Indicators Of Metabolic Control Research Articles

Effectiveness of Educational and Psychoeducational Self‐Management Interventions in Children and Adolescents With Type 1 Diabetes: A Systematic Review and Meta‐Analysis

Aim: Type 1 diabetes (T1D) is one of the most common chronic conditions in children and adolescents. Approximately 1.5 million young people are currently living with T1D throughout the world. Despite recent improvement in overall indices of metabolic control in children and adolescents with T1D, control remains suboptimal and additional approaches are needed. The aim of the study was to conduct a systematic review and meta‐analysis of educational and psychoeducational self‐management interventions, to help optimize future interventions including physical activity support.Methods: A systematic review and meta‐analysis were conducted according to our registered protocol (PROSPERO CRD42022295932) and are reported in line with the PRISMA 2020 guidance. We searched five databases (MEDLINE, EMBASE, PsycINFO [via Ovid], CINAHL [via EBSCO], Cochrane Library) from 1994 up to May 2024. We included randomized controlled trials assessing the effectiveness of self‐management interventions. Outcomes of interest included HbA1c and quality of life (QoL) as well as self‐care behaviors, diabetes knowledge, and self‐efficacy. Meta‐analyses were conducted using a random effects model.Results: In total, 46 papers were included, reporting on 30 interventions. Meta‐analyses showed small short‐term improvements in HbA1c (MD = −2.58 mmol/L, 95% CI −4.44 to −0.71, p = 0.007) and QoL (mean difference [MD] = 1.37, 95% CI 0.19–2.54, p = 0.02). Prespecified subgroup analyses suggested no significant difference in effectiveness of psychoeducational and education‐only interventions. Quality of included studies was low with 27 having a high risk of bias.Conclusion: There is a lack of robust evidence that current self‐management interventions result in clinically meaningful improvements in HbA1c and QoL. Future research should focus on redefining approaches to supporting and encouraging self‐management.

ОЦЕНКА РАСПРОСТРАНЕННОСТИ И СТРУКТУРЫ ХРОНИЧЕСКОЙ БОЛЕЗНИ ПОЧЕК ПРИ САХАРНОМ ДИАБЕТЕ

The incidence of diabetes mellitus has more than doubled over the past ten years. The prevalence of chronic kidney disease is comparable to the prevalence of diabetes mellitus. Chronic kidney disease occurs in diabetes mellitus in 20-40% of cases. The aim of the study was to analyze the prevalence and structure of chronic kidney disease in diabetes mellitus according to the diabetes registry «Polyclinic № 4», Saransk. According to the diabetes registry data, the structure and prevalence of chronic kidney disease in patients with type 1 and type 2 diabetes mellitus, anthropometric indicators, the duration of diabetes mellitus and chronic kidney disease, and indicators of metabolic control of diabetes were analyzed. In the present study, the prevalence of chronic kidney disease was 17% in type 1 diabetes mellitus and 19% in type 2 diabetes mellitus. At the same time, in both types of diabetes mellitus, chronic kidney disease of stage C2 (50% in type 1 and 52% in type 2) and C3 stage (39% in type 2 and 28% in type 1) predominated. type of diabetes). Glycosylated hemoglobin was within the target range in 78% of type 1 diabetic patients and in 83% of type 2 diabetic patients. In patients with diabetes mellitus and chronic kidney disease, it is necessary to intensify hypoglycemic therapy, achieving target indicators of carbohydrate metabolism. The only indicator of the lipid spectrum, which is presented in the registry, was total cholesterol, it is necessary to study the full lipid spectrum.

Continuous Glucose Monitoring (CGM) and Metabolic Control in a Cohort of Patients with Type 1 Diabetes and Coeliac Disease

The association between type 1 diabetes (T1D) and coeliac disease (CD) is well known. Metabolic control of thirty-seven patients aged between 1 and 18 years, with coexisting T1D and CD were evaluated. The control group includes 37 patients affected only by diabetes. All data relating to the metabolic control of all patients were acquired through examination of medical records and CMG reports available on dedicated online platforms. Glucose variability was expressed as Coefficient of Variation (CV) and Standard Deviation of blood glucose values (SD). The formula used for CV computation is: CV (%) = 100 × SD (daily glycemia)/Mean (daily glycemia). Patients with T1D and CD showed a significant reduction in rapid pre-prandial insulin. The same reduction was present if we consider only patients using CGM. In patients without CGM, there was no difference in the doses of basal, pre-prandial and total insulin. Indicators of metabolic control were overlapping between the two groups in patients who used CGM. On the contrary, diabetic and coeliac patients without CGM had increased levels of glycaemic variability indicators and HbA1c. Finally, the percentage of target glycaemic values and >250 mg/dL glycaemic values were significantly decreased and increased, respectively in T1D and CD patients without CGM. With this study we wanted to demonstrate if CGM could improve metabolic control of patients with coexisting T1D and CD. Our data show a worse metabolic control in patients with T1D and CD who did not use CGM. Instead, patients who use CGM, regardless of the concomitant CD, manage to achieve the same glycaemic targets through an adjustment of titration of pre-prandial insulin doses.

Assessment of metabolic control indicators in women of reproductive age with polycystic ovarian syndrome

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Comparison of mothers of adolescents diagnosed with type 1 diabetes mellitus and mothers of healthy adolescents in terms of difficulty in emotion regulation, depression and anxiety levels and clinical variables.

The aim of our study was to evaluate the difficulty in emotion regulation, depression and anxiety levels of mothers with a child diagnosed with type 1 diabetes mellitus (T1DM) compared to mothers of the non- T1DM control group. Our study included 72 adolescents followed up with T1DM and 72 healthy adolescents and their mothers. Psychiatric evaluation of children was performed according to DSM-IV diagnostic criteria. All mothers were administered the `Difficulties in Emotion Regulation Scale-Brief Form (DERS-16)` and the `Hospital Anxiety-Depression Scale (HAD)`. The most common psychiatric diagnoses in the T1DM group were attention deficit and hyperactivity disorder and anxiety disorders. The total and subscale scores of the DERS-16 and HAD scales of the mothers in the T1DM group were significantly higher than the control group. There was a statistically significant positive correlation between the DERS-16 total score and the HAD total and subscale scores of the mothers in the T1DM group. In the multivariate model found to be significant (p < 0.001), only HbA1c levels an indicator of metabolic control, had significant and negative effects on emotion regulation, anxiety and depression (p < 0.05), while sociodemographic characteristics did not have a significant effect (p > 0.05) Conclusions. Difficulty in emotion regulation and depression-anxiety levels were found to be higher in mothers of adolescents with T1DM compared to the control group. Difficulties in emotion regulation, depression and anxiety symptoms in the parent may reduce the treatment compliance of the adolescent with T1DM, which may result in worse metabolic control. Therefore, both adolescents and their parents should be evaluated in terms of psychiatric symptoms and necessary guidance should be given.

Evaluation of the Effect of Pistaciakhinjuk Leaves Billardieri on Metabolic Control and Quality of Life in Type 2 Diabetic Patients Referred to Sedigheh Tahereh Endocrine and Metabolism Center in Isfahan

Background: Type 2 diabetes is a metabolic abnormality that results in increased plasma glucose, glycosylated hemoglobin and decreased quality of life due to decreased insulin secretion. Considering the side effects of chemical drugs, researchers are looking for alternative and complementary methods such as herbal treatments. The aim of this study was to determine the effect of the tea of pistaciakhinjuk plant on the indicators of metabolic control and the quality of life in patients with type 2 diabetes.&#x0D; Methods: On total, 72 patients with type 2 diabetes were randomly divided into 2 groups, intervention and control. The intervention group consumed 240 cc of pistaciakhinjuk leaf tea daily after breakfast and dinner for one month. The control group continued their usual treatment process. Data collection was done with Jacobsen's questionnaire measuring the quality of life in diabetes patients and data analysis was done using descriptive and inferential statistics methods.&#x0D; Results: The independent t-test and also the analysis of variance test with repeated observations showed that the average score of metabolic indicators and quality of life one month and three months after the intervention in the test group was significantly lower than the control group (p value &lt; 0.05).&#x0D; Conclusion: The results showed that there was a statistically significant difference in the experimental group before and after the intervention. This means that pistaciakhinjuk leaves billardieri affected fasting sugar, glycosylated hemoglobin and quality of life in patients with type 2 diabetes.

A comprehensive assessment of neurocognitive and psychological functioning in adults with early-treated phenylketonuria.

Relative to youth with early-treated phenylketonuria (ETPKU), much less is known regarding the cognitive profile of adults with ETPKU. The present study aimed to address this gap by providing a comprehensive assessment of neuropsychological functioning among adults with ETPKU. A sample of 40 adults with ETPKU (ages 18 - 36) and a demographically matched group of 32 healthy individuals without PKU participated. Participants completed a comprehensive neuropsychological battery including the NIH Toolbox, Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II), Conners' Continuous Performance Test (CPT-3), select subtests from the Weschler Adult Intelligence Scale - Fourth Edition (WAIS-IV) as well as several self-report measures of cognitive and psychoemotional functioning. Scores from these tests were combined to create cognitive composites reflecting overall task performance in the areas of verbal ability, visuospatial skills, executive functioning, motor skills, and processing speed. No group differences were observed for full scale IQ or verbal ability. However, individuals with ETPKU demonstrated poorer performance on measures of executive functioning, processing speed, motor skills, and visuospatial skills as compared to the non-PKU group. Within the ETPKU group, recent blood phenylalanine levels (an indicator of metabolic control) were significantly correlated with performance across most cognitive domains and aspects of psychological functioning. Present findings suggest that the neuropsychological profile of adult ETPKU is characterized by circumscribed impairments in select cognitive domains. In addition, the results underscore the importance of maintaining metabolic control across the lifespan in individuals with ETPKU.

Perceived Family Stress Predicts Poor Metabolic Control in Pediatric Patients with Type 1 Diabetes: A Novel Triadic Approach.

Objective Poor metabolic control and low treatment adherence remain major issues for many pediatric patients with type 1 diabetes. Important risk factors for both include psychosocial variables such as stress. To date, stress in type 1 diabetes patients and their parents has been investigated at an individual level. The present study tested the hypothesis that patients', mothers', and fathers' perceived stress is positively related to each other and therefore is a factor common to the family. This factor was then hypothesized to be related to patients' poorer treatment adherence behavior and metabolic control. Research Design and Methods. This cross-sectional study at the University Children's Hospital Zurich included 190 type 1 diabetes patients (age: 7–18 years; illness duration: ≥1 year) and their families. The Perceived Stress Scale was used to measure the self-reported stress of patients, mothers, and fathers. Patients' treatment adherence was rated by their endocrinologists. HbA1c served as indicator of metabolic control. A structural equation model (SEM) was conducted for analysis. Results The SEM showed adequate model fit. Patients' (β = .567, p ≤ .001), mother's (β = .621, p ≤ .001), and father's (β = .585, p ≤ .001) perceived stress loaded all on a single factor, perceived family stress. This factor was significantly associated with treatment adherence (β = −.384, p ≤ .001) and with HbA1c (β = .210, p = .012) of patients. Conclusions Results confirmed perceived family stress to be a common family construct. Because perceived family stress might have a negative impact on patients' treatment adherence and HbA1c, subjective stress appraisals of patients and both parents should be considered when counseling children and adolescents with type 1 diabetes.

Metabolic control during the neonatal period in phenylketonuria: associations with childhood IQ.

In phenylketonuria, treatment and subsequent lowering of phenylalanine levels usually occur within the first month of life. This study investigated whether different indicators of metabolic control during the neonatal period were associated with IQ during late childhood/early adolescence. Overall phenylalanine concentration during the first month of life (total "area under the curve"), proportion of phenylalanine concentrations above upper target level (360 μmol/L) and proportion below lower target level (120 μmol/L) during this period, diagnostic phenylalanine levels, number of days until phenylalanine levels were <360 μmol/L, and lifetime and concurrent phenylalanine levels were correlated with IQ scores of 64 PKU patients (mean age 10.8 years, SD 2.9). Overall phenylalanine concentration and proportion of phenylalanine concentrations >360 μmol/L during the first month of life negatively correlated with IQ in late childhood/early adolescence. Separately, phenylalanine concentrations during different periods within the first month of life (0-10 days, 11-20 days, 21-30 days) were negatively correlated with later IQ as well, but correlation strengths did not differ significantly. No further significant associations were found. In phenylketonuria, achievement of target-range phenylalanine levels during the neonatal period is important for cognition later in life, also when compared to other indicators of metabolic control. In phenylketonuria, it remains unclear during which age periods or developmental stages metabolic control is most important for later cognitive outcomes. Phenylalanine levels during the neonatal period were clearly and negatively related to later IQ, whereas no significant associations were observed for other indices of metabolic control. This emphasizes the relative importance of this period for cognitive development in phenylketonuria. No further distinctions were observed in strength of associations with later IQ between different indicators of metabolic control during the neonatal period. Thus, achievement of good metabolic control within 1 month after birth appears "safe" with respect to later cognitive outcomes.

Relación entre sentido de coherencia y diabetes mellitus: una revisión sistemática

The aim was to synthesize the best scientific evidence on the effect of sense of coherence in disease development, treatment, and biomedical metabolic control indicators, as well as the complications involved for people at risk of developing diabetes and for diabetics. The systematic review method was implemented. Search and selection efforts of two independent reviewers on Scopus, Web of Science, PubMed, Ebsco, Science Direct, and manuals databases, available until 2017, in Spanish and English, of the population aged 18 and over. From a total of 154 studies, 20 articles were included in the systematic review. Over half of the studies used the SOC-13 version to verify the sense of coherence and the most frequent indicator of metabolic control was glycated hemoglobin. In addition to this, 14 of the 20 studies found a statistically significant relationship between sense of coherence and diabetes. It is concluded that the sense of coherence has a strong correlation with diabetes in the different phases of the disease and is related to the reduction of risk for the development of the disease, a reduction of glycated hemoglobin values, and the appearance of diabetes mellitus-related complications.

Continuous Glucose Monitoring in Adults with Type 1 Diabetes: Real-World Data from the German/Austrian Prospective Diabetes Follow-Up Registry.

Background: To analyze key indicators of metabolic control in adults with type 1 diabetes (T1D) using real-time or intermittent scanning continuous glucose monitoring (rtCGM/iscCGM) during real-life care, based on the German/Austrian/Swiss Prospective Diabetes Follow-up (DPV) registry. Methods: Cross-sectional analysis including 233 adults with T1D using CGM. We assessed CGM metrics by gender, age group (18 to <30 years vs. ≥30 years), insulin delivery method (multiple daily injections vs. continuous subcutaneous insulin infusion [CSII]) and sensor type (iscCGM vs. rtCGM), working days versus weekends, and daytime versus night-time using multivariable linear regression models (adjusted for demographic variables) or Wilcoxon signed-rank test. Results: Overall, 79/21% of T1D patients used iscCGM/rtCGM. Those aged ≥30 years spent more time in range (TIR [70-180 mg/dL] 54% vs. 49%) and hypoglycemic range <70 mg/dL (7% vs. 5%), less time in hyperglycemic range >180 mg/dL (38% vs. 46%) and had a lower glucose variability (coefficient of variation [CV] 36% vs. 37%) compared with adults aged <30 years. We found no significant differences between genders. Multivariable regression models revealed the highest Time In Range (TIR) and lowest time with sensor glucose >250 mg/dL, CV and daytime-night-time differences in those treated with CSII and rtCGM. Glucose profiles were slightly more favorable on working days. Conclusions: In our real-world data, rtCGM versus iscCGM was associated with a higher percentage of TIR and improved metabolic stability. Differences in ambulatory glucose profiles on working and weekend days may indicate lifestyle habits affecting glycemic stability. Real-life CGM results should be included in benchmarking reports in addition to hemoglobin A1c (HbA1c) and history of hypoglycemia.

Positive health beliefs are associated with improvement of glycated hemoglobin and lipid profiles in Mexican patients with type 2 diabetes mellitus: a cross-sectional study

BackgroundHealth beliefs are relevant to consider in patients with type 2 diabetes since disease control depends mainly on the patient’s behaviour. The aim of this study was to assess the association between health beliefs and glycated hemoglobin levels in Mexican patients with type 2 diabetes.MethodsAn analytical cross-sectional study was conducted, and 336 patients were included. Fasting blood levels of glycated hemoglobin, glucose, cholesterol; triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) were measured. Body fat percentage, weight, height; waist circumference, and systolic and diastolic blood pressures were also obtained. A previously validated self-administered questionnaire was used to assess the health beliefs with regards to non-pharmacological treatment. Health beliefs were classified as positive, neutral, and negative.ResultsThe average age of patients was 54.7 ± 8.5 years, with a higher proportion of females (69%). The questionnaire had a good internal consistency with a Cronbach’s alpha score of 0.83. More than 90% of patients attributed a health benefit to diet and exercise, 30 to 40% experienced barriers, and more than 80% had a perception of complications associated to uncontrolled diabetes. Patients with positive health beliefs had lower HbA1c levels (8.2 ± 1.7%) compared to those with neutral (9.0 ± 2.3%), or negative (8.8 ± 1.8%; p = 0.042).The LDL-c levels were lower (p = 0.03), and HDL-c levels were higher (0.002) in patients with positive heath beliefs.ConclusionsPositive health beliefs are associated with better metabolic control indicators in patients with type 2 diabetes.

Tip 1 Diyabetli Çocuk ve Adölesanların Diyet Kalitesi, Diyet Asit Yükü ve Glisemik Kontrol ile İlişkisi

Amaç: Artmış diyet kalitesi, Tip 1 Diabetes Mellitus’ta (T1DM) iyi bir metabolik kontrol ve azalmış komplikasyon riski ile ilişkili olabilirken, günümüzde sıkça tüketilen Batı tarzı diyetlerin düşük diyet kalitesi ve yüksek diyet asit yüküne sahip olduğu gösterilmiştir. Bu araştırmada, T1DM’li çocuk ve adölesanların diyet kalitesi ve asit yükünün saptanması ve bu parametrelerin metabolik kontrol ile ilişkisinin değerlendirilmesi amaçlanmıştır.&#x0D; Bireyler ve Yöntem: Araştırmaya, 8-18 yaş arasında 75 T1DM’li ve 88 sağlıklı birey dahil edilmiş ve tüm katılımcıların antropometrik ölçümleri yapılmıştır. Diyet kalitesinin ve asit yükünün saptanabilmesi için 24 saatlik geriye dönük besin tüketim kaydı alınmıştır. Diyet kalitesi, Sağlıklı Yeme İndeksi (SYİ)-2015 ve Türkiye Beslenme Rehberi’ne (TÜBER) göre revize edilen SYİ-2015 ile değerlendirilmiştir. Diyet asit yükünün tahmini ise potansiyel renal asit yükü (PRAL) değeri ve net endojen asit üretimi (NEAP) skoru hesaplanarak yapılmıştır. Metabolik kontrolün göstergesi olarak, son ölçülen HbA1c değerleri kaydedilmiştir.&#x0D; Bulgular: Araştırma sonucunda, T1DM’li grubun diyet kalitesi (SYİ-2015: 50.5±10.2, TÜBER’e göre SYİ-2015: 45.5±9.6) sağlıklı gruptan (SYİ-2015: 43.9±10.7, TÜBER’e göre SYİ-2015: 37.8±10.9) daha yüksek ve diyet asit yükleri daha düşük (diyabetlilerde PRAL: -3.5±20.4, NEAP: 39.3±16.4; sağlıklı PRAL: 9.8±15.0, NEAP: 55.9±21.6 mEq/gün) bulunmuştur (p&lt;0.001). Ayrıca, diyabetik grupta PRAL ve NEAP skorları ile HbA1c düzeyleri arasında pozitif yönde bir ilişki saptanırken, TÜBER’e göre SYİ-2015 toplam puanları ile HbA1c arasında negatif yönde bir ilişki olduğu görülmüştür (p&lt;0.05).&#x0D; Sonuç: T1DM’li çocukların ve ergenlerin diyet kalitesi sağlıklı yaşıtlarından daha iyi olsa da, T1DM’li kişilerin diyet kalitesi önerilen sınıflandırmaya göre hala orta-düşük düzeydeydi. Ayrıca, diyet kalitesinin iyileştirilmesi ve diyet asit yükünün azaltılması, iyi bir metabolik kontrol için faydalı olabilir.

Impact of attention deficit hyperactivity disorder on metabolic control in adolescents with type1 diabetes

ObjectiveDiabetes mellitus type 1 (T1D) incidence is increasing in pediatric population. Good metabolic control, measured by glycated hemoglobin (HbA1c), significantly reduces the risk for chronic complications. Comorbid disorders, including attention-deficit hyperactivity disorder (ADHD), may influence glycemic control. To date little is known about the prevalence of ADHD among adolescents with T1D and its influence on diabetes self-management. Therefore, we aimed to identify adolescents with T1D and ADHD and assess the effect of ADHD on metabolic control. MethodThis cross-sectional case-control study included 101 patients (11–17 years old) with T1D. Development and Well-Being Assessment (DAWBA) questionnaire and subsequent psychiatric clinical examination were used to identify ADHD in a group with T1D. Indicators of metabolic control were collected from available medical documentation for preceding 12 months and compared between the group of patients with T1D and ADHD and the group of T1D patients without ADHD. ResultsADHD was diagnosed in 11.9% adolescents with T1D (12 of 101). We found a statistically significant difference (p = .022) in HbA1c between the two groups – higher in the group with T1D and ADHD (8.4% or 68.3 mmol/mol) than in the group with T1D without ADHD (7.8% or 61.7 mmol/mol). ConclusionsAlmost 12% of adolescents with type 1 diabetes were diagnosed with ADHD and they had poorer glycemic control. Adolescents with T1D and ADHD must be diagnosed early and offered appropriate treatment focused on preventing negative ADHD impact on metabolic control.

Харчування матері як індикатор метаболічного контролю вагітності

Харчування матері як індикатор метаболічного контролю вагітності

Relation between cost of drug treatment and body mass index in people with type 2 diabetes in Latin America.

AimsDespite the frequent association of obesity with type 2 diabetes (T2D), the effect of the former on the cost of drug treatment of the latest has not been specifically addressed. We studied the association of overweight/obesity on the cost of drug treatment of hyperglycemia, hypertension and dyslipidemia in a population with T2D.MethodsThis observational study utilized data from the QUALIDIAB database on 3,099 T2D patients seen in Diabetes Centers in Argentina, Chile, Colombia, Peru, and Venezuela. Data were grouped according to body mass index (BMI) as Normal (18.5≤BMI<25), Overweight (25≤BMI<30), and Obese (BMI≥30). Thereafter, we assessed clinical and metabolic data and cost of drug treatment in each category. Statistical analyses included group comparisons for continuous variables (parametric or non-parametric tests), Chi-square tests for differences between proportions, and multivariable regression analysis to assess the association between BMI and monthly cost of drug treatment.ResultsAlthough all groups showed comparable degree of glycometabolic control (FBG, HbA1c), we found significant differences in other metabolic control indicators. Total cost of drug treatment of hyperglycemia and associated cardiovascular risk factors (CVRF) increased significantly (p<0.001) with increment of BMI. Hyperglycemia treatment cost showed a significant increase concordant with BMI whereas hypertension and dyslipidemia did not. Despite different values and percentages of increase, this growing cost profile was reproduced in every participating country. BMI significantly and independently affected hyperglycemia treatment cost.ConclusionsOur study shows for the first time that BMI significantly increases total expenditure on drugs for T2D and its associated CVRF treatment in Latin America.

Leukocyte telomere length correlates with glucose control in adults with recently diagnosed type 2 diabetes

AimsWe investigated leukocyte relative telomere length (TL) in patients with type 2 diabetes (T2D) diagnosed for no longer than five years and its association with clinical and biochemical variables. MethodsPeripheral blood leukocyte relative TL was investigated in 108 patients with T2D (87 women, 21 men) and 125 (37 women, 88 men) age-matched control subjects with normal glucose tolerance, by quantitative polymerase chain reaction. Multiple linear regression analysis was used to examine the association between relative TL and demographic, anthropometric and biochemical indicators of metabolic control among patients with T2D. ResultsPatients with T2D had a median time since diagnosis of 1 year and most were on metformin monotherapy, with satisfactory glucose control determined by HbA1c levels. Median relative TL was not different between patients with T2D and control subjects. However, multiple linear regression analyses showed that relative TL was inversely associated with time since T2D diagnosis, fasting plasma glucose levels and HbA1c levels, but not with HbA1c levels assessed in the preceding 5–12 months, after adjustment for age, sex and body mass index. ConclusionThis study suggests that relative TL is not shorter in patients with recently diagnosed T2D, but is inversely correlated with glucose levels, even among patients with overall satisfactory glucose control.

P.3.d.022 - Sustained remission and symptom stability in patients with schizophrenia receiving aripiprazole once-monthly: a 52-week, open-label, maintenance study

We investigated leukocyte relative telomere length (TL) in patients with type 2 diabetes (T2D) diagnosed for no longer than five years and its association with clinical and biochemical variables.Peripheral blood leukocyte relative TL was investigated in 108 patients with T2D (87 women, 21 men) and 125 (37 women, 88 men) age-matched control subjects with normal glucose tolerance, by quantitative polymerase chain reaction. Multiple linear regression analysis was used to examine the association between relative TL and demographic, anthropometric and biochemical indicators of metabolic control among patients with T2D.Patients with T2D had a median time since diagnosis of 1 year and most were on metformin monotherapy, with satisfactory glucose control determined by HbA1c levels. Median relative TL was not different between patients with T2D and control subjects. However, multiple linear regression analyses showed that relative TL was inversely associated with time since T2D diagnosis, fasting plasma glucose levels and HbA1c levels, but not with HbA1c levels assessed in the preceding 5–12 months, after adjustment for age, sex and body mass index.This study suggests that relative TL is not shorter in patients with recently diagnosed T2D, but is inversely correlated with glucose levels, even among patients with overall satisfactory glucose control.

Is Community Noise Associated with Metabolic Control in Patients with Cardiovascular Disease?

This study aimed to explore the association between community noise exposure and indicators of metabolic control (blood lipids and glucose) among Bulgarian patients with CVD. A representative cross-sectional sample (\(n = 217\)) was taken from three tertiary hospitals in the city of Plovdiv, Bulgaria. We collected blood samples, anthropometric measurements, and data on sociodemographics, lifestyle, medical conditions, and housing characteristics. A global noise annoyance (GNA) scale was constructed based on different residential noise annoyances. Day-evening-night (\(L_{\mathrm{den}})\) and nighttime (\(L_\mathrm{night})\) road traffic noise levels were determined in a subsample of 132 participants at their living room and bedroom facades, respectively, and further corrected to indoor levels, based on the window-opening frequency, orientation of rooms, and soundproofing insulation. Multilevel linear models were employed to study the effect of these noise indicators on participants’ lipid profile and blood glucose. The most consistent finding was for triglycerides, which increased significantly per one interquartile range increase in GNA (0.26 mmol/l, 95% CI 0.04, 0.47) and per 5 dB increase in outdoor \(L_\mathrm{den}\) (0.24 mmol/l, 95% CI 0.12, 0.35), indoor \(L_\mathrm{den}\) (0.18 mmol/l, 95% CI 0.08, 0.28), and indoor \(L_\mathrm{night}\) (0.08 mmol/l, 95% CI 0.001, 0.16). Outdoor (0.16 mmol/l, 95% CI 0.02, 0.29) and indoor (0.13 mmol/l, 95% CI 0.01, 0.25) \(L_\mathrm{den}\) were associated with an increase in LDL-cholesterol. In sensitivity analyses, we identified several effect modifiers of the relationship between noise and total cholesterol. To conclude, community noise exposure could be an important risk factor for unsatisfactory blood lipid control.

HbA1c levels in patients of acute decompensated heart failure

Background: Hospitalization for Heart Failure (HF) is increasing in India. Diabetes Mellitus (DM) is closely related to HF. Hb1Ac is an index of metabolic control of DM. Hb1Ac is associated with increased risk of Acute Decompensated Heart Failure (ADHF). The relation between Hb1Ac and ADHF is less well defined.Aims and Objectives: The aim of the study was to find out the prevalence of ADHF among patients admitted for cardiac complaints and to investigate Hb1Ac levels in confirmed patients.Materials and Methods: A hospital based study was conducted at NRI Heart Centre, NRI General Hospital, Guntur from May to July 2013 after institutional ethical approval. All patients of ADHF were included in the study. Patients were analysed for HbA1c.Results: Out of 1147 patients admitted in Coronary Care Unit, there were 101 cases of ADHF giving a prevalence of 8.8%. The mean age was found to be 54.69 years. 19.8% of the patients were of age less than 40. There were 74.3% males and 25.7% females. The mean HbA1c in non diabetic, pre-diabetic and diabetic was 5.32%, 6.0% and 8.45% respectively.Conclusion: Elevated HbA1c is associated with increased morbidity in the heart failure and efforts should be made to treat these patients with proven therapies to lower the blood glucose levels.Asian Journal of Medical Sciences Vol.7(4) 2016 55-58