scholarly journals Association of Pulmonary Function Decline over Time with Longitudinal Change of Glycated Hemoglobin in Participants without Diabetes Mellitus

2021 ◽  
Vol 11 (10) ◽  
pp. 994
Author(s):  
Wen-Hsien Lee ◽  
Da-Wei Wu ◽  
Ying-Chih Chen ◽  
Yi-Hsueh Liu ◽  
Wei-Sheng Liao ◽  
...  

Pulmonary damage and function impairment were frequently noted in patients with diabetes mellitus (DM). However, the relationship between lung function and glycemic status in non-DM subjects was not well-known. Here, we evaluated the association of longitudinal changes of lung function parameters with longitudinal changes of glycated hemoglobin (HbA1c) in non-DM participants. The study enrolled participants without prior type 2 DM, hypertension, and chronic obstructive pulmonary disease (COPD) from the Taiwan Biobank database. Laboratory profiles and pulmonary function parameters, including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), were examined at baseline and follow-up. Finally, 7055 participants were selected in this study. During a mean 3.9-year follow-up, FVC and FEV1 were significantly decreased over time (both p < 0.001). In the multivariable analysis, the baseline (unstandardized coefficient β = −0.032, p < 0.001) and longitudinal change (unstandardized coefficient β = −0.025, p = 0.026) of FVC were negatively associated with the baseline and longitudinal change of HbA1c, respectively. Additionally, the longitudinal change of FVC was negatively associated with the risk of newly diagnosed type 2 DM (p = 0.018). During a mean 3.9-year follow-up, our present study, including participants without type 2 DM, hypertension, and COPD, demonstrated that the baseline and longitudinal change of FVC were negatively and respectively correlated with the baseline and longitudinal change of HbA1c. Furthermore, compared to those without new-onset DM, participants with new-onset DM had a more pronounced decline of FVC over time.

2021 ◽  
Vol 11 (7) ◽  
pp. 648
Author(s):  
Ho-Ming Su ◽  
Wen-Hsien Lee ◽  
Ying-Chih Chen ◽  
Yi-Hsueh Liu ◽  
Jiun-Chi Huang ◽  
...  

Although many cross-section studies have assessed the determinants of glycated hemoglobin (HbA1c), there have been limited studies designed to evaluate the temporal correlates of HbA1c in non-diabetic patients. This study aimed to identify the major determinants of longitudinal change of HbA1c in non-diabetic patients. This study included subjects from the 104,451 participants enrolled between 2012 and 2018 in the Taiwan Biobank. We only included participants with complete data at baseline and follow-up (n = 27,209). Patients with diabetes at baseline or follow-up (n = 3983) were excluded. Finally, 23,226 participants without diabetes at baseline and follow-up were selected in this study. △Parameters was defined as the difference between the measurement baseline and follow-up. Multivariable linear regression analysis was used to identify the major determinants of HbA1c longitudinal change (△HbA1c). During a mean 3.8 year follow-up, after multivariable analysis, new-onset hypertension (coefficient β: 0.014, p < 0.001), high △heart rate (coefficient β: 0.020, p = 0.002), high △BMI (coefficient β: 0.171, p = 0.028), high △fasting glucose (coefficient β: 0.107, p < 0.001), low △creatinine (coefficient β: −0.042, p < 0.001), high △total cholesterol (coefficient β: 0.040, p < 0.001), high △hemoglobin (coefficient β: 0.062, p < 0.001), high △GPT (coefficient β: 0.041, p = 0.001), and low △albumin (coefficient β: −0.070, p < 0.001) were significantly associated with high △HbA1c. In non-diabetic population, strategies to decrease the development of new-onset hypertension, resting heart rate, body mass index, fasting glucose, total cholesterol, and GPT and increase serum albumin level might be helpful in slowing the longitudinal change of HbA1c. In addition, increased hemoglobin and decreased serum creatinine over time also had an impact on the HbA1c elevation over time in non-diabetic population.


2016 ◽  
Vol 27 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Jitti Hanprasertpong ◽  
Ingporn Jiamset ◽  
Alan Geater ◽  
Thanarpan Peerawong ◽  
Wikanda Hemman ◽  
...  

ObjectiveThe aim of this study was to evaluate any association between metformin use and oncological outcomes of cervical cancer in patients with type 2 diabetes mellitus (DM).MethodsWe retrospectively identified 248 patients with cervical cancer with type 2 DM who received primary treatment between 2004 and 2015. The clinicopathological characteristics and oncological outcomes were collected and analyzed. The patients were then separated into metformin use (n = 118) or non–metformin use (n = 130) groups.ResultsWith a median follow-up of 2.85 years, patients who were given metformin had lower recurrence rate than patients who did not receive metformin (P = 0.011). The 5-year disease-free survival (DFS) and overall survival (OS) were 81.55% and 93.27% in the metformin use group, and 65.06% and 86.82% for the non–metformin use group, respectively. In multivariate analysis, non–metformin use (hazard ratio [HR], 1.89; P = 0.037), baseline hypertension (HR, 2.52; P = 0.005), and stage (HR for stage II vs I, 3.48; HR for stage III vs I, 6.45; P = 0.01) were independent adverse prognostic factors for DFS, whereas the statistically significant independent prognostic factors for OS were age (HR for age >65 vs ≤50, 3.86; P = 0.044) and stage (HR for stage III-IVA vs I-II, 3.45; P = 0.007).ConclusionsOur findings demonstrate that metformin use is associated with improved DFS, but not in OS in patients with cervical cancer with type 2 DM. Further large-scale and long-term follow-up studies are warranted to confirm the antitumor effects of metformin.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xue Cao ◽  
Zhe Tang ◽  
Jie Zhang ◽  
Haibin Li ◽  
Manjot Singh ◽  
...  

Abstract Background Some previous studies on different populations have yielded inconsistent findings with respect to the relationship between levels of high-density lipoprotein cholesterol (HDL-C) and future type 2 diabetes mellitus (T2DM) incidence. This study was designed to gain further insight into this relationship through a cohort study with a 25-year follow-up duration. Methods In total, 1462 individuals that were 55 years of age or older and were free of T2DM at baseline were enrolled in the present study. T2DM incidence among this study population was detected through self-reported diagnoses or the concentration of fasting plasma glucose. The data were derived from nine surveys conducted from 1992 to 2017. The correlation between HDL-C levels and the T2DM risk was assessed through Cox proportional-hazards model and proportional hazards model for the sub-distribution with time-dependent variables. Results Over the follow-up period, 120 participants were newly diagnosed with new-onset T2DM. When research participants were separated into four groups on the basis for quartiles of their levels of HDL-C measured at baseline, and incidence of diabetes declined with higher baseline HDL-C levels at 12.60, 9.70, 5.38, and 5.22 per 1000 person-years, respectively. Adjusted hazard ratios (HRs) were 0.98 (95% confidence interval [CI]: 0.62–1.55), 0.48 (95% CI: 0.27–0.85) and 0.44 (95% CI: 0.25–0.80) for individuals with HDL-C levels within the 1.15–1.39, 1.40–1.69, and ≥ 1.70 mmol/L ranges relative to participants with HDL-C levels < 1.15 mmol/L. Multiple sensitivity analyses similarly revealed reduced risk of diabetes incidence with increased HDL-C levels. Incorporating the levels of HDL-C into a multivariate model significantly enhanced the overall power of the predictive model (P values were 0.0296, 0.0011, respectively, for 5- and 10-year risk of diabetes). Conclusions Levels of HDL-C were independently and negatively associated with the risk of the new-onset T2DM among middle-aged and elderly Chinese.


Folia Medica ◽  
2016 ◽  
Vol 58 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Evgeni V. Mekov ◽  
Yanina G. Slavova ◽  
Marianka P. Genova ◽  
Adelina D. Tsakova ◽  
Dimitar T. Kostadinov ◽  
...  

Abstract Introduction: Diabetes mellitus (DM) is estimated to affect 2-37% of COPD patients, results varying widely between studies. DM may also correlate with quality of life and lung function. Aim: To examine correlations between DM and quality of life and lung function in COPD patients admitted to hospital with exacerbation of COPD. Patients and methods: A hundred and fifty-two patients were included in the study. They were all examined for diabetes mellitus. All patients completed CAT and mMRC questionnaires and underwent spirometry. Results: 13.2% (20/152) of patients received medications for DM. 21.7% (33/152) had newly diagnosed DM and 30.9% (47/152) had prediabetes. DM is not associated with reduced quality of life and worse pulmonary function. However, untreated DM is associated with both reduced quality of life and worse pulmonary function. HbA1c is negatively correlated with FVC and positively correlated with CAT score. Conclusions: COPD patients hospitalized for exacerbation are at high risk for impaired glucose metabolism. Untreated DM is associated with worse lung function and lower quality of life, which stresses the importance of screening for the disease. The patients may benefit from optimizing blood glucose level.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ji Hyun An ◽  
Kyung-do Han ◽  
Jin-Hyung Jung ◽  
Juhwan Yoo ◽  
Maurizio Fava ◽  
...  

Objectives: Although obesity is associated with increased risk for depression in patients with type 2 diabetes mellitus (DM), the relationship between body weight variability (BWV) and depression remains poorly studied. This study was to investigate the incidence of depression in patients with type 2 DM according to their BWV.Methods: Intraindividual variation in body weight were measured in the nationwide, population-based retrospective cohort of 540,293 patients with type 2 DM from the Korean national health insurance system between 2009 and 2010. The diagnoses of new-onset depression occurring until the end of 2017 were ascertained. Risk of new-onset depression was examined using multivariate-adjusted Cox proportional hazards regression analysis by BWV quartile.Results: 93,149 (17.2%) patients developed new-onset depression for the follow up. BWV was significantly associated with an increased risk of depression after adjusting for confounding factors. The highest BWV quartile group had a hazard ratio (HR) of 1.17 (95% CI 1.15–1.19) compared to the lowest BWV quartile group as a reference. Obese patients in the highest BWV quartile group showed 12% increased risk of depression (HR 1.12, 95% CI 1.09–1.15) while non-obese patients in the highest BWV quartile group showed 20% increased risk of depression (HR: 1.20, 95% CI: 1.17–1.23) compared to their respective lowest BWV quartile groups.Conclusion: A higher BWV was significantly associated with an increased risk of depression in patients with type 2 DM. Thus, BWV may serve as an indicator for early detection of depression in type 2 DM patients.


2021 ◽  
Vol 25 (4) ◽  
pp. 567-571
Author(s):  
D. A. Feldman

Annotation. Today, diseases of the cardiovascular system retain their leading position among the incidence in the world. The presence of comorbid pathology in the form of type 2 diabetes mellitus (DM) significantly complicates the course of these diseases, worsening its prognosis. The aim of the study: to analyze the prognostic value of asymmetric dimethylarginine (ADMA) as a marker of recurrent cardiovascular events in patients with acute myocardial infarction with type 2 diabetes for 6 months of follow-up. 120 patients were examined: group 1 – patients with acute myocardial infarction (AMI) in combination with type 2 diabetes mellitus (n=70), group 2 - patients with isolated AMI (n=50). The control group included 20 practically healthy individuals. All patients underwent general clinical and instrumental examinations, on the first day of AMI the level of ADMA was determined using a commercial test system "Human Asymmetrical Dimethylarginine ELISA". Statistical processing of the obtained data was performed using the software package StatSoft Inc, USA – "Statistica 6.0". The analysis of the average level of ADMA showed a significantly higher value of this indicator in patients with AMI in combination with type 2 DM than in patients without concomitant type 2 DM 2.57 times (1.57±0.11 μmol / l and 0.61±0.06 μmol / l, respectively), (p<0,05. ADMA level >1,72 μmol / l in patients with AMI in combination with type 2 DM and >0,69 μmol / l in patients with AMI without concomitant type 2 DM was identified as a predictor of recurrent acute myocardial infarction within 6 months of follow-up. Thus, the level of ADMA was higher in the presence of comorbid pathology in the form of type 2 DM in patients with AMI, reflecting endothelial dysfunction combining disease. It is advisable to further study this indicator of endothelial dysfunction as a predictor of the adverse course of AMI in combination with concomitant type 2 DM.


BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020065 ◽  
Author(s):  
Wei-Syun Hu ◽  
Cheng-Li Lin

PurposeThe objective of the current study was to explore the role of CHA2DS2-VASc score in predicting incidence of atrial fibrillation (AF) in patients with type 2 diabetes mellitus (DM). Furthermore, the use of the CHA2DS2-VASc score for stratifying new-onset AF risk in patients with DM and with/without hyperosmolar hyperglycaemic state (HHS) was also compared.MethodsThe study subjects were identified from Longitudinal Health Insurance Database provided by the National Health Research Institutes. The patients with DM were divided into two groups based on a history of HHS or not. The predictive ability of CHA2DS2-VASc score for stratifying new-onset AF risk in the two groups was calculated using the area under the curve of receiver-operating characteristic (AUROC).ResultsThe present study involved a total of 69 530 patients with type 2 DM. Among them, 1558 patients had a history of HHS, whereas 67 972 patients did not. The AUROC of the CHA2DS2-VASc score as a predictor of incident AF in patients with DM and with/without HHS was 0.67 (95% CI 0.59 to 0.75) and 0.71 (95% CI 0.70 to 0.72), respectively.ConclusionsTo conclude, we reported for the first time on the assessment of CHA2DS2-VASc score for incident AF risk discrimination in patients with type 2 DM. We further found that the predictive ability of the CHA2DS2-VASc score was attenuated in patients with type 2 DM and with HHS in comparison with those without HHS.


2021 ◽  
Author(s):  
Nigusie Gashaye Shita ◽  
Ashagrie Sharew Iyasu

Abstract Background Type 2 diabetes mellitus patients with hyperglycemia for a long period of time are significant causes of mortality and morbidity worldwide. Studying the predictors of glycemic control help to minimize deaths and the development of acute and chronic diabetes complication. Hence, the aim of this study is to asses’ predictors of glycemic control among patients with Type 2 diabetes in Ethiopia. Methods A retrospective cohort study was conducted among Type 2 Diabetes mellitus (T2DM) patients enrolled between December 2011 and December 2012 at Debre Markos and Felege Hiwot Referral Hospital. A total of 191 T2DM patients was included in the study who meets the eligibility criteria. Generalized linear mixed model was employed. Results The prevalence of good glycemic control among type 2 diabetes patients was 58.4% where as 23.25% of variation was explained in the fitted model due to adding the random effects. The significance predictors of glycemic control among patients with Type 2 diabetes at 95% confidence level were reside in rural(0.454, 0.614)), patients age 38–50, 51–59 and 60–66 years(1.267,1.776), (1.057,1.476) and (1.004, 1.403), respectively, Proteinuria positive(1.211,1.546), diastolic blood pressure ≥ 90 (1.101, 1.522), systolic blood pressure ≥ 140 (1.352, 1.895), creatinine (0.415, 0.660), duration per visit (0.913, 0.987), duration since diagnosis (0.985, 0.998), weight 78–88(0.603, 0.881). Conclusion Level of glycemic control among type 2 diabetes patients was poor. Resident, age, weight, duration of T2DM since diagnosis, duration of type 2 DM per visit, follow up time, protein urea, diastolic blood pressure, systolic blood pressure and creatinine were significant predictors of glycemic control among type 2 DM patients. During diabetic patients follow up, clinicians should give appropriate attention to these significant variables for good glycemic control since it is the main goal of diabetes management.


2018 ◽  
Vol 11 (4) ◽  
pp. 5-13
Author(s):  
L. A. Mineeva ◽  
L. I. Balashevich ◽  
A. A. Baranov ◽  
L. B. Shubin ◽  
A. V. Kabanov

Purpose: To assess the changes in eye optics and visual functions depending on the level of blood sugar and glycated hemoglobin (HbA1c) in insulin-dependent type 2 diabetes mellitus (IPSD) patients with excessive body weight, who receive long-term insulin therapy.Material and methods. 32 patients (64 eyes), of which 84.4 % were women and 15.6 % men, with insulin-dependent diabetes mellitus (IPSD) but without severe general diabetic complications or concomitant eye pathology were monitored ophthalmologically for 3 years. The average duration of insulin therapy was 6 years. The average age of the patients was 60.94 ± 1.04 years; average weight, 89.1 ± 14.8 kg; average height, 163.8 ± 7.3 cm; average body mass index, 31.3 ± 4.8 kg/m2. The level of blood glucose level was determined daily with individual Accu-Check and/or OneTouch select glucometers, supplemented by scheduled monthly examinations with an endocrinologist. The level of glycated hemoglobin (HbA1c) was determined once every 3–6 months. Vision was measured by international requirements for patients with diabetes using the ETDRS (Early Treatment Diabetic Retinopathy Study Research Group) system with an ESV-3000 device. To assess lens transparency, the international Lens Opacities Classification System III (LOCS III) was used. Glycaemia level was monitored by the patients themselves with the help of individual blood glucose meters and by endocrinologists in scheduled monthly checkups. HbA1c level was measured once every 3 to 6 months.Results. Over the follow-up period, the subjective visual acuity slightly deteriorated. The anterior segment remained practically unchanged, the vitreous body showed a destruction increase, the state of the retina remained stable and conformed to that of nonproliferative diabetic retinopathy. The glucose level showed a significant drop, while the level of glycated hemoglobin HbA1c practically remained constant. The LOCS III criteria showed an increased clarity of the lens nucleus (NO), a worse transparency of cortical layers (C) deteriorated; the NC nucleus colour and P parameters of the posterior subcapsular layer practically remained the same. Conclusions. According to our data, during the development of diabetic cataracts in patients with type 2 IPSD, NO of the lens changes first followed by C changes (they become worse). With the normalization of glycemia level, diabetic retinopathy does not progress, the NO of the lens can improve, and the NC and P do not change. Normalization of glycemia is not a retarding factor for the already existing changes in C or the state of the vitreous. HbA1c is a marker and trigger for possible lens changes in patients with type 2 diabetes and prolonged insulin therapy. HbA1с is effective for tracking the dynamics of changes in the eye in these patients. The fact that the positive correlation of HbA1c and C at follow-up start changed to the negative correlation toward the end of the study indicates a disruption in lens state compensation and does not cancel the negative dynamics of state C even with a decrease in the level of HbA1c.


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