  
Bader Alsuwayt
Keyword(s):  
Diabetes Mellitus ◽  
Glycated Hemoglobin ◽  
Glycosylated Hemoglobin ◽  
Diabetic Patients ◽  
Study Results ◽  
Patients With Diabetes ◽  
Insulin Use ◽  
Low Rate ◽  
Statin Use ◽  
Hba1c Levels

Aim: To describe the rate of the controlled level of glycosylated hemoglobin (HbA1c) among diabetes mellitus patients in Dammam city, Kingdom of Saudi Arabia (KSA). To assess the association between the status of HbA1c and the different patient-related factors namely: insulin use, metformin, dyslipidemia, and statin use. Methods: This cross-sectional study was performed at Security Forces Hospital, Dammam, KSA, between November 2020 and February 2021. A sample of two hundred known diabetic patients who were regularly followed up at the outpatient department (OPD) was selected randomly for the current study. Results: A very low rate (24%) of controlled HbA1C levels in patients with diabetes (type 1 DM and type 2 DM), The data showed that 85 % of all participants in our study are T2DM patients, while only 15% are T1DM patients, Our data showed that patients with dyslipidemia, hypothyroidism, or hypertension have a high level of uncontrolled HbA1C levels. Surprisingly, both dyslipidemia and statin use were predictors of uncontrolled HbA1C, Unexpectedly, non-metformin use has a protective effect toward controlling HbA1C, While insulin use is a strong predictor of uncontrolled HbA1C (OD 5.20). Conclusion: A low rate of controlled glycated hemoglobin (HbA1c) level among patients with diabetes (T1DM and T2DM) in our sample urges the need for immediate intervention to investigate and improve the current findings. Further investigations are needed to fully explain the high rate of uncontrolled HbA1c among insulin, metformin and statins users. Keywords: Glycated hemoglobin, HbA1c, Diabetes mellitus, Statins, Metformin.

HBA1C IS ASSOCIATED WITH FRAILTY IN A GROUP OF ABORIGINAL AUSTRALIANS

2018 ◽  
pp. 1-4
Author(s):  
Z. Hyde ◽  
K. Smith ◽  
L. Flicker ◽  
D. Atkinson ◽  
S. Fenner ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Hba1c Level ◽  
Binary Logistic Regression ◽  
Glycated Haemoglobin ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Aboriginal Australians ◽  
Obesity And Diabetes ◽  
Hba1c Levels

In this cross-sectional study of 141 Aboriginal Australians aged ≥45 years living in the remote Kimberley region of Western Australia, we explored whether glycated haemoglobin (HbA1c) levels were associated with frailty. Sixty-four participants (45.4%) had a HbA1c level ≥6.5% and 84 participants (59.6%) were frail. A significant trend was observed with regard to HbA1c levels and frailty, with those having HbA1c levels ≥6.5% having the greatest prevalence of frailty (70.3%). In binary logistic regression analyses, having a HbA1c level ≥6.5% was associated with being frail after adjustment for age, sex, and education. This association was attenuated after further adjustment for body mass index (BMI). Poorer glycaemic control is very common and a potential risk factor for frailty in remote-living Aboriginal Australians, and appears to be partly mediated by BMI, a known risk factor for diabetes mellitus. Obesity and diabetes mellitus are potentially important modifiable risk factors for frailty.

scholarly journals Impact of Admission Glycosylated Hemoglobin A1c on Angiographic Characteristics and Short Term Clinical Outcomes of Nondiabetic Patients with Acute ST-Segment Elevation Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Islam El-sherbiny ◽  
Baher Nabil ◽  
Tamer Saber ◽  
Fathy Elsayed Abdelgawad
Keyword(s):  
Hba1c Level ◽  
Glycosylated Hemoglobin ◽  
University Hospital ◽  
Complete Revascularization ◽  
Cardiac Events ◽  
Short Term ◽  
Acute Stemi ◽  
Adverse Cardiac Events ◽  
Significant Difference ◽  
Hba1c Levels

We aimed to assess the predictive value of admission HbA1c level in nondiabetic patients presented by acute STEMI, on outcome of PCI and short term outcome of adverse cardiac events.Methods. 60 nondiabetic patients were admitted to Cardiology Department, Zagazig University Hospital, with acute STMI: 27 patients with HbA1c levels of 4.5% to 6.4% (group 1), 17 patients with HbA1c levels of 6.5% to 8.5% (group 2), and 16 patients with HbA1c levels higher than 8.5% (group 3). Either invasive intervention was done at admission by (pPCI) or coronary angiography was done within month (3–28 days) from taking thrombolytic. Participants were followed up for 6 months.Results. There was significant difference among different groups of HbA1c as regards the number of diseased vessels, severity of CAD lesions (pvalue < 0.01), and TIMI flow grades (pvalue < 0.05). There was significant difference among different groups as regards the adverse cardiac events on short term follow-up period (pvalue < 0.05).Conclusion. The present study showed that admission higher HbA1c level in patients presented by acute STEMI is associated with more severe CAD, lower rate of complete revascularization, and higher incidence of adverse cardiac events.

scholarly journals Elevated glycosylated hemoglobin levels and their interactive effects on hypertension risk in nondiabetic Chinese population: a cross-sectional survey

2020 ◽  
Author(s):  
jian song ◽  
nana wei ◽  
yingying zhao ◽  
yuhong jiang ◽  
xuesen wu ◽  
...  
Keyword(s):  
Hba1c Level ◽  
Glycosylated Hemoglobin ◽  
Interactive Effects ◽  
Prevalence Rates ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hypertension Risk ◽  
History Of ◽  
Family History Of Hypertension ◽  
Hba1c Levels

Abstract Background: Abnormal glucose metabolism has been suggested to be involved in the development of hypertension. This study investigated the effect of the association and potential interaction of glycosylated hemoglobin (HbA1c) and other factors on the risk of hypertension among Chinese nondiabetic adults. Methods : As a cross-sectional survey, the current work deployed a questionnaire survey, anthropometric tests, and biochemical measures for each of the eligible participants. The HbA1c levels were quantified and grouped by quartiles. Correlations between HbA1c and hypertension, isolated systolic hypertension (ISH), and isolated diastolic hypertension (IDH) risk in nondiabetics were investigated by univariate and multivariate logistic analyses. For evaluating the interactive effects, the parameters of relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were calculated, respectively. Results : In the current study, 1,462 nondiabetic subjects were enrolled. In total, the prevalence rates of hypertension, ISH and IDH were 22.4%, 9.6% and 4.5%, respectively. When HbA1c levels were grouped by quartile, it was revealed that the prevalence rates of hypertension and ISH were substantially elevated across groups (Pfor trend<0.001). In the multivariable logistic regression analyses, in comparison with the first quartile of HbA1c, the normalized OR for hypertension risk was 1.90 (95% CI: 1.28-2.80) for the highest quartile. Also, the risk of ISH was significantly increased with HbA1c level in the highest quartile relative to in the bottom quartile (OR: 2.23,95% CI:1.47-3.71). However, no significant relationship between the HbA1c level and IDH risk was observed (OR: 1.78, 95% CI: 0.82-3.84). Eventually, it was demonstrated from the interactive effect analysis that HbA1c significantly interacted with abdominal obesity(RERI: 1.48, 95% CI: 0.38-2.58; AP: 0.37, 95% CI: 0.14-0.60 and SI: 1.96, 95% CI: 1.06-3.62) and family history of hypertension(AP: 0.37, 95% CI: 0.05-0.70) in influencing the risk of hypertension in nondiabetic participants.Conclusion: Higher HbA1c levels were associated with an increased risk of hypertension and ISH, but not IDH among Chinese nondiabetic adults. Moreover, the risk of hypertension was also aggravated by the upregulated HbA1c in a synergistic manner alongside abdominal obesity and family history of hypertension.

Short-Term Effect of Hypergastrinemia Following Esomeprazole Treatment On Well-Controlled Type 2 Diabetes Mellitus: A Prospective Study

2020 ◽  
Vol 20 (7) ◽  
pp. 1090-1096
Author(s):  
Yusuf Bozkuş ◽  
Umut Mousa ◽  
Özlem T. İyidir ◽  
Nazlı Kırnap ◽  
Canan Ç. Demir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hba1c Level ◽  
Intervention Group ◽  
Control Group ◽  
Metformin Monotherapy ◽  
The Mean ◽  
Hba1c Levels

Objective: Proton pump inhibitor (PPI) drugs reduce gastric acid secretion and lead to an increase in serum gastrin levels. Many preclinical and some clinical researches have established some positive effects of gastrin or PPI therapy on glucose regulation. The aim of this study was to prospectively investigate the short term effects of esomeprazole on glycaemic control in patients with type 2 diabetes mellitus. In addition, the presence of an association between this effect and gastrin levels was evaluated. Methods: Thirty-two subjects with type 2 diabetes mellitus were enrolled and grouped as intervention (n=16) and control (n=16). The participants in the intervention group were prescribed 40 mg of esomeprazole treatment for three months. At the beginning of the study and at the 3rd month, HbA1c level (%) and gastrin levels (pmol/L) of participants were assessed. Then, the groups were compared in terms of their baseline and 3rd month values. Results: In the intervention group, the mean gastrin level increased significantly from 34.3±14.4 pmol/L to 87.4±43.6 pmol/L (p<0.001). The mean HbA1c level was similar to the pre-treatment level (6.3±0.7% vs. 6.4±0.9%, p=0.441). There were no statistically significant differences in all parameters of the control group. The majority of individuals were on metformin monotherapy (65.6 %). The subgroup analysis of metformin monotherapy revealed that, in intervention group, there was a significant increase in gastrin levels (39.9±12.6 vs. 95.5±52.5, p=0.026), but the HbA1c levels did not change (6.0±0.4 % vs. 5.9±0.6 %, p=0.288); and in control group, gastrin levels did not change (37.5 ± 26.7 vs. 36.1 ±23.3, p=0.367), but there was an increase in HbA1c levels (6.1 ± 0.50 vs. 6.4 ± 0.60, p=0.01). Conclusion: Our study demonstrates that esomeprazole has no extra benefit for the controlled diabetic patient in three months. However, in only the metformin-treated subgroup, esomeprazole may prevent the rise in HbA1c level.

scholarly journals Effective monitoring of diabetic patients on progressive chronic kidney disease among patients attending diabetic clinic at Muhimbili National Hospital, Tanzania

2021 ◽  
Vol 1 (3) ◽  
pp. 044-052
Author(s):  
Gudila Valentine Shirima ◽  
Paschal Joseph Rugajjo ◽  
Obadia Venance Nyongole ◽  
Francis Furia ◽  
Kimu Marko Njiku
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Clinical Notes ◽  
Renal Functions ◽  
Diabetic Clinic

Background: Diabetic Kidney Disease is a complication of Diabetes Mellitus (DM) following the natural history of diabetes. Worldwide up to 40 % of patients with diabetes mellitus will develop Diabetic Kidney Disease. Kidney Disease Outcome Quality Initiative (KDOQI) guidelines recommends monitoring for proteinuria, blood sugar, renal functions and blood pressure in the patients with DM so that progression to complications including renal failure is prevented. Our study aimed to audit on effective monitoring of progressive chronic kidney disease among patients attending diabetic clinic at Muhimbili National Hospital. Material and methods: This was a retrospective clinical audit which included patients who attended diabetic clinic at Muhimbili National Hospital in 1st January 2017 to 31st December 2017. Simple random sampling technique using software called OpenEpi Random Program was used to get the sample of 120 patients. Patients with missing clinical notes were excluded from the audit. Records of the clinical notes, socio-demographic characteristics and investigations of the selected patients were retrieved from the Jeeva system and recorded using a structured questionnaire. We analyzed our data using Statistical Package for Social Sciences (SPSS) version 20.0 Results: One hundred and fourteen DM patents records were reviewed. Around 79% of the patients involved in the study were aged above 45years, 60% were females. Majority had type 2 DM (76.3%). Minority i.e. 15/114 (13.2%) of the patients had their urine for protein checked in the year 2017 as well as serum creatinine in the last 3months. Seven percent had HbA1c test done i.e. 8/114 (7%). Blood pressure was monitored in 72.8% (83/114) of the patients. Only16 out of 66 patients (24.2%) had blood pressure controlled. Majority of the patients 10/15 (66.7%) who had renal functions records had normal eGFR. Findings on monitoring for proteinuria, renal functions, control of HbA1c and Blood pressure control were all below audit standards. Conclusion: Our study found that there is generally poor monitoring of diabetic outpatient for progressive chronic kidney disease when compared to the KDOQI standards which calls the health care providers to adhere on set SOPs according to the guidelines available aiming at improving services and quality of life to diabetic patient.

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