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Association of Dyslipidemia and Glycated Haemoglobin in Gestational Diabetes Mellitus  [PDF]
M. Lenin, R. Ramesh, V. Kuzhandai Velu, Seetesh Ghose
Journal of Diabetes Mellitus (JDM) , 2017, DOI: 10.4236/jdm.2017.74022
Abstract: Background: GDM is a condition where there is an onset of carbohydrate intolerance during pregnancy. In this condition many changes will take place in carbohydrate metabolism and other metabolic pathways especially in lipid metabolism. These metabolic changes associated with insulin resistance and dyslipidemia. We have aim to study the association between dyslipidemia and glycated haemoglobin. Materials and Methods: The study was conducted in 80 pregnant women of rural population of Puducherry in two groups. Group 1 includes 40 newly diagnosed GDM patients by DIPSI and Group II with 40 normal pregnant women, age group were between 20 to 40 years. Fasting blood glucose, 2-hour post glucose and lipid profile were estimated by auto analyzer. HbA1c was analysis by HPLC method. For comparisons of means student t-test was used to determine the significance between GDM and controls. Results: There was statistically significant difference in lipid profiles (P = 0.05), HDL (P = 0.04), VLDL (P = 0.00), LDL (P = 0.04) HDL (P = 0.04) in GDM groups. HbA1c (P = 0.02) levels were statistically significant with GDM pregnant women. There was no statically significant difference between FG (P
Value of Serum Glycated Albumin in Prediction of Coronary Artery Disease in Type 2 Diabetes Mellitus
Public Health Research , 2012, DOI: 10.5923/j.phr.20120203.01
Abstract: Coronary artery disease (CAD) is a major vascular complication of diabetes mellitus and reveals high mortality. Up to 30 % of diabetic patients with myocardial ischemia remain asymptomatic and are associated with worse prognosis compared to non-diabetic counterpart, which warrants routine screening for CAD in diabetic population. The purpose of this study was to evaluate the clinical value of serum glycated albumin level in predicting the presence of CAD in patients with type 2 diabetes. Ninety patients with type 2 diabetes were divided into four groups having the coronary artery disease with lumen diameter narrowing < 30 %, Group II with mild CAD contained those patients with lumen diameter narrowing 30-50 %, and Group III with Major CAD contained those subjects with lumen diameter narrowing 50-70 %. Finally group IV with severe CAD including the patients with lumen diameter narrowing > 70 %. Serum levels of glycated albumin was determined using ELISA as well as serum concentrations of glucose, lipids, were taken in questionnaire in all groups. Serum glycated albumin levels were significantly increased in diabetic patients with CAD.
Estimation of Duration of Symptoms in Fulminant Type 1 Diabetes Mellitus Using HbA1c or Glycated Albumin
Akitsu Kawabe, Takashi Seta, Sumie Fujii, Masayo Yamada, Shogo Oki, Jun Murai, Hiroshi Saito and Masafumi Koga
Japanese Clinical Medicine , 2012, DOI: 10.4137/JCM.S9509
Abstract: Fulminant type 1 diabetes mellitus (FT1DM) develops as a result of very rapid and almost complete destruction of pancreatic cells. Because of an abrupt increase in plasma glucose, HbA1c and glycated albumin (GA) might increase along with duration of symptoms in FT1DM patients. We attempted to devise a formula to estimate duration of symptoms based on the increased levels in HbA1c or GA. Four patients who developed FT1DM during the course of type 2 diabetes mellitus and in whom HbA1c was measured before onset were investigated in this study. The percents of the estimated duration of symptoms calculated from HbA1c (four patients) and GA (two patients) to the actual duration were 137 ± 88% and 122%, respectively. In FT1DM patients in whom HbA1c and/or GA before onset and at the time of ketoacidosis are measured, duration of symptoms might be estimated with using the increased levels in HbA1c or GA.
Prevalence of Dyslipidemia in Children and Adolescents with Diabetes Mellitus Type I
H Moayeri,Z Oloomi
Iranian Journal of Pediatrics , 2006,
Abstract: Background: Dyslipidemia is frequently observed in patients with diabetes mellitus and has led to development of screening programs and intervention studies. Dyslipidemia has been identified as an important risk factor for coronary heart disease. Methods: 128 patients with type I diabetes attending a single pediatric endocrine clinic underwent anthropometric and biochemical assessment. Anthropometric measurements followed WHO criteria. Blood samples were analyzed for glycated hemoglobin (HbA1C), cholesterol (chol), triglycerides (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL), and blood pressure was recorded. Findings: Patients' mean age was 12.6 ± 4.1 years. Patients' mean age at the onset of diabetes was 7.1 ± 2.8 years. Mean duration of diabetes was 6.9 ± 3.2 years. 48.5% of patients had some form of dyslipidemia. 21.4% had isolated hypertriglyceridemia, 11.6% isolated hypercholesterolemia and 15.5% mixed hyperlipidemia. Factors associated with dyslipidemia included longer duration of diabetes, higher mean age, higher mean HbA1C (p 0.001). Hypertriglyceridemia was more frequent in female patients and subjects with higher BMI (p<0.05). The mean value of TG 199.9 ± 74.1 mg/dl, TC 178.5 ± 29 mg/dl and LDL 141.2± 37 were significantly higher in patients with poor metabolic control (mean value of HbA1C 9.3 ± 1.8) than the diabetic patients with better control (mean value of HbA1C 7.1 ± 0.77), TG 156.8 ± 55.9 mg/dl; TC 143.5 ± 37.6 mg/dl and LDL 108± 21.2. Conclusion: Our findings indicated that type I diabetic patients with poor metabolic control are at higher risk of developing dyslipidemia. However, given the well documented problems of lifestyle regulation and compliance in optimizing control especially in this age group, we need to develop alternative and simple interventional strategies to improve outcome. Monitoring of lipids should be extended and yearly screening of patients for dyslipidemia recommended.
Carbohydrate Intake Is Correlated with the Glycated Albumin to Glycated Hemoglobin Ratio in Drug-Naive Patients with Type 2 Diabetes  [PDF]
Satoru Sumitani, Yoshihiko Utsu, Shuhei Nishina, Kenta Okuro, Atsushi Kogetsu, Seigo Ishii, Akiko Deguchi, Bunzo Sato, Isao Tachibana, Soji Kasayama, Masafumi Koga
Journal of Diabetes Mellitus (JDM) , 2016, DOI: 10.4236/jdm.2016.61002
Abstract: Background: The glycated albumin (GA) to HbA1c ratio (GA/HbA1c ratio) has been reported to reflect postprandial hyperglycemia. Carbohydrate is the primary dietary macronutrient that causes postprandial hyperglycemia. Thus, we investigated whether carbohydrate intake was associated with the GA/HbA1c ratio in patients with type 2 diabetes. Methods: Daily energy intake and carbohydrate intake were estimated in twenty-two patients with type 2 diabetes who received no pharmacological therapy (18 men and 4 women, age 53 ± 11 years old). The energy index and the carbohydrate index were defined as the ratio of daily energy intake to body weight and daily carbohydrate intake to body weight, respectively. Results: The energy index was significantly correlated with the GA/HbA1c ratio (r = 0.451, p = 0.035), but not with fasting plasma glucose (FPG), HbA1c and GA. The carbohydrate index was significantly correlated with GA (r = 0.461, p = 0.031) and the GA/HbA1c ratio (r = 0.554, p = 0.007), but not with FPG and HbA1c. Multivariate analysis revealed that the carbohydrate index was independently associated with the GA/HbA1c ratio (β = 0.397, p = 0.046). Conclusions: The carbohydrate index was significantly correlated with GA and the GA/HbA1c ratio in the patients with type 2 diabetes. These results suggest that carbohydrate intake may be associated with the GA/HbA1c ratio through postprandial hyperglycemia.
The Relationship between Glycated Hemoglobin and Complexity of Coronary Artery Lesions among Older Patients with Diabetes Mellitus  [PDF]
Jinling Ma, Xiujie Wang, Yutang Wang, Yuexiang Zhao, Meng Gao, Xiaoqian Li
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0091972
Abstract: Objectives Glycated hemoglobin (HbA1c) is associated with an increased risk of cardiovascular disease. The aim of this study was to examine the relationship between HbA1c levels and the complexity of coronary artery lesions among the older patients with diabetes mellitus (DM). Methods This retrospective study enrolled a total of 3805 consecutive type 2 DM patients aged 60 years and older who underwent their first elective coronary angiography and had their HbA1c levels measured at the Chinese PLA General Hospital between December 2005 and December 2012.The complexity of the coronary artery lesions was evaluated using the Syntax score, and the subjects were divided into three groups according to their HbA1c levels. Logistic regression and Pearson correlation were used to analyze the association between the measured HbA1c levels and Syntax score. Results The mean age was 72.3±10.6 years. The higher HbA1c levels were significantly associated with higher Syntax score (p<0.001). The unadjusted correlation coefficient of HbA1c levels and the Syntax score was 0. 371 (p<0.001). In addition, the higher HbA1c categories were able to independently predict patients with intermediate or high Syntax score (Syntax score ≥23) after adjustment for age, sex, hypertension, smoking, dyslipidemia and creatinine levels in the logistic regression analysis. Conclusion HbA1c is significantly associated with the complexity of coronary lesions among older patients with DM. A higher HbA1c value is an independent predictor of the prevalence of complex coronary lesions. Further prospective multi-centre studies are needed to confirm this finding.
Brijesh Mukherjee
International Journal of Bioassays , 2013,
Abstract: The progressive complications of unmanaged diabetes include heart disease, blindness, kidney failure, amputation of extremities due to circulation problems, and nerve disorders, as well as other chronic conditions. Decades of research have established that prolonged exposure to excess glucose is the cause of diabetes complications, and that long-term control of blood glucose levels is required to avoid or lessen the damage caused by excess glucose. The process of protein glycation is now understood to be both a marker for the progress of diabetes complications and an underlying cause of many of the most serious complications. Diabetes monitoring for protein glycation, an essential element for the long-term control of the complications of diabetes mellitus, is currently managed by a combination of daily self-monitoring of blood glucose (SMBG) measurements and physician-assessed hemoglobin A1c (A1C) levels every 3–6 months. Short term methods like self-monitoring of blood glucose and long term methods like measurement of HbA1c have limitations. Various researchers have identified glycated albumin (GA) as the ideal marker for an intermediate index to measure glycation.
Atherogenic dyslipidemia and diabetes mellitus: what’s new in the management arena?
Ajoy Kumar, Vibhuti Singh
Vascular Health and Risk Management , 2010, DOI: http://dx.doi.org/10.2147/VHRM.S5686
Abstract: therogenic dyslipidemia and diabetes mellitus: what’s new in the management arena? Review (5099) Total Article Views Authors: Ajoy Kumar, Vibhuti Singh Published Date July 2010 Volume 2010:6 Pages 665 - 669 DOI: http://dx.doi.org/10.2147/VHRM.S5686 Ajoy Kumar1, Vibhuti Singh2 1Bayfront Family Medicine Residency, St Petersburg FL, USA; 2University of South Florida College of Medicine and Suncoast Cardiovascular Center, St Petersburg, FL, USA Abstract: When compared with the general population, the diabetic population is at higher risk of cardiovascular disease (CVD), as predicted by the Framingham Risk Score calculations (10-year risk 20%). For this reason diabetes is considered a “coronary disease equivalent” condition, as classified by the National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III. Furthermore, patients with diabetes who experience a myocar-dial infarction have a poorer prognosis than non-diabetic patients, which contributes to their overall higher mortality. Dyslipidemia is a major underlying risk factor contributing to the excess CVD risk, and is usually more atherogenic in the presence of diabetes. It is uniquely manifested by raised levels of triglycer-ides, low levels of high-density lipoprotein cholesterol, and smaller, denser, and more atherogenic low-density lipoprotein particles. Recent trials have suggested the need for more aggressive treatment of dyslipidemia in this subpopulation than the current recommendations by the NCEP-ATP III. This review addresses the newer developments in the diabetes arena in terms of our current understanding of atherogenic dyslipidemia in diabetes and data from the latest randomized trials addressing its management.
Estimation of Duration of Symptoms in Fulminant Type 1 Diabetes Mellitus Using HbA1c or Glycated Albumin
Akitsu Kawabe,Takashi Seta,Sumie Fujii,Masayo Yamada
Japanese Clinical Medicine , 2012,
Using glycated hemoglobin hba1c for diagnosis of diabetes mellitus: an indian perspective  [PDF]
Rajni Dawar Mahajan,Bhawesh Mishra
International Journal of Biological and Medical Research , 2011,
Abstract: Glycated Hemoglobin (HbA1c) gives an estimate of long-term average glycemic status. It is used routinely to assess glycemic control in diabetics to attain treatment goals and prevent long term complications. Its recommendation for diagnosis of diabetes mellitus has evoked mixed response worldwide. We reviewed a number of published articles to analyze the pros and cons of using HbA1c for diagnosis of Diabetes mellitus in India. We observed that though HbA1c has some indisputable advantages over fasting plasma glucose estimation for diagnosing diabetes mellitus, a number of biochemical, clinical and economical factors limit its use as single diagnostic agent. Diagnostic methods and laboratories are insufficiently standardized for HbA1c in India. The clinician must consider the overall patient profile in addition to a number of local variations and disorders especially hemoglobinopathies /anemias before accepting an abnormal HbA1c value. Supportive or repeat tests may be required leading to increase in cost and delay in diagnosis. In the present Indian scenario, especially the fragmented unorganized health care sector in suburban areas, HbA1c cannot be accepted as a sole and independent test to diagnose diabetes mellitus.
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