Hemoglobin In Diabetic Patients Research Articles

Study of variation glycated haemoglobin in diabetic patients using PCA method. Case study: Moroccan eastern region

In collaboration with the regional centre of diabetes and chronic diseases, we will present in this work, the variability of glycated haemoglobin of 200 diabetic patients, in the eastern region of Morocco. This work is the analysis of the values of glycated haemoglobin in the three quarters of the study in 2021, which are presented by variable quantitative values with the statistical method principal component analysis PCA. This study also includes an analysis of socio-demographic parameters, which are analysed by the multiple correspondence analysis MCA method. The proposed approach will be used to study the distribution of patients in a subset of equi-qualities according to the duration of evolution and type of diabetes. This analysis allowed us to understand and know the distribution of the Eastern population. This allows us to begin a more in-depth analysis of our sample and the various complications of diabetes, particularly diabetic retinopathy, which remains a major public health problem in Morocco, in order to develop more appropriate strategies for the management of diabetic patients in the Eastern region of Morocco.

Efficacy of Sodium Fluoride as an Anticoagulant in the Estimation of Glycated Haemoglobin in Diabetic Patients: An Alternative to EDTA

Introduction: Vacutainer used for collecting blood sample for plasma glucose estimation contains sodium fluoride (NaF) as an additive and for Glycated Haemoglobin (HbA1c) an Ethylenediamine Tetraacetic Acid (EDTA) tube. This necessitates additional blood to be collected for testing from the same patient at same period of time. Aim: To evaluate difference in the HbA1c values in blood samples collected in EDTA and NaF coated vacutainers. Materials and Methods: This cross-sectional study was conducted at Biochemistry section of central laboratory, Father Muller Medical College and Hospital, Mangalore, Karnataka, India, for the duration of two months (June to July 2018). The samples drawn for fasting plasma glucose estimation in NaF vacutainer and for HbA1c estimation in EDTA sample of same patients was included in present study. The data were entered in the statistical software Statistical Package for the Social Sciences (SPSS) version 23.0. Results: Samples from 140 patients whose blood had been drawn for fasting plasma glucose levels and estimation of HbA1c in which 80 subjects were males and 60 females with mean age of 54.4±13.6 years. There were no significant changes in the mean levels of HbA1c in EDTA and NaF tubes (8.61±1.93 and 8.64±1.93 respectively). Conclusion: Current results exclude the absolute necessity for the blood collection in EDTA vacutainers for HbA1c estimation.

Systematic review and meta-analysis: influence of iron deficiency anemia on blood glycosylated hemoglobin in diabetic patients

Diabetes is a common metabolic disease with an increasing incidence in middle-aged and elderly people in recent years. Chronic hyperglycemia is the basic feature of diabetes, which can cause long-term damage to eyes, kidneys, nerves, heart, and blood vessels, resulting in functional decline or even failure. Glycosylated hemoglobin (HbA1c) can be used as an indicator of an individual's blood sugar status over the past 3 months; however, it is slightly affected by ischemic anemia. The data retrieval was performed in the databases of PubMed, Embase, and Ovid-Medline from their inception to April 2021, including keywords such as iron deficiency anemia (IDA), diabetes, HbA1c, immunoassay, and ion-exchange chromatography. After passing of sensitivity and heterogeneity analysis, Review Manager 5.3 was employed for meta-analysis. A total of 6 studies were included in this paper. The analysis results showed that IDA could be considered to have an impact on HbA1c outcomes in non-diabetic populations. In people with diabetes, IDA is not thought to have an impact on HbA1c outcomes. A total of 6 articles were included to discuss the effects of IDA on blood HbA1c in diabetic patients. The study found that when patients with diabetes were tested for blood sugar, the HbA1c did not accurately reflect their blood sugar control over the past 3 months.

Correlation of retinal nerve fiber layer and ganglion cell complex thickness with glycosylated hemoglobin in diabetic patients

Aim The aim of this study was to correlate the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness with glycosylated hemoglobin (HbA1c) in diabetic patients.Setting and design This is a comparative case series study that was conducted on 58 eyes of 30 diabetic patients attending the Outpatient Clinics of the Ophthalmology Department, Beni-Suef University Hospital, Beni-Suef, Egypt, between June and August 2019.Patients and methods The 30 cases were divided into two equal groups: uncontrolled diabetic group (group 1), with HbA1c more than or equal to 7%, and controlled group (group 2), with HbA1c less than 7%. Both eyes in each patient were scanned using optical coherence tomography, ‘Optovue.’ Blood samples for HbA1c testing were collected as well.Results There was a significant negative correlation between average, superior, inferior, and nasal RNFL quadrant thickness and HbA1c in group 1, which was found with HbA1c level more than 9%. In group 2, there was no statistically significant correlation of HbA1c and all RNFL parameters in both eyes. In addition, in group 1, there was a significant negative correlation of average, superior, and inferior GCC quadrant thickness and a positive correlation of focal loss volume with Hb1Ac level more than 9%. In group 2, the average and inferior GCC thickness showed a positive correlation with HbA1c. Furthermore, focal loss volume and global loss volume were negatively correlated with HbA1c.Conclusion There was a statistically significant correlation between thinning of most of RNFL and GCC quadrants and uncontrolled HbA1c more than 9%.

Relationship between Perioperative Cardiovascular Events and Glycated Hemoglobin in Diabetic Patients Undergoing Noncardiac Surgery.

This retrospective nested case-control study is aimed at investigating the relationship between HbAlc and perioperative cardiovascular events (PCE) in patients with diabetes who underwent complex or moderately complex noncardiac surgery at the Second Affiliated Hospital of Xinjiang Medical University in 2013-2018. The patients were divided into four groups according to HbA1c ≤7%, 7.1%-7.9%, 8.0%-8.9%, and ≥9%. The occurrence of PCE among the groups was compared using univariable and multivariable analyses. Finally, 318 patients were included. There were 90 cases of PCE among the 318 patients; the occurrence rate of PCE was 28.3%. No death occurred. The occurrence rates of PCE in the HbA1c ≥ 8.0% − 8.9% and HbA1c ≥ 9.0% groups were 30.8% and 35.4%, respectively (P < 0.001 vs. the HbA1c 7.1%-7.9% group). The occurrence rate of PCE in the HbA1c ≤ 7% group was 25.9% (P > 0.05 vs. the HbA1c 7.1%-7.9% group). The multivariable logistic regression analysis showed that the course of diabetes (HbA1c stratification ≤7%, 7.1%-7.9%, 8.0%-8.9%, ≥9%, OR = 3.672, 95% CI: 1.552-8.687), HbA1c (OR = 1.895, 95% CI: 1.227-4.830), SBP (OR = 1.194, 95% CI: 1.015-2.023), and microalbuminuria (OR = 1.098, 95% CI: 1.005-1.023) was independently associated with PCE in diabetic patients. In conclusion, HbA1c levels are related to the incidence of PCE in diabetic patients undergoing complex or moderately complex noncardiac surgery.

Glycaemic control and correlation between estimated average glucose and glycated haemoglobin in diabetic patients seen in a tertiary hospital in Benin City, Nigeria

Diabetes mellitus is on the increase worldwide and in Nigeria, with prevalence ranging from 0.65% in rural Mangu to as high as 11.0% in urban Lagos. Its prevention, early diagnosis and adequate treatment to prevent morbidity and mortality are essential. Glycated haemoglobin estimation is a marker of glycaemic control and it reflects average plasma glucose over previous eight to twelve weeks. Reporting estimated average glucose along with glycated haemoglobin values may be useful in the assessment of long term glycaemic control of diabetic patients. This work aims to assess glycaemic control in diabetic patients and determine the association between estimated average glucose and glycated haemoglobin values. This work is a retrospective study. Data of 100 diabetic patients (Type 1 and 2) seen in the endocrine outpatient clinic of the University of Benin Teaching Hospital between March 2017 and October 2017 were analyzed. Glycated haemoglobin (HbA1c) assay was done using high performance liquid chromatography (Bio - Rad). Estimated average glucose was derived using Nathan’s regression formula. Good glycaemic control was established at glycated haemoglobin < 7% according to the American Diabetes Association recommendation. Mean age of the subjects was 61.5 ± 14.8 years. Mean fasting plasma glucose, estimated average glucose, glycated haemoglobin in the subjects were 188.6 ± 100.3, 165.4 ± 24.8 mg/dl, 7.4 ± 2.4% respectively. Estimated average glucose showed a strong positive correlation with glycated haemoglobin, which was statistically significant; r = 1.000, p = 0.000. 46% of the subjects had glycated haemoglobin values < 7%, while 54% had values ≥ 7%. Estimated average glucose correlated strongly and significantly with glycated haemoglobin, therefore reporting estimated average glucose along with glycated haemoglobin values may be useful and beneficial in the assessment of long term glycaemic control of diabetic patients. Glycaemic control is yet to be optimal in the study population. Key words: Estimated average blood glucose (eAG), glycated haemoglobin (HbA1c), diabetes mellitus.

Glycated albumin is a better indicator for glucose levels than glycated hemoglobin in patients with diabetes mellitus on insulin therapy

BackgroundDiabetes mellitus (DM) is a metabolic disease with a large incidence in the world and constitutes a global health problem. By 2030 it is estimated that there will be around 439 million people suffering from DM. Diabetes mellitus is a metabolic disease caused by a lack or absence of the hormone insulin. In type 2 DM pharmacotherapy can be given one of which is insulin. To monitor therapy, random blood glucose, glycated hemoglobin (HbA1c) and glycated albumin (GA) levels can be examined. The objective of this study was to determine the relationship of glycated albumin and glycated hemoglobin (HbA1c) with random blood glucose in insulin-treated diabetics.MethodsA cross-sectional study was conducted involving 92 type 2 diabetic patients treated with insulin. The study used a questionnaire and blood samples. We measured the GA , HbA1C and random blood glucose levels. A multiple linear regression was used to analyze the data. ResultsMean HbA1c was 9.21 ± 2.15%, mean glycated albumin was 24.4 ± 8.65%, and mean blood glucose was 229.47 ± 98.7 mg/dL. Multiple linear regression tests showed that HbA1c (B= 5,544; â=0.121; p=0.420) and GA (B=5.899; â=0.517; p=0.001) was signigicantly corelated with random blood gucose, respectively, indicating that glycated albumin is significantly related to and has the greatest influence on glucose level.ConclusionGlycated albumin is correlated with and has greater influence on glucose level than does HbA1c. Glycated albumin could be a better marker for glycemic control than glycated hemoglobin in diabetic patients treated with insulin.

Prevalence of Diabetic Nephropathy among Type 2 Diabetes Mellitus, and Glycaemic Control Evaluated by Glycaeted Haemoglobin in Diabetic Patients with and without Diabetic Nephropathy

AbstractBackground: Diabetic Nephropathy (DN) is by far the most common cause of End-Stage Renal Disease (ESRD). Approximately one-third of individuals with diabetes develop DN, with a high likelihood of progression to ESRD. In addition, DN is associated with considerably increased cardiovascular disease risk and mortality.Aim of Study: The purpose of this study is to determine the prevalence of diabetic nephropathy between T2DM, and glycaemic control evaluated by a glycaeted haemoglobin in diabetic patients with and without diabetic nephropathy.Material and Methods: This study was carried out on 100 diabetic patients who attended a private clinic in Aden-Yemen. Over a period from 1st June 2018 to 1st January 2019. All the participants studied were subjected to assessment of sex, age and duration of diabetes with laboratory investigations includ-ing determination of urinary albumin to creatinine ratio, and glycated haemoglobin (HbA1c).Results: The results showed that 14% of all patients have been studied had diabetic nephropathy, there were statistically significant relationships between diabetic nephropathy and duration of diabetes (p=0.040), there were no statistically significant relationships between diabetic nephropathy and age, sex and glycated haemoglobin level (HbA1c) of the patients.Conclusion: Screening for microalbuminuria will enable early identification of patients with DN. Duration of DM and was strong predictor associated with the development of DN in the patients studied.This also raises a red flag against the common medical practice of only using Serum Creatinine as a test to determine renal function.

P2265Impact of glycated hemoglobin in diabetic patients with coronary artery disease undergoing surgery, angioplasty or clinical treatment in a very long-term follow-up

P2265Impact of glycated hemoglobin in diabetic patients with coronary artery disease undergoing surgery, angioplasty or clinical treatment in a very long-term follow-up

A Comparative Study of Glycated Albumin versus Glycated Haemoglobin in Diabetic Patients with End Stage Renal Disease on Haemodialysis

A Comparative Study of Glycated Albumin versus Glycated Haemoglobin in Diabetic Patients with End Stage Renal Disease on Haemodialysis

Dietary glycemic load and metabolic status in newly diagnosed type 2 diabetes in southeastern China.

Large-scale epidemiological investigations worldwide have shown that dietary glycemic load is associated with metabolic diseases, including diabetes. However, only a few studies have examined the correlations between glycemic load and blood glucose and lipids in Chinese diabetic patients. Therefore, this study aimed to determine these correlations in southeastern China. 201 patients with newly diagnosed type 2 diabetes and 126 participants with normal blood glucose were enrolled at the Sun Yat-sen Memorial Hospital, Guangdong Province. Carbohydrate intake and glycemic load were assessed based on 3-day dietary records. Using glycemic load as the dependent variable, a correlation analysis and multiple regression analyses were used to analyze the correlations between glycemic load and blood glucose and lipids. The mean glycemic load in diabetic patients was significantly higher than that in the control group (p<0.05). Correlation analysis showed that glycemic load was positively correlated with body mass index and glycated hemoglobin in diabetic patients (p<0.05) but negatively correlated with high-density lipoprotein cholesterol in all subjects (p<0.05). Multivariable regression analysis indicated that, among participants in southeastern China, a higher glycemic load increased the odds of having diabetes, a low high-density lipoprotein cholesterol, and higher Charlson weighted index of comorbidities score, as well as being overweight. A high-glycemic load diet may be associated with a risk of diabetes, glycemic control, lipid metabolism, prognosis of diseases, and body composition. It is necessary to control dietary glycemic load for both patients with diabetes and healthy people in southeastern China.

Nigerian Honey Ameliorates Hyperglycemia and Dyslipidemia in Alloxan-Induced Diabetic Rats.

Diabetic dyslipidemia contributes to an increased risk of cardiovascular disease. Hence, its treatment is necessary to reduce cardiovascular events. Honey reduces hyperglycemia and dyslipidemia. The reproducibility of these beneficial effects and their generalization to honey samples of other geographical parts of the world remain controversial. Currently, data are limited and findings are inconclusive especially with evidence showing honey increased glycosylated hemoglobin in diabetic patients. It was hypothesized that this deteriorating effect might be due to administered high doses. This study investigated if Nigerian honey could ameliorate hyperglycemia and hyperlipidemia. It also evaluated if high doses of honey could worsen glucose and lipid abnormalities. Honey (1.0, 2.0 or 3.0 g/kg) was administered to diabetic rats for three weeks. Honey (1.0 or 2.0 g/kg) significantly (p < 0.05) increased high density lipoprotein (HDL) cholesterol while it significantly (p < 0.05) reduced hyperglycemia, triglycerides (TGs), very low density lipoprotein (VLDL) cholesterol, non-HDL cholesterol, coronary risk index (CRI) and cardiovascular risk index (CVRI). In contrast, honey (3.0 g/kg) significantly (p < 0.05) reduced TGs and VLDL cholesterol. This study confirms the reproducibility of glucose lowering and hypolipidemic effects of honey using Nigerian honey. However, none of the doses deteriorated hyperglycemia and dyslipidemia.

HB Puerta del Sol [HBA1:c.148A>C], HB Valdecilla [HBA2:c.3G>T], HB Gran Vía [HBA2:c.98T>G], HB Macarena [HBA2:c.358C>T] and HB El Retiro [HBA2:c.364_366dupGTG]: description of five new hemoglobinopathies.

Structural hemoglobinopathies do not usually have a clinical impact, but they can interfere with the analytical determination of some parameters, such as the glycated hemoglobin in diabetic patients. Thalassemias represent a serious health problem in areas where their incidence is high. The defects in the post-translational modifications produce hyper-unstable hemoglobin that is not detected by most of electrophoretic or chromatographic methods that are available so far. We studied seven patients who belong to six unrelated families. The first two families were studied because they had peak abnormal hemoglobin (Hb) during routine analytical assays. The other four families were studied because they had microcytosis and hypochromia with normal HbA2 and HbF without iron deficiency. HbA2 and F quantification and abnormal Hb separation were performed by chromatographic and electrophoretic methods. The molecular characterization was performed using specific sequencing. The Hb Puerta del Sol presents electrophoretic mobility and elution in HPLC that is different from HbA and similar to HbS. The electrophoretic and chromatographic profiles of the four other variants are normal and do not show any anomalies, and their identification was only possible with sequencing. Some variants, such as Hb Valdecilla, Hb Gran Vía, Hb Macarena and Hb El Retiro, have significant clinical impact when they are associated with other forms of α-thalassemia, which could lead to more serious forms of this group of pathologies as for HbH disease. Therefore, it is important to maintain an adequate program for screening these diseases in countries where the prevalence is high to prevent the occurrence of severe forms.

Anti-atherosclerotic effects of sitagliptin in patients with type 2 diabetes mellitus.

BackgroundAdvanced glycation end products, selectins, and adiponectin play important roles in the development of atherosclerosis in individuals with diabetes. Sitagliptin has been shown to reduce the concentration of glycated hemoglobin in diabetic patients. However, its effects on soluble receptor for advanced glycation end products (sRAGEs), selectins, and adiponectin in these patients are poorly understood. This study was conducted to assess the effects of sitagliptin on the circulating levels of sRAGEs, monocyte chemoattractant protein-1 (MCP-1), selectins, and adiponectin in patients with type 2 diabetes.MethodsDiabetic patients eligible for sitagliptin monotherapy or combination therapy (eg, sitagliptin plus a sulfonylurea) were administered sitagliptin (50 mg/day) for 6 months. Levels of soluble P-selectin (sP-selectin), soluble E-selectin (sE-selectin), soluble vascular cell adhesion molecule-1 (sVCAM-1), MCP-1, sRAGEs, and adiponectin were measured by ELISA at baseline and after 3 and 6 months of treatment.ResultsAt baseline, the levels of MCP-1, sP-selectin, sE-selectin, and sVCAM-1 were higher and the level of adiponectin was lower in diabetic patients than in nondiabetic patients. Sitagliptin therapy for 3 and 6 months significantly reduced plasma levels of sP-selectin, sE-selectin, sVCAM-1, and MCP-1 relative to baseline, while significantly increasing adiponectin levels. sRAGEs did not exhibit a statistical significance, although there was an increasing tendency. Furthermore, the reductions in sP-selectin, sE-selectin, sVCAM-1, and MCP-1 during sitagliptin therapy were significantly greater in responders, defined as patients with a significant increase in adiponectin levels, than in nonresponders. In contrast, responders showed a significant increase in the plasma concentration of sRAGEs.ConclusionSitagliptin shows an adiponectin-dependent anti-atherothrombotic effect, which may be beneficial for primary prevention of atherothrombosis, in patients with type 2 diabetes.

Anakinra and Tocilizumab Enhance Survival and Function of Human Islets during Culture: Implications for Clinical Islet Transplantation

Pretreatment culture before islet transplantation represents a window of opportunity to ameliorate the proinflammatory profile expressed by human β-cells in duress. Anakinra (IL-1 receptor antagonist) and tocilizumab (monoclonal IL-6 receptor antibody) are two known anti-inflammatory agents successfully used in the treatment of inflammatory states like rheumatoid arthritis. Both compounds have also been shown to reduce blood glucose and glycosylated hemoglobin in diabetic patients. We therefore sought to evaluate the impact of anakinra and tocilizumab on human β-cells. The islets were precultured with or without anakinra or tocilizumab and then transplanted in a marginal mass model using human islets in immunodeficient mice. Islet viability was evaluated in an in vitro model. The pretreatment culture led to a significantly improved engraftment in treated islets compared to the vehicle. Anakinra and tocilizumab are not toxic to human islets and significantly reduce markers of inflammation and cell death. These results strongly support a pretreatment culture with anakinra and tocilizumab prior to human islet transplantation.

Cardiac rehabilitation in patients with type 2 diabetes mellitus and coronary disease: A comparative study

Introduction and AimsDiabetic patients have a 2–4 times higher risk of cardiovascular disease than non-diabetic individuals.The aims of this study are to evaluate the effects of a cardiac rehabilitation program (phase II) in patients with diabetes and coronary disease and to compare the results with regard to control of cardiovascular risk factors and improvement in functional capacity with coronary patients without diabetes. MethodsThis was a prospective study of patients diagnosed with ischemic heart disease referred for a cardiac rehabilitation program between January 2009 and June 2013. The population was divided into two groups: diabetic and non-diabetic.Patients were assessed at the beginning of phase II and three months later and the following parameters were recorded: body mass index, waist circumference, lipid profile, blood glucose and glycated hemoglobin in diabetic patients, blood pressure, smoking, physical activity level (using the International Physical Activity Questionnaire) and functional capacity (on treadmill stress testing). ResultsThe study population consisted of 682 patients (253 diabetic and 429 non-diabetic). Diabetic patients were significantly older, had a worse cardiovascular risk profile (higher prevalence of overweight, dyslipidemia, hypertension and sedentary lifestyle) and lower functional capacity.At the end of phase II, there was a statistically significant improvement (p<0.05) in all risk factors and functional capacity, which was similar in both groups, except for body mass index, triglycerides and functional capacity. ConclusionsDiabetic patients may benefit from a cardiac rehabilitation program and achieve comparable results to non-diabetic patients.

Reabilitação cardíaca em doentes coronários com diabetes mellitus tipo 2: Estudo comparativo

Introduction and AimsDiabetic patients have a 2‐4 times higher risk of cardiovascular disease than non‐diabetic individuals. The aims of this study are to evaluate the effects of a cardiac rehabilitation program (phase II) in patients with diabetes and coronary disease and to compare the results with regard to control of cardiovascular risk factors and improvement in functional capacity with coronary patients without diabetes. MethodsThis was a prospective study of patients diagnosed with ischemic heart disease referred for a cardiac rehabilitation program between January 2009 and June 2013. The population was divided into two groups: diabetic and non‐diabetic. Patients were assessed at the beginning of phase II and three months later and the following parameters were recorded: body mass index, waist circumference, lipid profile, blood glucose and glycated hemoglobin in diabetic patients, blood pressure, smoking, physical activity level (using the International Physical Activity Questionnaire) and functional capacity (on treadmill stress testing). ResultsThe study population consisted of 682 patients (253 diabetic and 429 non‐diabetic). Diabetic patients were significantly older, had a worse cardiovascular risk profile (higher prevalence of overweight, dyslipidemia, hypertension and sedentary lifestyle) and lower functional capacity. At the end of phase II, there was a statistically significant improvement (p<0.05) in all risk factors and functional capacity, which was similar in both groups, except for body mass index, triglycerides and functional capacity. ConclusionsDiabetic patients may benefit from a cardiac rehabilitation program and achieve comparable results to non‐diabetic patients.

Effect of nonsurgical periodontal treatment on glycosylated hemoglobin in diabetic patients: a systematic review.

This review was designed to determine whether non-surgical periodontal treatment is able to reduce serum glycosylated hemoglobin (HbA1c) levels in patients with diabetes mellitus (DM). Several previous reports showed that scaling and root planning (SRP) improve periodontal status in patients with DM, but whether it also improves metabolic control of the disease is unclear. A systematic review was conducted according to the recommendations of the Cochrane Collaboration and PRISMA. A literature search was conducted in October 2012 using three libraries (Cochrane, Web of Knowledge, and Scopus) and the keywords "periodontal disease" and "diabetes mellitus." Only 21 of the articles met the inclusion criteria for this review. A total of 1,454 patients were thus included in this study to evaluate whether periodontal treatment improved serum HbA1c levels. Both the methodological quality and the risk of bias of each study were taken into account using the Jadad scale. Only ten of the included studies had an acceptable-good score of 3-5. Fourteen of the studies reported a significant decrease in serum HbA1c levels (p < 0.05) after periodontal treatment. The remaining seven studies failed to find a significant decrease in serum HbA1c. The findings of this review suggest that the published literature is insufficient and inconclusive to clearly support periodontal treatment as a means to improve serum HbA1c levels in patients with type 1 DM. It also demonstrates the need for homogeneous studies, with larger samples and longer follow-up periods, to properly address this question.

Effectiveness of a primary care-based intervention to reduce sitting time in overweight and obese patients (SEDESTACTIV): a randomized controlled trial; rationale and study design.

BackgroundThere is growing evidence suggesting that prolonged sitting has negative effects on people’s weight, chronic diseases and mortality. Interventions to reduce sedentary time can be an effective strategy to increase daily energy expenditure. The purpose of this study is to evaluate the effectiveness of a six-month primary care intervention to reduce daily of sitting time in overweight and mild obese sedentary patients.Method/DesignThe study is a randomized controlled trial (RCT). Professionals from thirteen primary health care centers (PHC) will randomly invite to participate mild obese or overweight patients of both gender, aged between 25 and 65 years old, who spend 6 hours at least daily sitting. A total of 232 subjects will be randomly allocated to an intervention (IG) and control group (CG) (116 individuals each group). In addition, 50 subjects with fibromyalgia will be included.Primary outcome is: (1) sitting time using the activPAL device and the Marshall questionnaire. The following parameters will be also assessed: (2) sitting time in work place (Occupational Sitting and Physical Activity Questionnaire), (3) health-related quality of life (EQ-5D), (4) evolution of stage of change (Prochaska and DiClemente's Stages of Change Model), (5) physical inactivity (catalan version of Brief Physical Activity Assessment Tool), (6) number of steps walked (pedometer and activPAL), (7) control based on analysis (triglycerides, total cholesterol, HDL, LDL, glycemia and, glycated haemoglobin in diabetic patients) and (8) blood pressure and anthropometric variables. All parameters will be assessed pre and post intervention and there will be a follow up three, six and twelve months after the intervention. A descriptive analysis of all variables and a multivariate analysis to assess differences among groups will be undertaken. Multivariate analysis will be carried out to assess time changes of dependent variables. All the analysis will be done under the intention to treat principle.DiscussionIf the SEDESTACTIV intervention shows its effectiveness in reducing sitting time, health professionals would have a low-cost intervention tool for sedentary overweight and obese patients management.Trial registrationA service of the U.S. National Institutes of Health. Developed by the National Library of Medicine. ClinicalTrials.gov NCT01729936

Évaluation du statut vitaminique dans une population diabétique ambulatoire

Summary Some vitamin deficiencies are more frequent in diabetes. Among them, the deficit in vitamin D has aroused a particular interest for its possible role in the complications and the pathogenesis of the disease. Other deficiencies as that of the vitamin B12 were put in relation to the treatment by biguanide. Objective The goal of this study is to evaluate the concentrations in vitamins D, B12 and B9 in a diabetic outpatients’ clinic and to study the factors influencing the results. Patients and method One hundred and fifty-six patients with diabetes were studied and compared to 48 non-diabetic patients. The dosage of vitamin D, B12, B9 and of glucose was performed in all patients, as well as glycated haemoglobin (HbA1c), creatinine and haemoglobin in diabetic patients. Vitamins concentrations were correlated with several parameters including the type of diabetes, its control, age, sex, treatment, haemoglobin and creatinine. Results No significant difference in vitamin D, B12 and B9 concentrations was found between diabetic patients and controls. Nevertheless, there was a high percentage of patients severely ( P = 0.021 and P = 0.040, respectively). Within the type 2 diabetes, vitamins B12 concentrations were lower in patients treated with biguanide than patients not receiving this treatment. Sex, age, control of diabetes, haemoglobin and creatinine did not significantly correlate with the concentrations of vitamins. Conclusion A high rate of vitamin D deficiency has been highlighted in diabetic outpatients as well as in control patients without an influence of age and sex. Lower vitamin D concentrations were observed in secondary diabetes which could be linked with the malabsorption encountered in pancreatic diseases. Within the diabetic population, biguanide therapy given in type 2 diabetic patients may account for lower vitamin B12 concentrations. Lower vitamin B9 observed in the cardiological group might reflect a relative alimentary insufficiency. A systematic screening for the vitamin status is thus essential in diabetic patients as well in patients with cardiac disease.