scholarly journals An Overview of Glycaemic Control Status among Diabetes Patients and Its Predictive Associated Factors: A Review

2019 ◽  
Vol 9 (2) ◽  
pp. 81-86
Author(s):  
Pradip Panta ◽  
Rubin Pote ◽  
Parbati Thapa ◽  
Anil Giri
Keyword(s):  
Medication Adherence ◽  
Glycemic Control ◽  
Glycaemic Control ◽  
Diabetes Management ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Good Glycemic Control ◽  
Important Indicator ◽  
Poor Glycaemic Control ◽  
Good Glycaemic Control

Diabetes Mellitus (DM) is a rapidly leading public health problem and responsible for three quarters of morbidity and 88% of mortality affecting millions of people worldwide. Achieving good glycaemic control is an important indicator in diabetes management. Glycated hemoglobin (HBA1C i.e.≤7%) and fasting blood glucose (FBG i.e.<130mg/dl) were used to determine glycaemic control for type 2 diabetic patients. Factors associated with good glycemic control were older age, high medication adherence and better health literacy. Duration of DM>7 years was inversely related to good glycemic control and was higher in patients residence in rural areas along with hyperlipidemia, sedentary lifestyle, physical activity and oral hypoglycemic drug (OHD) as part of their T2DM therapeutic regimen. Patients on insulin and oral hypoglycemic agents, patients on insulin and low-medication adherents were more likely to have uncontrolled and poor glycaemic control while exercise contributed to glycaemic control status as a protective factor. Besides, patient’s information on glycemic control and lifestyle modification, consultation is probably infrequent due to various reasons such as patients’ economic issues, educational levels, health awareness and remote distance to health care centers, have direct impact to possess the good glycaemic control. Hence, data gotten by specialists can't exhaustively mirror patients' wellbeing status and may prompt have imperfect wellbeing choices. So, this is also the markable reason behind poor glycaemic control and has been now widely reported even though efforts have been implemented. Thus, to achieve wide-scale promotion of diabetes management, it is essential to explore knowledge of medication adherence and better health knowledge along with promoting good practices (regular exercise behavior, dietary habits and awareness of diseases).

THE ROLE OF TRIGLYCERIDE GLUCOSE INDEX AS PREDICTOR OF GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2021 ◽  
pp. 106-108
Author(s):  
Charchit Mehta ◽  
Vidyasagar C R ◽  
Raveesha A
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycaemic Control ◽  
General Medicine ◽  
Poor Glycaemic Control ◽  
Good Glycaemic Control ◽  
Triglyceride Glucose Index

Objectives- To explore the association of Triglyceride Glucose index with HbA c and To evaluate their 1 potential role as predictors of glycemic control in patients with type 2 diabetes mellitus. Design: observational study Setting: Conducted in the Department of General Medicine at Sri Devaraj Urs medical college, Kolar, Karnataka. Subjects: 98 diabetic subjects were studied and were evaluated for predicting glycemic control using triglyceride glucose index. Results: Among subjects with good glycaemic control (HbA1c <7%) mean Triglyceride was 136 + 21.78 mg/dl and Among subjects with poor glycaemic control (HbA1c >7%) mean Triglyceride was 190.35 + 62.94 mg/dl. there was a statistically signicant difference found between Triglyceride and HbA1c. Among subjects with good glycaemic control (HbA1c <7%) mean Triglyceride glucose index was 9275.06 + 2154.22 mg/dl and Among subjects with poor glycaemic control (HbA1c >7%) mean Triglyceride glucose index was 24223.63+ 15794.73mg/dl. there was a statistically signicant difference found between Triglyceride glucose index and HbA1c Conclusion: We can use Triglyceride glucose index in predicting glycaemic control in type 2 DM which is inexpensive and cost effective.

scholarly journals Clinical characteristics and determinants of glycaemic control among type 2 diabetes mellitus (T2DM) patients in Fiji

2021 ◽  
Author(s):  
Pablo Romakin ◽  
Donald Wilson ◽  
Sabiha Khan ◽  
Masoud Mohaammadnezhad
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycaemic Control ◽  
Blood Sugar ◽  
Diabetes Management ◽  
Control Level ◽  
Poor Glycaemic Control

Abstract Background: Glycemic control is the centre in diabetes management. In patients with type 2 diabetes mellitus (T2DM), glycemic control is associated with clinical determinants. The aim of this study was to determine the proportion of poor glycemic control level and its clinical determinants among T2DM patients.Methods: This retrospective cross-sectional study was conducted on the medical records of T2DM patients attending diabetes clinics at the three selected health centres in Suva, Fiji. Patients who met the following criteria were included in the study: adult T2DM >18 years old registered during 2011 to 2016; on treatment for >1year; had >4 clinic visits and; had a recent HbA1c result in 2017. Logistic regression analysis was performed. A p value of <0.05 was considered as significant.Results: There were 200 female (59.2%) and 138 male (40.8%) T2DM patients included in this study with a mean age of 56.5 years (SD = + 9.9). Majority have poorly controlled random blood sugar (RBS), 67.1% and fasting blood sugar (FBS), 63.0%. Two-thirds (65.4%) had co-morbidities. The proportion of poor glycaemic control (HbA1c <7%) was 77.2% with mean HbA1c of 8.6% (+ 2.04). RBS, FBS, cholesterol, estimated glomerular filtration rate (eGFR) and diastolic blood pressure (DBP) were significant (p<0.05) determinants of poor glycaemic control.Conclusions: This study identified clinical determinants of T2DM patients that are highly associated with glycemic control. Health care workers managing T2DM patients should address these clinical determinants in order to achieve glycemic control.

scholarly journals Glycated Hemoglobin and short-term Prognosis in Patients with Acute Coronary Syndrome with Diabetes Mellitus: A Prospective Cohort Study

2021 ◽  
Vol 17 (2) ◽  
pp. 108-113
Author(s):  
Fysal Faruq ◽  
Syed Ali Ahsan ◽  
Manzoor Mahmood ◽  
MRM Mandal ◽  
Kamruzzaman Siddiki ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cohort Study ◽  
Glycaemic Control ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Diabetic Patients ◽  
Poor Glycaemic Control ◽  
Coronary Syndrome ◽  
Good Glycaemic Control

Background: Data on the association between glycemic control after percutaneous coronary intervention (PCI) and clinical outcomes are limited and controversial in diabetic patients. Objective:The aim of the study was to assess the impact of good glycaemic control on three months clinical outcomes in diabetic acute coronary syndrome (ACS) patients undergoing PCI, from a Bangladesh health service perspective. Materials and methods:This prospective cohort study which was conducted in UCC, BSMMU included 346 consecutive diabetic ACS patients who underwent PCI at department of cardiology, BSMMU. Diabetic patients were categorized into two groups based on their 3 months HbA1c levels: 169 (48.84%) diabetics with good glycaemic control (HbA1c < 7%) and 177 (51.16%) diabetics with poor glycaemic control (HbA1c ≥7%).The outcome was major adverse cardiovascular events (MACEs), defined as cardiac death, myocardial infarction (MI), definite stent thrombosis, target vessel revascularization and stroke. Results: At 3 months follow up, patients with poor glycaemic control had a significantly higher incidence of MI (6.2% vs 1.2%; p=0.021). No other adverse events were found significantly different between the groups at 3 months of PCI. Conclusion:Good glycaemic control to obtain HbA1c level <7% in diabetic ACS patients undergoing coronary artery stenting may be beneficial in reducing the risk of MACEs and improvement of clinical outcome after PCI during 3 months follow up. University Heart Journal Vol. 17, No. 2, Jul 2021; 108-113

scholarly journals Comparison of Coagulation Profile in Type 2 Diabetic Patients with Good Glycaemic Control and Poor Glycaemic Control

2020 ◽  
Author(s):  
Binia Sherin ◽  
Bhuvanamha Devi Ramamurthy ◽  
Muthu Sudalaimuthu ◽  
Shivashekar Ganapathy
Keyword(s):  
Glycaemic Control ◽  
Bleeding Time ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Poor Glycaemic Control ◽  
Coagulation Profile ◽  
Good Glycaemic Control ◽  
Type 2 Diabetics ◽  
Type 2 Diabetic

Introduction: Diabetes Mellitus (DM) is a global health problem, characterised by high levels of glucose in blood with impairment of carbohydrate, fat and protein metabolism. Patients with DM have a high risk of developing atherothrombotic events. This leads to initiation and progression of microvascular and macrovascular complications. Aim: To compare the coagulation profile parameters in patients with Type 2 DM with good glycaemic control (Glycated Haemoglobin (HbA1c) <7) and poor glycaemic control (HbA1c ≥7) and to evaluate the association of coagulation profile and glycaemic control in diabetic patients. Materials and Methods: This study was conducted in a tertiary care hospital of Southern India on 84 patients among which 42 were Type 2 Diabetics with good glycaemic control and 42 were Type 2 Diabetics with poor glycaemic control. Blood samples were collected from the individuals chosen for the study and analysed for coagulation profile including Bleeding Time, Platelet Count, Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), fibrinogen and d-Dimer. Statistical analysis was done by unpaired student’s t-test using SPSS 21.0. Results: In the present study, it was observed that Bleeding Time, aPTT and fibrinogen concentration were increased (statistically significant, p<0.05) in Type 2 Diabetics with poor glycaemic control when compared with Type 2 Diabetics with good glycaemic control. No significant changes were noted in Platelet Count, PT and d-Dimer among the two study groups. Conclusion: The alteration in coagulation profile of Type 2 Diabetic people has shown that hyperglycaemia leads to abnormalities in the coagulation and Type 2 Diabetic patients with poor glycaemic control are at high risk for developing atherothrombotic and haemorrhagic events. So, evaluation of coagulation profile in diabetic patients may help the clinicians in early intervention to prevent the initiation of microvascular and macrovascular disease at the earliest.

scholarly journals Glycemic control, medication adherence, and injection practices among diabetic patients treated in the 3 tertiary referral hospitals in Bhutan: a call for more action

2018 ◽  
Vol 12 (1) ◽  
pp. 27-33
Author(s):  
Thinley Dorji ◽  
Pempa Lhamo ◽  
Tshering Tshering ◽  
Lungten Zangmo ◽  
Kencho Choden ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Glycemic Control ◽  
Blood Sugar ◽  
Injection Technique ◽  
Diabetic Patients ◽  
Tertiary Referral ◽  
Good Glycemic Control ◽  
Adherence To Medication ◽  
Referral Hospitals ◽  
Injection Practices

AbstractBackgroundThe burden of diabetes has increased rapidly with an increasing cost of treatment.ObjectivesTo describe the glycemic control, injection practices, and treatment adherence among diabetic patients treated with insulin.MethodsThis cross-sectional study was conducted using a convenience sampling method at the 3 tertiary referral hospitals in Bhutan. Sociodemographic, injection practices, and clinical details were collected. Good glycemic control was defined as glycated hemoglobin A (HbA1c) <7% if available or fasting blood sugar 70–130 mg/dL and 2 h postprandial blood sugar <180 mg/dL if HbA1c values were unavailable. Medication adherence was assessed using the Morisky, Green and Levine (MGL) scale. The injection technique was assessed using a 10-item checklist.ResultsWe studied 207 patients. Good glycemic control was achieved by only 58 (28.0%) of patients. Using the MGL scale score, the objective adherence with insulin therapy was mostly low to medium and a gross discordance was with self-declared adherence (P < 0.001). The injection technique was fair to poor in half of the participants. Those with good injection techniques also had good adherence to medication (P = 0.025, adjusted odds ratio = 4.4, 95% confidence interval 1.2–16.4). The majority (154, 74.4%) had self-injected insulin, while the remaining were dependent on their home caregivers. Forty percent of the participants used storage practices that were not recommended. The disposal of the used insulin needles was generally unsafe.ConclusionsGlycemic control and adherence to insulin administration recommendations were poor. The injection technique needs to be improved and standardized, and methods of safe disposal of sharps need to be developed.

Real-World Clinical Effectiveness and Tolerability of Hydroxychloroquine 400 Mg in Uncontrolled Type 2 Diabetes Subjects who are not Willing to Initiate Insulin Therapy (HYQ-Real-World Study)

2019 ◽  
Vol 15 (6) ◽  
pp. 510-519 ◽  
Author(s):  
Amit Gupta
Keyword(s):  
Body Weight ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Real World ◽  
Antidiabetic Drugs ◽  
Hypoglycemic Agents ◽  
Oral Hypoglycemic Agents ◽  
Good Glycemic Control ◽  
Hs Crp ◽  
Change In Mean

Objective: The epidemic of T2DM is rising across the globe. Systemic inflammation plays a pivotal role in the pathogenesis and complications of T2DM. Combination of two or more oral hypoglycemic agents (OHA) is widely prescribed in patients with T2DM, however many patients have poor glycemic control despite receiving combination therapy. The new antidiabetic drugs are relatively costly or many patients have anxiety over the use of injectable insulin. The objective of this observational study was to investigate the effectiveness and tolerability of hydroxychloroquine (HCQ) in T2DM patients uncontrolled on multiple OHA and despite high sugar level not willing to initiate insulin therapy in a real-world clinical setting. Methods: A prospective, investigator-initiated, observational, single-centred study was conducted where 250 patients (18-65 years) with T2DM for more than 5 years, with uncontrolled glycemia despite on a combination of multiple OHA, HbA1c between ≥7% and <10.5%, FPG >130 mg/dL or PPG >180 mg/dL and BMI between >25 and <39 kg/m2, were prescribed hydroxychloroquine sulphate 400 mg once daily for 48 weeks. Percentage of drugs used at the baseline were as follows: metformin 2000 mg (100%), glimepiride 4 mg (100%), pioglitazone 30 mg (100%), sitagliptin 100 mg (100%), canagliflozin 300 mg (52.4%), empagliflozin 25 mg (22.8%), dapagliflozin 10 mg (17.6%) and voglibose 0.3 mg (62%). Mean change in HbA1c, blood glucose and hs-CRP at baseline, week 12, 24 and 48 were assessed using the paired t-test. Results: After 48 weeks of add-on treatment with HCQ, almost all SGLT-2 inhibitors were withdrawn; metformin dose was reduced to 1000 mg, glimepiride reduced to 1 mg and sitagliptin reduced to 50 mg OD. Patients continued to have good glycemic control. HbA1c was reduced from 8.83% to 6.44%. Reduction in FPG was 40.78% (baseline 177.30 mg/dL) and PPG was reduced by 58.95% (baseline 329.86 mg/dL). Change in mean body weight was -4.66 Kg. The reduction in glycemic parameters and mean body weight was significant (p < 0.0001). Hs-CRP was significantly reduced from 2.70±1.98 mg/L to 0.71±0.30 mg/L 9 (p < 0.0001). More reduction in glycemic parameters and body weight was observed among the patients with higher hs-CRP (> 3 mg/L) as compared to patients with baseline hs- CRP ≤ 3 mg/L. Most common adverse events reported with the drug therapy were GI irritation (3.6%) and hypoglycemia (2%). None of the patients required medical assistance for hypoglycemia. Conclusion: Add-on treatment of HCQ effectively improved glycemic control in T2DM patients uncontrolled on multiple antidiabetic drugs. By virtue of its antidiabetic and anti-inflammatory properties, it may emerge as a valuable therapeutic intervention for the patients with T2DM.

scholarly journals EFFECT OF GLYCAEMIC CONTROL ON PITUITARY GONADOTROPHINS OF TYPE 2 DIABETIC SUBJECTS IN ENUGU, NIGERIA

2018 ◽  
Vol 6 (8) ◽  
pp. 16-24
Author(s):  
Maduka Ignatius C ◽  
Nnamdi Ngozika A
Keyword(s):  
Glycaemic Control ◽  
Diabetic Patients ◽  
Male Population ◽  
Female Population ◽  
Control Subjects ◽  
Good Glycaemic Control ◽  
Diabetic Population ◽  
Control Evaluation ◽  
Group B ◽  
The Impact

Glycation is considered to be the main molecular basis of several diabetic complications. Association between chronic hyperglycaemia and the development of long-term diabetic-specific complications have been reported but are yet to be completely understood. In this study, the effect of glycaemic control on pituitary gonadotrophins (FSH and LH) was evaluated in male and female diabetics in Enugu, Nigeria. Two hundred and twenty four (240) diabetic patients (92 males and 148 females) within the age range of 31 – 73 years, who were receiving treatment, were randomly recruited for the study. One hundred and thirty four (134) age- and sex-matched apparently healthy volunteers (44 males and 90 females) were recruited as the control subjects. The study subjects were grouped into three categories: Male population (40-72 years), Group A Female population (<50 years) and Group B Female population (≥50 years). The impact of glycaemic control on various parameters was evaluated by classifying the diabetic patients into 3 subgroups on the basis of their HbA1c levels:  Good (HbA1c < 7%), Fair (HbA1c 7 to 8%) and (Poor HbA1c > 8 %) glycaemic status. Fasting blood sugar, HbA1c, FSH and LH were determined for all the subjects. The results obtained revealed that the male diabetics had significantly lower (p<0.05) FSH levels when compared with the control subjects. In the two groups of female diabetic subjects, the FSH levels were significantly lower (p<0.05) when compared with their respective control subjects. The glycaemic control evaluation and correlation of HbA1c with the gonadotrophins in the male diabetic population show no statistically significant results. However, in the female diabetic population, subjects with poor glycaemic status show significantly increased (p<0.001) LH levels compared to those with good glycaemic control. In addition, in group B female diabetic population, HbA1c gave significant positive correlation with both FSH (r=0.261, p=0.014) and LH (r = 0.338, p<0.001). This suggests that there is a direct relationship between HbA1c and the gonadotrophic hormones. As glycaemic control is compromised, these hormones tend to increase. This study generally reveals increasing trend in the levels of the gonadotrophins across the different glycaemic status. It can be concluded that good glycaemic control of diabetes can exert better influences on pituitary gonadotrophins.

scholarly journals A Pilot Study Investigating the effect of Glycemic Control on Electrodiagnostic Parameters in Type II Diabetic Patients

2021 ◽  
pp. 146-153
Author(s):  
Parikshit Ashok Muley ◽  
Dalia A. Biswas ◽  
Avinash Taksande
Keyword(s):  
Risk Factor ◽  
Pilot Study ◽  
Glycemic Control ◽  
Glycaemic Control ◽  
Independent Risk Factor ◽  
Diabetic Patients ◽  
Type Ii ◽  
Duration Of Diabetes ◽  
Group Number

Background: Diabetes is a chronic metabolic abnormality due to either decreased secretion of insulin or decreased tissue sensitivity of insulin resulting in elevated blood glucose. Most common complication of diabetes is peripheral neuropathy. In this research project, we will be conducting a pilot study to observe the effect of glycaemic control on physiological functioning of nerve with the help of neurophysiological parameters, independent of duration of diabetes. Objectives: To investigate relationship of quality of glycemic control & severity of neurological changes. To find out whether glycemic control acts as an independent risk factor for progression of diabetic neuropathy despite the duration of diabetes. To validate the HBA1C at 10 for future longitudinal study to understand the association between glycemic control & progression of neuropathy. Methodology: 60 type II diabetic patients visiting diabetic OPD (Medicine) will participate in the study. The patients will be divided in to 2 groups of Group number 1 with (30 subjects) HBA1C < 10 and Group number 2 having (30 subjects) HBA1C >10. Electrodiagnostic study will be conducted on motor (tibial nerve) and sensory (sural nerve) will be performed in Neurophysiology lab. Neurophysiological parameters data of two groups will be analysed and compared. Expected Results: The pilot study will help to find out whether glycaemic control acts as a separate risk factor for progression of diabetic neuropathy despite duration of diabetes. Conclusion: This pilot study will help to establish the association between quality of glycaemic control and severity of neurological changes. Also, this will help to validate the HBA1C at 10 for further longitudinal study to know whether poor diabetes control is an independent risk factor associated to the severity of neuropathy in type II diabetes.

Should the quality of glycemic control guide dental implant therapy in patients with diabetes? Focus on implant survival

2021 ◽  
Vol 17 ◽  
Author(s):  
Dalia Nourah ◽  
Salwa Aldahlawi ◽  
Sebastiano Andreana
Keyword(s):  
Risk Factors ◽  
Glycemic Control ◽  
Dental Implant ◽  
Failure Rate ◽  
Implant Failure ◽  
Diabetic Patients ◽  
Marginal Bone Loss ◽  
Good Glycemic Control ◽  
Implant Therapy

Introduction: Optimal glycemic control is crucial to dental implant long-term functional and esthetic success. Despite HbA1c levels of 7% or lower used as an indicator for good glycemic control, however, this level may not be attainable for all diabetic patients. Most dentists do not consider patients with poor glycemic control candidates for implant therapy due to higher implant failure, infection or other complications. Aim: This review challenges the concept of one size fits all and aims to critically appraise the evidence for the success or failure rate of dental implants and peri-implant health outcomes in patients with less-than-optimal glycemic control. Discussion: Evidence suggests that estimating glycemic control from HbA1c measurement alone is misleading. Moreover, elevated preoperative HbA1c was not associated with increased mortality and morbidity after major surgical procedures. Literature for the survival or success of implants in diabetic patients is inconsistent due to a lack of standardized reporting of clinical data collection and outcomes. While a number of studies report that implant treatment in patients with well-controlled diabetes has a similar success rate to healthy individuals, other studies suggest that the quality of glycemic control in diabetic patients does not make a difference in the implant failure rate or marginal bone loss. This discrepancy could indicate that risk factors other than hyperglycemia may contribute to the survival of implants in diabetic patients. Conclusion: In the era of personalized medicine, the clinician should utilize individualized information and analyze all risk factors to provide the patient with evidence-based treatment options.

Sign in / Sign up

Export Citation Format

Share Document