ABSTRACT
BACKGROUND: The aim of this study was to explore the differences in the clinical characteristics and diagnostic rates of diabetes mellitus (DM) according to various criteria in different age groups and to evaluate the efficacy of each criterion for screening older patients. METHODS: We studied 515 patients and measured the fasting plasma glucose level (FPG), 2-hour plasma glucose level after the 75 g oral glucose tolerance test (2-hour postload glucose [2-h PG]), and glycosylated hemoglobin (HbA1c) for re-evaluation of hyperglycemia without a history of diabetes. Patients with newly diagnosed DM were grouped by age as younger ( < 65 years) or older (≥65 years). RESULTS: Older patients had significantly lower HbA1c, FPG, and 2-h PG levels and a higher homeostatic level of pancreatic β-cell function compared with younger patients (P < 0.001). The older group had the lowest diagnostic rate when using the FPG level (45.5%) and the highest diagnostic rate when using the 2-h PG level (84.6%). These results were mostly due to the higher frequency of isolated post-challenge hyperglycemia in the older patients than in the younger group (28.8% vs. 9.2%). The use of both the FPG and HbA1c levels significantly enhanced the low diagnostic power when employing only the FPG levels in the older group (71.2% vs. 45.5%). CONCLUSION: In the older patients, the 2-h PG level was the most accurate diagnostic criterion. When we consider the costs and convenience, a combination of the FPG and HbA1c criteria may be recommended as a screening test for DM in older people.
Subject(s)
Humans , Blood Glucose , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Early Diagnosis , Fasting , Glucose , Glucose Tolerance Test , Glycated Hemoglobin , Hyperglycemia , Mass Screening , PlasmaABSTRACT
Insulin resistance in patients with diabetes mellitus may be aggravated by various causes, including infection, obesity, and medications known to affect insulin sensitivity. During pregnancy, insulin resistance can be the result of hormones secreted by the placenta. Blood glucose control during pregnancy is important in preventing obstetric complications including miscarriage, congenital malformations, and macrosomia. We report a case of severe insulin resistance in an obese diabetic pregnant woman whose one-day insulin requirements were up to 1,000 IU.
Subject(s)
Female , Humans , Pregnancy , Abortion, Spontaneous , Blood Glucose , Diabetes Mellitus , Insulin Resistance , Insulin , Obesity , Placenta , Pregnant WomenABSTRACT
Subject(s)
Rabbits , Bone Regeneration , Calcium Phosphates , Dental Implants , Mandible , Osteogenesis , Pilot Projects , Regeneration , TransplantsABSTRACT
Subject(s)
Arteries , Autoimmune Diseases , Bone Marrow , Fragaria , Gingivitis , Glomerulonephritis , Korea , Magnetic Resonance Imaging , Maxilla , Osteonecrosis , Respiratory System , Surgery, Oral , Tooth , Toothache , Ulcer , Vasculitis , Veins , Granulomatosis with PolyangiitisABSTRACT
Subject(s)
Humans , Male , Anesthesia, General , Dental Clinics , Floors and Floorcoverings , Mouth , Mucocele , Mucus , Ranula , Salivary Glands , Salivary Glands, Minor , Skull , Skull Base , Sublingual Gland , Submandibular GlandABSTRACT