Random Plasma Glucose Levels Research Articles

Developing an automated algorithm for identification of children and adolescents with diabetes using electronic health records from the OneFlorida+ clinical research network.

To develop an automated computable phenotype (CP) algorithm for identifying diabetes cases in children and adolescents usingelectronic health records (EHRs) from the UF Health System. The CP algorithm was iteratively derived based on structured data from EHRs (UF Health System 2012-2020). We randomly selected 536 presumed cases among individuals aged <18 years who had (1) glycated haemoglobin levels ≥ 6.5%; or (2) fasting glucose levels ≥126 mg/dL; or (3) random plasma glucose levels ≥200 mg/dL; or (4) a diabetes-related diagnosis code from an inpatient or outpatient encounter; or (5) prescribed, administered, or dispensed diabetes-related medication. Four reviewers independently reviewed the patient charts to determine diabetes status and type. Presumed cases without type 1 (T1D) or type 2 diabetes (T2D) diagnosis codes were categorized as non-diabetes/other types of diabetes. The rest were categorized as T1D if the most recent diagnosis was T1D, or otherwise categorized as T2D if the most recent diagnosis was T2D. Next, we applied a list of diagnoses and procedures that can determine diabetes type (e.g., steroid use suggests induced diabetes) to correct misclassifications from Step 1. Among the 536 reviewed cases, 159 and 64 had T1D and T2D, respectively. The sensitivity, specificity, and positive predictive values of the CP algorithm were 94%, 98% and 96%, respectively, for T1D and 95%, 95% and 73% for T2D. We developed a highly accurate EHR-based CP for diabetes in youth based on EHR data from UF Health. Consistent with prior studies, T2D was more difficult to identify using these methods.

Assessing the Features of Diabetic Foot Ulcers among Individuals with Type 2 Diabetes Mellitus in Thi Qar, Iraq

Background This study aimed to evaluate the characteristics of diabetic foot ulcers in individuals with type 2 diabetes mellitus (T2DM) in Iraq. Methods The study included 881 participants with T2DM and different types of foot ulcers, who attended a specialized diabetes center. Data on demographics, clinical characteristics, biochemical investigations, comorbidities, and treatment regimens were collected and analyzed. Results The majority of the cases (96.8%) were due to T2DM, with an average age of 58 years and a mean BMI of 30 kg/m2. Participants had elevated serum creatinine, blood urea, and glucose levels, with uncontrolled HbA1c levels. Comorbidities included hypertension, ischemic heart disease, diabetic neuropathy, and retinopathy. Most participants were on insulin and statins. Diabetic foot ulcers were mainly on the right foot (48%) and classified as Grade 2 in Wagner's system. Some participants had Charcot deformity or stages of amputation. Conclusions Random plasma glucose levels and diabetic retinopathy were significantly associated with the classification of foot ulcers. Further research is needed to explore additional variables related to T2DM and foot ulcers, emphasizing the importance of glucose control and retinopathy in ulcer classification.

Perinatal Outcomes of Diet Therapy in Gestational Diabetes Mellitus Diagnosed before 24 Gestational Weeks.

To evaluate perinatal outcomes and risk factors for large for gestational age (LGA; birth weight over 90 percentile) in gestational diabetes diagnosed before 24 gestational weeks and treated with diet therapy alone until delivery (Diet Early gestational diabetes mellitus (Diet Early GDM)), we assessed the maternal characteristics and perinatal outcomes of patients with early GDM (n = 309) and normal glucose tolerance (NGT; n = 309) at Keio University Hospital. The gestational weight gain (GWG) expected at 40 weeks was significantly lower in the Diet Early GDM group than in the NGT group. The Diet Early GDM group exhibited a significantly lower incidence of low birth weight (<2500 g) and higher Apgar score at 5 min than the NGT group. Multiple logistic regression analysis revealed that the pre-pregnancy body mass index and GWG expected at 40 weeks were significantly associated with LGA for Diet Early GDM. No differences were observed in random plasma glucose levels in the first trimester, 75 g oral glucose tolerance test values, and initial increase or subsequent decrease between the two groups. Dietary early GDM did not exhibit a worse prognosis than NGT. To prevent LGA, it might be important to control maternal body weight not only during pregnancy but also before conception.

Plasma calprotectin and new-onset type 2 diabetes in the general population: a prospective cohort study.

Systemic inflammation plays a pivotal role in the development of type 2 diabetes (T2D). Here we hypothesized that circulating levels of calprotectin, a myeloid cell-derived biomarker of inflammation, is associated with the development of new-onset T2D in the general population. A total of 4,815 initially non-diabetic participants of the Prevention of Renal and Vascular ENd-stage Disease (PREVEND), a prospective population-based cohort study, were assessed for plasma levels of calprotectin at baseline. Circulating levels of calprotectin were investigated for potential associations with the risk of new-onset T2D, defined as a fasting plasma glucose level ≥7.0 mmol/l, a random plasma glucose level ≥11.1 mmol/l, a self-reported physician-based diagnosis of T2D, the use of glucose-lowering drugs, or any combinations thereof. Median plasma calprotectin levels were 0.49 [0.35-0.69] mg/l. Plasma calprotectin levels were significantly associated with the risk of new-onset T2D (hazard ratio [HR] per doubling 1.42 [95% confidence interval: 1.22-1.66], P<0.001). The association remained independent of adjustment for age and sex (HR 1.34 [95%CI: 1.14-1.57], P<0.001), but not after further adjustment for potentially confounding factors (HR 1.11 [95% CI: 0.90-1.37], P=0.326), with adjustment for hyperlipidemia and high-sensitivity C-reactive protein explaining the loss of significance. Stratified analyses showed significant effect modification by hypertension, history of cardiovascular disease and HOMA-IR (Pinteraction≤0.001 for each), with higher HRs in individuals without hypertension, without history of cardiovascular disease and with below-median HOMA-IR. Elevated plasma levels of calprotectin are associated with a higher risk of developing T2D in the general population and may represent a moveable inflammatory biomarker. This association, however, does not represent a direct effect, and seems dependent on hyperlipidemia and systemic inflammation.

Screening for Renal Function Impairment in Patients with Chronic Type II Diabetes Mellitus in a Tertiary Care Hospital of Pakistan

Objective: The objective of the present study was to detect early biochemical changes, in type II diabetics, indicating renal function impairment leading to Chronic Kidney Disease (CKD). Methodology: This study was conducted in the Department of Biochemistry at Shaikh Zayed FPGMI, Lahore during September 2016 to April 2017. It was a cross-sectional analytical study and was done through nonprobability convenient sampling The study comprised of 50 diagnosed patients of type II diabetes mellitus (for the last 10 years) and 50 healthy subjects. Both male and female participants in equal number between the age of 35-75 were included in the study. Blood glucose level (random), blood urea, serum creatinine, urinary albumin and urinary creatinine were estimated and albumin to creatinine ratio (ACR) in mg/g was calculated. eGFR was also calculated using S/creatinine. The lab values of the study parameters were recorded on the designed proforma after getting proper written consent from the participants. SPSS 20.0 was used for data entry and analysis. Results: Mean values of random plasma glucose level, blood urea, serum creatinine, urine albumin, urine creatinine, ACR and eGFR of patients when compared with those of healthy group showed significant p-values (≤0.05). Conclusion: There was a significant difference in renal laboratory parameters between diabetic patients and healthy controls indicating the presence of CKD. In a developing country like Pakistan type II diabetes mellitus is an incidental finding due to lack of regular health monitoring and it is very difficult to determine the exact duration of the disease. Patients of type II DM develop CKD (Chronic Kidney Disease) due to persistent high plasma glucose levels. Therefore good control of DM and regular monitoring of renal parameters will be helpful in preventing the development of CKD. Key Words: Diabetes Mellitus, Nephropathy, Chronic Kidney Disease, Urinary Albumin to Creatinine ratio.

Diabetes and chronic kidney disease in Chinese adults: a population-based cohort study

IntroductionCohort evidence of the association of diabetes mellitus (DM) with chronic kidney disease (CKD) is limited. Previous studies often describe patients with kidney disease and diabetes as diabetic kidney disease...

Isolated Systolic Hypertension among Diabetes Mellitus Subjects; a national cross-sectional study in Indonesia

Isolated systolic hypertension (ISH) reflects atherosclerosis. Studies reported hypertension prevalence among diabetes mellitus (DM); however, limited studies provided community prevalence. The present study aimed to explore ISH prevalence among DM in Indonesia. This study obtained data from the 2018 Indonesia Basic Health Survey. The DM category was determined by fasting plasma glucose (PG) level ≥126 mg/dL or 2 hours postprandial and random PG level ≥200 mg/dL or previously diagnosed by a doctor. ISH is categorized if systolic blood pressure is≥140 mmHg and diastolic blood pressure is 90 mmHg. This study also explored the subject’s determinants, i.e., compliance, demography, and lipid profile. A Chi-square and Binary logistic regression were used to determine the association. The study included 3,911 DM individuals and disclosed the prevalence of ISH at 17.5%. ≥65 years old (OR=13.61 95%CI: 3.297-19.365) and 45-64 years old OR=4.59 95%CI: 3.297-6.383)), high HDL-cholesterol (OR=0.77; 95%CI: 0.626-0.936), and longer DM duration (OR=2.89; 95%CI: 2.405-3.474), all together were related to the ISH. Subjects with the oldest age category, i.e., ≥65 years old, had the highest OR. Older DM individuals with low HDL-C and longer DM duration were related to the ISH, suggesting lipid profile treatments, mainly the HDL-C, is a pivotal effort to delay ISH.

Analysis of Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Case-Control Study

The incidence of DM (Diabetes mellitus) is rising all over the world. Inadequate glycemic control in patients having type 2 DM presents a higher risk of developing associated complications. This study was conducted to analyse the information on the management of diabetes in standard clinical practice. The study provides description of clinical profile of subjects with DM2 (Type 2 diabetes mellitus) under treatment with insulin and oral hypoglycemic drugs. A total of 500 patients diagnosed with DM2, and equal number of age and gender matched controls participated in the study. Clinical data including previous medical history of diabetes, medication taken for treatment, comorbidities, pre-prandial and post-prandial plasma glucose, and glycosylated haemoglobin (HbA1c) levels were collected. It was observed that among all participants 59.4% were obese and 30.6% were overweight. It was also found that 57.4% patients were suffering from hypertension while 56% were suffering from hyperlipidemia. Patient’s data about family history revealed that 62.2% patients had both or either of the two parents suffering from diabetes. The mean fasting and random plasma glucose levels were found to be 178.6mg/dL and 245.4mg/dL respectively. Moreover, only 8% patients achieved glycemic goals and had HbA1c levels under normal limits. The study reveals that lack of awareness and poor self-care can increase the risk of comorbidities associated with type 2 DM. This study provides a basis for further investigations on quality of life of diabetic patients in various regions of Pakistan.

Analysis of Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Case-Control Study

The incidence of DM (Diabetes mellitus) is rising all over the world. Inadequate glycemic control in patients having type 2 DM presents a higher risk of developing associated complications. This study was conducted to analyse the information on the management of diabetes in standard clinical practice. The study provides description of clinical profile of subjects with DM2 (Type 2 diabetes mellitus) under treatment with insulin and oral hypoglycemic drugs. A total of 500 patients diagnosed with DM2, and equal number of age and gender matched controls participated in the study. Clinical data including previous medical history of diabetes, medication taken for treatment, comorbidities, pre-prandial and post-prandial plasma glucose, and glycosylated haemoglobin (HbA1c) levels were collected. It was observed that among all participants 59.4% were obese and 30.6% were overweight. It was also found that 57.4% patients were suffering from hypertension while 56% were suffering from hyperlipidemia. Patient’s data about family history revealed that 62.2% patients had both or either of the two parents suffering from diabetes. The mean fasting and random plasma glucose levels were found to be 178.6mg/dL and 245.4mg/dL respectively. Moreover, only 8% patients achieved glycemic goals and had HbA1c levels under normal limits. The study reveals that lack of awareness and poor self-care can increase the risk of comorbidities associated with type 2 DM. This study provides a basis for further investigations on quality of life of diabetic patients in various regions of Pakistan.

Association of serum lipids and random plasma glucose levels with severity of diabetic retinopathy

Diabetic retinopathy is the most common vision-threatening chronic microvascular, microangiopathy complication of diabetes militias.We have designed this cross sectional observational study to understand the role of serum lipids and random plasma glucose level with severity of diabetic retinopathy (DR). This study was accomplished with 210 patients that came to us in the diabetic clinic. There were two groups: Group A - All DM patients with no apparent sign of diabetic retinopathy (Grade I) and Group B - All DM Patients with any signs of diabetic retinopathy (Grade II - V). Diabetic retinopathy (DR) was graded according to The International Clinical Diabetic Retinopathy Disease Severity Scale on dilated fundus examination and fundus phtotograpgy. Serum lipids (Total, LDL, and HDL cholesterol and triglycerides) were then assessed according to NCEP ATP III guidlines. The correlation of the severity DR was then assessed with serum lipids and random plasm glucose.We found that total cholesterol and triglycerides played a detrimental role in the severity of diabetic retinopathy and the likelihood of developing a more severe form of diabetic retinopathy was dependent on their levels (P&amp;#60;0.05). The Association of HDL and LDL with different grades of diabetic retinopathy was also found significant (P&amp;#60;0.05). However, the association of VLDL (P&amp;#62;0.05) was found insignificant. Similarly, the values of total cholesterol, triglycerides and HDL showed a significant rise with severity of diabetic macular edema (DME)In this present study, the significant association of total cholesterol, triglycerides and HDL with DR thus concludes that along with strict glycemic monitoring and control, the of control of hyperlipidemia is also noteworthy to prevent the progression of DR and DME.

Correlation analysis of HbA1c versus random, fasting, and postprandial glucose levels as predictors of glycemic control in type 2 diabetes patients

Background: Glycated Hemoglobin (HbA1c) is used for assessing glycemic control over the past 8–12 weeks. This is critical for determining the efficacy of diabetes treatment and predicting the progression of microvascular complications. However, in health-care situations where tests for HbA1c are either unavailable or unfeasible for any reason, clinicians rely only on plasma glucose values for assessing the glycemic control of the patient. Aims and Objectives: The purpose of this study was to determine the relationship between HbA1c and fasting, postprandial, and random plasma glucose levels. Materials and Methods: Routine blood samples obtained from the laboratory to measure HbA1c and plasma glucose (fasting/postprandial/random) were used for study. A total of 207 samples were used to investigate the relationship between HbA1c and fasting and postprandial glucose (PPG/PP). The correlation of HbA1c with random glucose values was investigated using 112 samples. HbA1c was estimated by immunoturbidimetry and glucose was estimated by hexokinase method. Pearson’s correlation analysis was done by SPSS version 20 software. Results: The Pearson correlation coefficient (r) with regard to PPG/PP and HbA1c was 0.75 (P=0.01, 95% CI), fasting glucose and HbA1c was 0.73 (P=0.01, 95% CI), and random glucose and HbA1c was 0.59 (P=0.01, 95% CI). Conclusion: PPG/PP correlates with HbA1c better than fasting or random glucose. When it is impossible to perform HbA1c measurements, PPG measurements should be used instead.

Prevalence and Risk Factors of Isolated Systolic Hypertension among Diabetes Mellitus Subjects; a national cross-sectional study in Indonesia

Isolated systolic hypertension (ISH) reflects atherosclerosis. Studies reported hypertension prevalence among diabetes mellitus (DM); however, limited studies provided community prevalence. Present study aimed to explore ISH prevalence among DM in Indonesia. This study obtained data from the 2018 Indonesian basic health survey. The DM category was determined by fasting plasma glucose (PG) level ≥126 mg/dL or 2-hours postprandial and random PG level ≥200 mg/dL or previously diagnosed by a doctor. ISH is categorized if systolic blood pressure is≥140 mmHg and diastolic blood pressure is 90 mmHg. This study also explored the subject's determinants, i.e., compliance, demography, and lipid profile. A Chi-square and Binary logistic regression were used to determine the association. The study included 3,911 DM individuals and disclosed the prevalence of ISH 17.5%. ≥65 years old (OR=13.61 95%CI: 3.297-19.365) and 45-64 years old OR=4.59 95%CI: 3.297-6.383)), high HDL-cholesterol (OR=0.77; 95%CI: 0.626-0.936), and longer DM duration (OR=2.89; 95%CI: 2.405-3.474), all together were related to the ISH. Subjects with the oldest age category, i.e., ≥65 years old, had the highest OR. Older DM individuals with low HDL-C and longer DM duration were related to the ISH, suggesting lipid profile treatments, mainly the HDL-C, is a pivotal effort to delay ISH.

Opportunistic Screening for Raised Blood Sugar and Diagnosing Prediabetes and Diabetes among Patients Coming for Eye, ENT Consultation: A Descriptive Study

INTRODUCTION: Diabetes is a pandemic of public health importance, and prediabetes has also emerged as a major public health concern. Unfortunately, one-third of individuals with diabetes are identified only after developing complications, and nearly three-fourths are unaware of their raised blood sugar status. Opportunistic screening at an earlier stage has good prognosis. The study aimed at an opportunistic screening of raised plasma glucose levels of outpatients and diagnosing prediabetes and diabetes among them. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted among patients visiting an Eye ENT hospital in Bhaktapur, Nepal, between January to December 2019. Outpatients aged 40-79 years with unknown history of diabetes were invited for free hyperglycemia screening. Descriptive analysis was computed for patients participating in random plasma glucose (RPG) screening and patients coming for definitive tests for diabetes with elevated RPG levels. RESULTS: Amongst 6,913 outpatients, 14.9% had RPG levels of 140 mg/dL and higher. Among 159 patients with RPG levels 140 mg/dL and higher, 40.9% had prediabetes, and 32.7% had diabetes. CONCLUSIONS: Opportunistic screening in hospital OPD settings is feasible to identify people at risk of hyperglycemia. Timely detection of a silent killer - diabetes and prediabetes can be useful for early intervention and preventing complications.

ACUTE HYPERGLYCEMIA, A RABBLE-ROUSER OR INNOCENT BYSTANDER? A PROSPECTIVE ANALYSIS OF CLINICAL IMPLICATIONS OF ACUTE HYPERGLYCEMIA IN STE-ACS PATIENTS

Objectives: The acute hyperglycemia on admission is considered to be in independent prognosticators of both in-hospital and long-term outcome regardless of diabetic status in patients with acute coronary syndrome (ACS). The objective of this study was to analyse the incidence of acute hyperglycemia and its impact on subsequent adverse in-hospital outcome, irrespective of diabetic status, in patients with STE-ACS undergoing primary PCI.&#x0D; Methodology: A total of 1756 patients were enrolled into the study, presenting with STE-ACS, and undergoing primary PCI at a tertiary care cardiac centre. Patients were categorised according to their random plasma glucose levels, at the time of presentation to ER, with RBS &gt; 200mg/dl taken as acute hyperglycemia. All patients were observed during their hospital stay and post procedure complications and outcomes were recoded. Clinical profile and outcomes were compared between the two groups. Multivariable logistic regression analysis was performed to determine the predictive value of acute hyperglycemia for the prediction of in-hospital mortality.&#x0D; Results: Of the 1756 patients, 79% (1388) were males and mean age was 55.59±11.23 years. In total, 29% (512) were found to have acute hyperglycemia and of these, 81.1% (415) were already diagnosed diabetic cases. Patients with acute hyperglycemia were observed to have higher incidence of heart failure (7% vs. 2.6%; p&lt;0.001), CIN (13.3% vs. 8.1%; p=0.001), and in-hospital mortality (7.2% vs. 1.9%; p&lt;0.001). On multivariable analysis, acute hyperglycemia was found to be an independent predictor of mortality with adjust OR of 2.33 [95% CI: 1.18-4.58; p=0.014]. Multi-vessel disease (2.22 [95%CI: 1.07-4.58; p=0.032]), pre-procedure LVEDP (1.07 [95%CI: 1.02-1.12; p=0.003]), and history of CVA/stroke (3.73 [95% CI: 1.2-11.59; p=0.023]) were found to be additional independent predictor of in-hospital mortality.&#x0D; Conclusion: The acute hyperglycemia, regardless of diabetic status, is found to be an independent predictor of in-hospital mortality among patients with STE-ACS undergoing primary PCI. Acute hyperglycemia, along with other significant predictors such as multi-vessel involvement, LVEDP, and history of CVA/stroke, can be considered for the risk stratification of these patients.

Management of Type 1 Diabetes in Children in the Outpatient Setting.

Management of Type 1 Diabetes in Children in the Outpatient Setting.

Correlation Between Gender and Random Plasma Glucose on The Outcome of Sepsis Patients with Type 2 Diabetes Mellitus in The Internal Medicine Room of Dr. Soetomo General Hospital

Background: Indonesia has a tropical climate, so it cannot be separated from sepsis. Sepsis is a severe health problem with very high mortality worldwide. Type 2 diabetes mellitus comorbidities that Indonesian people often suffer from can affect patient outcomes. The effect of gender on patient outcomes is still controversial. It is estimated that gender differences can affect hormonal responses, which cause differences in immune responses. In addition, random plasma glucose levels can also be associated with the outcome of septic patients with type 2 diabetes mellitus due to impaired immune response that occurs in patients. Method: This research is a retrospective study using the Cross-Sectional method by taking the medical record data of sepsis patients treated in the internal medicine room of Dr. General Hospital. Soetomo Surabaya for January 1, 2020 – December 31, 2020. Result: Of the 215 study subjects divided into two groups, 123 patients died, while 92 patients were discharged. There were no significant results that gender in type 2 diabetes mellitus sepsis patients was associated with patient outcomes from hospital care (p = 0.055). In addition, there was also no significant relationship between random plasma glucose levels of patients and patient outcomes during hospitalization (p = 0.790). Conclusion: Gender and random plasma glucose levels in septic patients with type 2 diabetes mellitus are not associated with hospital outcomes.

To Control Diabetes Using Machine Learning Algorithm and Calorie Measurement Technique

Because of the increasing workload, people are having several clinical examinations to determine their health status, resulting in limited time. Here, we present a healthful consuming device based on rule mining that can modify your parameter dependency and recommend the varieties of meals that will boost your fitness and assist you to avoid the types of meals that increase your risk for sicknesses. Using the meals database, the data mining technique is useful for gathering meal energy from breakfast, after breakfast, lunch, after lunch, dinner, after dinner, and bedtime for ninety days. The purpose of this study is to determine to mean random plasma glucose levels and h1bc levels using the Nathan, ADAG (A1C-derived average glucose), and DTTC (Dynamic Temporal and Tactile Cueing) methods. This system can identify and recognize food images, as well as keep track of the food items ingested by the user. Deep learning techniques are mostly utilized for picture recognition and categorization. The KNN (k-nearest neighbors algorithm) classification approach is used to determine if diabetes is normal, pre-diabetic, or chronic. This study employs deep learning and a smart camera app called “calorie mom” to track nutrition from meal photographs. In addition, the commonly used measures of divisions such as accuracy, sensitivity, uniqueness, and recalling diabetic dataset using Python 3 Jupyter Notebook were employed to evaluate the performance of a machine learning classifier.

Random plasma glucose levels and cause-specific mortality among Chinese adults without known diabetes: an 11-year prospective study of 450,000 people

IntroductionWe examined the associations between long-term usual random plasma glucose (RPG) levels and cause-specific mortality risks among adults without known diabetes in China.Research design and methodsThe China Kadoorie Biobank recruited...

171-LB: Stress Hyperglycemia Is Associated with Higher Preadmission Glucose and Post-Discharge Diabetes Incidence

Stress hyperglycemia is associated with worse outcomes, but its associated risks and contributors are not well known. We evaluated characteristics associated with high inpatient random plasma glucose levels (RPG) in a retrospective cohort of the national VA Health Care System. Patients were age ≥18 yrs, without diagnosed diabetes (DM), hospitalized ≥3 days in 2002-2014 with ≥2 RPGs, and had regular care ≥2 yrs before and ≥3 yrs after hospitalization. In 205,270 pts, mean age was 73.8 yrs and BMI 28.0 kg/m2; 96% were male, 75% white, 16% black. Second highest inpatient RPG levels (iRPG-2max) of &amp;lt;130, 130-139, 140-159, 160-179, 180-199, and ≥200 mg/dl were found in 63%, 10%, 13%, 6%, 3%, and 4% of patients, respectively, without demographic differences between groups. Those with higher iRPG-2max had longer lengths of stay (LOS; median 5 days with &amp;lt;130 mg/dl vs. 10 days with ≥200, p&amp;lt;0.001), and higher rates of acute kidney injury (AKI; 9.3% with &amp;lt;130 vs. 29.3% with ≥200 group; OR 3.8, 95% CI 3.6-4.0) but no differences in rates of infection. Before admission, higher iRPG-2max groups were more likely to have ≥2 outpatient RPGs (oRPG) ≥130 mg/dl (7.2% with &amp;lt;130 mg/dl vs. 15.2% with ≥200, p&amp;lt;0.001). After discharge, higher iRPG-2max groups had more incident DM within 1 and 3 yrs (1.3% and 3.4%, respectively, with &amp;lt;130 vs. 14.9% and 18.4% with ≥200, both p&amp;lt;0.001). In multivariate analysis, higher iRPG-2max was more likely with oRPG ≥130 mg/dl vs. oRPG &amp;lt;110 (adj OR 1.81, 95% CI 1.75-1.87), and with DM in 3 yrs post-discharge vs. no DM (adj OR 2.52, 95% CI 2.49-2.70). Conclusion: Patients with outpatient random plasma glucose (RPG) ≥130 mg/dl have a higher risk of stress hyperglycemia, which is associated with longer length of stay, more acute kidney injury, and higher incidence of diabetes after discharge. Thus, patients with ≥2 pre-admission RPGs ≥130 should have inpatient RPGs monitored carefully, and those with high inpatient RPGs should be screened for diabetes for up to 3 years after discharge. Disclosure S. Fang: None. S. Aiyedipe: None. A. Khakharia: None. E. Giraldi: None. K. A. Easley: None. L. S. Phillips: Other Relationship; Self; Diasyst Inc., Research Support; Self; AbbVie Inc., Eli Lilly and Company, GlaxoSmithKline plc., Janssen Pharmaceuticals, Inc., Kowa Pharmaceuticals America, Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk Pharma Ltd., Pfizer Inc., Sanofi-Aventis. M. K. Rhee: None.

The effect of pre-infarction angina on no-reflow phenomenon and in-hospital MACE in primary PCI patients

Abstract Funding Acknowledgements Type of funding sources: None. Background No reflow has detrimental outcomes in STEMI patients undergoing primary PCI (PPCI). It leads to poor post PCI LV function and higher mortality. The protective effect of ischemic pre-conditioning ( clinically manifested as pre-infarction angina) was controversial in the literature. Purpose Our aim was to study the effect of pre-infarction angina on the occurrence of no-reflow phenomenon and in-hospital major adverse cardiac events (MACE) in PPCI patients. Methods After obtaining ethical approvals and informed consents, we prospectively studied 120 STEMI patients admitted for PPCI in a consecutive manner. Patients with history of CABG or previous PCI and in-stent restenosis were excluded. The definition of in-hospital MACE included cardiac death, myocardial reinfarction, stent thrombosis, or target vessel revascularization. The data were analysed by professional statisticians using SPSS software. Results 15 patients ( 12.5%) had no-reflow, 5 patients ( 4.2%) had cardiac death and one patient had both(0.8 %). The admission characteristics of the studied groups are presented in table 1. Pre-infarction angina was present in 43 patients in the normal flow group and 6 patients in the no-reflow/MACE group. The odds ratio for no-reflow/MACE in those who had pre-infarction angina was 0.52 (95% CI 0.19-1.45, P = 0.21). Conclusion In our studied group, pre-infarction angina has not shown to be protective against no-reflow and in-hospital MACE in PPCI patients. The loss of the protective effect of ischemic pre-conditioning might be secondary to higher admission random plasma glucose levels in our patients compared to those included in similar studies. Similar effect was previously shown in studies on mice. Further in-human studies are needed to confirm the negative effect of hyperglycemia on ischemic pre-conditioning. Characteristics of studied groups Normal flow (n = 99) No-reflow/MACE(n = 21) P value Age (mean ± SD) 56.3 ± 10.3 62.3 ± 7.9 0.014 Male sex (n) 75 13 0.19 Diabetes (n) 37 12 0.094 Hypertension (n) 48 7 0.21 Smokers (n) 52 9 0.42 Dyslipidemia (n) 54 15 0.16 Family history of IHD (n) 17 2 0.52 Pre-infarction angina 43 6 0.21 Admission random plasma glucose in mg/dl(mean ± SD) 186.4 ± 84.7 275.3 ± 104.1 0.001