Glucose variability and glycated hemoglobin HbA1c in type 1 and type 2 diabetes

Abstract Gut microbiota plays an important role in the regulation of the immune system and host’s metabolism. We aimed to characterize the gut microbiota of Tunisian participants with and without diabetes. We enrolled ten participants with type 1 diabetes mellitus (T1DM), ten patients with type 2 diabetes mellitus (T2DM), and 11 subjects without diabetes. Bacteria was quantified in fecal samples by quantitative PCR (qPCR). Statistical tests and multivariate analysis were performed using RStudio program. Results showed that the proportions of Firmicutes, Akkermansia muciniphila, and Faecalibacterium prausnitzii (P≤0.041), as well as, the ratio Firmicutes/Bacteroidetes decreased in participants with T1DM compared with those without diabetes (p = 0.036). Participants with T2DM presented a reduction in the amounts of A. muciniphila and F. prausnitzii compared with those without diabetes (P≤0.036). Furthermore, A muciniphila is negatively correlated with glucose level (P=0.022) and glycated hemoglobin (HbA1c) (P=0.035). Multivariate analysis revealed that participants with diabetes formed a cluster apart compared with those without diabetes. In conclusion the gut bacteria of Tunisian participants with diabetes was altered. The gut bacterial profile, especially the distribution of A muciniphila in participants with diabetes was affected by glycemic dysregulation. The investigation of the gut microbiota may help clinicians to improve diagnosis and treatment of diabetes and its complications.

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Comparison of Glycated Hemoglobin Results Based on At-Home and In-Lab Dried Blood Spot Sampling to Routine Venous Blood Sampling In-Lab in Adult Patients With Type 1 or Type 2 Diabetes

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2017.10.053 ◽

2018 ◽

Vol 42 (4) ◽

pp. 426-432.e1 ◽

Cited By ~ 1

Author(s):

Thomas G. Elliott ◽

Kent C. Dooley ◽

Mira Zhang ◽

Harlan S.D. Campbell ◽

Darby J.S. Thompson

Keyword(s):

Type 2 Diabetes ◽

Glycated Hemoglobin ◽

Venous Blood ◽

Adult Patients ◽

Blood Sampling ◽

Dried Blood Spot ◽

Venous Blood Sampling ◽

Blood Spot

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Nocturnal Hypoglycemia in Type 2 Diabetes

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.2478/rjdnmd-2018-0011 ◽

2018 ◽

Vol 25 (1) ◽

pp. 99-103

Author(s):

Simona Clus ◽

Gabriela Crețeanu ◽

Amorin Popa

Keyword(s):

Type 2 Diabetes ◽

Disease Duration ◽

Clinical Manifestations ◽

Glucose Monitoring ◽

Glucose Variability ◽

Ambulatory Setting ◽

Pharmacological Interventions ◽

Nocturnal Hypoglycemia

Abstract Background and aims: It is known that the majority of critical unacknowledged hypoglycemia has an increased incidence in patients with type 1 diabetes (T1DM) with a long evolution. The aim of this research is to evaluate the variability of glucose level and hypoglycemic events in patients with type 2 diabetes (T2DM) having pharmacological interventions with hypoglycemic risk. These events are sometimes asymptomatic also in T2DM: frequently in elderly, patients with autonomic neuropathy, or having a long evolution of disease. Material and method: This analysis includes 72 patients with T2DM, with a relative good metabolic control, and possible glucose fluctuations. Glucose variability was appreciated using continuous glucose monitoring systems (CGMS) used for more than 72 hours in hospital or ambulatory setting. Results: The incidence, duration and severity of hypoglycemia are not correlated with HbA1c value, age, disease duration or treatment. Approximately a quarter of patients had nocturnal hypoglycemia and in 37,5% of events hypoglycemia was prolonged, more 45 minutes. Clinical manifestations in diurnal hypoglycemia were presents in only 40% of the recorded events. Conclusions: The study suggested that CGMS is beneficial for patients with type 2 diabetes, with hypoglycemic risk and complications, to adjusted medication, education and prevention the cardiovascular events.

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