Percentage Of Glycosylated Hemoglobin Research Articles

Effect of Cucurbita ficifolia Bouché on glutathione level and glycosylated hemoglobin percentage in a Mexican rural population with type 2 diabetes

Ethnopharmacological importanceCucurbita ficifolia Bouché fruit is widely used in Mexican traditional medicine to treat type 2 diabetes (T2D) because it has been attributed with antioxidant and hypoglycemic properties in different experimental models and T2D patients. An imbalance in physiological glutathione (GSH) concentrations increases the susceptibility to developing complications associated with oxidative stress in T2D patients. Aim of the studyTo investigate the effect of C. ficifolia on the antioxidant properties of GSH, general health measurements, and biochemical parameters in a Mexican rural population, and to evaluate the changes in socio-affective scores of patients due to improvement in T2D. Materials and methodsTwenty-seven women diagnosed with T2D with poor glycemic control volunteered and were divided into two groups: C. ficifolia (0.5 g/kg of fresh pulp weight) with hypoglycemic pharmacotherapy, and another group with only hypoglycemic pharmacotherapy, for 12 weeks. We evaluated the effect of the fresh pulp of C. ficifolia on body mass index, blood pressure, glucose, glycosylated hemoglobin, cholesterol, triglycerides, and GSH. Expanding the study, we evaluated the quality of life, anxiety, and depression scores before and after the intervention. ResultsTreatment with the fresh pulp of C. ficifolia for 12 weeks reduced glycosylated hemoglobin, similar to the hypoglycemic pharmacotherapy group, and significantly increased GSH concentrations. The patients' moods did not change despite increased GSH concentrations and improved T2D control. ConclusionsThe increased GSH concentrations due to the consumption of fresh pulp of C. ficifolia could help to protect against oxidative stress and extend therapeutic benefits in addition to the usual hypoglycemic drugs in patients with T2D.

Polydatin nanoparticles attenuate oxidative stress and histopathological changes in streptozotocin model of diabetic nephropathy: targeting Nrf2/HO-1/NF-κβ signaling pathways

BackgroundOne of the most prevalent and serious side effects of diabetes mellitus is diabetic nephropathy, which is characterized by abnormalities in kidney structure that can occur before kidney function declines. Up to 90% of persons with diabetic nephropathy and 40% of adults with severe diabetic nephropathy are unaware that they have kidney disease. Through Nrf2/HO-1/NF κβ/TNF α signaling pathways, biochemical, oxidative stress, and antioxidant biomarkers, ultrastructural, immunohistochemical, and histopathological studies, so we attempt to evaluate the potential corrective mechanisms of polydatin nanoparticles against diabetic nephropathy in comparison with polydatin and metformin.ResultsPOLY-CSNPs, POLY, and METF treatment lowered fasting superoxide dismutase, catalase activities, and glutathione content in treating the diabetic blood sugar level, glycosylated hemoglobin percentage, and oxidative stress such as lipid peroxidation level, and also enhanced antioxidant biomarkers like superoxide peroxidase, superoxide dismutase, catalase activities, and glutathione content in treating the diabetic nephropathy. POLY-CSNPs, POLY, and METF also significantly reduced the area % of immunohistochemical reaction of TNF α (tumor necrosis factor alpha) and NF κβ (nuclear factor-kappa-β), while significantly increasing the mRNA expression’s levels for nuclear factor erythroid 2-related factor 2 and heme oxygenase-1. The results observed that POLY-CSNPs showed extremely significant efficacy in treated diabetic rats as contrasted with POLY. Histological and ultrastructural studies showed marked improvement in glomeruli, basal laminae, and proximal tubules appearing nearly identical to the normal.ConclusionsPOLY-CSNPs revealed a marked ameliorative effect on diabetic nephropathy via its anti-inflammatory, antioxidant, and prolonged-release properties.

Associations Between Mean Platelet Volume and Various Factors in Type 2 Diabetes Patients: A Single-Center Study from Poland.

BACKGROUND Thromboembolic episodes, which are largely mediated by blood platelets, are prevalent chronic complications of diabetes. The mean platelet volume (MPV) serves as a marker for in vivo platelet activation. This study aimed to assess the factors influencing MPV in 106 patients with type 2 diabetes, compared with 59 non-diabetic individuals at a single center in Poland. MATERIAL AND METHODS We performed linear regression analysis, with MPV as the dependent variable and factors such as age, sex, thrombopoiesis-influencing cytokines, blood pressure, body mass index, glycosylated hemoglobin percentage, platelet count, large platelet count, lipid profile parameters, creatinine concentration, estimated glomerular filtration rate, treatment modalities, and comorbidities as independent variables. MPV was measured using the ADVIA 2120 hematology analyzer, with a reference range of 7-12 fL. RESULTS The analysis revealed that in patients with type 2 diabetes, an increase in platelet count by 10×10³/μL resulted in a decrease in MPV by 0.05 (P<0.001), while an increase in large platelet count by 1×10³/μL led to an increase in MPV by 0.18 (P<0.001). Additionally, patients taking ß-blockers or insulin had lower MPVs by 0.77 (P=0.008) and 5.63 (P<0.001), respectively, compared with those not on these medications. CONCLUSIONS This study delineates the relationship between MPV, platelet parameters, and treatment modalities in type 2 diabetes, paving the way for further research to elucidate underlying mechanisms and potential clinical applications.

Association Between Diabetic Control And Anti-Diabetic Medication Adherence Using 8-Point Morisky Medication Adherence Scale In Local Population Of Khyber Pakhtunkhwa

Abstract:&#x0D; Background: Drug adherence to medications in diabetes is very necessary for strict glycemic control. Many factors in diabetics are associated with low adherence to drugs resulting in complications.&#x0D; Methods: This research was conducted as an observational study with cross-sectional study design. It was scheduled between July 2022 to December 2022 in medical outpatient department of Combined Military Hospital, Peshawar&#x0D; Results: 115 individuals were inducted over a period of 6 months from medical OPD ex Combined Military Hospital Peshawar. Five patients failed to follow-up with research team resulting in a total of 110 participants included in results. Average age across the study sample was 50.25 ± 11.97 years with 58 (52.73%) males and 52 (47.27%) females. Most participant in our study sample were educated up to matriculation with BMI &lt;25kg/m2.&#x0D; Average duration of diabetes across the sample was 6.1 ± 3.69 years. In treatment options, 53 (48.18%) individuals were only managed with oral therapy, 16 (14.55%) on insulin only while 41 (37.27%) were prescribed with both oral hypoglycemic drugs and insulin. Most common comorbid across study population was hypertension, seen in 59 (53.94%) diabetic patients, followed by cataract in 41 (37.47%) and IHD in 33 (30%) patients.&#x0D; In all 110 individuals, only 29 (26.36%) individuals had good glycemic control i.e., HbA1c &lt;7% with average glycosylated hemoglobin percentage measuring 8.29% ± 1.59%. As per MMAS-8 score, 25 (22.73%) patients reported good adherence, 31 (28.18%) patients reported fair adherence while rest 54 (49.09%) were found to have bad adherence. Average MMAS-8 score was 5.17.&#x0D; Conclusion: There is a correlation between medication adherence as measured by MMAS-8 score with control of diabetes as measured by HbA1c score in the range of 1.824% across the range of MMAS-8 score from 0-8. Sleep quality, BMI and multiple comorbid conditions were also linked with raised HbA1c.&#x0D; Key words: Drug adherence, Morisky Medication Adherence Scale, Diabetes, Non-diabetes, diabetic medications

Plasma copeptin level in type 2 diabetic patients and its role in diabetic nephropathy

BackgroundCopeptin, the stable COOH-terminal portion of pre-provasopressin and a surrogate marker of vasopressin, was shown to be positively associated with the decline in kidney function in the general population. However, the impact of copeptin on renal function in diabetic patients remains unclear. This study aims to assess the clinical significance of plasma copeptin level in type 2 diabetic patients with and without nephropathy and to evaluate its relation to various clinical and laboratory parameters.MethodsThis study was carried out on 45 type 2 diabetic patients, divided according to urinary albumin/creatinine ratio into 15 with normoalbminuria, 15 with microalbminuria and 15 with macroalbminuria. Also, 15 healthy subjects were included as a control group. Plasma copeptin level, glycosylated hemoglobin percentage, urinary albumin/ creatinine ratio and serum creatinine were measured. Estimated glomerular filtration rate (eGFR) was calculated.ResultsThe mean plasma copeptin level was statistically significantly higher in patients with microalbuminuria as compared to the control and normoalbuminuric groups. It was also, higher in patients with macroalbuminuria as compared to the control, normoalbuminuric and microalbuminuric groups. Plasma copeptin level was positively correlated with glycosylated hemoglobin, urinary albumin /creatinine ratio and serum creatinine but negativey correlated with eGFR.ConclusionAn increased plasma copeptin level is considered as a good predictor for deterioration of renal function in diabetic patients, suggesting that copeptin can be used to identify diabetics at risk for diabetic kidney disease development. Clearly, further well-designed prospective studies are required to prove this hypothesis.

Plant Extracts as Add-On Therapeutics in Homeopathy: An Open-Label, Randomized Trial Using Mother Tinctures in Prediabetes.

Objectives: Prediabetes is a major public health concern. Different plant extracts are used in homeopathy as mother tinctures (MTs) for the treatment of prediabetes as an adjunct to individualized homeopathic medicines (IHMs); however, their effectiveness remains under-researched. Design: Open-label, randomized (1:1), active-controlled, pragmatic, exploratory trial. Setting: Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Howrah, West Bengal, India. Subjects: Eighty-nine patients with prediabetes. Interventions: Group 1 (n = 45; IHMs plus any one of the following MTs: Cephalandra indica, Gymnema sylvestre, and Syzygium jambolanum; experimental/verum) versus Group 2 (n = 44; IHMs only; control). Outcome measures: Blood parameters, including-the fasting blood sugar (FBS) level, blood sugar level 2 h after ingestion of 75 g of glucose (oral glucose tolerance test [OGTT] result), and glycosylated hemoglobin percentage (HbA1c%), and symptoms, including the Diabetes Symptom Checklist-Revised (DSC-R) score; all of them were measured at baseline and after 3 and 6 months. Results: Although recruitment of 140 patients was initially planned, the target sample size could not be achieved because of coronavirus disease pandemic-related restrictions. Only 89 patients could be enrolled, and the trial had to be terminated prematurely owing to the time constraints of the project. The data of 82 patients (Group 1, n = 40; Group 2, n = 42) were analyzed using a modified intention-to-treat approach. Improvements in all outcomes were greater in Group 1 than in Group 2, but without a significant difference: FBS level (F1, 80 = 4.095, p = 0.046), OGTT result (F1, 80 = 2.399, p = 0.125), HbA1c% (F1, 80 = 1.612, p = 0.208), and DSC-R score (F1, 80 = 0.023, p = 0.880). Conclusions: A promising but nonsignificant trend favored the combination of MTs and IHMs compared with IHMs alone among the patients with prediabetes, especially in FBS. Therefore, further studies are required. Clinical Trial Registration Number: CTRI/2018/08/015319; secondary identifier (UTN): U1111-1218-6016.

The effect of nettle (Urtica dioica) supplementation on the glycemic control of patients with type 2 diabetes mellitus: A systematic review and meta‐analysis

Type 2 diabetes mellitus (T2DM) is a major health problem, worldwide, that is associated with increased morbidity and mortality. Several randomized controlled clinical trials (RCTs) have investigated the effect of nettle (Urtica dioica) supplementation on markers of glycemic status in patients with T2DM, with conflicting results. Therefore, the present study assessed the effect of nettle on some glycemic parameters in patients with T2DM. A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science, from database inception up to June 2019, to identify RCTs investigating the effect of nettle supplementation on glycemic markers, including fasting blood sugar (FBS) concentrations, insulin levels, homeostasis model assessment-estimated insulin resistance index, and glycosylated hemoglobin percentage in adults with T2DM. The Cochrane Collaboration tool was used to assess the methodological quality of the included studies. Results of this meta-analysis were reported based on the random effects model. Eight RCTs, comprising 401 participants, were included in the present systematic review and meta-analysis. Based on the Cochrane Collaboration risk of bias tool, five studies were considered as good quality, one was fair, and two studies were poor, respectively. The results of the meta-analysis revealed a significant reduction in FBS concentrations (weighted mean difference [WMD]: -18.01 mg/dl, 95% confidence interval [CI]: -30.04 to -5.97, p < .001, I2 = 94.6%) following nettle supplementation. However, no significant reduction was observed in insulin levels (WMD: 0.83 Hedges' g, 95% CI: -0.26 to 1.92, p = .13, I2 = 89.4%), homeostasis model assessment-estimated insulin resistance index (WMD: -0.22, 95% CI: -0.83 to 0.40, p = .49, I2 = 69.2%), or glycosylated hemoglobin percentage (WMD: -0.77%, 95% CI: -1.77 to 0.22, p = .12, I2 = 83.0%). The findings of the present study suggest that nettle supplementation may be effective in controlling FBS for T2DM patients. However, further studies are needed to confirm the veracity of these results.

Effects of Roflumilast on Rehospitalization and Mortality in Patients.

Introduction: Hospitalization for chronic obstructive pulmonary disease (COPD) exacerbation portends the greatest risk of rehospitalization and mortality. Treatments that prevent hospitalizations could significantly lessen COPD morbidity and mortality. Methods: We performed a prospective, randomized, double-blind, placebo-controlled study of roflumilast 500 ug daily versus placebo in patients hospitalized for acute COPD exacerbation. Primary outcome was time to all-cause mortality or non-elective rehospitalization at 180 days post-randomization. Secondary outcomes were death or hospitalization from a respiratory cause, quality of life, change in health status, forced expiratory volume in 1 second (FEV1) and roflumilast tolerance. Results: A total of 64 patients with moderate to severe COPD (FEV1, 37.6 ± 16.4% predicted; 61% female, 61.6 ± 7.9 years old) were assigned to roflumilast or placebo. No deaths occurred in the follow-up period. There was no difference in the time to first readmission between the roflumilast and placebo groups (46.1 days versus 47.3 days respectively, p=0.93). There were 29 and 30 readmissions in the roflumilast and placebo groups, respectively (p=0.47). The St George's Respiratory Questionnaire (SGRQ) decreased 10.8 points and 7.8 points in the roflumilast and placebo groups, respectively and were not different. EuroQuality of Life Five Dimension scale (EQ5D) scores improved, but not significantly in either group. Weight loss and nausea were more common with roflumilast but not different from placebo. Change in glycosylated hemoglobin percentage (HgbA1C%) was not different between groups. Sub-analysis for the impact of chronic bronchitis did not affect outcomes. Conclusion: In this pilot study conducted in patients hospitalized with an exacerbation of COPD, roflumilast did not affect time to all-cause rehospitalization, quality of life, FEV1 or any other measured parameter.

Distinct Metabolic Profiles are Associated with Colorectal Adenomas and Serrated Polyps.

Prevention of colorectal cancer (CRC) by colonoscopy is recommended according to age and personal/familial history. Metabolic alterations are associated with colorectal adenomas, but data are scarce regarding serrated polyps and advanced polyps. The aim of this study was to evaluate the association between metabolic alterations and colorectal polyp type and advanced polyps. A case-control study was conducted among consecutive subjects, 40 to 70 years old, who underwent screening/diagnostic colonoscopy from 2010 to 2015. Subjects who were treated for diabetes, who had a family/personal history of CRC, and who were at high risk for CRC were excluded. Participants underwent anthropometric, laboratory, and ultrasonographic evaluations and a medical and lifestyle interview. Polyps were histologically classified as adenomatous or serrated polyps and divided into advanced and non-advanced categories. The study included 828 participants (58.4 ± 6.6 years, 50.4% men). Abdominal obesity (odds ratio [OR] = 1.67, 95% CI: 1.20-2.30), hypertension (OR = 1.47, 95% CI: 1.03-2.09), and a high glycosylated hemoglobin percentage (HbA1c%) (OR = 1.57, 95% CI: 1.06-2.34) were independently associated with colorectal adenomas, whereas a high triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio was independently associated with serrated polyps (OR = 2.31, 95% CI: 1.32-4.03). A combination of three metabolic alterations was strongly associated with colorectal polyps. Abdominal obesity, hypertension, and a high HbA1c% are independently associated with adenomas, whereas a high TG/HDL ratio is associated with serrated polyps. These parameters are easily accessible in clinical practice and may help define high-risk groups for CRC.

Association between diet-related inflammation, all-cause, all-cancer, and cardiovascular disease mortality, with special focus on prediabetics: findings from NHANES III.

Chronic inflammation is associated with increased risk of cancer, cardiovascular disease (CVD), and diabetes. The role of pro-inflammatory diet in the risk of cancer mortality and CVD mortality in prediabetics is unclear. We examined the relationship between diet-associated inflammation, as measured by dietary inflammatory index (DII) score, and mortality, with special focus on prediabetics. This prospective cohort study used data from the Third National Health and Nutrition Examination Survey (NHANES III). We categorized 13,280 eligible participants, ages 20-90years, according to glycosylated hemoglobin (HgbA1c) level and identified 2681 with prediabetes, defined as a glycosylated hemoglobin percentage of 5.7-6.4. Computation of DII scores and all statistical analyses were conducted in 2015. The DII was computed based on baseline dietary intake assessed using 24-h dietary recalls (1988-1994). Mortality was determined from the National Death Index records through 2006. Over follow-up ranging between 135 and 168 person-months, a total of 3016 deaths were identified, including 676 cancer, 192 lung cancer, 176 digestive-tract cancer, and 1328 CVD deaths. Cox proportional hazard regression was used to estimate hazard ratios. The prevalence of prediabetes was 20.19%. After controlling for age, sex, race, HgbA1c, current smoking, physical activity, BMI, and systolic blood pressure, DII scores in tertile III (vs tertile I) was significantly associated with mortality from all causes (HR 1.39, 95% CI 1.13, 1.72), CVD (HR 1.44, 95% CI 1.02, 2.04), all cancers (HR 2.02, 95% CI 1.27, 3.21), and digestive-tract cancer (HR 2.89, 95% CI 1.08, 7.71). Findings for lung cancer (HR 2.01, 95% CI 0.93, 4.34) suggested a likely effect. These results were moderately enhanced after additional adjustment for serum low-density lipoprotein and triglyceride and following eliminating deaths during the first year. A pro-inflammatory diet, as indicated by higher DII scores, is associated with an increased risk of all-cause, CVD, all-cancer, and digestive-tract cancer mortality among prediabetic subjects.

Assessment of functional status of outer hair cells in Type 2 diabetes by using distortion product otoacoustic emissions

Background: Outer hair cells in the organ of Corti are not directly involved in deciding the threshold of the acoustic stimulus, but their damage will increase the hearing threshold and may even cause the neuronal deafness. Type 2 diabetes is increasing globally at an alarming rate; one of many complications of Type 2 diabetes is loss of hearing. In Type 2 diabetes, poor glycemic status is the cause for neuropathy or microangiopathy which may affect the normal hearing. Aims and Objectives: To observe the effect of Type 2 diabetes on the functional status of outer hair cells. To illustrate the effect of Type 2 diabetes on outer hair cells for right and left ear is same or different. Materials and Methods: A total of 50 Type 2 diabetic subjects, aged between 30 to 55 years, both sexes were included as test group after assessing their glycemic index. 50 age and sex matched healthy individuals are also included as control group. Functioning of outer hair cells was assessed with distortion product otoacoustic emissions (DPOAEs). Results: Glycosylated hemoglobin percentage among test (8.58 ± 0.83) and control group subjects (5.28 ± 0.50) is statistically significant (

Glycosylated hemoglobin is a good indicator of blood glucose status in Persian cats

The purposes of this study were to determine normal value of glycated hemoglobin in Persian cats and to investigate its relation to fasting plasma glucose. Blood samples were collected from 67 clinically healthy adult Persian cats (32 males and 35 females). After separation and washing of red blood cells, hemolysate was prepared and subjected to weak cation exchange chromatography for determination of glycosylated hemoglobin. Glucose was measured in fasting plasma samples (after 10–12 h of fasting) using glucose oxidase method. Glycosylated hemoglobin % in the studied cats was 1.56 ± 0.47 in males and 1.61 ± 0.52 in females. Fasting plasma glucoses were 88.3 ± 10.2 and 90.8 ± 11.5 mg/dl in males and females, respectively. Glycosylated hemoglobin % and plasma glucose strongly correlated together (r = 0.79, p < 0.001). Three cats with persistent high fasting plasma glucose showing glycosylated hemoglobin percentage of 2.6, 2.8, and 2.9 % which exceeded the upper limit of the normal value obtained in this study were found. We concluded that glycosylated hemoglobin % is a good indicator of fasting plasma glucose, and its determination can be considered as a method for diabetes screening in Persian cats. Considering three cats with persistent high fasting plasma glucose and glycosylated hemoglobin percent, we concluded that glycosylated hemoglobin percent could be a good biochemical test for screening or diagnosis diabetes in cats.

Patient counseling excellence honored

Patient counseling excellence honored

Potential role of the endocannabinoid receptor antagonist rimonabant in the management of cardiometabolic risk: a narrative review of available data

The endocannabinoid system (ECS) is an endogenous physiological system composed of two cannabinoid receptors and several endogenous ligands. The ECS is intimately involved in appetite regulation and energy homeostasis, which makes it an intriguing target for pharmacological treatment of obesity, diabetes, and the metabolic syndrome. Rimonabant is the first cannabinoid receptor (CB-1) antagonist being studied and utilized to treat obesity (it is approved in Europe but is currently under review in the United States). Large randomized trials with rimonabant have demonstrated efficacy in treatment of overweight and obese individuals with weight loss significantly greater than a reduced calorie diet alone. In addition, multiple other cardiometabolic parameters were improved in the treatment groups including increased levels of high density lipoprotein cholesterol, reduced triglycerides, reduced waist circumference, improved insulin sensitivity, decreased insulin levels, and in diabetic patients improvement in glycosylated hemoglobin percentage. There was an increase in the adverse effects of depression, anxiety, irritability, and nausea in rimonabant-treated groups. This novel medication may become an important therapeutic option in the fight to reduce cardiovascular disease worldwide through its unique action on cardiometabolic risk.

Endothelial dysfunction in geriatric diabetic patients: the role of microalbuminuria in elderly type 2 diabetic patients? A randomized controlled study

Microalbuminuria is considered a marker of extensive endothelial dysfunction and is associated with excess of other cardiovascular risk factors. Our aim is to assess the importance of the presence of microalbuminuria in elderly diabetic patients. A total of 40 normotensive elderly type 2 diabetic patients of both genders with mean age >65 years were randomly included and were further subdivided according to the presence of persistent microalbuminuria into microalbuminuric and normoalbuminuric groups. All patients in both groups were subjected to thorough clinical and laboratory investigations including the assay of serum thrombomodulin (TM) and glycosylated hemoglobin level. Early-morning midstream urine samples were evaluated for levels of beta 2 microglobulin, alpha 1 microglobulin, TM, and N-acetyl-beta-D-glucosaminidase (NAG). There was no significant difference between both groups regarding the clinical demographic characteristics. There were statistically significant higher values for glycosylated hemoglobin percentage, serum triglycerides and serum TM and urinary B2 microglobulin, urinary alpha 1 microglobulin, urinary NAG and urinary thrombomodulin in microalbuminuric group in comparison to normoalbuminuric group (P < 0.05). Microalbuminuria is associated with markers of endothelial dysfunction in elderly normotensive type 2 diabetic patients. We recommend incorporation of periodic testing for microalbuminuria in this sector of patients.

Intensive 50-week evaluation of glipizide administration in 50 cats with previously untreated diabetes mellitus

Objective To evaluate use of the oral hypoglycemic drug glipizide in diabetic cats. Design Prospective study. Animals 50 cats with recently diagnosed but untreated diabetes mellitus. Procedure Each cat received glipizide (5 mg, q 12 h) for 16 weeks. Medication was not given during the subsequent 16 weeks; then glipizide treatment was repeated. Each cat was evaluated prior to treatment and at 2, 4, 8, 12, and 16 weeks during each of the 3 phases: blood samples for serum glucose and insulin determinations were obtained every 2 hours, from 8 AM to 6 PM. A preprandial blood glycosylated hemoglobin percentage was determined for the first sample obtained at each visit. Results During the first 22 weeks of the study, diabetes worsened in 28 of the 50 cats, which then were disqualified from the study and treated with insulin. Of the remaining 22 cats that improved clinically, 7 had corresponding metabolic improvement in each diabetes-related parameter assessed and did not become hypoglycemic. Six of the 22 cats became hypoglycemic. Glipizide was discontinued, and diabetes did not recur. Serum glucose concentration did not improve in 6. Three cats had metabolic and clinical improvement during initial glipizide treatment, but had recurrence of the disease during repeated treatment; glipizide was discontinued and insulin was administered. None of the 50 treated cats died, and observed morbidity was mild and transient. Transient anorexia and vomiting were observed in 8 cats, and 4 became transiently icteric with abnormal liver enzyme activities. Clinical Implications Trial use of glipizide is feasible in diabetic cats of owners who are unable or unwilling to administer insulin. (J Am Vet Med Assoc 1997;210:772–777

Fetal polycythemia and thrombocytopenia in pregnancies complicated by maternal diabetes mellitus

In 40 pregnancies complicated by maternal diabetes mellitus umbilical venous blood was obtained by cordocentesis within 24 hours of elective delivery at 36 to 40 weeks' gestation. The mean fetal hematocrit was significantly higher and the mean platelet count significantly lower than the corresponding values of our reference ranges. Furthermore, blood gas analysis demonstrated these fetuses to be normoxemic but acidemic. The degree of fetal acidemia was significantly associated with both maternal and fetal blood glucose concentrations. The fetal hematologic indices were significantly related to the maternal glycosylated hemoglobin percentage but not to the degree of fetal acidemia or to the maternal or fetal blood glucose concentration at the time of cordocentesis. Fetal acidemia, polycythemia, and thrombocytopenia may contribute to the increased incidence of late unexplained intrauterine deaths in pregnancies complicated by maternal diabetes mellitus.

Diagnostic value of glycosylated hemoglobin in intravascular hemolysis after cardiac surgery

Glycosylated hemoglobin (GH), hemoglobin (Hb), hematocrit, LDH and serum bilirubin were measured pre-operatively, and 1-10 days and 11-42 d post-operatively in 42 patients undergoing cardiac surgery. Their mean age was 39.90 years, ranging from 4 to 68 yr. In the early post-operation days, Hb and hematocrit, but not GH percentage, were significantly decreased. This demonstrates that, at this stage, acute blood loss rather than hemolysis is more prominent. In the later post-operative days, GH, but not Hb or hematocrit, decreased significantly. This indicates the presence of chronic hemolysis with bone marrow compensation. In our study, the incidence of chronic mild hemolysis after cardiac surgery was very high (68.8%). We conclude that GH determination is a simple, easy and sensitive method to detect chronic hemolysis and we suggest measuring it in every case with suspicion of hemolysis.