Glycosylated Hemoglobin A1c Research Articles

Rapid and non-invasive diagnosis of type 2 diabetes through sniffing urinary acetone by a proton transfer reaction mass spectrometry

Urinary acetone in urine is produced from fat metabolism in human body, which can be accelerated in diabetic patients because of insufficient utilization and storage of glucose. In this study, we tried to develop a novel diagnosis method of type 2 diabetes (T2D) through sniffing urinary acetone by a proton transfer reaction mass spectrometry (PTR-MS). A total of 180 T2D patients and 180 healthy volunteers were recruited from three hospitals for multicenter study. Urine samples were collected in the morning when donators were fasting and stored in glass bottles. Acetone in the headspace of these bottles was qualitatively and quantitatively detected by the PTR-MS in 8 h. Using a threshold of 690.1 ppbv, a diagnostic model was established using urinary acetone with an accuracy of 81.3% (sensitivity: 73.3%, specificity: 89.3%) in hospital Ⅰ. In the verification studies, the accuracies were 92.5% (sensitivity: 88.7%, specificity: 96.2%) in hospital Ⅱ and 83.7% (sensitivity: 76.9%, specificity: 90.4%) in hospital Ⅲ, respectively. The accuracy is comparable to that of clinically used diagnosis methods, fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), and glycosylated hemoglobin A1c (HbA1c) test. The sensitivity for 35 newly diagnosed patients was 85.7%. The newly developed technology is completely non-invasive and much more rapid than clinical FPG, OGTT, and HbA1c tests. It has a promising prospect in clinical use. But the applicability in different human races still need more validations.

Sex difference in the associations among liver function parameters with incident diabetes mellitus in a large Taiwanese population follow-up study.

The prevalence of diabetes mellitus (DM) in Taiwan between 2017 and 2020 was 11.05%, which is higher than the global prevalence (10.5%). Previous studies have shown that patients with DM have higher liver enzyme levels than those without DM. However, it is unclear whether there are sex differences in the association between incident DM and liver function. Therefore, the aim of this longitudinal study was to investigate this issue in a large Taiwanese cohort. We identified 27,026 participants from the Taiwan Biobank, and excluded those with baseline DM (n = 2,637), and those without follow-up data on DM, serum fasting glucose or glycosylated hemoglobin A1c (n = 43). The remaining 24,346 participants (male: 8,334; female: 16,012; mean age 50.5 ± 10.4 years) were enrolled and followed for a median of 4 years. Of the enrolled participants, 1,109 (4.6%) had incident DM and 23,237 (95.4%) did not. Multivariable analysis showed that high levels of glutamic-oxaloacetic transaminase (AST) (p < 0.001), glutamic-pyruvic transaminase (ALT) (p < 0.001), albumin (p = 0.003), α-fetoprotein (p = 0.019), and gamma-glutamyl transpeptidase (GGT) (p = 0.001) were significantly associated with incident DM in the male participants. In comparison, high levels of AST (p = 0.010), ALT (p < 0.001), albumin (p = 0.001) and GGT (p < 0.001), and low total bilirubin (p = 0.001) were significantly associated with incident DM in the female participants. There were significant interactions between total bilirubin and sex (p = 0.031), and GGT and sex (p = 0.011) on incident DM. In conclusion, liver function parameters were significantly associated with incident DM. Further, there were differences in the associations between the male and female participants.

Correlations of Omentin-1 and Leptin with Bone Metabolism and Plasma Glucose Upon Type 2 Diabetes Mellitus and Osteoporosis.

The goal was to investigate the correlations of peripheral blood Omentin-1 and leptin (LEP) levels with bone metabolism and plasma glucose in patients with type 2 diabetes mellitus (T2DM) complicated with oste-oporosis (OP). One hundred patients with T2DM admitted from September 2019 to September 2021 were divided into group A (n = 36, OP with T-score ≤ -2.5), group B (n = 50, osteopenia with T-score between -1 and -2.5), and group C (n = 14, non-OP with T-score > -1) according to the values of bone mineral density (BMD). Thirty healthy adults physically examined in the same period were selected as group D. The levels of peripheral blood Omentin-1 and LEP, bone metabolism, and plasma glucose were compared among the four groups. The correlations of peripheral blood Omentin-1 and LEP levels with bone metabolism and plasma glucose were explored by Pearson's analysis. In group A, the levels of Omentin-1 and LEP in peripheral blood were lowest, the serum levels of beta C-terminal cross-linked telopeptides of type I collagen (β-CTX) and osteocalcin (OCN) were highest, the serum level of total N-terminal propeptide of type I procollagen (tPINP) was lowest, and the levels of fasting plasma glucose (FPG), 2-hours postprandial plasma glucose (2hPG) and glycosylated hemoglobin A1c (HbA1c) were highest, se-quentially followed by those of group B, group C, and group D (p < 0.05). Omentin-1 and LEP in peripheral blood were negatively correlated with β-CTX, OCN, 2hPG, and HbA1c and positively correlated with tPINP and FPG (p < 0.05). The expressions of Omentin-1 and LEP in peripheral blood have correlations with bone metabolism and plasma glucose in patients with T2DM complicated with OP.

Hispanic adults with type 2 diabetes mellitus using lipid-lowering agents have better periodontal health than non-users.

Recent studies suggest that lipid-lowering agents (LLA) may reduce chronic periodontitis, but it is unknown whether this benefit extends to people with type 2 diabetes (T2D). We assessed the association between LLA use and periodontitis in Hispanic adults with T2D. This was a cross-sectional observational study. We assessed the association of LLA use and periodontal parameters in 253 Puerto Ricans 40-65 years with T2D who participated in the Lipid-Lowering agents use in Periodontitis and Diabetes Study study. Participants were classified as (a) none- or <1 year, (b) 1-4 years, or (c) >4 years. The primary outcome consists of a tertile percent of sites with probing pocket depth (PPD) ⩾ 4 mm and the secondary outcome includes tertiles of percent sites with clinical attachment loss (CAL) ⩾ 4 mm. Multinomial logistic regression models adjusted for age, gender, smoking status, education, waist circumference, glycosylated hemoglobin A1C (HbA1c), bleeding on probing, examiner, and anti-inflammatory agents were used to estimate the association. LLA (92.5%, statins) was used by 52% of participants. LLA use 1-4 years was associated with lower odds of PPD ⩾ 4 mm (OR: 0.22, p = 0.005; high versus low tertile) or lower odds of CAL ⩾ 4 mm (OR: 0.33, p = 0.02, middle versus low tertile), compared to those with LLA minimal or no use. This association was lost for participants who used LLA for >4 years. LLA users for >4 years with periodontal disease had elevated HbA1c (OR: 1.36, p = 0.05). The use of LLA for 1-4 years was associated with lower values of periodontal parameters versus minimal LLA use. This association was not present among people using LLA > 4 years users, but these participants had poorer glycemic control compared to other participants. In this cross-sectional study, the finding that LLA use 1- 4 years is associated with lower values of periodontal parameters of severity in T2D individuals may help clarify some of the controversies regarding the benefit of these medications in this population.

Diabetic Neuropathy, a Cause of Pulmonary Dysfunction in Patients of Type 2 Diabetes Mellitus

Introduction: Diabetic neuropathy (DN) is most commonly associated with diabetic peripheral neuropathy (DPN). About 66% of diabetic patients have either clinical or subclinical neuropathy. Materials and Methods: One hundred and twenty patients were enrolled in our study, 60 patients are of Type 2 diabetes mellitus (T2DM) with neuropathy (DPN), and 60 were of T2DM without neuropathy. They were assessed for neuropathy. Serum fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin A1C (HbA1C), and duration of disease were obtained from the patients. Forced expiratory volume at the 1st s (FEV1) and forced vital capacity were recorded and % FEV1 was calculated. Results: The mean age of T2DM with neuropathy was 49.17 ± 7.1 and in patients of T2DM without neuropathy was 46.63 ± 8.028. The mean value of % FEV1 in T2DM with neuropathy is 95.45 ± 7.16, while in T2DM without neuropathy, it is 83.53 ± 6.22, and the difference was statistically significant. Linear correlation of % FEV1 with fasting plasma glucose (FPG) (r = 0.474, P = 0.008) and HbA1C (r = 0.588, P = 0.001) shows a statistically significant association in diabetic peripheral neuropathy. The standardized β weights of FPG, postprandial plasma glucose, and HbA1C show significant values in patients of DPN. Conclusion: Diabetic peripheral neuropathy (DPN) is associated with decreased pulmonary function as compared to patients of diabetes without neuropathy, the glycemic status of patients may also adversely affect % FEV1. Thus, proper control of hyperglycemia will decrease the further progression of the disease. We also suggest performing pulmonary function test in patients of diabetes mellitus with DN in the preoperative period so as to optimize the perioperative care.

PS-C06-12: HETEROGENEITY AND OVERLAP OF THE LONGITUDINAL ASSOCIATIONS AMONG INCREASED ARTERIAL STIFFNESS, HYPERTENSION AND DIABETES MELLITUS: A 16-YEAR PROSPECTIVE OBSERVATIONAL STUDY

Background: Hypertension and diabetes mellitus frequently coexist; however, differences in the bi-directional longitudinal relationships of arterial stiffness with hypertension and diabetes mellitus have not yet been clarified. Methods: In this 16-year prospective observational study, 3981 middle-aged Japanese subjects without hypertension/diabetes mellitus at the study baseline underwent annual measurements of the blood pressure, serum glycosylated hemoglobin A1c (HbA1c), and brachial-ankle pulse wave velocity (baPWV). Results: By the end of the study period, 664, 779, 154 and 406 subjects developed hypertension, prehypertension, diabetes mellitus and prediabetes, respectively. Increased baPWV at the baseline was associated with a significant odds ratio for new onset of prehypertension/hypertension without (beta = 5.0 x 10–3, P &lt; 0.01) or with (beta = 4.0 x 10–3, P &lt; 0.01) coexisting prediabetes/diabetes mellitus; no such association was found with new onset of prediabetes/diabetes mellitus alone. Furthermore, baPWV showed significant longitudinal associations with the development of all of the above conditions. Conversely, elevated mean blood pressure, even in the pre-hypertensive range, showed a significant longitudinal association with increase of the baPWV. Conclusions: In middle-aged Japanese subjects, a vicious cycle may be triggered between elevated blood pressure, even from the prehypertensive stage, and arterial stiffening and development of diabetes mellitus may be observed as a cross phenomenon of this vicious cycle with a collateral event. Arterial stiffness may be a key element in the development of hypertension, so that its contribution to cardiovascular risk may be greater in patients with hypertension than in those with diabetes mellitus.

Is there an Association of Glycosylated Haemoglobin A1c and Anthropometric Measurements in Premenopausal and Postmenopausal Breast Cancer Patients?

Background: Breast cancer is the commonest malignancy among women globally. It is a leading cause of cancer death in less developed countries and the second leading cause of cancer death in developed countries. Diabetes and breast cancer are two conditions that frequently coexist, and menopause may be a metabolic watershed. The purpose of this study is to examine the relationship between glycosylated haemoglobin (HbA1c) and anthropometric measurements in premenopausal and postmenopausal breast cancer patients Methods: 100 patients diagnosed with breast cancer between December 2020 to November 2022 were evaluated and their HbA1c levels were correlated with anthropometric measurements and tumour characteristics Results: In our study mean age of the patients was 47.75 ±11.77 SD years. In patients with normal HbA1c 64% patients were pre-menopausal. In Pre-diabetic HbA1c group 70% were post-menopausal and in diabetic HbA1c group 93% were postmenopausal. Mean waist circumference was 84.56 ± 6.64 SD cms; more in pre-diabetic and diabetic patients; (p value 0.000). Most of the patients (71%) had waist to hip ratio ≥0.85 (p value 0.349). Pre-diabetic and diabetic patients were overweight (p value 0.000). 6 patients were known cases of type II diabetes mellitus and were on insulin/OHAs. T3 tumours were more common in both premenopausal and postmenopausal patients followed by T4 tumours. Stage IIB breast cancer was present in 39% of premenopausal and stage IIIA was seen in 30% of the postmenopausal patients. Grade II disease was more common in both premenopausal and postmenopausal (p value 0.858). Invasive ductal carcinoma-No special type (IDC-NST) was seen in 77% of the patients (p value 0.156). Estrogen Receptor (ER) positivity was seen in 42% of premenopausal and 33% of postmenopausal patients, negative Progesterone Receptor (PR) seen in 86% in premenopausal and 89% in postmenopausal patients and positive Her2 neu receptor was observed in 30% in premenopausal and 56% in postmenopausal patients. Conclusion: Our study demonstrated that a considerable proportion of breast cancer patients were prediabetic. Glycaemic status and HbA1c were clearly associated with measures of visceral obesity in carcinoma of breast patients. Postmenopausal patients had higher levels of HbA1c compared to premenopausal cases. However; clinicopathological and tumour characteristics in our study didn’t demonstrate any significant correlation with glycaemic status and need more research and randomized controlled trials. Collectively, findings from our study particularly emphasize the need to control hyperglycemia and identify vulnerable groups of breast cancer patients who might benefit from interventions to improve glycaemic control.

Epidemiological features of New-Onset Type 1 Diabetes Mellitus in children and adolescent during 2010-2014 in Albania - a unique experience.

Aim: Diabetes mellitus is a major public health problem worldwide. Type 1 diabetes mellitus (T1DM) is the most common metabolic chronic disease in genetically susceptible children and adolescents, due to an autoimmune process characterized by a selective destruction of insulin producing β-cells. The aim is to assess the epidemiological features of new-onset T1DM in children and adolescent at the national level during the period 2010-2014 in Department of Pediatrics, Endocrine Unit, University Hospital Center 'Mother Teresa', Tirana, as the unique center for pediatric endocrinology and diabetology in Albania.Methods: The clinical and laboratory characteristics of 152 patients aged &lt;15 years newly diagnosed with T1D from 1 January 2010 to 31 December 2014 were studied. T1D was diagnosed according to WHO 2006 criteria and DKA was diagnosed based on ISPAD 2014 criteria. Patients were classified into 3 sub-groups (I: 0-4 years, II: 5-9 years, and III; 10-14 years). Statistical analysis was performed using SPSS 26. Results: The incidence of new-onset of T1DM was 5.012/100.000/year. The mean age of children at diagnosis was 8.3 ± 3.6 years. The patients were mostly diagnosed at ages 5-9 years (40.1%), and 10-14 years (39.5%), followed by the 0-4 years age group (20.4%). Mean duration of symptoms was 23.35 ± 17.16 days; longer in the subgroup 5-9 years (P= 0. 0.013). Three quarters (75%) of children with T1DM live in urban areas. Viral infections or other circumstance triggers were in 41.9% of children aged 0-4 years compared to other subgroups (P=0.002). Most of the children were born in the spring−summer months (53.23%) compared to the autumn−winter months (46.77%). Approximately 1/4 of the children were born and diagnosed with type 1 diabetes in each of the seasons of the year and 52.63% of the patients studied were first born. Family history for DMT1 and DMT2 is observed in 15.8% and 17.8% of the children, respectively. Polyuria (99.3%), polydipsia (99.6%) and weight loss (98.1%) were the most common symptoms and 67.8% of patients presented with diabetic ketoacidosis (DKA). Misdiagnosis was in 21 (13.8%) patients. Mean glycosylated hemoglobin A1c (HbA1c) was 11.63%; 11.9 ± 2.0 in DKA positive children and 11.1 ± 2.4 in DKA negative children (p= 0.195).At diagnosis and during follow up of T1DM 25% (38/152) developed associated autoimmune diseases; 68.42% at diagnosis of T1DM and 65.79% (25/38) of patients were female. During follow up children with T1DM developed associated CD and SAT, 2.54, and 2.19 years, respectively.Conclusion: Diabetes mellitus is one of the major public health problems worldwide. Albania is a country with middle incidence of T1DM and the age at onset is decreasing. The symptoms lasted significantly longer and mean HbA1c levels were significantly higher in older children. The incidence of DKA in children with newly diagnosed T1DM is high.

Comparative evaluation of clinical outcomes of dapagliflozin and empagliflozin in type-2 diabetes mellitus.

Sodium-glucose transporter 2 (SGLT-2) inhibitors provide additional benefits besides glycemic control. This study aims to compare the clinical outcomes of dapagliflozin and empagliflozin. This retrospective study evaluated data retrieved from medical records of patients who were under follow-up with the diagnosis of type 2 diabetes mellitus (T2DM) and were started on dapagliflozin or empagliflozin treatment between January 1, 2017, and June 1, 2020. Demographic features, comorbidities, clinical features, duration of diabetes, baseline, and follow-up laboratory test results were recorded. The significance level was set at p < 0.05. This study comprised 342 patients who are on the treatment with dapagliflozin (n = 228) or empagliflozin (n = 114). The glycosylated hemoglobin a1c (HBA1C) level was significantly decreased in both the dapagliflozin (8.18-7.59, p < 0.001) and empagliflozin (8.35-7.58, p < 0.001) groups. The urine albumin-to-creatinine ratio (ACR) was also decreased in both groups. A decrease in urine ACR was observed independent of using a renin-angiotensin-aldosterone system (RAAS) blocker both in the whole group and in patients with diabetic nephropathy. The time to addition of a new anti-diabetic agent to the treatment was shorter in the dapagliflozin group (14.4months vs 17.7months, p = 0.041, respectively). Dapagliflozin and empagliflozin are the drugs to choose for renoprotection in diabetics independent of the use of a RAAS blocker. Even the time to addition of a new anti-diabetic agent is longer in the empagliflozin group, head-to-head comparative trials are needed to asess the potential differences in this regard.

Monitoring of Autoantibodies Following Autologous Hematopoietic Stem Cell Transplantation in 6 Children with Recently Diagnosed Type 1 Diabetes Mellitus.

BACKGROUND Bone marrow stem cells have been shown to be a promising therapeutic strategy for autoimmune diseases. This study aimed to assess the safety and efficacy of autologous hematopoietic stem cell (ABMSC) transplantation without immunoablation used to suppress the autoimmune reaction in 6 children with newly diagnosed autoimmune diabetes mellitus. We monitored the levels of islet cell antibodies (ICA), antibodies against islet antigen-related tyrosine phosphatase 2 (IA2), glutamic acid-decarboxylase (GAD) antibodies, and anti-insulin antibodies (AIA). MATERIAL AND METHODS Between 2018 and 2022, 6 children (age 6-10 years, average 8 years) recently diagnosed with type 1 diabetes mellitus with the presence of ICA, IA2, GAD, AIA and ketoacidosis, were treated with an ABMSC stimulated with Filgrastim, granulocyte colony-stimulating factor (G-CSF), 10 ug/kg/day for 4 days. Bone marrow was harvested on day 5, collected by puncture and identified as mononuclear cells >180×10⁶/kg, CD34+ >0.22%, and transplanted by intravenous (i.v.) infusion. Patients were monitored with ICA, IA2, GAD, AIA, C-peptide, blood glucose, and glycosylated hemoglobin A1c (HbA1C) 6 months after the procedure. RESULTS At 6-month follow-up, we observed a negative value of the ICA, which was previously positive (P<0.001). The IA2 (p=0.037) and GAD (P=0.377) antibodies decreased slowly but were significantly lower. AIA remained high. A decrease in blood glucose and HbA1C levels was observed (P<0.001). No complications occurred during follow-up. CONCLUSIONS Autologous hematopoietic stem cell transplantation without immunoablation was safe and effective in significantly decreasing the production and effect of autoantibodies against ICA, GAD, and IA2, as well as decreasing blood sugar levels and HbA1c.

COVID-19 Fear and Anxiety in Patients with Diabetes Mellitus and their Effect on HbA1c

Objective: To determine the severity of fear and anxiety of COVID-19 in diabetic patients and to evaluate their relationship with HbA1c. Materials and methods: Between December 2020 and March 2021, a total of 249 patients were included in the study. Demographic characteristics, duration of diabetes, glycosylated hemoglobin A1c (HbA1c) values of the patients were recorded. Fear and anxiety related to COVID-19 were evaluated with the validated Turkish version of the Fear of COVID Scale (FCS) and Coronavirus Anxiety Scale (CAS). FCS and CAS were compared between the diabetic group and the control group. The relationship between FCS and CAS and HbA1c, diabetes year, age, gender, educational status, place of residence, and employment status was investigated. Results: Median level of HbA1c and duration of diabetes mellitus were 7.65% (range 5.4-13.6) and 10 years (range 1-32) respectively. FCS was higher in the diabetic group compared to the control group (p=0.025). There was no significant difference between the diabetic and control groups regarding CAS. There was no relationship between HbA1c and FCS and CAS (p=0.919, r=0.008, p=0.725, r=0.027, respectively). Anxiety was higher in females than males in diabetic groups (p=0.009). Conclusions: The fear of COVID-19 is higher in diabetic patients compared to the general population. There was no relationship between fear and anxiety of COVID-19 and HbA1c. However, to protect long-term mental health, there should be strategies to detect and reduce the anxiety and fear caused by the pandemic in the services for diabetic patients.

The COVID-19 vaccination hesitancy among Chinese individuals with diabetes and the impact on glycemic control of vaccination: a questionnaire study

ObjectiveThe study aimed to investigate the attitudes of people with diabetes mellitus (DM) on COVID-19 vaccination and its influence on the glycemic control.MethodsData were collected from a consecutive series of adults (age > 18 years) with type 2 diabetes under regular follow-ups in the Integrated Care Diabetes Outpatient Clinic of Peking University First Hospital from December 1st to December 31st 2021. An online interview questionnaire was conducted, and demographic data including age, sex category, history of drug allergy, history of hypertension, the duration of diabetes, reasons for vaccine hesitancy (VH) and adverse reactions after each injection of vaccines was collected. Glucose levels were collected from medical records.ResultsThirty-nine (22.9%) subjects experienced VH and 131 (77.1%) people living with diabetes received inactivated vaccine against COVID-19. Hesitant individuals had a higher proportion of female gender (vaccinated group vs. VH group, 62/131 vs. 26/39, p = 0.044), higher baseline glycosylated hemoglobin A1c (HbA1c) (vaccinated group vs. VH group, 6.56 ± 0.95% vs. 7.54 ± 2.01%, p < 0.001) and elevated baseline postprandial blood glucose (PBG) (vaccinated group vs. VH group, 8.32 ± 1.97 mmol/L vs. 9.44 ± 2.94 mmol/L, p = 0.015). Subjects of male gender (p = 0.025) and history of hypertension (p = 0.021) were likely to get vaccinated, while higher HbA1c was negatively associated with an elevated propensity to receive anti-COVID-19 vaccine (p = 0.003). Most common reasons for hesitating to receive COVID-19 vaccination were worrying about the possibility of leading to other diseases (30.8%), followed by fearing of glucose variation (17.9%). Systemic adverse reactions were reported in 30.5% individuals after the first injection of inactivated vaccines, and resolved within 3 days in medium. Fasting blood glucose (FBG) decreased significantly after the third injection compared with FBG after the second dose (second vs. third, 6.78 ± 1.24 mmol/L vs. 6.41 ± 1.30 mmol/L, p = 0.027). HbA1c reduced significantly from 6.56% before vaccination to 6.35% after the second injection (p = 0.012).ConclusionsOur study demonstrated that vaccine hesitancy was lower among male subjects and people with hypertension, while vaccine confidence was reduced in people with poor glycemic control. HbA1c level was lower along with vaccination.

Effect of "one-stop" outpatient management on the control rate of multiple metabolic disorders patients

Objective: To explore the effect of "one-stop" outpatient management on the therapeutic schedule and control rate of patients with metabolic disorders. Methods: A total of 332 patients who met the inclusion criteria were enrolled and treated regularly in the "one-stop" outpatient department of the Department of Cardiology of the Third Hospital of Peking University from November 1, 2020 to April 30, 2022. The general information, personal history, family history, drug treatment plan, blood pressure, height, weight, waist circumference, and hip circumference of patients were collected through the outpatient electronic medical record system, and patients were followed up through conducting "one-stop" comprehensive management. The baseline clinical characteristics were analyzed, and the changes of metabolic indexes, treatment conditions and control rate of patients with different metabolic disorders before and after the "one-stop" outpatient management were compared. Results: The time interval between the first visit and the last visit was 44 (26, 60) weeks in 332 patients, whose age was (57.2±13.2) years, including 219 males (66.0%). After the "one-stop" outpatient management, fasting blood glucose (FBG) [ 6.6 (5.6, 7.9) mmol/L vs 6.3 (5.6, 6.9) mmol/L], glycosylated hemoglobin A1c (HbA1c) [ (7.2±1.5) % vs (6.6±0.8) %], low density lipoprotein cholesterol (LDL-C) [ 2.70 (1.97, 3.55) mmol/L vs 2.04 (1.66, 2.63) mmol/L] and blood uric acid (UA) [ (383.7±107.1) μmol/L vs (341.2±90.6) μmol/L] all decreased significantly (all P values<0.05). The control rates of hypertension (19.8% vs 28.2%), diabetes (45.2% vs 66.5%), hyperlipidemia (54.9% vs 87.6%) and hyperuricemia (16.7% vs 49.0%) were significantly improved after the "one-stop" outpatient management (all P values<0.05). Conclusion: The "one-stop" outpatient management of cardiovascular department can significantly improve the metabolic condition and the control rate of patients with multiple metabolic disorders.

Investigating the Significance of Glycosylated Hemoglobin A1C (HbA1C) Test in the Diagnosis and Management of Diabetic Individuals.

Background: Since the 1980s, Glycosylated hemoglobin (HbA1c) has been used as the "gold standard" for glycemic control and as a predictor of diabetes complications. HbA1c has become a solid biomarker for diagnosis and prediction of diabetes, because of the meaningful information offered by a single HbA1c test. It is also helpful in the treatment of pre-diabetes and other kinds of diabetes. Objective: To reveal sensitivity of HbA1c in contrast to other diabetes diagnostic tests, to report the performance, effectiveness and validity of HbA1c test in the diagnosing and monitoring diabetes. To find out the awareness rate of significance of HbA1c test in diabetic monitoring. Material &amp; Methodology: A cross-sectional research was conducted through a random sample approach, during the months of September and December of 2021. A sample size of 40 patients and health professionals including technologist and Doctor were taken. The data was gathered through a pre-validated research questionnaire among patients and health workers in major hospitals of Islamabad and Rawalpindi. Data was analyzed through Statistical Package for the Social Science(SPSS) software version 22. Result: The results found that 85% patients are agree with the significance of HbA1c test in diabetic monitoring while 15% patients are disagreeing with the significance of HbA1c test in diabetic monitoring. The results also reveal that 47% health professional feel that HbA1c test has better diagnostic accuracy than other diabetes diagnostic tests, 22% believe it is more dependable than other glucose tests, and 30% believe it is successful in diabetes mellitus prognosis. Conclusion: It was determined that in assessing and managing diabetes mellitus HbA1c test is considered one of the significant diagnostic test. It has the capacity to recall the previous three months' cumulative history of Glycosylated hemoglobin. The accuracy, sensitivity and reliability of HbA1c test is very high and clear in contrast to other blood glucose diagnostic tests. HbA1c test is more accurate than both a fasting glucose test and random glucose test. Moreover, HbA1c test does not need any fasting it perform any time.

Detection value of FOXO1 gene methylation, blood glucose and lipids in patients with type 2 diabetic kidney disease.

Forkhead transcription factor O1 (FOXO1) methylation is associated with inflammation. Diabetic kidney disease (DKD) is characterized with increased inflammatory markers such as uric acid, hemogram indices, C-reactive protein derived markers, omentin and neuregulin. This study aimed to investigate the effect of DNA methylation in FOXO1 gene promoter, blood glucose and lipids in the process of type 2 DKD. Bisulfite genomic sequencing was used to monitor DNA methylation in the promoter region (+1021, +1193) of FOXO1 gene. The detections were taken in glycosylated hemoglobin A1c, fasting plasma glucose and blood lipid. 81 participants were divided into the control group, the preliminary diabetes mellitus group, the pure diabetes mellitus group, and the DKD group. The other groups displayed higher fasting plasma glucose than the control group (all P value < .05). The fasting plasma glucose level was higher in the pure diabetes mellitus group than the preliminary diabetes mellitus group (P = .004). The levels of HbA1c were higher in other groups than control group and preliminary diabetes mellitus groups (all P values < .01). The high-density lipoprotein level was lower in the DKD group (P = .021, P = .022) than control and pure diabetes mellitus group. The levels of low-density lipoprotein were statistically lower in preliminary diabetes mellitus and DKD groups than control group (all P value < .02). Along with the progress of DKD, a down trend was observed in the total methylation rate of FOXO1 gene (P = .025), which contains 5 CpG sites (1021, +1193) in the promoter. Hypomethylation in the promoter of FOXO1 gene, hyperglycemia and low level of serum lipid might be associated with the pathogenesis of type 2 DKD.

Development and validation of a novel 10-year cardiovascular risk prediction nomogram for the United Arab Emirates national population

ObjectivesAtherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality among United Arab Emirates (UAE) nationals. Recent studies have shown that current tools are poor in predicting the...

Association between glycemic control and albuminuria among Peruvian adults with diabetes mellitus 2: a cross-sectional analytical study.

Albuminuria is a risk factor for microvascular and macrovascular complications in the diabetic population. However, few studies have correlated poor glycemic control and albuminuria prevalence in Hispanic populations. To evaluate the association between glycemic control and albuminuria among Peruvian adults with type 2 diabetes mellitus (T2DM). Cross-sectional analytical study among adults with T2DM in Lima, Peru. We included adults over 18 years old who were in a clinical follow-up program at a private clinic in Lima in 2018. Poor glycemic control was defined as a serum value of glycosylated hemoglobin A1C (HbA1C) ≥ 7%. Albuminuria was defined as albumin values &gt; 30 mg/dl in the first morning urine. We generated generalized linear regression models from the Poisson family with robust variance. We calculated the crude and adjusted prevalence ratios (PRs) with their 95% confidence interval (CI). We analyzed 907 participants of median age 58 years (interquartile range, IQR 49 to 66), and 62.8% were males. The prevalence of poor glycemic control was 39.8%, and the prevalence of albuminuria was 22.7%. The prevalences of albuminuria in groups with poor glycemic control and adequate glycemic control were 32.7% and 16.1%, respectively. In the adjusted regression analysis, we found a statistically significant association between poor glycemic control and albuminuria (annual percentage rate, aPR = 1.70; 95% CI: 1.28-2.27). The prevalence of poor glycemic control and albuminuria was high in our study population. Moreover, Peruvian T2DM adults with poor glycemic control were more likely to have albuminuria.

The modifiable effect of vitamin D in the association between long-term exposure to ambient air pollution and glycosylated hemoglobin in patients with hypertension

ObjectivesEvidence on the association between long-term exposure to ambient air pollution and serum glycosylated hemoglobin A1c (HbA1c) is limited and inconclusive. In addition, whether vitamin D can modify the association between air pollution exposure and glucose metabolism has not been previously investigated. We aimed to evaluate the effects of various air pollutants on serum HbA1c levels in patients with hypertension and, further, to explore the modification effect of individual serum vitamin D levels. MethodsThis study was derived from UK Biobank study, and 246 027 participants with hypertension were included in our analysis. Individual exposures to particulate matters (PMs) and nitrogen oxides were estimated using the land use regression model. The associations between air pollutants and HbA1c were assessed using the multivariable linear regression model. Among the 222 845 participants with a measurement of serum vitamin D, we explored the associations in subgroups stratified by vitamin D levels. ResultsLong-term air pollutant exposures were significantly associated with higher HbA1c levels. After adjusting for potential confounders, 10-μg/m3 (or 1-m–1) increases in concentrations of PM with diameters ≤2.5 µm (PM2.5), PM with diameters ≤10 µm, PM with diameters from 2.5 µm to 10 µm, PM2.5 absorbance, nitrogen oxides, and nitrogen dioxide were significantly associated with 0.59 (95% confidence interval, 0.28–0.89), 0.49 (0.33–0.65), 0.81 (0.48–1.14), 0.56 (0.44–0.69), 0.06 (0.04–0.09), and 0.16 (0.12–0.21) mmol/mol increase in serum HbA1c levels, respectively. The associations were weakened but remained significant after additional adjustment of vitamin D. In addition, the associations of air pollutants with HbA1c were more evident in participants with low serum vitamin D levels (all P values for interaction <0.001). ConclusionsLong-term exposures to ambient air pollutants were associated with higher levels of HbA1c in a dose–response fashion in a large UK cohort. Serum vitamin D status significantly modified these associations, and high serum vitamin D levels may attenuate the relationships between air pollution exposures and HbA1c levels.

Potential Benefits of Selenium Supplementation in Reducing Insulin Resistance in Patients with Cardiometabolic Diseases: A Systematic Review and Meta-Analysis.

Selenium is a trace element that has been reported to be effective in regulating glucose and lipid metabolism. However, there is conflicting evidence from different clinical trials of selenium supplementation in treating cardiometabolic diseases (CMDs). This meta-analysis aimed to identify the effects of selenium supplementation on insulin resistance, glucose homeostasis, and lipid profiles in patients with CMDs. Randomized controlled trials (RCTs) of selenium supplementation for treating CMDs were screened in five electronic databases. Insulin levels, homeostatic model assessment of insulin resistance (HOMA-IR), fasting plasma glucose (FPG), and glycosylated hemoglobin A1C (HbA1c) were defined as the primary outcome markers, and lipid profiles were considered the secondary outcome markers. Ten studies involving 526 participants were included in the meta-analysis. The results suggested that selenium supplementation significantly reduced serum insulin levels (standardized men difference [SMD]: -0.53; 95% confidence interval [CI] [-0.84, -0.21], p = 0.001, I2 = 68%) and HOMA-IR (SMD: -0.50, 95% CI [-0.86, -0.14], p = 0.006, I2 = 75%) and increased high-density lipoprotein cholesterol (HDL-C) levels (SMD: 0.97; 95% CI [0.26, 1.68], p = 0.007, I2 = 92%), but had no significant effect on FPG, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and very low-density lipoprotein cholesterol (VLDL-C). Current evidence supports the beneficial effects of selenium supplementation on reducing insulin levels, HOMA-IR, and increasing HDL-C levels. Selenium supplementation may be an effective strategy for reducing insulin resistance in patients with CMDs. However, more high-quality clinical studies are needed to improve the certainty of our estimates.

Hypoglycemic Effect of Exopolysaccharide from Lactiplantibacillus plantarum JLAU103 on Streptozotocin and High-Fat Diet-Induced Type 2 Diabetic Mice.

Two doses (300 mg/kg bw and 600 mg/kg bw) of the Lactiplantibacillus plantarum JLAU103 exopolysaccharide (EPS103) were orally administered to a type 2 diabetic (T2DM) mouse model induced by streptozotocin and a high-fat diet. The hypoglycemic, hypolipidemic and neuroprotective effects of EPS103 on T2DM mice were evaluated. The results indicated that administration of EPS103 could alleviate insulin resistance, reduce the levels of fasting blood glucose, glycosylated hemoglobin A1c, leptin and fasting serum insulin, improve glucose tolerance, protect pancreas and liver, and modulate blood lipid disorders. EPS103 promoted hepatic glycogen synthesis by upregulating the phosphorylation of GSK3β. Meanwhile, it upregulated the phosphorylation of IRS-1, PI3K and Akt, as well as the expression of IRS-2 and GLUT4, and downregulated the expression of PEPCK, G6Pase and PGC-1α, indicating that EPS103 promotes the uptake and transport of glucose and inhibits gluconeogenesis, which might be related to the activation of the IRS-1/PI3K/Akt pathway. Additionally, EPS103 can protect against brain nerve damage through improving oxidative stress injury, restoring the expression of IRS-2, alleviating neuronal apoptosis and inhibiting inflammation in the hippocampus of T2DM mice. Taken together, our results demonstrated that EPS103 may be a potential therapeutic agent for the treatment of T2DM.