ABSTRACT
AIMS: To evaluate the relative contribution of blood glucose levels at different time points of the day to HbA(1c) in Type 1 diabetes. METHODS: Consecutive home blood glucose records (n = 146) from 71 Type 1 diabetic patients who were on an intensive diabetes therapy programme were examined. Each home blood glucose record included six daily blood glucose profiles over 2 months. The relationship between glycaemic values at each time point and HbA(1c) measured at the end of each record period was analysed. RESULTS: Significant linear correlations were found between HbA(1c) and glycaemia at each time point of the day (ranged from 0.413 to 0.593), the strongest being with predinner glycaemia (r = 0.593; P = 0.000). Total daily glycaemia, mean preprandial and mean postprandial glycaemia were also significant and linearly correlated with HbA(1c) (r = 0.701; r = 0.686; r = 0.620, respectively; P < 0.0001). Multiple linear regression analysis showed that predinner, prebreakfast and post-breakfast glycaemia correlated significantly and independently with HbA(1c). The model accounted for 47.8% of the variance in HbA(1c). CONCLUSIONS: Our study shows that among individual time points, prebreakfast and predinner are those with more influence on HbA(1c) in Type 1 diabetes and, to a lesser extent, post breakfast. It also confirms that preprandial glycaemia better predicts overall glycaemic control in Type 1 diabetes than postprandial glycaemia.
Subject(s)
Blood Glucose/metabolism , Circadian Rhythm , Diabetes Mellitus, Type 1/blood , Glycated Hemoglobin/metabolism , Humans , Linear Models , Postprandial PeriodABSTRACT
Bilateral adrenal nodular hyperplasia (BAND) is rarely presented as a cause of Cushing Syndrome. The pathogenicity of the disease is unknown and it does not present either symptoms or specific signs, furthermore, its steroid dynamic is atypical and the morphologic tests are not conclusive. The clinical stories of six BAND-diagnosed patients in our Department have been reviewed with the aim of unifying the criteria of the preoperative diagnosis with regard to treatment, comparing our results with literature's wider series. The results from both studies demonstrate an hypophyseal dependence together with some others showing a adrenal autonomy. Thus, our conclusions perpetuate the pathogenic question about BAND (whether is an adrenal primary disfunction or a secondary effect caused by hypophyseal ACTH hypersecretion?) and we point out the usefulness of radioisotopic gammagraphy and abdominal-TAC, since usually they show the bilaterality of the injury at adrenal level.
