scholarly journals Glycemic control in diabetes mellitus in patients assisted by a university hospital in the state of Piauí (Brazil)

Author(s):  
Jose A. NERY-NETO ◽  
Andrew O. SANTOS ◽  
Larissa C. SILVA ◽  
Elison C. HOLANDA ◽  
Maria C. BRITO ◽  
...  

Objectives: To investigate glycemic control in outpatient clinics at a university hospital, as well as to correlate HbA1c with fasting glucose and post-prandial glycemia, in order to assess which variable best correlates with an HbA1c. Methods: This is a descriptive cross-sectional study, with data that were collected from electronic medical records, from the random consultation of the medical of the blood glucose measurement. To check glycemic control, the parameters defined by the Brazilian Diabetes Society (2017-2018) were used: fasting glucose <100 mg / dL, HbA1c <7% and postprandial glucose <160 mg / dL. A statistical analysis was performed with the aid of the SPSS® program (version 13.0), adopting p <0.05 as the level of statistical significance. Results: 250 medical records were applied, with the average age of the participants being 60.1 ± 12.9 years (87 men and 163 women). A fasting glycemia was altered beyond the recommended in 80.8% of the individuals evaluated, HbA1c in 45.2% of the cases and 66% of the participants in the study possessed postprandial glycemia in addition to the recommended goals. The correlation between HbA1c/fasting blood glucose (rs= 0.74) and HbA1c/postprandial blood glucose (rs = 0.60) was, respectively, strong and moderate. Conclusions: With this study, it was possible to verify that a significant portion of the limits of use did not have good glycemic control. The correlation between fasting glucose and HbA1c confirmed that HbA1c is the best parameter for monitoring blood glucose levels in diabetes mellitus. In addition, the fasting blood glucose / HbA1c correlation showed greater strength in the postprandial blood glucose / HbA1c correlation.

Author(s):  
Luh Putu Febrayana Larasanty ◽  
I GNA. Dewantara Putra ◽  
Rhyce Dewata Sari ◽  
Komang Dede Saputra ◽  
I GA. Gede Minanjaya ◽  
...  

This study aims to investigate the influence of patient characteristics on the choice of insulin therapy in type 2 diabetes mellitus outpatients in Denpasar municipality. This is a descriptive analysis study using the patient's medical records as research material. Patients who meet inclusion and exclusion criteria are being recorded based on their medical records. Characteristics that are taken are age, gender, fasting blood glucose level (FBG), 2-hour postprandial blood glucose level (2-hours PPG) and HbA1c values of patients. Types of insulin therapy gained from patient medical records and drug use report in pharmacy. Characteristics data and type of insulin analyzed using correlation test to determine the effect of the patient characteristics on the selection of insulin therapy. 43 patients became the research subject. Males gendered patients (72.09%) and the patients aged less than 65 years (90.70%) are the dominant characteristics of the research subjects. The average value of FBG of patients is 212 mg / dL; 2-hours PPG 280 mg / dL and HbA1c 10.1%. There is a correlation between sex, age, HbA1c value and FBG with the type of insulin obtained by patients (p <0.05). Based on the results of statistical tests, age and gender have a strong correlation on insulin choice, HbA1c and FBG level has a moderate influence and 2-hours PPG have a weak correlation. Patient characteristics had an influence on the type of insulin choice for diabetes mellitus type 2 outpatient in the Denpasar municipality.


2021 ◽  
Author(s):  
Zhiyang Wang ◽  
Carine Ronsmans ◽  
Benjamin Woolf

Background: Although previous studies suggested the protective effect of zinc for type-2 diabetes, the unitary causal effect remains inconclusive. Objective: We investigated the causal effect of zinc as a single intervention on glycemic control in type-2 diabetes patients, using a systematic review of RCTs and two-sample Mendelian randomization (MR). Methods: Four outcomes were identified: fasting blood glucose/fasting glucose, hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), and serum insulin/fasting insulin level. In the systematic review, four databases were searched up to June 2021. Results were synthesized through the random-effects meta-analysis. Single nucleotide polymorphisms (SNPs) that are independent and are strongly related to zinc supplements were selected from MR-base to perform the two-sample MR with inverse-variance weighted (IVW) coefficient. Results: In the systematic review, 14 trials were included. The zinc supplement led to a significant reduction in the post-trial mean of fasting blood glucose (mean difference (MD): -26.52, 95%CI: -35.13, -17.91), HbA1C (MD: -0.52, 95%CI: -0.90, -0.13), and HOMA-IR (MD: -1.65, 95%CI: -2.62, -0.68), compared to the control group. In the two-sample MR, zinc supplement with 2 SNPs associated with lower fasting glucose (IVW coefficient: -2.04, 95%CI: -3.26, -0.83), but not specified type-2 diabetes. Conclusion: Although the study was limited by the few trials (review) and SNPs (two-sample MR), we demonstrated that the single zinc supplementary improved glycemic control among type-2 diabetes patients with causal evidence to a certain extent.


Author(s):  
Nithyapriya M. ◽  
S. Purushotaman

Background: Type 2 Diabetes Mellitus (DM) is a metabolic disorder, treated by insulin and oral hypoglycaemic agents (OHA). Despite treatment, to protect diabetic population from its complications is difficult. So, there is a need for an OHA with different mechanism of action and minimal side effects. Bromocriptine Mesylate QR (Quick release) formulation was approved by FDA for treatment of type 2 DM. Hence, this study was planned to highlight the usefulness of Bromocriptine QR in type 2 diabetes mellitus.Methods: Total 140 patients with type 2 DM were randomized into two groups. The control group was treated with Metformin 500 mg BD (twice daily) and Glipizide 5 mg BD for a period of 3 months. The study group received Bromocriptine quick release 1.6 mg once daily, metformin 500 mg BD and Glipizide 5 mg BD for a period of 3 months. In both control and study groups, fasting blood glucose, postprandial blood glucose was monitored at 0, 1st, 2nd and 3rd month. HbA1C was done at baseline and at the end of 3 months.Results: There was statistically significant decrease in fasting blood glucose, postprandial blood glucose and HbA1C when compared to baseline in both control group (p <0.05) and study group (p <0.05) at the end of 3 months. But the decrease in FBS, PPBS, HbA1C was higher in the study group (p=0.0001) than the control group (p=0.001).Conclusions: In type 2 DM patients, Bromocriptine QR, combined with metformin and Glipizide reduced fasting and postprandial blood glucose and HbA1C significantly compared to metformin and glipizide alone.


2021 ◽  
Vol 18 ◽  
Author(s):  
Wafa ◽  
Renni Septini ◽  
Rani Sauriasari

Objective: Pharmacological therapy for type 2 diabetes mellitus features various combinations of treatments, with different therapies providing different levels of effectiveness. In clinical settings, choices are driven by cost, effectiveness, and safety considerations, and these choices are still under question in Indonesia. This study aimed to compare the effectiveness of metformin-sulfonylurea and metformin-acarbose combination therapies on glycemic parameters in patients with type 2 diabetes mellitus. Methods: This study was carried out at Gatot Soebroto Army Hospital in Jakarta and utilized a retrospective cohort study design. Participants had consumed the same drug without switching for six months and were divided into a metformin-sulfonylurea group (n = 100) and a metformin-acarbose group (n = 100). The effectiveness of treatment was evaluated by considering hemoglobin A1c (HbA1c), two hours postprandial glucose, and fasting blood glucose. Results: After six months’ consumption, there were no statistical differences between results for the metformin-sulfonylurea and metformin-acarbose groups in terms of change of HbA1c (p = 0.062), controlled two hours postprandial blood glucose (p = 0.649), and controlled fasting blood glucose (p = 0.282). Regular exercise was the most significant factor for constant/decreased HbA1c, whereas being male and following a diet were the most significant factors for controlled two hours postprandial blood glucose and fasting blood glucose, respectively. Conclusion: Based on the analysis performed, there was no significant difference in the effectiveness of six months’ consumption of metformin-sulfonylurea and metformin-acarbose on HbA1c, two hours postprandial blood glucose, and fasting blood glucose.


Endocrine ◽  
2015 ◽  
Vol 52 (3) ◽  
pp. 561-570 ◽  
Author(s):  
A. Seval Ozgu-Erdinc ◽  
Cantekin Iskender ◽  
Dilek Uygur ◽  
Aysegul Oksuzoglu ◽  
K. Doga Seckin ◽  
...  

2017 ◽  
Vol 05 (01) ◽  
pp. 037-042 ◽  
Author(s):  
Meghna Borah ◽  
Rohini Goswami

Abstract Aims: To elucidate the sociodemographic and clinical characteristics of patients with type 2 diabetes mellitus (T2DM) attending a tertiary care hospital in Dibrugarh, Assam. Subjects and Methods: A total of 132 T2DM patients (74 males and 48 females) were included in the study. Patients were evaluated with detailed history, meticulous examination, and laboratory investigations and given a detailed interview questionnaire to fill out. Statistical Analysis Used: Graph Pad Prism, published by GraphPad Software, Inc., California. Results: The highest prevalence was found in the age group 41–50 years (28%). A large number of the study population (35%) was sedentary. It was observed that the body mass index was over the normal range in 42% of the study subjects. Central obesity was observed in 76 patients (58%). Only 9% of the patients had managed to achieve good glycemic control (<6.5%). In our study, 39% of the patients were taking the prescribed medications irregularly. A significant proportion of the study subjects had associated comorbidities such as hypertension (50%), obesity (42%), and dyslipidemia (37%). Fasting blood glucose, postprandial blood glucose, and glycated hemoglobin levels were elevated in both males and females. The values were higher in males, but statistically, the difference was not significant. Conclusions: The present study revealed that poor glycemic control, irregular medication intake, obesity, dyslipidemia, sedentary lifestyles, and hypertension were prevalent in T2DM patients. Hence, the overall risk profile in patients from Assam was very poor and needs improvement. These data can support health professionals' actions to effectively maintain and provide a more comprehensive approach to management of T2DM.


2017 ◽  
Vol 19 (12) ◽  
pp. 1181-1191 ◽  
Author(s):  
Mia K Reeve-Johnson ◽  
Jacquie S Rand ◽  
Dianne Vankan ◽  
Stephen T Anderson ◽  
Rhett Marshall ◽  
...  

Objectives The objectives of this study were to determine the reference interval for screening blood glucose in senior cats, to apply this to a population of obese senior cats, to compare screening and fasting blood glucose, to assess whether screening blood glucose is predicted by breed, body weight, body condition score (BCS), behaviour score, fasting blood glucose and/or recent carbohydrate intake and to assess its robustness to changes in methodology. Methods The study included a total of 120 clinically healthy client-owned cats aged 8 years and older of varying breeds and BCSs. Blood glucose was measured at the beginning of the consultation from an ear/paw sample using a portable glucose meter calibrated for cats, and again after physical examination from a jugular sample. Fasting blood glucose was measured after overnight hospitalisation and fasting for 18–24 h. Results The reference interval upper limit for screening blood glucose was 189 mg/dl (10.5 mmol/l). Mean screening blood glucose was greater than mean fasting glucose. Breed, body weight, BCS, behaviour score, fasting blood glucose concentration and amount of carbohydrate consumed 2–24 h before sampling collectively explained only a small proportion of the variability in screening blood glucose. Conclusions and relevance Screening blood glucose measurement represents a simple test, and cats with values from 117–189 mg/dl (6.5–10.5 mmol/l) should be retested several hours later. Cats with initial screening blood glucose >189 mg/dl (10.5 mmol/l), or a second screening blood glucose >116 mg/dl (6.4 mmol/l) several hours after the first, should have fasting glucose and glucose tolerance measured after overnight hospitalisation.


2012 ◽  
Vol 19 (01) ◽  
pp. 093-097
Author(s):  
NAJAM AKHTAR ◽  
MOWADAT HUSSAIN RANA

Objective: The objective of the study was to compare changes in fasting blood glucose and serum cholesterol levels followinginitiation of conventional and atypical antipsychotics in patients of psychosis. Study Design: An Interventional Comparative design was used.Place and Duration of Study: The study was conducted at Department of Psychiatry, Military Hospital Rawalpindi from August 2007 to August2008. Patients and Methods: A total of 110 patients were assigned to treatment with haloperidol (n=35), risperidone (n=36) and olanzapine(n=39). Fasting blood glucose and serum cholesterol levels were recorded at baseline and subsequently repeated at 02nd week, 06th week and08th week of treatment. In all the subjects, all the blood samples were drawn as a fasting sample in early morning. Results: ANOVA analysesindicated that changes in mean fasting glucose and cholesterol levels reached significance in period 2 (from 2nd week to 6th week) but not inperiod 1 (from 0 to 2nd week) and period 3 (from 6th week to 8th week). The increase in mean fasting glucose and cholesterol levels over timereached statistical significance in the olanzapine group after 6 weeks. No significant change in glucose was detected in the haloperidol andrisperidone groups. Conclusions: There is a higher risk of hyperglycemia and hypercholesterolemia with olanzapine treatment as compared torisperidone and haloperidol in the study population. These changes appear between 2 to 6 weeks after starting treatment.


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