scholarly journals Challenges in Hemoglobin A1C Measurement in 183 Patients with Diabetes having Hemoglobin Variants and Chemically Modified Derivatives

2021 ◽  
Vol 2 (4) ◽  
pp. 7
Author(s):  
Dilshad Ahmed Khan ◽  
Sumbal Nida
Keyword(s):  
Hemoglobin A1c ◽  
Clinical Chemistry ◽  
Glycosylated Hemoglobin ◽  
Diabetic Patients ◽  
Chemically Modified ◽  
Patients With Diabetes ◽  
Hemoglobin Variants ◽  
Selection Of

Diabetes is considered as one of the most common metabolic disorder. It has challenged in terms of diagnosis,monitoring and management in the patients with type-2 diabetes. Glycosylated Hemoglobin (HbA1c) hasrecently been validated for the diagnosis diabetes in non-fasting condition, long term blood glycose monitoringand also predicting its complications in the patients. National Glycohemoglobin Standardization Program andInternational Federation of Clinical chemistry have been collaborating for the harmonization of HbA1cmethods and directing the laboratories to maintain strict quality goals. However, standardization of variousHbA1c methods being used worldwide still needs consideration especially in diabetic patients havinghemoglobin variants. The main objectives are to review HbA1c methods and address challenges in itsmeasurement methodology for the patients with diabetes mellitus having hemoglobin variants or chemicallymodified derivatives. Thus, to provide guidance to the clinical pathologist for selection of appropriate methodfor their laboratories.

scholarly journals Perfil sociodemográfico, condiciones de salud y atención a personas con diabetes

2017 ◽  
Vol 14 (2) ◽  
pp. 22
Author(s):  
Meiby Lorena Rojas-Castañeda ◽  
Rosa Del Carmen Coral-Ibarra ◽  
Luz Dalila Vargas-Cruz
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Medical Records ◽  
Glycosylated Hemoglobin ◽  
Health Conditions ◽  
Diabetic Patients ◽  
Demographic Profile ◽  
Patients With Diabetes ◽  
The Impact

Objetivo: Analizar el perfil sociodemográfico, condiciones de salud y atención a personas con diabetes, a partir de la revisión de historias clínicas. Materiales y Métodos: estudio descriptivo transversal. La población fue de 821 historias clínicas de pacientes con diabetes mellitus. En total la muestra fue de 230 historias clínicas por método aleatorio simple. Se utilizó el instrumento Impacto en la Condición de Salud y Calidad de Vida de las Atenciones de Salud en Pacientes Diabéticos Tipo 2 de Macul, que evalúa el perfil sociodemográfico, las condiciones de salud y el tipo de atención otorgada. Resultados: 39 % de los pacientes presentó el valor de la última hemoglobina glicosilada mayor de 12 %, el 41,3 % no presentó ningún riesgo de pie diabético, 46,9 % tuvo diagnóstico de obesidad y el 23,9 % presentó sobrepeso. El porcentaje de cumplimiento de citas al mes por parte del médico y la enfermera fue del 100 %, a diferencia del control por parte de la nutricionista que debe realizase cada 6 meses, sólo se registró un cumplimiento del 71,7 %. No se encontró relación estadísticamente significativa entre asistencia al programa con adherencia al tratamiento, o con compensación de la enfermedad. Conclusiones: los pacientes con diabetes a pesar de estar en un programa de atención integral, no tienen un óptimo control glicémico, lo cual sugiere la revisión del cumplimiento del régimen terapéutico por parte de los profesionales de la salud para prevenir complicaciones que se puedan presentar a corto, mediano o largo plazo.PALABRAS CLAVE: atención a la salud, complicaciones crónicas, diabetes mellitus tipo 2, enfermedad crónica.SOCIO-DEMOGRAPHIC PROFILE, HEALTH CONDITIONS AND ATTENTION TO PEOPLE WITH DIABETES.ABSTRACT Objective: To analyze the socio-demographic profile, health conditions and attention to people with diabetes from a review of medical records. Materials and Methods: cross-sectional descriptive study. The population was of 821 medical records of patients with diabetes mellitus. In total the sample was of 230 medical records through a simple aleatory method. The Impact instrument was used in the Health Condition and Life Quality of the Health Care in Diabetic Patients Type 2 from Macul, that evaluates the socio-demographic profile, the health conditions and the type of attention given. Results: 39% of the patients presented the value of the last glycosylated hemoglobin greater than 12%, 41,3% did not present any risks of diabetic foot, 46,9% had an obesity diagnose and 23,9% presented overweight. The doctor and the nurse percentage of compliance of appointments per month was 100%, as opposed to the control by the nutritionist that must be performed every 6 months, only a of 71,1% of compliance was registered. A statistically significant relationship was not found between compliance to the program and treatment adherence, or with compensation for the disease. Conclusions: patients with diabetes despite of being in a program of comprehensive care, do not have an optimal glycemic control, which suggests a review of the compliance of the therapeutic regime by the health professionals to prevent complications that may occur in a short, medium, or long term.KEYWORDS: health care, chronic complications, diabetes mellitus type 2, chronic disease. PERFIL SÓCIO DEMOGRÁFICO, CONDIÇÕES DE SAÚDE E CUIDADOS PARA AS PESSOAS COM DIABETESRESUMO Objetivo: Analisar o perfil sócio demográfico, condições de saúde e cuidados para as pessoas com diabetes a partir da revisão de histórias clínicas. Materiais e Métodos: estudo descritivo transversal. A população foi de 821 historias clínicas de pacientes com diabetes mellitus. Em total a amostra foi de 230 historias clínicas por método aleatório simples. Utilizou-se o instrumento Impacto na Condição de Saúde e Qualidade de Vida das Assistências Médicas em Pacientes Diabéticos Tipo 2 de Macul, que avalia o perfil sócio demográfico, as condições de saúde e o tipo de atendimento recebido. Resultados: 39% dos pacientes apresentaram o valor da última hemoglobina glicada (Hb A1c) maior de 12%, o 41,3% não apresentou nenhum risco de pé diabético, 46,9% tiveram diagnóstico de obesidade e o 23,9% apresentaram excesso de peso. A porcentagem de cumprimento de consultas ao mês por parte do médico e a enfermeira foi do 100%, a diferença do controle por parte da nutricionista que deve realizar-se a cada 6 meses, apenas registrou-se um cumprimento do 71,7%. Não se encontrou relação estatisticamente significativa entre assistência ao programa com aderência ao tratamento, ou com compensação da doença. Conclusões: os pacientes com diabetes a pesar de estar num programa de atendimento integral, não tem um óptimo controle glicémico, o qual sugere a revisão do cumprimento do regime terapêutico por parte dos professionais da saúde para prevenir complicações que se possam apresentar a curto, médio ou longo prazo. Palavras-chave: assistência médica, complicações crónicas, diabetes mellitus tipo 2, doença crónica.

scholarly journals Changes over Time in Hemoglobin A1C (HbA1C) Levels Predict Long-Term Survival Following Acute Myocardial Infarction among Patients with Diabetes Mellitus

2021 ◽  
Vol 10 (15) ◽  
pp. 3232
Author(s):  
Ygal Plakht ◽  
Harel Gilutz ◽  
Arthur Shiyovich
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hemoglobin A1c ◽  
Prognostic Significance ◽  
Diabetic Patients ◽  
Term Survival ◽  
Patients With Diabetes ◽  
One Year ◽  
Hba1c Levels

Frequent fluctuations of hemoglobin A1c (HbA1C) values predict patient outcomes. However, data regarding prognoses depending on the long-term changes in HbA1C among patients after acute myocardial infarction (AMI) are scarce. We evaluated the prognostic significance of HbA1C levels and changes among diabetic patients (n = 4066) after non-fatal AMI. All the results of HbA1C tests up to the 10-year follow-up were obtained. The changes (∆) of HbA1C were calculated in each patient. The time intervals of ∆HbA1C values were classified as rapid (<one year) and slow (≥one year) changes. The outcome was all-cause mortality. The highest mortality rates of 53.8% and 35.5% were found in the HbA1C < 5.5–7% and ∆HbA1C = −2.5–(−2%) categories. A U-shaped association was observed between HbA1C and mortality: adjOR = 1.887 and adjOR = 1.302 for HbA1C < 5.5% and ≥8.0%, respectively, as compared with 5.5–6.5% (p < 0.001). Additionally, ∆HbA1C was associated with the outcome (U-shaped): adjOR = 2.376 and adjOR = 1.340 for the groups of <−2.5% and ≥2.5% ∆HbA1C, respectively, as compared to minimal ∆HbA1C (±0.5%) (p < 0.001). A rapid increase in HbA1C (but not decrease) was associated with a greater risk of mortality. HbA1C values and their changes are significant prognostic markers for long-term mortality among AMI-DM patients. ∆HbA1C and its timing, in addition to absolute HbA1C values, should be monitored.

scholarly journals Relation between Glycosylated Hemoglobin (Hemoglobin A1c) and Aortic Stiffness in Type 2 Diabetic Patients

2013 ◽  
Vol 62 (18) ◽  
pp. C167-C168
Author(s):  
Erkan Kahraman ◽  
Taner Sen ◽  
Saadet Guven ◽  
Gokhan Keskin ◽  
Serkan Topaloglu ◽  
...  
Keyword(s):  
Aortic Stiffness ◽  
Hemoglobin A1c ◽  
Glycosylated Hemoglobin ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

scholarly journals Unexpected Detection of Abnormal Hemoglobin Variants During Routine HbA1c Analysis by HPLC Technique: Challenges and Opportunities in HbA1c Testing

2021 ◽  
Vol 9 (1) ◽  
pp. 15-21
Author(s):  
Neelam Narsingrao Sreedevi ◽  
Guduru Vijay Kumar ◽  
Boda Chendar ◽  
Madrol Vijaya Bhaskar ◽  
Kompella Sree Satya Sai Baba ◽  
...  
Keyword(s):  
Hemoglobin A1c ◽  
Glycated Hemoglobin ◽  
Incidental Finding ◽  
Diabetic Patients ◽  
Hb E ◽  
Challenges And Opportunities ◽  
Abnormal Hemoglobin ◽  
Diabetic Population ◽  
Hemoglobin Variants

Background: Glycated Hemoglobin A1c (HbA1c) assay is most widely used in diabetic patients for assessing long-term control of glycemia. The presence of hemoglobin variants may be an incidental finding and can interfere with HbA1c measurements. The aim of the present study is to investigate the prevalence and impact of interference of different abnormal hemoglobin variants on HbA1c measurements during routine HbA1c testing. Methods: A total of 12,092 HbA1c samples were collected from January to August 2018. HbA1c quantification was carried out on a Variant II Bio-Rad’s HPLC analyzer. Abnormal chromatograms were further analyzed using the extended-run high-pressure liquid chromatography (HPLC) analysis in the A2/F mode. Results: The samples were examined for presence of abnormal variants. Samples producing abnormal chromatograms were further analyzed in A2/F mode to characterize hemoglobin variants. Abnormal variants were identified in 126 (1%) samples, and 74 (0.59%) sickle cell traits (SCT) were the most common variant in our findings. Moreover, 30 (0.24%) cases were eluted in the variant window in A1c mode, which on further analysis were found to be Hb E & Hb D traits. Furthermore, 3 (0.02%) cases were eluted at a RT <1 min as (unknown) and identified as Hb H. Also,19 (0.15%) samples were eluted in the P3 window at different retention times. Conclusion: Observing each chromatograph after the analysis can help us in identifying silent hemoglobin variants in routine HbA1c testing. Knowledge and awareness of common hemoglobin variants affecting measurement of HbA1c is imperative to avoid reporting of falsely low HbA1c values in diabetic population.

scholarly journals Predictors of dietary self-efficacy in high glycosylated hemoglobin A1c type 2 diabetic patients

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093128
Author(s):  
Tamás Köbling ◽  
Zita Váradi ◽  
Éva Katona ◽  
Sándor Somodi ◽  
Péter Kempler ◽  
...  
Keyword(s):  
Social Isolation ◽  
Self Efficacy ◽  
Hemoglobin A1c ◽  
Mental Health Problems ◽  
Patient Adherence ◽  
Rank Order ◽  
Glycosylated Hemoglobin ◽  
Diabetic Patients ◽  
Glycosylated Hemoglobin A1c

Objective To predict dietary self-efficacy behaviors in high glycosylated hemoglobin A1c (HbA1c) patients using type D personality (TDP) and other psychosocial measures. Methods A cross-sectional, predictive research design was implemented. Participants were type 2 diabetes mellitus patients diagnosed more than 2 years prior to the study. Data were collected for demographics, dietary self-efficacy and psychological measures. Spearman’s rank-order correlation was used to test for relationships, the Mann–Whitney test was used to test for differences and multiple linear regression was used to examine predictors of dietary self-efficacy. Results Lower dietary self-efficacy was strongly correlated with greater social isolation (r = 0.93) and moderately correlated with more mental health problems (r = 0.20) and higher TDP scores (r = 0.17). Higher HbA1c was inversely related to self-reported physical health (r = −0.19). Social and emotional isolation and time since diagnosis predicted dietary self-efficacy (greater isolation was associated with more dietary management difficulties). Conclusions Regression outcomes suggested that a 10% decrease in social isolation improves dietary self-efficacy by 30%, a significant boost to therapeutic adherence. We recommend assessment of social isolation to improve dietary self-efficacy and achieve better patient adherence to therapy.

scholarly journals Evaluation of serum adropin and irisin levels and its association with anthropometric obesity indices and biochemical parameters in Type 2 diabetic patients

2021 ◽  
pp. 1-8
Author(s):  
Foad Alzoughool ◽  
Huda Al Hourani ◽  
Manar Atoum ◽  
Sajedah Bateineh ◽  
Hanan Alsheikh ◽  
...  
Keyword(s):  
Negative Correlation ◽  
Biochemical Parameters ◽  
Significant Positive Correlation ◽  
Glycosylated Hemoglobin ◽  
Significant Negative Correlation ◽  
Diabetic Patients ◽  
Positive Correlation ◽  
Obesity Indices ◽  
Group Serum

BACKGROUND/AIM: The newly described proteins adropin and irisin are a highly conserved polypeptide that plays essential roles in metabolic and energy homeostasis, insulin resistance, and fat browning. The aim of this study is to evaluate the circulating levels of serum adropin and irisin in type 2 diabetes mellitus (T2DM) patients and also to elucidate possible relationships between serum adropin and irisin levels with anthropometric obesity indices and biochemical parameters. SUBJECTS AND METHODS: Single-center prospective observational study included 90 T2DM patients referred to the diabetes outpatient clinic. Height, weight, and waist circumference (WC) were measured. Body mass index (BMI) and waist to height ratio (WHtR) were calculated. Fasting blood glucose, glycosylated hemoglobin, serum lipids, creatinine, urea, and blood urea nitrogen were evaluated. Estimated glomerular filtration rate (GFR) was calculated, serum adropin and irisin were evaluated. RESULTS: The results showed a significant positive correlation between adropin and irisin in females but not in males (r = 0.311; P = 0.042). In males’ group, serum adropin levels showed significant negative correlation with serum glucose (–0.423, P = <  0.05), HbA1C (–0.364, P = <  0.05), and GFR (–0.355, P = <  0.05). In contrast, creatinine was showed a significant positive correlation with adropin in males (0.381, P = <  0.05). In females’ group, adropin showed a significant negative correlation with weight (–0.371, P = <  0.05), BMI (–0.349, P = <  0.05), WC (–0.402, P = <  0.01), and WHtR (–0.398, P = <  0.01). Contrary, in males’ group, serum irisin levels showed significant positive correlation with weight (0.338, P = <  0.05), BMI (0.332, P = <  0.05), WC (0.409, P = <  0.01), and WHtR (0.432, P = <  0.01). CONCLUSION: This study demonstrated that, in T2DM patients, circulating serum adrpoin correlated negatively with anthropometric obesity indices of obesity in females, while serum irisin was positively correlated with anthropometric obesity indices of obesity in males.

Gatifloxacin-Associated Hypoglycemia

2002 ◽  
Vol 18 (6) ◽  
pp. 319-320 ◽  
Author(s):  
Miguel A Parilo
Keyword(s):  
Case Summary ◽  
Fluoroquinolone Antibiotics ◽  
Patients With Diabetes ◽  
Administration Error ◽  
Oral Hypoglycemic Medications ◽  
Hypoglycemic Therapy ◽  
Intravenous Dextrose ◽  
Drug Administration Error

Objective: To report a case of prolonged hypoglycemia associated with glyburide and gatifloxacin use. Case Summary: An 82-year-old white woman with diabetes mellitus type 2 and chronic renal insufficiency developed postoperative pneumonia. She had previously been on long-term glyburide therapy. Protracted hypoglycemia after institution of gatifloxacin developed despite discontinuation of oral hypoglycemic therapy. After 2 days of intravenous dextrose, sustained normoglycemia was achieved. Discussion: Hypoglycemic reactions with glyburide and fluoroquinolone antibiotics have been reported, but not with gatifloxacin. Although drug administration error cannot be excluded, no documentation exists to support this. The onset of hypoglycemia soon after administration of gatifloxacin and reports of similar interactions favor the hypothesis that hypoglycemia was induced by a gatifloxacin–glyburide interaction. Conclusions: Fluoroquinolone-associated hypoglycemia has been documented, and an interaction of gatifloxacin and glyburide appears probable. Patients with diabetes should be monitored for the development of resistant hypoglycemia, especially if they are on concomitant oral hypoglycemic medications.

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