HbA1c In Diabetic Patients Research Articles

The Maximum Threshold Value for HbA1c in Diabetic Patients Undergoing Elective Total Knee Arthroplasty.

To establish an optimal preoperative HbA1c threshold that enhances surgical outcomes and minimises postoperative complications in diabetic patients undergoing elective total knee arthroplasty (TKA). Prospective cohort study. Place and Duration of the Study: Department of Orthopaedics, First People's Hospital of Lianyungang, China, from January 2021 to March 2024. A total of 152 diabetic patients scheduled for elective TKA were included. Data on preoperative HbA1c levels were collected and analysed to assess their impact on postoperative outcomes using the Oxford Knee Score (OKS). Patients were divided into groups based on HbA1c levels and compared for functional and pain recovery one year postoperatively. Statistical analyses included binary and multivariate logistic regression, with an emphasis on the minimum clinically important difference for OKS. Patients with a preoperative HbA1c below 7.35mmol/L exhibited significantly better functional and pain recovery outcomes at one-year post-TKA. The receiver operating characteristic curve (ROC) analysis confirmed the predictive power of HbA1c, with an Area Under the Curve of 0.734 for functional improvement and 0.721 for pain improvement. The study identifies 7.35mmol/L as the optimal preoperative HbA1c threshold for diabetic patients undergoing elective TKA, with lower levels associated with improved functional and pain outcomes. Maintaining HbA1c below this level preoperatively can significantly enhance postoperative recovery and patient satisfaction. Diabetes mellitus, Total knee arthroplasty, Haemoglobin A1c, Oxford knee score.

Correlation between the levels of serum C-reactive protein and plasma glycated HbA1c in diabetic patients and non-diabetic individuals in the western parts of Nepal

Correlation between the levels of serum C-reactive protein and plasma glycated HbA1c in diabetic patients and non-diabetic individuals in the western parts of Nepal

The Relationship of Plasma Glucose Level and HbA1c among Diabetic Patients attending Chitwan Medical College

INTRODUCTION: Type 2 diabetes mellitus is a complex heterogeneous group of metabolic conditions characterized by an increased level of blood glucose, due to impairment in insulin action and/or insulin secretion. Normally the level of HbA1c is less than 6%. HbA1c level reveals the mean glucose level over the previous 10-12 weeks. HbA1c has become a very important part of the management of patients with diabetes mellitus. In addition, the HbA1c is a better indicator of chronic glycemic levels and has a better index to determine the risk for long-term complications as well. So for the screening or diagnosing DM by using glycated hemoglobin (HbA1c) level is very important. The aim of the study was to correlate the plasma glucose level and HbA1c in diabetic patients attending in Chitwan Medical College and Teaching Hospital. MATERIALS AND METHODS: The study was a cross sectional study carried out in Department of Biochemistry in collaboration with Department of Medicine, Chitwan Medical College, Nepal. The standard screening procedures such as fasting blood sugar (FBS), post prandial blood sugar (PPBS) and HbA1c were the parameters taken into account for the research work. RESULTS: It was found that both FBS and PPBG strongly correlated significantly with HbA1c values (r = 0.79, p <0.001 and r = 0.75, p <0.001). CONCLUSIONS: The results suggest that both fasting and postprandial blood glucose significantly correlated with HbA1c. However, our data suggest that HbA1c values may be a weak parameter to identify pre-diabetes cases. HbA1c threshold of ≥ 6.8% can be considered a relatively sensitive marker for the diagnosis of diabetes in the study population.

Cross Sectional Study on Prevalence of Falsely Low HbA1c in Diabetic Patients on Dapsone Therapy

Background : Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels.[1] Objective: The aim of our study was to establish the prevalence of falsely low HbA1c in diabetes patient on dapsone therapy and the possible mechanism behind it. Study design: we conducted a retrospective Cross-sectional study on 30 subjects more than or equal to 18yrs attending the Endocrinology and Dermatology outpatient department (OPD ) ,patients with diabetes mellitus on oral anti diabetic drugs and or insulin therapy on dapsone therapy and patients on documented dapsone therapy for Hansen’s disease or any other skin condition were eligible for enrolment. HbA1c measured by HPLC(high performance liquid chromatography) was compared with expected A1c value suggested by other parameters like fructosamine assay and mean blood glucose. Also other parameters of haemolysis was measured to establish the possible mechanism behind the falsely low A1c. Results: Out of 30 subjects 25 patients were found to have low HbA1c value compared to their fructosamine assay and expected HbA1c. Prevalence of inappropriately low A1c was 25(83.45%) ,16 of them in diabetic group (53.3%) and 9 in non-diabetic group (30.0%).. There were higher number of subjects in discordance group with >2% methaemoglobin with marginally positive correlation .Factors of haemolysis too was higher in more number of subjects [reticulocyte count (18.2%) mcv(90.9)LDH(86.6%)] in discordance Hba1c group compared to cordance HbA1c group but was not statically significant owning to small sample size. Conclusion :The prevalence of falsely low A1c in patient on dapsone therapy was as high as 83.5% and possible reason for this being hemolysis suggesting there are a number of drugs, some of them quite commonly used, which can cause inappropriately high or low HbA1c levels for the degree of glycemia

A study on serum ferritin, C-reactive protein, and its correlation with HBA1c in type 2 diabetes mellitus

Abstract Introduction: Diabetes mellitus is a multifaceted metabolic disorder with impaired glucose status in the human body relative to insulin deficiency. Resistance to its action causes impaired glucose tolerance and hyperglycemia. Serum ferritin and C-reactive protein (CRP) are acute-phase reactants correlated with glycated haemoglobin (HBA1c) in a diagnosed diabetic patient as chronic inflammatory markers. Aim: The study aimed to study the relationship between HBA1c in diabetes patients and inflammatory markers such as serum ferritin and CRP. Materials and Methods: The study group comprised 106 subjects who met the criteria of type 2 diabetes mellitus, an age group between 30 and 90, involving both genders; inclusion and exclusion criteria were added to the study group. Fasting blood sugar, postprandial blood sugar, HBA1c, urine routine, lipid profile, serum ferritin, and CRP were assessed in all study subjects. Data were statistically analyzed and compared the relationship among HBA1c, serum ferritin, and CRP. Results: In this study, 31.1% constituted the age group between 50 and 60. A total of 51.9% were males. A total of 64.2% were on oral hypoglycaemics, and 18% had urine albumin on examination. On Spearman’s rho correlation between serum ferritin and HbA1c, the r value is 0.011, and the P value is 0.911 having a positive correlation. On Spearman’s rho correlation between CRP and HbA1c, the r value is 0.017, and the P value is 0.865 showing a positive correlation. Conclusion: In this study, inflammatory indicators, including serum ferritin and CRP levels, have a positive correlation with HbA1c values, though statistically not significant, showing higher HbA1c values with elevated serum ferritin and CRP levels. Raised inflammatory markers suggest a chronic inflammatory process in a condition or disease such as diabetes mellitus. By measuring these parameters, we can discover essential aspects of screening, the course of diabetes, its complications, and prevention.

Associations between adoption of eHealth management module and optimal control of HbA1c in diabetes patients

In January 2021, the eHealth App was launched in Hong Kong by the Hong Kong government to support the Electronic Health Record Sharing System (eHRSS). A Health Management Module in the eHealth App introduced new functions to record blood pressure, blood sugar, and heart rate, and downloading and sharing records. This study aims to compare the level of glycaemic control between users of the eHealth App and non-users. Type 2 diabetes patients who have joined the eHRSS with existing haemoglobin A1c (HbA1c) level records are recruited. Correlations between predictors and optimal HbA1c control (<7%) are examined using logistic regression analyses. A total of 109,823 participants are included, with 76,356 non-users of eHealth App, 31,723 users of eHealth App, and 1744 users of the eHealth Management Module together with the App. We collect HbA1c values from Jan 2021 to May 2022, and they are 6 months after the use of the App on average. Users of the eHealth Management Module are found to have more optimal HbA1c levels across all subgroups, with the strongest effect observed in younger females (aOR = 1.66, 95% CI = 1.27–2.17). eHealth App usage is also positively associated with optimal HbA1c levels, particularly amongst younger females (aOR = 1.17, 95% CI = 1.08–1.26). Overall, users of eHealth App and eHealth Management Module demonstrate more optimal HbA1c levels when compared with non-users, particularly among younger adults and females. These findings support its potential adoption in diabetes patients. Future studies should examine the impact of eHealth interventions on other clinical targets and diabetes complications.

TO KNOW THE ASSOCIATION OF PLATELET ACTIVITY ON GLYCEMIC STATUS AND VASCULAR COMPLICATIONS IN DIABETES MELLITUS

Background: Diabetes mellitus is a global pandemic disease. Hyperglycemia contributes to greater platelet reactivity through direct effects and by promoting glycation of proteins. Mean platelet volume(MPV) and Mean platelet count(MPC) is an indicator of average size and activity of the platelets and is high in diabetes mellitus. Objectives: 1) To nd the association between MPC and MPVwith HBA1C in diabetic patients. 2) To nd the association of MPC and MPV with vascular complications in diabetic patients. Methodology: A retrospective study conducted in the Department of Pathology from January 2021 to June 2021. Data was collected from backbone stored in digital form. Sample size : 92 diabetic patients and are divided into 2 groups. 1) Group 1: HbA1c &lt;7. 2) Group 2: HbA1C ≥7. Platelet count, MPV, HbA1c values and vascular complications were analyzed. Results: Out of 92 diabetic patients 74 had vascular complications. MPC in group 1 and group 2 was found to be 231.727 and 312.346 respectively with signicant p value of 0.036 and mean difference of -80.6184. MPV in group 1 and group 2 was found to be 10.200 and 9.999 respectively which showed no signicant correlation with p value of 0.528 and mean difference of 0.2012. The MPC and MPV in diabetic patients with complications were 332.056 and 10.239 respectively showing no signicant correlation. Conclusion: MPC and MPV were found to be raised in group 2. MPC between the 2 groups showed statiscally signicant difference. However MPV does not show any signicance between the two groups. Though there was no signicant difference between Platelet count and vascular complication, MPVwas higher in patients with complications. Diabetic patients suffer mostly from vascular complications, therefore platelet count and HbA1c can be a useful prognostic marker of vascular complications in diabetics.

Performance Evaluation of a New Fluorescent-Based Lateral Flow Immunoassay for Quantification of Hemoglobin A1c (HBA1c) in Diabetic Patients

Rapid hemoglobin A1C (HbA1c) level monitoring is essential in slowing the progression of diabetes. This need becomes challenging in low resources countries where the social burden of the disease is overwhelming. Recently, fluorescent-based lateral flow immunoassays (LFIAs) gained wide attention for small laboratories and population surveillance. We aim to evaluate the performance of Finecare™ HbA1c Rapid Test, certified by CE, NGSP, and IFCC, for the quantitative measurement of hemoglobin A1C (HbA1c) along with its reader. A total of 100 (fingerstick and venepuncture whole blood) samples were analyzed by Wondfo Finecare™ HbA1c Rapid Quantitative Test and the results were compared with the reference assay Cobas Pro c503. A strong correlation was observed between Finecare™/Cobas Pro c503 with fingerstick (r > 0.93, p < 0.0001) and venous (r > 0.97, p < 0.0001) blood samples. Finecare™ measurements showed excellent agreement and compliance with Roche Cobas Pro c503 as the mean bias was negligible; 0.05 (Limits-of-agreement: -0.58-0.68) with fingerstick and 0.003 (Limits-of-agreement: -0.49-0.50) with venous blood. Interestingly, a very small mean bias (0.047) was also shown between the fingerstick and the venepuncture data, indicating that the type of sample used does not affect the results and the high reproducibility of the assay. Finecare™ showed 92.0% (95% CI: 74.0-99.0) sensitivity and 94.7% (95% CI: 86.9-98.5) specificity compared to the Roche Cobas Pro c503 using fingerstick whole blood samples. Finecare™ showed 100% (95% CI: 86.3-100) sensitivity and 98.7% (95% CI: 92.8-100) specificity compared to the Cobas Pro c503 using venepuncture samples. Cohen's Kappa denoted excellent agreement with Cobas Pro c503; 0.84 (95% CI: 0.72-0.97) and 0.97 (95% CI: 0.92-1.00) using fingerstick and venous blood samples, respectively. Most importantly, Finecare™ showed a significant difference between normal, pre-diabetic, and diabetic samples (p < 0.0001). Similar results were obtained when an additional 47 samples (from different participants; mainly diabetic) were analyzed in a different lab using different Finecare™ analyzer and different kit lot number. Finecare™ is a reliable and rapid assay (5 min) which can be easily implemented for long-term monitoring of HbA1c in diabetic patients, particularly in small laboratory settings.

Assessment of serum Pentraxin3 level in Iraq patients with and without Diabetic Retinopathy

Diabetic retinopathy is the main cause of vision loss worldwide. It is considered one of the most severe diabetic microvascular complications affecting the retina's blood vessels due to prolonged hyperglycemia. Pentraxin 3 is an acute-phase glycoprotein that is correlated with inflammation. Inflammation is mechanistically involved in the development of diabetic retinopathy. This study aims to measure serum pentraxin3 levels in type 2 diabetic patients with and without retinopathy and compare their levels to controls. Also, investigate the relationship between circulating pentraxin3 and the development of diabetic retinopathy. This case–control study included one hundred and twenty (120) individuals aged 40 to 70 years. Individuals were divided into 3 groups: Group 1 included 40 types 2 diabetic patients with retinopathy, group 2 included 40 type 2 diabetic patients without retinopathy and group 3- included 40 persons as controls. Significant increase in the mean value of serum pentraxin3 in the diabetic patient with retinopathy as compared to diabetic patients with and without retinopathy as compared to and control(p=0.000) as well as a significant increase in the mean value of serum pentraxin3 in the diabetic patient with retinopathy as compared to diabetic patients without retinopathy (p=0.000). In addition, a significant positive correlation was found between serum pentraxin3 level and HbA1C in diabetic patients with retinopathy group (r=0.936, p= 0.0001). Higher serum level of pentraxin 3 in diabetic patients with retinopathy and its association with poor glycemic control, as well as pentraxin 3, is an acute-phase reactant, so serum pentraxin 3 levels may have a significant role in the initiation and development of diabetic retinopathy. Keywords: diabetes mellitus, diabetic retinopathy, pentraxin‑3.

Changes in clinic visits and diabetes and metabolic control in patients with type 2 diabetes during COVID-19 pandemic: A real world evidence

PurposeThe study aim was to evaluate the effects of public lockdown during the covid-19 pandemic on glucose and metabolic parameters as well as body weight control in type 2 diabetic patients. MethodsThis study was conducted in two outpatient Diabetes Clinics and analyzed data available in database of Diabetes Clinic. Data related to a year before covid-19 pandemic and a year during covid-19 pandemic was collected from the database and analyzed. Patients with type 2 diabetes included in the analysis if they had referred to Diabetes Clinics both before and during covid-19 pandemic. Demographic information and data about metabolic status were collected from the records of previous outpatient Clinic visits and compared ResultsFinally 9440 patients with mean age of 61.08 ± 11.62 referred to Diabetes Clinics in both the year before and the year of the corona pandemic. Mean FBS and HbA1c in diabetes patients reduced significantly from 155.37 ± 62.93 and 7.97 ± 1.74 before pandemic, respectively to 138.77 ± 45.39 and 7.54 ± 1.34, respectively during covid-19 outbreak. During covid-19 pandemic, all metabolic parameters including glycemic and lipid profile (except for triglyceride) and BMI (body mass index) reduced significantly statistically, but, these changes were not clinically significant. However, triglyceride level increased statistically significantly but again it was not significant clinically. ConclusionDuring COVID-19 lockdown, glycemic and metabolic control of diabetes patients have improved significantly except for triglycerides.

Evaluation of patient profiles, treatment paradigms and clinical efficacy, and safety outcomes in adult patients with vitamin D deficiency or insufficiency in India: A multicenter, prospective, non-interventional study

Background: Nationwide studies assessing sociodemographic factors associated with poor vitamin D status and efficacy-safety of vitamin D supplementation in Indian clinical practice are limited. Methods: In this multicenter, prospective, non-interventional study, patients with vitamin D deficiency (25[OH]D &lt;20 ng/mL)/insufficiency (25[OH]D 21-29 ng/mL) were enrolled at 9 sites across India and prescribed vitamin D supplements per routine practice. Primary endpoints were patient profiles associated with vitamin D deficiency/insufficiency and change in visual analog scale (VAS) scores for clinical signs/symptoms from baseline to weeks 4 and 8. Key secondary endpoints were prescription pattern of vitamin D supplements and incidence of adverse drug reactions (ADRs)/serious ADRs. Change in systolic/diastolic blood pressure (SBP/DBP [hypertensive patients]) and glycated hemoglobin (HbA1c [diabetic patients]) were assessed from baseline to weeks 8 and 12, respectively. Paired t test was used to assess statistical significance, except for patient profile association, where analysis of variance model was used. Results: Of 201 enrolled patients (mean [standard deviation] age: 43.4 [14.52] years), 61.7% were women. Most demographic and anthropometric factors, except for current sunscreen use (p=0.0297) and socioeconomic status (p=0.0222), were not significantly associated with vitamin D deficiency/insufficiency. Upper-lower class had significantly higher odds (p=0.033) for vitamin D deficiency versus insufficiency versus lower class. Most of the patients were prescribed 60000 IU/week orally. VAS scores for bone and lower back pain, bone loss, low bone mineral density, and muscle pain were significantly reduced at weeks 4 and 8 (p&lt;0.001). SBP/DBP of hypertensive patients and HbA1c of diabetic patients were also significantly decreased (p&lt;0.05). No ADRs/serious ADRs were observed. Conclusion: Sunscreen use and socioeconomic status were significantly associated with vitamin D deficiency/insufficiency. Vitamin D supplementation improved clinical symptoms, HbA1c levels (diabetic patients), and SBP/DBP (hypertensive patients), without any adverse safety outcomes. Nevertheless, studies with long-term follow-up and larger sample sizes are warranted.

Impact of Insulin, Biguanide and Sulfonylurea Treatment on hba1c in Diabetic Patients: An Interventional Study in Rajshahi, Bangladesh

Proper management and selection of a single drug or multiple drugs for the treatment of diabetes is very important. The choice of treatment depends on a number of factors. With the proper treatment, the state of diabetes can be managed very smoothly. The main objective of this study was to compare the efficacy of insulin, biguanides and sulfonylurea on HbA1C in diabetic patients. This interventional type of study was carried out among 102 diabetic patients attending at different hospitals in Rajshahi of Bangladesh. In this case purposive sampling technique was followed and data revealed that mean age of the patients was 45.98±11.23 years and most of them (35.30) were housewife. Among the insulin receiving group, 41.18% were male and 58.82% were female. In case of the biguanide receiving taking group 44.12% were male and 55.88% were female while for the sulfonylurea receiving group 35.29% were male and 64.71% were female. Regarding body mass index (BMI) among the respondents, it was found that 0.98% had BMI &lt;18.50 kg/m2, led sedentary lifestyle (65.7%), most of them were from urban area (67.6%) and non-smoker (86.0%) with family history of type 2 diabetes mellitus (T2DM) (17.0%). In the insulin receiving group, 82.35% had desired glycemic control; in the biguanide receiving group, 73.53% had desired glycemic control; and in the sulfonylurea receiving group, 64.71% had desired glycemic control. Data shows that the insulin receiving patients had relatively better glycemic control as compared to the other two mendicant receiving groups at 6th month. This finding suggests that the selection of the best drug is the most key part of the treatment of T2DM. Therefore, this study would help to select the best choice of drug for the treatment of diabetes in Bangladesh. J Bio-Sci. 30(1): 123-130, 2022 (June)

Effectiveness of a web-based program on self-care behaviors and glycated hemoglobin in patients with type 2 diabetes: Study protocol of a randomized controlled trial.

Type 2 diabetes (T2DM) decreases the life expectancy and quality of life of diabetics and causes economic and societal problems. For this purpose, diabetes self-management education and support (DSMES) has been designed for many years, which is recently provided through technology-assisted education. Therefore, we developed a web-based program in accordance with DSMES to assess its effect on self-care behaviors and glycated hemoglobin (HbA1c) for patients with T2DM during the coronavirus disease (COVID-19) pandemic, which is described in detail in this paper. This randomized controlled trial (RCT) was performed on 70 diabetic patients in Al-Zahra Hospital for three months. After random allocation, web-based educational content (including videos, lectures, educational motion graphics, text files, educational posters, and podcasts) according to DSMES was provided for the intervention group to improve self-care behaviors and HbA1c levels. The control group received routine educational pamphlets. A diabetes self-management questionnaire (21 questions) with a Likert scale was completed to assess self-care behaviors scores before and after intervention and three months later. Also, HbA1c was determined before and after the intervention. Analysis of variance with repeated measurements will be applied to compare mean scores of self-care behaviors components three times, and an independent t-test analyzed mean differences of HbA1c values. The obtained results of this study might be useful for promoting self-care behaviors and assessing HbA1c in diabetic patients.

A Study of Thyroid-Stimulating Hormone in Patients with Type 2 Diabetes Mellitus

Background: Diabetes and thyroid dysfunctions are closely related to endocrine disorders. Research has shown that there is a clear connection between hyperinsulinemia, insulin resistance, increased glycated haemoglobin (HbA1c) levels, and abnormal thyroid function. Hypothyroidism is relatively common in diabetic patients, particularly in those with suboptimal glycemic control. As a result, screening for thyroid dysfunction in diabetic patients can aid in the early identification and treatment of hypothyroidism, potentially reducing the risk of complications associated with the condition. Objectives: Correlation of TSH and HbA1c in diabetic patients. Materials and Methods: This hospital-based cross-sectional study was conducted in the Department of Medicine, Assam Medical College, Dibrugarh, between February 2022 and February 2023. A total of 120 patients with diabetes attending the department without any prior history of thyroid disease or any factor that may affect thyroid function were included in this study. Thyroid-stimulating hormone (TSH) and HbA1c were done in all subjects. Results: The result showed that the mean age was 57.68 years with female preponderance (58.33%) and increased mean levels of HbA1c (7.8850%) and TSH (13.566 micro IU/mL). In our study, the mean serum TSH level was significantly higher in uncontrolled diabetes than that in controlled diabetes patients. HbA1c also showed a positive correlation (r = 0.574; P &lt; 0.001) with thyroid abnormality. Conclusions: Conducting thyroid function screenings on diabetic patients can aid in the identification of asymptomatic hypothyroid patients. Early detection of underlying thyroid dysfunction facilitates timely treatment, which may enhance glycemic control and ultimately improve the quality of life for diabetic patients.

TYPE 2 DIABETES MELLITUS PATIENTS WITH AND WITHOUT HYPERTENSION: XANTHINE OXIDASE ACTIVITY AND URIC ACID CONCENTRATION

A metabolic condition known as type 2 diabetes mellitus (T2DM) has spread all over the world. Pancreatic insulin resistance and β-cell dysfunction are its defining features. In 2021, almost 537 million people worldwide had diabetes. The prevalence of hypertension (HTN) in T2DM more than 50% result from uncontrolled blood glucose. The prevalence of microvascular and macrovascular complications in T2DM with HTN, more common than in those without HTN. Hyperglycemia is related to overproduction of reactive oxygen species (ROS) and oxidative stress (OS). The etiology of metabolic disorders is associated with OS. On the other hand, OS increases the risk of cardiovascular disease (CVD) by causing endothelial dysfunction. An important source of ROS is xanthine oxidase (XOD), while uric acid (UA) has two properties: pro- oxidant and antioxidant. Sixty T2DM patients with and without hypertension participated in this research. These patients were compared to a control group of thirty people. Lipid profile, XOD and UA were determined in this research. The results of the study showed a significant increase in XOD and UA values in T2DM patients compared to controls. The elevated OS agents and lipids biomarkers mainly in T2DM group could contribute to increasing cardiometabolic risks and weakening the overall health status of the participants. Triglyceride (TG), total cholesterol (TC), LDL-c and HDL-c abnormalities are risk factors of CVD. Dyslipidemia and elevated HbA1c in diabetic patients can be considered as a very high-risk group for CVD.

Interaction of sex and diabetes on the association between hemoglobin glycation index, hemoglobin A1c and serum uric acid

BackgroundHemoglobin glycation index (HGI), which is calculated by blood glucose and hemoglobin A1c(HbA1c), reflects the individual discrepancy in HbA1c. This study aimed to investigate the association between HGI/HbA1c and serum uric acid(SUA) stratified by sex and diabetes.MethodsThe study recruited 33772 participants who underwent physical examinations between April 2016 and August 2021 in Beijing Chao-Yang Hospital. A random subsample of 3000 subjects was utilized to calculate the formula of HGI and data of the remaining 30772 participants were used for analysis. HGI and HbA1c were categorized according to quartiles (Q1, Q2, Q3, Q4), using Q1 as the reference. We used multiple linear regression and restricted cubic splines for data analysis.Results30772 participants with a mean age of 44.4 years old were included in the analysis, 48.6% (N = 14944) of which were female and 7.7% (N = 2363) with diabetes. Associations of HGI, HbA1c and SUA were modified by sex and diabetes. The relationship between SUA levels and HGI was positive in women without diabetes, with one unit increase in HGI associating with an 11.3 μmol/L increase in SUA (P < 0.001) after adjusting for other confounders. On average, each one-unit increase in HbA1c was associated with a 14.3 μmol/L decrease in SUA in women with diabetes, a 14.9 μmol/L decrease in SUA in men with diabetes, and a 16.5 μmol/L increase in SUA in women without diabetes (all P < 0.001). The SUA levels in men without diabetes showed a bell-shaped relation with HbA1c, increasing as the HbA1c rose to around 5.7% and then falling with a further increase of HbA1c (P < 0.001).ConclusionsSUA levels were inversely correlated with HbA1c in diabetic patients, also in men with prediabetes (HbA1c ≥ 5.7%), but positively correlated with HbA1c and HGI in women without diabetes. Glycemic control may help to reduce the risk of hyperuricemia in non-diabetes women.

Average HbA1c in Diabetic Patients in Southern KPK-Pakistan

Abstract Diabetes mellitus is a complex metabolic syndrome characterized by either insulinopenia or insulin resistance. This study is focused on the ever-growing prevalence of diabetes mellitus and its poor glycemic control in southern KPK This descriptive cross-sectional study was conducted at the outdoor unit, Department of medicine DHQ hospital Bannu, over six months, extending from 30th December 2021 to 30th June 2022. The sample size was 91 and was calculated using the standard WHO formula. The confidence interval used was 95%, with a 5% margin of error. P value &lt;0.05 was taken as statistically significant. Consecutive non-probability sampling technique was applied. Diabetic patients under treatment below 70 years were included in the study. HbA1c was used as an assessment tool for glycemic control and divided into three categories: good glycemic control with HbA1c&lt;7%, poor glycemic control with HbA1c&gt;9%, and very poor glycemic control with HbA1c&gt;10%. Data was entered and analyzed using SPSS version 19.0.About 18.6% diabetic patients had HbA1c&gt;6%, 25.6% patients had HbA1c between6-8%, 26.7 % patients had HbA1c between 8-10% and 29.6 % had HbA1c&gt;10%.This study revealed that the majority (55%) of diabetic patients belonging to southern KPK had poor glycemic control, as revealed by HbA1c, more than 8%.

Correlation between HbA1c and carotid artery intima-media thickening(cIMT) in diabetic patients

Introduction: Correlation between carotid artery intima-media thickening and HbA1c levels in diabetic patients as a non invasive marker of progressive atherosclerosis. Objectives: The aim of this study is to study the role of two non invasive markers, carotid intima media thickening and HbA1c in diabetic patients and establish the usefulness of both the parameters in evaluating early risk factor assessment. Material and methods: 100 patients meeting the required criteria were taken coming to OPD/IPD bases to Dhiraj hospital in the age group of 35-70 years.HbA1c levels were used according to American diabetes association. Carotid intima media thickening was measures on B mode ultrasonography in radiology department. Results: among the 100 patients, 68 patients were female and 32 patients were male. The mean of HbA1c values were 8.0 ± 2.2%. The mean cIMT values were 0.78 ± 0.3 cm. Conclusion: HbA1c and carotid artery intimal thickness is useful as a diagnostic marker and early risk factor analysis for atherosclerotic changes in diabetic patients.

Effect of Vitamin C Adjuvant Therapy on Lipid Profile in Diabetes patients with Co-Morbid Cardiovascular Disease

The study was aimed to evaluate the effect of Vitamin C adjuvant therapy significantly on lipid profile and HbA1c in diabetes patients with co-morbid cardiovascular disease.A total of 64 diabetic patients were enrolled by using a randomization procedure and assigned to control group and an intervention group.Patients in the intervention group received Vitamin C 500mg bid supplementation along with antidiabetic and antihyperlipdemic therapy as per the standard treatment protocol for a period of three months, whereas patients in the control group received only antidiabetic and antihyperlipidemic therapy for a period of three months. The mean age, BMI, duration of diabetes, of the subjects were 50.04±14.58, 27.94±4.71 and 9.93±4.83 respectively. The incidence of elevated CRP was found to be 68%. No statistically significant difference for any variable of comparison of glucose, lipid parameters and CRP was detected at baseline. There was a reduction in levels of clinical variables found after 3 months of daily use of vitamin C 500mg bid in the intervention group. Based on the results of this study concluded that Vitamin C as an adjuvant therapy produces beneficial effect in type 2 diabetes patients. Vitamin C 1g/day showed improved lipid profile which helps in cardiovascular risk mitigation.

C77 EFFECT OF SACUBITRIL/VALSARTAN ON BOTH METABOLIC PARAMETER AND INSULIN RESISTANCE IN NON OBESE NON DIABETIC PATIENTS WITH HEART FAILURE

Abstract Background Sacubitril/Valsartan has been shown to improve mortality and reduce hospitalizations in patients with heart failure with reduced ejection fraction (HFrEF). Moreover Sacubitril/Valsartan showed a significantly reduction in the HbA1c in diabetic patients. The effect of Sacubitril/Valsartan on metabolic parameter and insulin resistence in both, non obese and non diabetic patients, have not been previously described. Aim We evaluated the effects of the Sacubitril/Valsartan on both glycaemic and metabolic parameter, on HOMA–IR and on echocardiographic parameters in patients with HFrEF. Methods A total of 59 non obese and non diabetic patients with a diagnosis of HFrEF (EF &amp;lt; 35%) have been enrolled. All the patients underwent a complete anthropometrical evaluation, laboratory determinations (including fasting glucose, fasting insulin, HbA1c) and echocardiogram evaluation. Data analysis was made after 24 weeks of treatment. The insulin resistance has been assessed by HOMA–IR. Results Data analysis demostrated a significant reduction in fasting plasma glucose (111.4 + 11.5 vs 106 + 10 mg/dl, P = 0.03), fasting plasma insulin (13.6 + 5.9 vs 10.5 + 4.4 µUI/ml), HbA1c value (6.14 + 0.5% vs 5.9 + 0.3%, P &amp;lt; 0.01) and insulin resistance (HOMA–IR, 3.74 + 2.2 vs 2.7 + 2.1, P = 0.03). The echocardiogram evaluation showed a significant reduction of the end–diastolic left ventricular volume (168 + 44 vs 150 + 38 ml, P &amp;lt; 0.05), a no significant reduction of the end–systolic left ventricular volume (98 + 26 vs 88 + 22 ml, P = 0.07), a significant reduction of E/e1 ratio and an average 7.8% increase in ejection fraction (EF), from a mean baseline of 32.3 + 2.4 to 40.1 + 3.8% (P &amp;lt; 0.0001). No differences in interventricular septal (IVS) thickness, posterior wall (PW) thickness, A–wave, E–wave and E/A ratio have been observed. No differences in anthropometrical parameters (weight, body mass index, waist circumference) and blood pressure were observed. Conclusions Our data, even if preliminary, seem to indicate that sacubitril/valsartan might enhance glycaemic control and improve insulin resistance in non obese/non diabetic patients with HFrEF. Also, our data confirm that sacubitril/valsartan treatment is able to improve ejection fraction in HFrEF patients.