scholarly journals The role of HbA1c as a diagnostic test for type 2 diabetes mellitus in Bangladesh

2016 ◽  
Vol 7 (2) ◽  
pp. 115
Author(s):  
Md. Matiur Rahman ◽  
Naila Atik Khan ◽  
Mohammad Masurn Alam ◽  
M. Iqbal Arslan ◽  
Md. Golam Hafiz
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Positive Predictive Value ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Predictive Value ◽  
Glucose Levels ◽  
Medical University

<p><strong>Background:</strong> Type 2 diabetes mellitus is a serious chronic disease with microvascular complications such as retinopathy, nephropathy and neuropathy and macrovascular complications such as cardiac, peripheral arterial and cerebrovascular disease. <strong>Objective:</strong> The aim of the study was to investigate the value of HbAlc as a diagnostic test for type 2 diabetes mellitus in Bangladeshi inclividuals. <strong>Methods:</strong> This cross sectional study was conducted in the Department of Biochemis­try, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. A total 657 patients, who were attended in the one point sample collection centre of Bangabandhu Sheikh Mujib Medical University for oral glucose tolerance test (OGIT) from 1st April 2014 to 30th June 2014, were purposively enrolled in this study. According to WHO criteria and based on OGIT findings study subjects were categorized into Normoglycemic (257), IFG (82), IGT (174), and DM (347). Fasting plasma glucose. HbA1c and plasma glucose at 2 hour after glucose load on OGIT was done from all the study subjects. <strong>Results:</strong> With a cut-off value of 6.J %, HbAlc had a maximal sensitivity and specificity of 97.0% and 49.0% respectively with a positive predictive value 65.5% and a negative predictive value 94.0%. HbA1c had a sensitivity of 93.0% and a specificity of 63.0% was calculated with a cut-off value of 6.5% with positive predictive value 77.5% and negative predictive value 90.0%. Both fasting plasma glucose levels and 2 hour plasma glucose levels were showed significant positive correlation with HbAlc (r = 0.788, P = 0.000 and r = 0.800, P = 0.000 respectively). <strong>Conclusion:</strong> The study suggests that measurement of HbAlc could be used to make diagnosis of T2DM in the Bangladeshi population.</p>

scholarly journals A STUDY OF PLASMA GLUCOSE AND SERUM CERULOPLASMIN IN TYPE-2 DIABETES MELLITUS (T2DM) AT A TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Mukul Sharma ◽  
Kapil Bhatia ◽  
Pratibha Misra ◽  
Sibin MK ◽  
Vivek N Ambade ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Care Hospital ◽  
Serum Ceruloplasmin ◽  
Glucose Levels ◽  
Fasting Plasma

Introduction: Diabetes mellitus (DM) is a metabolic disorder occurring due to either defect in the secretion of insulin or defect in the action of insulin characterized by hyperglycemia. Hyperglycemia causes oxidative stress due to increased production of mitochondrial Reactive oxygen species (ROS) in T2DM. Ceruloplasmin (Cp) acts as an antioxidant through its ferroxidase activity. There is an association between the raised serum Cp levels and elevated plasma glucose levels in Type-2 Diabetes mellitus (T2DM) patients. Aim and objectives: The aim of this study is to evaluate the correlation between the fasting plasma glucose (FPG), 2hour plasma glucose (2hPG), and serum Cp level in T2DM patients as compared to non diabetics. Materials and methods: 165 cases of T2DM were recruited along with the 40 healthy age and sex matched controls. The blood samples were analyzed for serum Cp and FPG and 2hPG after 75-gram oral glucose. Results: The serum Cp levels of the patient group with T2DM were significantly higher than the control group (p = 0.000). There was a significant positive association between serum Cp level and 2hPG level of the patient population (r = 0.283, p = 0.000), but there was no significant correlation found between serum Cp levels and fasting plasma glucose levels in patients (r = 0.146, p =0.061). Similar findings were seen in the sub group analysis. Conclusion: Our study concludes a significant positive correlation between serum Cp and 2hPG levels in T2DM patients. Hence Cp levels may be considered as a part of the routine diagnostic panel to assess diabetes mellitus. Keywords: Serum Ceruloplasmin, Type-2 Diabetes Mellitus, Fasting plasma glucose, 2hour plasma glucose

scholarly journals Leukocyte telomere length is inversely associated with post-load but not with fasting plasma glucose levels

2017 ◽  
Vol 242 (7) ◽  
pp. 700-708 ◽  
Author(s):  
Mykola Khalangot ◽  
Dmytro Krasnienkov ◽  
Alexander Vaiserman ◽  
Ivan Avilov ◽  
Volodymir Kovtun ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Telomere Length ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Leukocyte Telomere Length ◽  
Glucose Levels ◽  
Fasting Plasma

Type 2 diabetes mellitus is characterized by shorter leukocyte telomere length, but the relationship between leukocyte telomere length and type 2 diabetes mellitus development is rather questioned. Fasting and post-load glycaemia associated with different types of insulin resistance and their relation with leukocyte telomere length remains unknown. We compared leukocyte telomere length and fasting or post-load glucose levels in persons who do not receive glucose lowering treatment. For 82 randomly selected rural residents of Ukraine, aged 45+, not previously diagnosed with type 2 diabetes mellitus, the WHO oral glucose tolerance test and anthropometric measurements were performed. Leukocyte telomere length was measured by standardized method of quantitative monochrome multiplex polymerase chain reaction in real time. Spearman’s or Pearson’s rank correlation was used for correlation analysis between fasting plasma glucose or 2-h post-load plasma glucose levels and leukocyte telomere length. Logistical regression models were used to evaluate risks of finding short or long telomeres associated with fasting plasma glucose or 2-h post-load plasma glucose levels. No association of fasting plasma glucose and leukocyte telomere length was revealed, whereas 2-h post-load plasma glucose levels demonstrated a negative correlation ( P < 0.01) with leukocyte telomere length. Waist circumference and systolic blood pressure were negatively related ( P = 0.03) with leukocyte telomere length in men. Oral glucose tolerance test result-based glycemic categories did not show differences between mean leukocyte telomere length in categories of normal fasting plasma glucose and 2-h post-load plasma glucose (NGT, n = 33); diabetes mellitus (DM), n = 18 and impaired fasting glucose/tolerance (IFG/IGT, n = 31) levels. A correlation relationship between leukocyte telomere length and 2-h post-load plasma glucose level in NGT; IFG/IGT and DM groups ( P = 0.027; 0.029 and 0.049, respectively) was revealed; the association between leukocyte telomere length and fasting plasma glucose was confirmed in DM group only ( P = 0.009). Increase of 2-h post-load plasma glucose (but not fasting plasma glucose) level improves the chances of revealing short telomeres: OR 1.52 (95% CI 1.04–2.22), P = 0.03. After the adjustment for age, gender, waist circumference, systolic blood pressure, and fasting plasma glucose, these phenomena remain significant. We conclude that 2-h post-load plasma glucose but not fasting plasma glucose is inversely associated with leukocyte telomere length. Impact statement • Contradictory epidemiologic data have been obtained about the link between the leucocyte telomere length (LTL) and diabetes. Type 2 diabetes (T2D) is likely to be pathophysiologically heterogeneous, but comparison of the association of LTL separately with fasting plasma glucose (FPG) and 2-h post-load plasma glucose (2hPG) levels has not been done before. Thus, the study of LTL changes associated with different types of hyperglycaemia, that largely determine the heterogenity of T2D is important. • In a population-based study of rural Ukrainians, we were the first to demonstrate that the increase of 2hPG (but not FPG) level increases the chances of revealing short telomeres. • The obtained data can help to clarify the relationship between the LTL shortening and different conditions of the insulin resistance (mainly liver resistance in high FPG and mostly muscle and adipose tissue resistance in high 2hPG).

scholarly journals Prediction of type 2 diabetes mellitus using fasting plasma glucose and HbA1c levels among individuals with impaired fasting plasma glucose: a cross-sectional study in Thailand

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041269
Author(s):  
Tullaya Sitasuwan ◽  
Raweewan Lertwattanarak
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Fasting Plasma

ObjectivesAbout 11%–30% of individuals with impaired fasting plasma glucose (IFG) have type 2 diabetes mellitus (T2DM), diagnosed by the 75 g oral glucose tolerance test (75 g OGTT). This study investigated (1) the prevalence and cut-off levels for fasting plasma glucose (FPG) and glycated haemoglobin A1c (HbA1c) in IFG individuals that most effectively predict the presence of T2DM diagnosed by a 75 g OGTT; (2) the predictors associated with T2DM; and (3) the pathophysiological characteristics of patients with IFG.Materials and methodsA single-centre, cross-sectional study was conducted in a primary care setting. A standard 75 g OGTT was performed on 123 subjects with IFG. Their beta-cell function and insulin resistance were calculated through plasma glucose and insulin levels monitored during the 75 g OGTT.ResultsIn the IFG subjects, the prevalence of T2DM using the 2-hour postload plasma glucose (2hPG) criterion was 28.5%. Pre-diabetes and normal glucose metabolism were found in 48.7% and 22.8%, respectively, by 75 g OGTT. An HbA1c level ≥6.0% or FPG ≥5.9 mmol/L were the optimal cut-off thresholds for the prediction of the presence of T2DM. HbA1c had a sensitivity of 76.7% and specificity of 55.7% (95% CI 57.7% to 90.1% and 95% CI 43.3% to 67.6%, respectively), while FPG had a sensitivity of 85.7% and specificity of 23.9% (95% CI 69.7% to 95.2% and 95% CI 15.4% to 34.1%, respectively). The presence of metabolic syndrome, a higher HbA1c and higher FPG levels were associated with the risk of T2DM in the Thai IFG population.ConclusionsAlmost one-third of the people with IFG had T2DM diagnosed by the 2hPG criterion. HbA1c was more effective than FPG in predicting the presence of T2DM in the IFG subjects. IFG individuals with HbA1c≥6.0% or FPG≥5.9 mmol/L should be advised to undergo a 75 g OGTT to detect T2DM earlier than otherwise.

scholarly journals Association of serum creatinine levels and risk of type 2 diabetes mellitus in Korea: a case control study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Do Kyeong Song ◽  
Young Sun Hong ◽  
Yeon-Ah Sung ◽  
Hyejin Lee
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Type 2 Diabetes Mellitus ◽  
Serum Creatinine ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Increased Risk

Abstract Background Reduced skeletal muscle has been suggested as a potential risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is the primary metabolite of creatine in skeletal muscle. Therefore, low serum creatinine levels may be associated with an increased risk of T2DM. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM in Korea. Methods We analyzed a total of 264,832 nondiabetic adults older than 40 years of age who had undergone a national health examination at least once from 2009 to 2015 in the Korean National Health Insurance Service Cohort. Hazard ratios for T2DM were calculated. Results In men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association. This association was confirmed after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, there was a trend that serum creatinine levels were inversely associated with the risk of T2DM among those with serum creatinine below 1.1 mg/dl. However, serum creatinine levels were not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Conclusions Reduced levels of serum creatinine were significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl. There was a trend that decreased levels of serum creatinine were associated with an increased risk of T2DM among women with serum creatinine below 1.1 mg/dl, although this result was not statistically significant.

scholarly journals Glucometers for Patients with Type 2 Diabetes Mellitus: Are they helpful?

2021 ◽  
Vol 9 (2) ◽  
pp. 140-144
Author(s):  
Andrew Thomas ◽  
Mohan T. Shenoy ◽  
K.T. Shenoy ◽  
Nirmal George
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Glucose Levels ◽  
The Mean ◽  
Glycated Hemoglobin Level

Background: The effectiveness of self-monitoring of blood glucose (SMBG) in type 2 diabetes mellitus (T2DM) patients is debated in the literature. We aimed at elucidating the association and patterns of complications between SMBG use and plasma glucose values. Methods: This cross-sectional study comprised 303 participants from outpatient departments with T2DM for over 12 months. We analyzed sociodemographic and clinical variables including: anthropometry, SMBG use, disease duration, treatment modality, complications, plasma glucose level, and glycated hemoglobin level (%). Results: The mean duration of T2DM was 93±76 months. Participants were grouped into SMBG users (n=115, 38%) and non-SMBG users (n=188, 62%). The mean fasting plasma glucose levels of SMBG and non-SMBG users were 140.7±42.7 (95% Confidence Interval [95%CI]: 132.72;148.67) mg/dl and 145.4±50 (95%CI: 138.12;152.67) mg/dl (p=0.03), respectively. The mean post-prandial plasma glucose levels of the SMBG and non-SMBG groups were 202±63.42 (95%CI: 190.23;213.76) mg/dl and 209±84.54 (95%CI: 196.56;221.43) mg/dl (p=0.002), respectively. The mean difference in HbA1c among the groups were 8.14±1.69% (95%CI: 7.59;8.68) and 8.15±1.98% (95%CI: 7.27;9.02) (p=0.4), respectively. Hypoglycemia (n=50, 43.5%) was the most common complication. The prevalence of neuropathy (n=5, 4.3%, p=0.036) and cardiovascular disease (n=21, 18.3%, p=0.042) were significantly higher in the SMBG group. Conclusion: Although plasma glucose values were significantly lower in the SMBG group, its clinical significance remains questionable. Furthermore, many participants in both the groups had shortfalls in awareness, monitoring, and glycemic control. SMBG use needs to be evaluated in a cohort of patients with T2DM with adequate health awareness.

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