Initial Fasting Plasma Glucose Research Articles

8814 Concordance in Defining Diabetes Remission: A Comparative Analysis of HbA1c, eA1c, and FPG Criteria After One Year of Digital Twin (DT) Intervention

Abstract Disclosure: P. Shamanna: None. M. Dharmalingam: None. A. Vadavi: None. A. Keshavamurthy: None. S. Bhonsley: None. M. Thajudeen: None. A. Balasubramanian: None. S.R. Joshi: None. Introduction: This study investigates the concordance among HbA1c, estimated A1c (eA1c), and fasting plasma glucose (FPG) remission criteria following one year of Digital Twin (DT) intervention. Understanding the agreement of these criteria in a cohort of 209 patients is critical for evaluating diabetes treatment efficacy. Methods: Diabetes remission was assessed in 209 patients after one year of DT intervention, using HbA1c, eA1c, and FPG criteria. Kappa values, along with sensitivity, specificity, and p-values, were calculated for concordance. Mean, standard deviation, and p-values for age, duration of diabetes, HbA1c, fasting plasma glucose, and eA1c were also computed. Results: The study revealed substantial agreement between HbA1c and eA1c criteria (Kappa: 0.751, indicating 'substantial' agreement), HbA1c and FPG criteria (Kappa: 0.703, indicating 'substantial' agreement), and eA1c and FPG criteria (Kappa: 0.719, indicating 'substantial' agreement), post one year of DT intervention. The average age of participants was 43.89 years (±8.72), with a diabetes duration of 3.65 years (±2.66). The initial HbA1c was 9.02% (±1.90), reducing to 6.00% (±0.67) at the end of the study. Initial and final fasting plasma glucose levels averaged 170.75 mg/dL (±61.11) and 109.33 mg/dL (±30.60), respectively. Remission rates were 72.73% for HbA1c, 75.60% for eA1c, and 71.29% for FPG. Conclusion: Our findings suggest that remission using either eA1c or FPG criteria can be reliably compared to the gold standard HbA1c criteria, with all showing 'substantial' agreement post one year of DT intervention. This high concordance, reflected in the statistically significant kappa values, highlights the effectiveness of eA1c and FPG criteria as robust tools in assessing diabetes remission alongside the HbA1c criteria. These insights are crucial for clinical practice and diabetes research, offering flexibility in evaluating patient outcomes. Presentation: 6/1/2024

Early vs. Late Gestational Diabetes: Comparison between Two Groups Diagnosed by Abnormal Initial Fasting Plasma Glucose or Mid-Pregnancy Oral Glucose Tolerance Test.

Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. It may be diagnosed using a fasting plasma glucose (FPG) early in pregnancy (eGDM) or a 75-g oral glucose tolerance test (OGTT) (late GDM). This retrospective cohort of women with GDM presents data from 1891 patients (1004 in the eGDM and 887 in the late GDM group). Student's t-test, chi-squared or Fisher's exact test and the Bonferroni test for post hoc analysis were used to compare the groups. Women with eGDM had higher pre-pregnancy BMI, more frequent family history of DM, more frequent history of previous GDM, and were more likely to have chronic hypertension. They were more likely to deliver by cesarean section and to present an abnormal puerperal OGTT. Even though they received earlier treatment and required insulin more frequently, there was no difference in neonatal outcomes. Diagnosing and treating GDM is necessary to reduce complications and adverse outcomes, but it is still a challenge. We believe that women with eGDM should be treated and closely monitored, even though this may increase healthcare-related costs.

The correlation between the prevalence of gestational diabetes mellitus and maternal age in Southern China

Abstract Objectives The present study aimed to survey the prevalence of gestational diabetes mellitus (GDM) in Southern China and further to analyze the correlation between the prevalence of GDM and maternal age. Methods A retrospective cross-sectional study was carried out at the Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, China between January and April 2020. Oral glucose tolerance tests (OGTT) was performed, using a 75 g glucose load and venous samples were drawn at 0 h, 1 h and 2 h at 24–28 weeks of gestation. GDM was diagnosed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Results The prevalence of GDM was 14.87% by IADPSG criteria. The incidence of GDM outcome increased and plasma glucose levels remained high among the age subgroups (<20, 20–24, 25–29, 30–34, 35–39, ≥40 years old) in pregnant women. Moreover, the levels of plasma glucose levels after OGTT kept rising among the pregnant women with non-gestational diabetes mellitus (non-GDM). Furthermore, pregnant women were inclined to have abnormal plasma glucose values at 1 h and 2 h than initial fasting plasma glucose (FPG) after OGTT as the age increased. Conclusions Our findings demonstrate that the incidence of GDM outcome and plasma glucose levels increase as the maternal age increase.

Prognosis associated with initial care of increased fasting glucose in early pregnancy: A retrospective study

AimTo evaluate whether the initial care of women with fasting plasma glucose (FPG) levels at 5.1–6.9mmol/L before 22 weeks of gestation (WG), termed ‘early fasting hyperglycaemia’, is associated with fewer adverse outcomes than no initial care. MethodsA total of 523 women with early fasting hyperglycaemia were retrospectively selected in our department (2012–2016) and separated into two groups: (i) those who received immediate care (n=255); and (ii) those who did not (n=268), but had an oral glucose tolerance test (OGTT) at or after 22 WG, with subsequent standard care if hyperglycaemia (by WHO criteria) was present. The number of cases of large-for-gestational age (LGA) infants, shoulder dystocia and preeclampsia with initial care of early fasting hyperglycaemia were compared after propensity score modelling and accounting for covariates. ResultsOf the 268 women with no initial care, 134 had hyperglycaemia after 22 WG and then received care. Women who received initial care vs those who did not were more likely to be insulin-treated during pregnancy (58.0% vs 20.9%, respectively; P<0.00001), gained less gestational weight (8.6±5.4kg vs 10.8±6.1kg, respectively; P<0.00001), had a lower rate of preeclampsia [1.2% vs 2.6%, respectively; adjusted odds ratio (aOR): 0.247 (0.082–0.759), P=0.01], and similar rates of LGA infants (12.2% vs 11.9%, respectively) and shoulder dystocia (1.6% vs 1.5%, respectively). When initial FPG levels were ≥5.5mmol/L (prespecified group, n=137), there was a lower rate of LGA infants [6.7% vs 16.1%, respectively; aOR: 0.332 (0.122–0.898); P=0.03]. ConclusionTreating women with early fasting hyperglycaemia, especially when FPG is ≥5.5mmol/L, may improve pregnancy outcomes, although this now needs to be confirmed by randomized clinical trials.

1476-P: Progression to Type 2 Diabetes from Normal or Impaired Fasting Glucose

The interaction of anthropometric variables with fasting blood glucose on progression from normal fasting glucose to overt diabetes (DM), is uncertain. In the Rochester Epidemiology Project (MN, USA), we identified 44,992 individuals with ≥ 2 fasting plasma glucose (FPG) tests from 2005-17, after excluding people who met criteria for DM (FPG &amp;gt; 125mg/dL) on/before their first FPG. The cohort was 58% female, had an age range of 18-65 yrs (44 ± 10, Mean ± SD) and BMI of 29 ± 7 kg/m2. Subjects who did not develop DM were censored at their last FPG value on/before Dec 31, 2017. Those who developed DM were assigned an event date as the first diagnostic value. Over a median follow-up of 7 yrs, 3888 (8.6%) developed DM. The Kaplan-Meier 10-year cumulative risk of incident DM was 12.8% (CI 12.4%-13.3%). As expected, multivariable Cox modeling identified elevated initial FPG [100-109mg/dL (HR 2.0; 1.9-2.2); 110-125mg/dL (HR 5.8; 5.4-6.3)] as conferring increased risk. Other independent risks were male sex (HR 1.30; 95% CI 1.22-1.38) and abnormal BMI [&amp;lt;18 kg/m2 (2.67; 1.96-3.63), 25-29.9 kg/m2 (1.37; 1.23-1.52), 30-34.9 kg/m2 (2.15; 1.92-2.39), ≥ 35 kg/m2 (3.59; 3.23-3.99)]. A very strong, nonlinear, age effect was also noted, with a fitted hazard ratio for age 60 versus 20 of 2.65. In this large cohort, male sex, age and abnormal category of BMI (including underweight) are associated with increased risk of progression to DM and additive to baseline FPG. Disclosure A.M. Egan: None. C. Wood-Wentz: None. K.R. Bailey: None. A. Vella: Advisory Panel; Self; vTv Therapeutics, Zealand Pharma A/S. Research Support; Self; Novo Nordisk A/S, Xeris Pharmaceuticals, Inc.

Hyperglycemia is associated with poor in-hospital outcome in elderly patients with acute ischemic stroke.

Fasting hyperglycemia is associated with poor neurologic outcome in acute ischemic stroke (AIS), but its relationship with in-hospital outcome in elderly patients remains largely unknown. To assess the association of in-hospital outcome with fasting plasma glucose (FPG) levels at admission in individuals with AIS.This retrospective propensity score-matched case-control study included patients aged over 60 years suffering from AIS and who were admitted to the emergency department from November 2013 to October 2016. Subjects were grouped into the poor-outcome and good-outcome groups based on mortality and intensive care unit (ICU) admission.The poor- and good-outcome groups comprised 74 and 1927 cases, respectively, before propensity score matching (PSM), and 74 and 296 cases, respectively, after PSM. Univariable logistic regression analysis showed that initial FPG after admission was associated with poor in-hospital outcome. Multivariable logistic regression analysis showed that initial FPG after admission was an independent predictor of poor in-hospital outcome (odds ratio = 1.11, 95% confidence interval: 1.037-1.188, P = .003).This study used PSM and strongly suggests that FPG is an independent predictive factor of poor in-hospital outcome in elderly patients with AIS. High initial FPG levels after admission may predict poor in-hospital outcome. Prospective studies are needed to confirm these findings.

SAT-LB023 Elevated Fasting Plasma Glucose Predicts Higher Odds For Becoming A Super-responder With Gelesis100 In The GLOW Pivotal Weight-loss Study

Background: In a previous pilot weight-loss study, an association was observed between baseline fasting plasma glucose (FPG) levels and the effectiveness of the Gelesis100 treatment. The aim of this subanalysis of the Gelesis Loss Of Weight (GLOW; NCT02307279) study is to further assess the association between FPG and body weight (BW) responders in subjects with overweight or obesity treated with Gelesis100, a non-systemic hydrogel. Methods: This subanalysis was conducted in subjects who were overweight or had obesity and who completed the GLOW study. GLOW was a multicenter, double-blind, placebo-controlled pivotal study with subjects randomized to 2.25 g of Gelesis100 or placebo in capsules taken with 500 mL of water before lunch and dinner while on a hypocaloric diet (-300 kcal/day) for 24 weeks. BW responders at 5% and 10% (super-responders) were analyzed using Logit model comparing Gelesis100 to placebo arms in 2 subgroups of subjects defined by their initial FPG (two consecutive consistent values). Subgroup 1 had normoglycemia (FPG < 100 mg/dL) and subgroup 2 had prediabetes (PD) (FPG ≥ 100 mg/dL and < 126 mg/dL) or untreated type 2 diabetes (T2D) (FPG ≥ 126 mg/dL). Results: The population included 206 subjects (94 males, 112 females, 138 in subgroup 1, 68 in subgroup 2, 105 on Gelesis100, 101 on placebo). In subgroup 1 (mean baseline FPG = 91 mg/dL), BW responders at 5% and 10% in Gelesis100 arm were 60% (placebo arm = 34%, adjusted odds ratio (OR) = 3.1, P = 0.0022) and 22% (placebo arm = 15%, OR = 1.5, P = 0.4254), respectively. In subgroup 2 (mean baseline FPG = 113 mg/dL), BW responders at 5% and 10% in Gelesis100 arm were 72% (placebo arm = 56%, OR = 2.2, P = 0.1509) and 44% (placebo arm = 14%, OR = 6.1, P = 0.0071), respectively. In the overall population, baseline FPG was inversely correlated with BW percent change in the Gelesis100 arm (r = -0.24, P = 0.0144). The safety and tolerability of Gelesis100 demonstrated no increased risk compared to placebo. No serious adverse events were observed in any arm. Conclusion: Gelesis100 offers a compelling new approach in the management of overweight and obesity. Notably, in Gelesis100-treated subjects with PD or untreated T2D, the odds of being super-responders are 6 times higher compared to placebo. This finding may be used as a tool for identifying subjects who are both at higher clinical risk and more likely to achieve greater levels of BW loss when treated with Gelesis100. The mechanisms underlying this finding require further investigations. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

Improvement of glucose metabolism via mung bean protein consumption: A clinical trial of GLUCODIATM isolated mung bean protein in Japan

Background: The main component of mung bean protein, accounting for more than 80%, is 8Sα globulin. Its structure closely resembles that of soybean β-conglycinin. Thereby, the mung bean protein is expected to have similar physiological effects to those of β-conglycinin, but there is no clinical evidence for these effects.Purpose of this study: The aim of this study was to confirm the positive effects of mung bean protein (GLUCODIATM) on glucose metabolism in clinical trials.Method: This clinical study was conducted using a double-blind placebo-controlled design with 45 prediabetes patients.Results: Many of the subjects were pre-diabetes with blood glucose levels exceeding 140 mg/dL by 2-hour plasma glucose level. However, the initial mean fasting plasma glucose level was less than 100 mg/dL. Therefore, mung bean protein did not lower fasting plasma glucose levels. The test period extended from summer to autumn, and increased fasting plasma glucose levels in the placebo group were observed due to seasonal factors. However, this increase was suppressed in the test group. Similarly, the mean insulin level increased in the placebo group, but the increase was also suppressed in the test group. Among obese subjects with a high body mass index, significant increases in fasting plasma glucose and insulin levels in the placebo group were observed. In the comparison between the test and the placebo groups with the average elevation value, there was a significant difference in fasting blood glucose level and significant tendencies in insulin level and homeostatic model assessment for insulin resistance value between the two groups.Conclusion: Mung bean protein suppresses fasting plasma glucose and insulin levels. Consequently, it may have an inhibitory effect on insulin resistance, a trigger of metabolic syndrome.Key words: mung bean protein, insulin, obesity, body mass index, randomized clinical trial, seasonal variation.

Utility of Pregestational Body Mass Index and Initial Fasting Plasma Glucose in Predicting Gestational Diabetes Mellitus

ObjectiveThe present study aimed to evaluate the pregestational body mass index (preBMI) and initial fasting plasma glucose (FPG) in predicting gestational diabetes mellitus (GDM) in southern Chinese women. Study DesignA total of 327 pregnant women were recruited from the third affiliated hospital of Sun Yat-Sen University, Guangzhou, China. The preBMI and initial FPG at 16-18 weeks’ gestation were measured. Oral glucose tolerance test was performed at 24-28 weeks’ gestation. The sensitivity and specificity of preBMI and initial FPG as predictors for GDM were evaluated by receiver-operator characteristic curve analysis. ResultsBoth preBMI and initial FPG correlated with the 0-hour, 1-hour and 2-hour plasma glucose during oral glucose tolerance test (P < 0.05). The area under receiver-operator characteristic curve was 0.63 (95% CI: 0.57–0.68) for preBMI and 0.68 (95% CI: 0.61–0.72) for initial FPG in diagnosing GDM. The optimal cutoff for preBMI was 21.5kg/m2 (sensitivity 52.1% and specificity 69.2%) and 4.6mmol/L (sensitivity 64.6% and specificity 65.2%) for initial FPG. Interestingly, the initial FPG had a better sensitivity compared to preBMI when the specificity was the same. Multivariate logistic regression analysis showed that initial FPG but not preBMI was the independent risk factor for the later development of GDM. After adjustment for the preBMI and the maternal age, the odds ratios of initial FPG and parity were 3.57 (95% CI: 1.72–7.45) and 2.11 (95% CI: 1.20–3.72). ConclusionsAlthough both preBMI and initial FPG could be used as indicators for GDM, the initial FPG may be more suitable for predicting GDM in southern Chinese women.

A retrospective analysis of negative diffusion-weighted image results in patients with acute cerebral infarction.

We aimed to investigate the clinicoradiologic determinants of negative diffusion-weighted image (DWI) results in patients with acute cerebral infarction (ACI). The medical records were reviewed of ACI patients. Patients were divided to the DWI positive and negative group. Positive DWI was used as independent variable and patients' clinicoradiologic factors were used as co-variables for multivariate logistic regression analysis. 349 patients received initial cerebral MRI within 72 hours of admission. Lacunar infarction was most common (42.1%) followed by posterior circulation infarction (30.1%) and partial anterior circulation infarction (18.1%). The majority of the patients (72.2%) had an NIHSS score of less than 5 at admission. 316 patients (90.54%) were positive on initial DWI. Patients with smoking, initial SBP ≥ 140 or DBP ≥ 90 mmHg, initial fasting plasma glucose (FPG) ≥7.0 mmol/L, initial MRI from onset of disease >1 d and anterior circulation infarction were liable to show positive DWI. Furthermore, DWI negative patients had significantly lower NIHSS scores (IQR 0,1,2) than DWI positive patients (IQR 1,2,4) (P = 0.000) at two weeks post onset of acute cerebral infarction. In conclusion, multiple clinicoradiologic factors are associated with negative and positive DWI and further delineation of these factors is required in future prospective studies.

Comment on Zhu et al. Fasting Plasma Glucose at 24–28 Weeks to Screen for Gestational Diabetes Mellitus: New Evidence From China. Diabetes Care 2013;36:2038–2040

The study by Zhu et al. (1) corroborates that the initial fasting plasma glucose (FPG) results of the oral glucose tolerance test (OGTT) can help to circumvent the performance of over half the OGTTs needed to work up pregnant women for gestational diabetes mellitus (GDM) in China. Thus, the algorithm to simplify the diagnosis of GDM suggested by us (2) earlier, which was accepted by the Chinese Ministry of Health (3), has been validated by the authors. However, a few facts need to be stressed. Strictly speaking, one cannot use …

Interventions of pregnancies with borderline gestational glucose intolerance: a randomized controlled trial

Objective To explore the effectiveness of dietary treatment in reducing macrosomia risks for pregnancies with borderline gestational glucose intolerance (BGGI). Methods From July 2009 to June 2011, a total of 1046 pregnant women with BGGI were randomized into group A (intervention, n=525) and group B (non-intervention, n=521). Another 521 pregnancies with normal glucose screening were assigned into group C (normal control). Randomization was applied following stratification according to age, body mass index (BMI), prior Cesarean section (C-section) and multiparity, etc. Women in group A underwent the examinations of fasting plasma glucose (FPG), 2 h-post prandial glucose and HbA1c once every 2 weeks. Their newborn outcomes were collected for analysis. Results Women of three groups were similar in age, parity, initial BMI and initial FPG. Dietary treatment for group A improved glucose-related indices and women's pregnancy weight gain (P<0.01). Also, in comparison with group B, the intervention of group A reduced risk of macrosomia (9.14% vs. 13.82%, P=0.02), prior C-section rate (43.87% vs. 56.07%, P<0.01) and postpartum hemorrhage (3.81% vs. 7.10%, P=0.02). However these indices were no better than group C. Dietary treatment did not increase the risk of fetal growth restriction, neonatal hypoglycemia and hyperbilirubinemia. Conclusion As a simple noninvasive therapeutic measure for improved glucose tolerance, BGGI may reduce the risk of risk of macrosomia and prior C-section rate. Key words: Diabetes, gestational; Fetal, macrosomia; Pregnancy outcome; Randomized controlled trials

A Chronic Leg Ulcer Presenting With Charcot–Marie–Tooth Disease and Type 2 Diabetes

Charcot-Marie-Tooth (CMT) disease is characterized by hereditary sensorimotor polyneuropathy with foot deformity, sensorineural hearing loss, moderate developmental delay, and gait disturbance. CMT presenting with type 2 diabetes and an ulcer has not been reported. This article reports a man who presented with the symptoms mentioned above and also with a leg ulcer and type 2 diabetes. He was diagnosed with CMT disease based on family history and genetic testing. A skin defect in the left leg had manifested for more than 1 year, and results of initial fasting plasma glucose revealed type 2 diabetes. The evolution of these manifestations, coupled with a slowly progressive weakness, numbness, muscular wasting, and sensory impairment, strongly suggested the co-occurrence of 3 different diseases in the same individual.

Using an initial fasting plasma glucose to decide the need for the Oral GlucoseTolerance Test during pregnancy

Gonderilme tarihi: 07.04.2013 Kabul tarihi: 18.07.2013 Abstract Purpose: To evaluate the utility of initial fasting plasma glucose (FPG) to limit the number of oral glucose tolerance test (OGTT)s needed for the diagnosis of gestational diabetes mellitus (GDM). Materials and methods: 390 pregnant women (estimated gestational ages 24–28 weeks) were evaluated for GDM using OGTT based on International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Two FPG thresholds (of the OGTT) were used to rule in and to rule out GDM. Results: Using IADPSG criteria, 61 (15.6%) of the participants had GDM. The area the under ROC curve of FPG used to detect GDM was 0.933. An FPG cut-off value of ≥5.1mmol/l had sensitivity of 70.49% and specificity of 100.00% in diagnosing GDM. An FPG cut-off value of ≤4.5 mmol/l had sensitivity of 93.44% and specificity of 67.6% in diagnosing GDM. Undergoing an initial FPG could have saved 67.7% of these women from taking the OGTT and only 1.5% (4 of the 264) would have been misclassified. Conclusion: Screening using an initial FPG rule-in and rule-out algorithm reduces the number of OGTTs needed for the diagnosis of GDM. Almost all GDM pregnancies can be diagnosed.

DO HYPOGLYCAEMIA AND HYPERGLYCAEMIA HAVE SIMILAR EFFECTS ON ALL-CAUSE MORTALITY ACROSS THE SPECTRUM OF SEVERITY OF CORONARY ARTERY DISEASE?

ObjectivesWe have previously reported that in older patients with acute myocardial infarction (AMI), increased as well as mildly decreased admission fasting plasma glucose (FPG) levels could predict higher in-hospital and...

Gestational diabetes in a tertiary care hospital: implications of applying the IADPSG criteria

The American Diabetes Association has endorsed the International Association of Diabetes and Pregnancy Groups (IADPSG) recommendation that every pregnant woman should undergo the 75 g oral glucose tolerance test (OGTT) to screen for gestational diabetes mellitus (GDM). To find the cost and workload implications of switching from the current two-step screening of GDM to the one-step IADPSG approach. The cost (US $) and laboratory workload units (WLU) were calculated for three possible strategies: (1) 50 g glucose screen, if positive, followed by the 100 g OGTT; (2) universal 75 g OGTT; and (3) screening with the initial fasting plasma glucose of the OGTT. For the 1,101 pregnant women screened in 1 year, the cost of the three strategies was $ 31,985, $ 55,250 and $ 35,875, respectively; the laboratory burden was 28,975 WLU, 18,662 WLU and 12,215 WLU, respectively. Switching to the one-step, strategy 2 (IADPSG) would increase the cost by 42 % but decrease the laboratory workload by 36 % compared to the two-step, strategy 1. However, an initial screen by the fasting plasma glucose of the OGTT is the ideal strategy, both in terms of cost and laboratory workload.

Gestational diabetes screening: The low-cost algorithm

The American Diabetes Association has endorsed the demanding recommendation by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) that every pregnant woman should undergo the oral glucose tolerance test (OGTT) for the screening of gestational diabetes mellitus (GDM). The aim of this study was to find out if the fasting plasma glucose (FPG) and newer emerging technologies could simplify the cumbersome IADPSG algorithm. Two FPG thresholds (of the OGTT) were used to rule in and rule out GDM in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort (n = 23316) and a population at high risk for GDM (n = 10283). For the HAPO cohort and the high-risk population, respectively, FPG thresholds of: (a) ≥5.1 mmol/L (specificity 100%) independently ruled in GDM in 1769 (8.3%) women and 2975 (28.9%) women; and (b) ≤4.4 mmol/L ruled out GDM in 11526 (49.4%) women (84.1% sensitivity) and 2228 (21.7%) women (95.4% sensitivity). Use of the FPG independently could have avoided 13295 (57.0%) and 5203 (50.6%) OGTTs in the 2 groups. The initial FPG—by significantly reducing the number of cumbersome OGTTs needed—can make the IADPSG recommendations more acceptable worldwide. The number of GDM women missed is population dependent. For low-resource countries, alternative newer and cheaper tests in development hold an exciting future.

Association between admission fasting plasma glucose and contrast-induced nephropathy in elderly acute myocardial infarction patients undergoing percutaneous coronary intervention

BackgroundDespite numerous prior studies have established the association between admission randomised glucose levels and poor outcomes in patients with acute myocardial infarction (AMI), less is known regarding the correlation between...

Carnitine and Metabolic Correlates in Hospitalized Psychiatric Patients

Carnitine deficiency may be encountered in the context of chronic psychiatric illness, particularly with the chronic use of valproic acid. Despite the importance of carnitine in lipid metabolism and mitochondrial function, its metabolic effects have not been studied in a psychiatric population. To raise awareness regarding the possible metabolic implications of carnitine homeostasis in psychiatric patients. Retrospective database review in a subgroup of 23 patients with documented hypo carnitinemia. Statistical analysis revealed a negative correlation between serum carnitine levels and lipid levels. Initial fasting plasma glucose levels correlated positively with acylcarnitine/free carnitine ratios, suggesting unfavorable secondary effects of carnitine insufficiency, which resolved once carnitine was supplemented. Carnitine is a plausible substrate for future investigations of metabolic status in psychiatric patients. Further studies are needed to evaluate whether serum carnitine levels may be useful as a marker for psychiatric patients at risk for developing metabolic syndrome, and whether carnitine supplementation may reduce that risk. (Journal of Psychiatric Practice 2011;17:35-40).

E0445 Admission hypoglycaemia and hyperglycaemia are associated with increased mortality in older patients with acute myocardial infarction

ObjectiveThe aim was to assess the association between fasting plasma glucose (FPG) levels on admission and mortality in older patients with acute myocardial infarction (AMI), and compare the effects of...