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Introduction: Type 2 diabetes mellitus is progressive loss ofglycemic control over a period of time. So the purpose of thepresent study was to evaluate the effectiveness and safety ofthe Sitagliptin as an ‘add-on’ to the ongoing drug therapy inpatients with Type 2 Diabetes Mellitus (T2DM).Material and Methods: It was a randomized, retrospectivepopulation based cohort study done in 259 patients for 36weeks from July’12 – March’13. Patients were randomlydivided into 2 groups. In 1st group, sitagliptin was added andno ongoing drug was withdrawn while in 2nd group sitagliptinwas added and dose of ongoing therapy was reduced to half.Results: The primary efficacy endpoint was reduction inglycated haemoglobin (HbA1C), fasting blood sugar, and 2hour post prandial blood sugar evaluated after 4, 8, 12, 18 and36 weeks. A better glycemic control was observed in 1st groupthan 2nd. Sitagliptin was well tolerated without side effects.Conclusion: Addition of Sitagliptin 100mg once daily as‘add-on’ drug therapy was well tolerated with significantglycemic control in T2DM after 36 weeks.
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Objective@#To investigate the effects of glycosylated hemoglobin A1c (HbA1c) from the patients with double heterozygotes Hb Q-H and Hb J-Bangkok combined with β-thalassemia on the results of different HbA1c detection systems. @*Methods@#Blood samples from 20 healthy adults and 20 patients with type 2 diabetes mellitus (T2DM) were collected to assess the results of five glycosylated hemoglobin detection systems. Blood samples from one Hb Q-H patient and one Hb J-Bangkok patient with β-thalassemia were also collected, and they were performed hemoglobin capillary electrophoresis with Capillarys2 and globin gene analysis by gap-PCR, PCR-RDB and DNA sequencing. The levels of HbA1c in all samples were detected by BioRad VARIANT Ⅱ (VⅡ), BioRad VARIANT ⅡTurbo2.0 (V Ⅱ-T2.0), Capillarys 2 Flex Piercing (C2FP), Primus Ultra2 (Ultra2) and Roche PPI 800 (PPI 800) glycosy lated hemoglobin detection instruments, respectively. For the samples with double heterozygotes, the levels of HbA1c were detected for 3 times each sample, and the results were preserved and analyzed. @*Results@#The genotype of the Hb Q-H sample was --α QT /--SEA;β N /β N , and HbA1 CD74 G＞C mutation occurred in globin α1 chain, forming Hb Q-Thailand hemoglobin variant without normal α-globin peptide chain. The genotype of Hb J-Bangkok combined with β-thalassemia was αα/αα;βCD56/βCD41-42, and the point mutation of GGC＞GAC occurred at codon 56 of globin β-chain, forming Hb J-Bangkok hemoglobin variant without normal β-globin peptide chain. For the Hb Q-H sample, HbA1c results were reported by 3 of 5 HbA1c detection systems. The chromatograms of VⅡ and VⅡ-T2.0 detection systems were obviously different from normal chromatograms, and HbA1c results were not reported. However, the chromatograms of the C2FP system were similar to normal chromatograms, and the result of HbA1c was 3.7%. The Ultra2 system and PPI system reported the HbA1c results, 5.3% and 5.7%, respectively, without abnormal alarm. For the Hb J-Bangkok with β-thalassemia sample, HbA1c results were also reported by 3 of 5 HbA1c detection systems. The chromatograms of VⅡ and Sebia detection systems were obviously different from normal chromatograms, and HbA1c results were not reported. However, the chromatograms of VⅡ-T2.0 system were different from normal chromatograms, and a P4 peak (84.9%) was found. The HbA1c result was reported as 4.7%. The Ultra2 system and PPI system reported the HbA1c results, 4.7% and 3.8%, respectively, without abnormal alarm. @*Conclusion@#The samples from the Hb Q-H patient and the Hb J-Bangkok patient with β-thalassemia do not contain normal HbA, and there should be no HbA1c results. The chromatograms of VⅡ and VⅡ-T systems are obviously abnormal, indicating that the results can not be reported. The C2FP system is interfered obviously by Hb Q-H, but reports the HbA1c results, while it does not report the HbA1c results of Hb J-Bangkok combined with β-thalassemia. Both of Hb Q-H and Hb J-Bangkok have obvious interference to PPI and Ultra2 detection systems.
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OBJECTIVES: Inadequate glycemic control amongst patients with Type 2 diabetes mellitus (T2DM) indicates a major public health problem and a significant risk factor for the progression and complications caused by diabetes. Glycemic control is the main therapeutic objective for the prevention of organ damage and other complications arising from diabetes. METHODS: This was a retrospective observational study of T2DM patients with complications, who were aged 40 years and older. The study was conducted retrospectively on medical records (in-patient and out-patient) obtained from a South Indian teaching hospital, Manipal, India. The patients included in the study had fasting blood sugar, postprandial blood sugar and HbA1c measured at least twice during follow-ups the previous year. Patients’ HbA1c levels were categorized into good control ≤7% (≤53mmol/mol), and poor control >7% (>53mmol/mol), and patients’ characteristics were analyzed. RESULTS: A total of 657 patients were included in the study. The mean age was 59.67 (SD = 9.617) years, with 152 (23.1%) females and 505 (76.9%) males, and 514 (78.2%) patients had poor glycemic control. Most of the patients were on insulin mono-therapy [n = 271 (42.1%)], about a third of the patients were on combination therapy that included an oral hypoglycemic agent and insulin [n = 236 (36.6%)]. Patients with a history of more than 10 years of diabetes [n = 293 (44.6%)], had a family history of diabetes [n = 256 (39%)] and obesity [n = 95 (14.5%)], all had poor glycemic control. CONCLUSION: This present study indicated a significant association of gender (female), age, high-density lipoprotein level, duration of diabetes and type of medication, with poor glycemic control in T2DM patients that had secondary medical complications.
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Female , Humans , Male , Blood Glucose , Diabetes Complications , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Fasting , Follow-Up Studies , Hospitals, Teaching , India , Insulin , Lipoproteins , Medical Records , Obesity , Observational Study , Public Health , Retrospective Studies , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus (T2DM) from the aspects of knowledge, attitude and practice (KAP), health-related quality of life (HRQoL), body mass index (BMI) and glucose control.</p><p><b>METHODS</b>Patients were individually randomized into intervention group (receiving integrative education, n=120) and control group (receiving usual education, n=120). The primary outcome was the changes in glycosylated hemoglobin A1c (HbA1c) levels after 3, 6, 9 and 12 months from baseline. Hierarchical linear models (HLMs) were used to assess within-group changes in outcomes over time and between-group differences in patterns of change. Secondary outcomes were KAP scores, HRQoL scores and BMI after 6 and 12 months, paired-sample t test was used to assess within-group changes in outcomes in 6 and 12 months, independent-sample t test was used to assess between-group differences in patterns of change.</p><p><b>RESULTS</b>HbA1c decreased statistically from baseline to 3 months, from 3 to 6 months, from 6 to 9 months and from 9 to 12 months in the intervention group (all P<0.01); and decreased significantly from baseline to 3 months, and from 3 to 6 months in the control group P<0.01). There was a significant between-group difference from baseline to 3 months (P=0.044), from 6 to 9 months (P<0.01) and from 9 to 12 months (P<0.01). Significant improvements in the intervention group along with significant between-group differences were found in KAP and HRQoL scores respectively (all P<0.05). The number in the intervention group of normal weight increased from 56 at baseline to 81 (6 months), 94 (12 months), the number in the control group were 63 (baseline), 69 (6 months), 70 (12 months), the χof hierarchical analysis of BMI were 6.93 (P=0.075), 10.31 (P=0.016), 15.53 (P<0.01), respectively.</p><p><b>CONCLUSION</b>Health education based on integrative therapy of Chinese and Western medicine is beneficial to the control of T2DM and should be recommended for T2DM.</p>
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AIM:To investigate the serum miRNA-101 expression level in patients with newly diagnosed type 2 diabetes mellitus (T2DM),and to evaluate the clinical implications of miRNA-101 expression level variation.METHODS:qRT-PCR was used to determine the serum miRNA-101 expression level.Pearson correlation analysis was performed to observe the relationship between two variables.Multiple stepwise linear regression analysis was used to assess the association of serum miRNA-101 level and other parameters.RESULTS:Serum miRNA-101 level in patients with newly diagnosed T2DM was significantly higher than that in control subjects (P ＜ 0.05).The serum level of miRNA-101 was positively correlated with the glycosylated hemoglobin A1c (HbA1c,P ＜0.05).Multiple linear regression analysis revealed that the circulating miRNA-101 was in significant positive correlation with HbA1c (P ＜ 0.05) after adjustment for age,sex and body weight.CONCLUSION:Enhanced circulating miRNA-101 level in newly diagnosed T2DM patients may be associated with elevation of HbA1 c.
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Objective To evaluate the diagnostic value of glycosylated hemoglobin A1c (HbA1c)and glycated albumin(GA) in hyperglycemia patients with liver cirrhosis (LCH).Methods One hundred LCH patients were divided into anemia and no-anemia group by Hb 110 g/L The no-anemia group was further divided into low albumin (serum albumin ＜ 30 g/L),and high albumin group (serum albumin 30-＜40 g/L).One hundred type 2 diabetes without liver cirrhosis were included as control group (T2DM).HbA1c,GA,fasting plasma glucose (FPG),postprandial 2h plasma glucose (2hPG) were collected for statistical analysis.Results (1) The HbA1c level in LCH with anemia tended lower than that in T2DM subjects [(6.76 ±2.20)％ vs (7.34 ± 1.23)％,P =0.06];though the level of GA [(19.10 ±7.47)％vs (16.68 ±2.90)％,P＜0.01] and 2hPG [(12.09 ±3.39) mmol/L vs (10.84 ±2.95) mmol/L,P＜0.05] were significantly higher than that in T2DM group.(2) No-anemia subjects in LCH group with albumin ＜ 30 g/L had obviously higher GA levels than those with albumin 30-＜ 40 g/L and T2DM (albumin≥40 g/L) [(18.79 ±2.28)％ vs (16.71 ±2.42)％ and (16.73 ±2.96)％,P＜0.01];though the level of HbA1c of three groups above has no significant difference.(3) The level of HbA1c between LCH without anemia group and T2DM group had no significant difference (P ＞ 0.05);and the level of GA between LCH without anemia group with albumin 30-＜ 40 g/L and T2DM group had no significant difference(P ＞0.05).(4) The HbA1c has a positive correlation with FPG and 2hPG in LCH (FPG∶r =0.45,P＜0.001;2hPG∶r =0.33,P=0.001) and T2DM subjects (FPG∶ r =0.76,P＜0.001;2hPG∶r =0.81,P ＜ 0.001).GA also has a positive correlation with FPG and 2hPG in LCH (FPG∶ r =0.48,P ＜0.001;2hPG:r=0.39,P ＜0.001) and T2DM subjects (FPG∶ r =0.74,P ＜0.001;2hPG∶ r =0.76,P ＜0.001).Conclusion It is unfavorable to use HbA1c to evaluate the blood glucose level in liver cirrhosis patients with Hb ＜ 110 g/L and to use GA in patients with serum albumin ＜ 30 g/L.
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Objective:To investigate the diagnostic and terapeutical value of FPG,GA,HbA1c and GA/HbA1c ratio in T1DM/T2DM.Methods:The study was made by case-control method.In our study,30 healthy subjects were selected from health physical ex-amination as control group while 160 diabetics were selected as case group,in which there are 76 TIDM and 84 T2DM.Analyzing the difference of relevance of FPG,GA and HbA1c,the difference of GA/HbA1c and threshold of the case and the control,and this analysis was also used between the T1DM and the T2DM.The data was managed by independent-sample t test,ROCK and Pearson correlation test of SPSS.Results:The results of FPG,GA ,HbA1c and GA/HbA1c ratio of T1DM and T2DM were significantly higher than those in the control group(P0.05),and weakly negative correlative with HbA1c(P>0.05);in T2DM group,there were positive correlation among FPG,GA and HbA1c(PFPG/GA>FPG/HbA1c;analyzing the ROC of measures in T1DM group,the sensitivity and specificity were re-spectively 86.8% and 100% for diagnosing DM when FPG threshold was set on 5.86 mmol/L ( AUC=0.922 ) ( P0.05).Conclusion:FPG,GA, HbA1c and GA/HbA1c ratio are of high value in monitoring of blood glucose, diagnosis and typing in T1DM and T2DM.There are missed diagnosis when we diagnose T1DM and T2DM by the upper limit of reagent instruestion of FPG,GA,HbA1c.It is more important for a person with T1DM to monitor FPG than others.
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BACKGROUND:Hyperglycemia has been detected in many critically ill patients in the department of emergency medicine. But its mechanism and prognosis have not been well elucidated. In this study, we measured the serum level of glycated hemoglobin A1C (HbA1c) in critically ill patients to evaluate the effects of hyperglycemia on the prognosis of the patients.METHODS:A total of 826 critically ill patients, who had been treated at the Department of Emergency Medicine of Chaoyang Hospital during October 2006 and November 2007, were divided into a diabetes mellitus group (n=184) and a non-diabetes mellitus group (642) according to whether they had diabetes mellitus. Fasting glucose and HbA1c were measured in all patients. Those in the diabetes mellitus group were further assigned to a drug therapy subgroup and a non-drug therapy subgroup; the serum level of HbA1c and its relationship with short-term outcome were evaluated.RESULTS:Fasting glucose increased in 78.8％ of the patients (88.6％ in the diabetes mellitus group, and 75.9％ in the non-diabetes mellitus group,P<0.05), and HbA1c was elevated in 45.5％ of the patients (78.3％ in the diabetes mellitus group, and 36.1％ in the non-diabetes mellitus group, P<0.01). Fasting glucose, HbA1c and 28-day mortality were improved more significantly (P<0.01) in the drug therapy subgroup than in the non-drug therapy subgroup. The 28-day mortality was more significantly different in patients with fasting blood glucose >8.33 mmol/L than in those with fasting blood glucose <8.33 mmol/L.CONCLUSIONS:Hyperglycemia of critically ill patients could not totally attribute to stress response, especially in those who have no history of diabetes mellitus. Prognosis of hyperglycemia may vary among critically ill patients.
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Objective To compare the serum thyroid hormones level in patients with pre-diabetes,newly diagnosed type 2 diabetes mellitus(T2DM)and healthy people,and to investigate the association of glucose metabolism with thyroid function.Methods Sixty newly diagnosed T2DM patients(T2DM group),60 pre-diabetes patients(pre-diabetes group),and 60 healthy people(healthy group) from outpatient departments were randomly enrolled in the study.Their thyroid peroxidase antibodies(TPOAb),thyroglobulin antibodies(TGAb),thyrotropin receptor antibodies(TRAb),and thyroid color dopplar ultrasound were all normal.Thyroid hormones was measured.Glycosylated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),glycated albumin(GA) was additionally measured in T2DM patients.We compared the difference of thyroid hormones among the 3 groups and investigated the factors that influence thyroid hormones level in each T2DM patients.Results There was no significant difference found on thyroid hormones level between the pre-diabetes group and healthy group(P＜0.05).T3 and FT3 level were(1.34±0.24)nmol/L and(3.88±0.51)pmol/L in the T2DM group,respectively,which were significantly lower than those in the pre-diabetes group([1.48±0.29]nmol/L and [4.12±0.55]pmol/L,t=-0.135 and -0.145,respectively,Ps＜0.01＝ and in the healthy group([1.49±0.26]nmol/L and [4.13±0.55]pmol/L,t=-0.240 and -0.260,respectively,P＜0.05 or 0.01) .In the T2DM group,T3 and FT3 were negatively correlated with FPG,GA,HbA1c(For T3:r=-0.275,-0.318 and -0.453,respectively,Ps＜0.05;For FT3:r=-0.280,-0.291 and -0.336 ,respectively,Ps＜0.05).Conclusion In patients with abnormal glucose metabolism, thyroid hormone was influenced only when the glucose metabolism level reached a certain abnormal degree.
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Objective To explore the correlations between the levels of glycosylated hemoglobin A1c (HbA1c)and N-Terminal pro-Brain Natriuretic peptide(NT-proBNP)in aged diabetes mellitus(DM)patients with heart failure(HF).Methods 127 patients diagnosed as DM complicated by HF and detected HbA1c and NT-proBNP when admitted into hospital,were divided into three groups according to the levels of HBA1C as follows:group A,4%≤HbA1c≤6.9%;group B,7%≤HbA1≤7.9%;group C,HbA1c≥8%.The levels of NT-proBNP were measured and compared.Results There was no statistical difference between group A and B(P＞0.05),where as the levels of NT-proBNP in group C increased significantly than that in group A and B(P＜0.01);In group C,HbA1c was linear positively correlated to NT-proBNP(r=0.558,P＜0.01).Conclusion Aged DM patients complicated by HF,the level of HbA1c between 4%and 7.9%was acceptable.Meawhile,HhA1c should the independent risk prediction factor for aged DM patients complicated by HF,which could be used as the guide to the clinical therapy to improve the prognosis.
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Glycosylated hemoglobin A1c(HbA1c)is the products of slow,continuous non-enzymatic saccharification reaction,which can reflect the average blood glucose of 2~3 months of the patients,and it is the most important index for long-term monitoring of glucose.There are so many methods for detecting HbA1c that America,Japan and Swede proposed their own standardized detection methods to reduce the difference laboratories.However,these methods were non-specific.A new method for was developed by International Federation of Clinical Chemistry and laboratory medicine (IFCC) in 2007,which was of high specificity,but which resulted in relatively low glycosylated hemoglobin.To avoid the confusion in reference value of glycosylated hemoglobin,average blood glucose was recommended by American Diabetes Association (ADA),European Association for the Study of Diabetes (EASD),and International Diabetes Federation (IDF).This paper review the origin of average blood glucose substituting HbA1c,relationship of HbA1c with average blood glucose,and the international multiple-center research of ADAG and its enlightenment,and we also discuss the relevant development in future.
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Objective To investigate the relationship of glycosylated hemoglobin A1C(HBA1c) and 2 hour postprandial blood glucose(2hPBG) with 12-hour urinary albumin excretion rate(UAE).Methods One hundred and thirteen patients with type 2 diabetes mellitus(T2DM),whose fast blood glucose(FBG) levels after treatment were less than 7.0 mmol/L,and 54 healthy subjects were the control group in this study.The level of HBA1c was detected by high performance liquid chromatography(HPLC).The level of 2hPBG was measured by glucose oxidase assay and the level of UAE was detected by radioimmunoassay.According to the level of HBA1c and 2hPBG,the patients were divided into 4 groups: group A(HBA1c7% and PBG