Serum HbA1c Levels Research Articles

Prevalence of Non-insulin-dependent Diabetes Mellitus Among Patients with Cholelithiasis: A Single-centered, Cross-sectional Study.

IntroductionGallstone disease (GD) is one of the major causes of morbidity and mortality in the west and most of the countries worldwide. Cholelithiasis and diseases of the biliary tract are becoming more prevalent with the socioeconomic burden in developing countries like Pakistan. GD is a chronic, recurrent hepatobiliary disease, the basis of which is the impaired metabolism of cholesterol, bilirubin, and bile acids, which is characterized by the formation of gallstones in the hepatic bile duct, common bile duct, or gallbladder. Epidemiologic studies have shown that individuals with diabetes have a higher risk of cholelithiasis but only a few studies have been done in Pakistan to establish the association so far. Hence, the aim of the present study is to establish the association between diabetes and gallstone disease.MethodsA cross-sectional study was conducted at Liaquat University Civil Hospital, Hyderabad, Pakistan, between February 2017 and August 2017. Patients between the ages of 10 and 70 from either sex, who were diagnosed with cholelithiasis were included in this study whereas those patients who underwent cholecystectomy previously were excluded. Diabetic cases were identified based on fasting glucose levels (FGL) and the serum levels of HbA1c. An interview-based questionnaire was employed to collect the patient's demographic profile and risk factors by the students. Informed consent was taken from all the study subjects and the confidentiality of the data was ensured.ResultsFrom the sample size of patients evaluated (a total of 204), based on investigative studies performed, 74 cholelithiatic patients (36.6%) were found to concurrently have diabetes as well. Among the 74 patients with both cholelithiasis and diabetes type-2 (NIDDM), 56 were female and 18 were males. The rest of the patients with cholelithiasis were found to be non-diabetic (78 were males and 52 female). The majority of the GD patients (51 (25 males and 26 females)) in the study sample was in the 50-60 age group. The mean age of the patients was 43 ± 12.1. In this study, we measured the fasting glucose levels (FGL). According to World Health Organization (WHO) and American Diabetes Association (ADA) criteria, we categorized 85 of the GD patients to be non-diabetic with serum fasting glucose levels between 70 and 100 gm/dL, and 45 patients were categorized to be in the pre-diabetic group with FGL levels between 100 and 126. Out of the 204 samples with GD, we found that 74 patients have diabetes, with serum FGL >126mg/dL. We measured HbA1c from each individual in the study sample. It was found that 79 patients had HbA1c levels <5.5, they are categorised as non-diabetic according to WHO and ADA criteria, 51 patients had values between 5.5 and 6.5 (pre-diabetic), and 35 GD patients had HbA1c values between 6.5 and 7.5 (categorized as diabetics with good control) and 39 patients with HbA1c above 7.5 (diabetes with poor control).ConclusionIn this study, we concluded that there is a higher prevalence of NIDDM in GD patients and there is an association between GD and NIDDM. This study also reiterated the association between obesity and GD. Female sex and advancing age also contribute to the formation of cholelethiasis. Cigarette smoking and alcohol consumption further worsen cholelithiasis but are not established primary risk factors.

Study on the correlation of diabetic retinopathy with serum HbA1c and TNF-α levels and in middle-aged and senile diabetes patients

Study on the correlation of diabetic retinopathy with serum HbA1c and TNF-α levels and in middle-aged and senile diabetes patients

Salient features and outcomes of Charcot foot – An often-overlooked diabetic complication: A 17-year-experience at a diabetic center in Bangkok

BackgroundCharcot foot is a rare but a serious diabetic condition. Recognition of this often overlooked condition to provide timely and proper management is important for a better prognosis. Limited data on Charcot foot was available in Asians. AimsThe aim of this study is to describe salient features and outcomes of Charcot foot in Thai patients. MethodWe presented our experience of 40 cases of Charcot foot patients who were treated from 2000 to 2016 at Theptarin Hospital, Bangkok, Thailand. ResultsA total of 40 Charcot foot patients were identified (13 acute, 27 chronic; mean age 58.7 ± 10.2 years; duration of diabetes 18.0 ± 8.8 years; T2DM 95%). The average serum HbA1c level was 9.2 ± 1.9%. While acute Charcot foot was frequently misdiagnosed as cellulitis in almost one-third of patients, osteomyelitis was a leading cause of misdiagnosis in 15% of chronic Charcot foot patients. Ulcer-free rate at 6 and 12 months were observed in 60% and 58% of patients, respectively. The mortality rate was 13% during a median follow-up period of 57 months. Only 61% of the patients resumed walking normally while almost one-fourth of them were wheelchair-bound. ConclusionsCharcot foot in Thai patients mainly developed in long-standing poorly controlled type 2 diabetes with neuropathy, and presented late in the course of the disease. It was often misdiagnosed resulting in improper management and poor outcome which included amputation.

Benefits of non-surgical periodontal treatment in patients with type 2 diabetes mellitus and chronic periodontitis: A randomized controlled trial.

Periodontitis and diabetes are highly prevalent conditions whose association has long been recognized. To evaluate the effect of non-surgical periodontal treatment on serum HbA1c (haemoglobin A1c or glycated haemoglobin) levels in patients with type 2 diabetes. This was a 6-month, single-masked, randomized clinical trial based on 90 patients (HbA1c: 7.7% (61mmol/mol)±1.13%) who were randomly assigned to either the treatment group (oral hygiene instructions+scaling and root planing using ultrasound and Gracey curettes) or the control group (oral hygiene instructions+supragingival removal of plaque and calculus using ultrasound). Pocket depth, gingival index, and plaque index were assessed at baseline and after 3 and 6months together with determinations of fasting plasma glucose, HbA1c, and bacterial counts. Treatment significantly improved the periodontal and metabolic parameters (p<.05), whereas in the control group no improvement was observed. These results were consistent with the bacteriological results in most but not all cases. Non-surgical periodontal treatment resulted in a better glycaemic status of type 2 diabetes patients and demonstrated the importance of oral health in their general health.

Efficiency of fenofibrate in facilitating the reduction of central macular thickness in diabetic macular edema.

Purpose:The purpose of this study is to study the benefit of addition of oral fenofibrate to the current regimen of diabetic macular edema (DME) management and quantify its effect on macular thickness and visual function in DME.Methods:Fifty-three eyes of 50 patients were randomized into treatment (Group A) (oral fenofibrate 160 mg/day) and control groups (Group B). Both groups underwent treatment of DME as per the standard treatment protocol of our hospital including intravitreal injections (anti-vascular endothelial growth factor/steroid) and grid laser. Patients were followed up every 2 months to note the visual acuity and central macular thickness (CMT) for 6 months.Results:Our groups were matched with respect to age (P = 0.802), mean diabetic age (P = 0.878), serum HbA1C levels (P = 0.523), and serum triglyceride levels (P = 0.793). The mean reduction in CMT was 136 μ in Group A and 83 μ in Group B at the end of 6 months. This difference was statistically significant (P = 0.031). Visual acuity improvement was 0.15 in Group A and 0.11 in Group B at the end of 6 months (P = 0.186). On subgroup analysis in Group A, we found that there was no difference in reduction of CMT between hypertensives and normotensives (P = 0.916), in patients with normal triglyceride levels and increased triglyceride levels (P = 0.975).Conclusion:Addition of fenofibrate to the standard protocol of DME management seems to facilitate reduction of CMT and probably have an added benefit on the visual functions.

Effect of diabetes mellitus type 2 on salivary glucose, immunoglobulin A, total protein, and amylase levels in adults: A systematic review and meta-analysis of case-control studies.

Background:Saliva is a fluid with the complex compound which can be used as diagnostic markers for type 2 diabetes (T2D). This meta-analysis evaluated salivary glucose, immunoglobulin A (IgA), total protein, and amylase levels in adult T2D compared with the controls as well as the correlation of salivary glucose levels with serum glucose and hemoglobin A1C (HbA1c) levels in both groups.Materials and Methods:Web of Science, Scopus, PubMed, and Cochrane Library databases were searched up to July 2017. A random-effects analysis was performed using the mean difference (MD) and 95% confidence intervals. The search terms were “T2D, IgA, amylase, total protein, or glucose” combination with “saliva.” The studied variables were the sample size, the percentage of male, the mean age, the condition of saliva sampling, and the salivary levels of mentioned factors.Results:A total of 25 studies were included in this meta-analysis with 1432 and 900 diabetic patients and healthy controls, respectively. MD of salivary glucose level in patients with T2D, compared with the healthy controls, in fasting and nonfasting conditions were 6.23 mg/dL (P = 0.0002) and 6.70 mg/dL (P < 0.00001), respectively. Furthermore, the fasting salivary total protein in the patients was significantly higher than the controls (MD = 167.96 mg/dL; P = 0.03). Non-fasting salivary amylase and secretory IgA levels were significantly lower in the patients (MD = −48.61 IU/mL; P < 0.00001) than in the controls (MD = −9.42 IU/mL; P = 0.0006), respectively. The pooled estimate showed a significant correlation between salivary and serum glucose in the patients (r = 0.765; P < 0.001) and the controls (r = 0.646; P < 0.001) and between salivary glucose and serum glycated hemoglobin in the patients (r = 0.721; P < 0.001).Conclusion:Measurement of these salivary factors can be helpful for diagnostic and monitoring purposes of T2D. In addition, salivary glucose as a diagnostic tool can evaluate serum glucose and HbA1c levels in the diabetic patients.

Could Insulin and Hemoglobin A1c Levels be Predictors of Hunger- Related Malnutrition/Undernutrition Without Disease?

Malnutrition results in functional changes in the liver and pancreas that negatively affect carbohydrate metabolism. The aim of this study was to evaluate whether insulin hormone and glycated hemoglobin A1c (HbA1c) could serve as predictors of hunger-related malnutrition/undernutrition without disease in adults. The Malnutrition Universal Screening Tool (MUST) was used to assess malnutrition in this single-center, cross-sectional study. The malnourished group (n = 67) comprised patients with a MUST score of ≥ 2, and the control group (n = 31) included subjects with a MUST score of 0 - 1. Serum albumin, prealbumin, C-reactive protein (CRP), fasting glucose, fasting insulin, hemoglobin and HbA1c levels, body mass index (BMI), and homoeostatic model for insulin resistance (HOMA-IR) scores were compared between the two groups. No significant difference was determined between the control and malnourished groups in respect of age or gender. HbA1c [5.5% (5 - 6.2) vs. 5.2% (3.9 - 6.7), p = 0.001], insulin levels [7.37 (2.36 - 52.16) vs. 3.91(1.17 - 30.08) µIU/mL, p < 0.001], and BMI [21.7 (14.1 - 34.0) vs. 17.8 (12.0 - 26.6) kg/m2, p < 0.001] were significantly lower in the malnourished group. Logistic regression analysis revealed that BMI was the only significant parameter (odds ratio [95% confidence interval] 0.680 [0.543 - 0.852]). Plasma insulin and HbA1c levels were significantly decreased in young adult malnourished patients without disease who had normal fasting glucose levels. These two parameters are known to be unaffected by inflammatory states, and therefore warrant further research on larger and different age sub-populations to assess if they might be early predictors of hunger-related malnutrition without disease.

Adrenocortical Suppression in Children with Nephrotic Syndrome Treated with Low-Dose Alternate Day Corticosteroids.

Corticosteroids form the mainstay of therapy for all forms of nephrotic syndrome. The long-term use of this medication is associated with serious side effects including adrenocortical suppression. The primary objective of this study was to identify adrenocortical suppression (assessed by single morning serum cortisol levels) in children with nephrotic syndrome on treatment with low-dose alternate day steroids. This cross-sectional study was conducted in the Department of Pediatrics in a tertiary care hospital from January 2014 to January 2015. Seventy children (1–18 years) with nephrotic syndrome (steroid sensitive and resistant) who were in remission and on low-dose alternate day steroids for at least 8 weeks or had received steroids of 2 mg/kg/d for at least 2 weeks in the last 1 year (infrequent relapsers) were enrolled. Relevant history was taken, clinical examination was done and blood samples were drawn for serum cortisol, lipid profile, kidney function tests, fasting blood sugar, glycated hemoglobin (HbA1c), and serum albumin. Forty percent (28/70) children had adrenocortical suppression as assessed by low morning serum cortisol levels. The mean serum cortisol levels were 188 nmol/L and were significantly lower in frequently relapsing individuals (85.9 nmol/L) as compared to other types of nephrotic syndrome (P = 0.05). The prevalence of adrenocortical suppression was higher in steroid-resistant patients (57%) as compared to 28% in frequently relapsing and 11% in steroid-dependent patients. Fifty-seven percent of patients with adrenocortical suppression had short stature while 50% had obesity. All individuals had normal serum HbA1c levels. The cumulative steroid doses and total duration of corticosteroid therapy were significantly higher in patients with adrenocortical suppression. Children with nephrotic syndrome treated with low-dose alternate day steroids have a high prevalence of adrenocortical suppression on screening with single morning cortisol sample. Those with frequently relapsing or steroid-resistant diseases are at a higher risk of suppression.

Glucagon-like peptide-1 receptor agonists reduced the low-density lipoprotein cholesterol in Japanese patients with type 2 diabetes mellitus treated with statins

Patients with type 2 diabetes mellitus (T2DM) often have hypercholesterolemia, and their serum low-density lipoprotein cholesterol (LDL-C) levels are not always well-controlled even by statin treatment. The glucose-lowering glucagon-like peptide-1 receptor agonists (GLP-1RAs) are reported to change the lipid profiles in T2DM patients, but their effects have been unclear. We examined whether GLP-1RAs affect serum cholesterol levels in T2DM patients with/without statin treatment. We retrospectively assessed the baseline and follow-up (median 119days) levels of serum lipids, HbA1c, and body mass index (BMI) in 103 and 214 Japanese patients with T2DM in whom GLP-1RAs were initiated (GLP-1RA group) and not initiated (control group), stratified by the use of statins. In the GLP-1RA group, the LDL-C, HbA1c, and BMI significantly decreased; high-density lipoprotein cholesterol and triglycerides did not decrease during follow-up. In the control group, these did not decrease. Among the statin users, the percentage change in LDL-C during follow-up was significantly greater in the GLP-1RA group than that in the control group (-6.5% vs -1.0%, P=.040). In the GLP-1RA group, the percentage reduction in LDL-C was not associated with that in BMI but was associated with that in HbA1c only among the statin users. Our findings demonstrated that GLP-1RAs reduced the serum LDL-C in Japanese patients with T2DM treated with statins. The percentage reduction in LDL-C by GLP-1RAs was associated with that in HbA1c, but not associated with that in BMI. The combination of GLP-1RAs and statins may be a reasonable therapeutic option in T2DM with dyslipidemia.

Association analysis of advanced glycation end-products in lens with diabetic retinopathy severity

Background The deposition of advanced glycation end products (AGEs) in lens is the risk factor of diabetic complications.Researches revealed that AGEs has autofluorescence.Crystallin is a longevity protein.AGEs accumulation is probably associated with diabetic retinopathy (DR). Objective This study was to evaluate the association of AGEs autofluorescence intensity with diabetes and with DR. Methods A cross-sectional study was carried out under the approval of Ethic Committee of Shenyang He Eye Hospital and informed consent of each patient.One hundred eyes of 100 patients with age-related cataract aged 50-70 years were included in He Eye Hospital from September to December 2015.The patients were divided into non-diabetes group (40 patients) and diabetes group (60 patients), and then the patients in diabetes group were subdivided into non-DR (NDR) group, non-proliferating DR (NPDR) group and proliferating DR (PDR) group according to the DR grading criteria, 20 patients for each.Glycosylated henoglobin Alc (HbA1c) and fasting plasma glucose (FPG) were detected for each subject, and the lens autofluorescence was assayed with lens fluorescence biomicroscope (Clearpath DS120). The association of lens autofluorescence intensity with serum HbA1c level or DR severity was analyzed. Results The age and diabetes course were matched among the non-diabetes group, NDR group, NPDR group and PDR group (F=2.587, 2.899, both at P>0.05), and the FBS and HbA1c level were evidently higher in the NDR group, NPDR group and PDR group than those in the non-diabetes group (all at P<0.01). The autofluorescence intensity of lens was (0.159±0.032), (0.256±0.024), (0.319±0.013) and (0.394±0.035) cd in the non-diabetes group, NDR group, NPDR group and PDR group, respectively, showing a significant difference among the groups (F=90.265, P=0.000). The autofluorescence intensity of lens in the NDR group, NPDR group and PDR group was significantly increased in comparison with the non-diabetes group and the autofluorescence intensity of lens was gradually increased with the severity of DR (all at P<0.01). A positive linear correlation was found between autofluorescence intensity of lens and serum HbA1c level in diabetes patients (r=0.654, P<0.05). Conclusions The autofluorescence intensity of AGEs in lens appears to be associated with the severity of DR and HbA1c.The autofluorescence intensity of AGEs in the lens of diabetes patient is probably one of the evaluation indexes of early stage of DR. Key words: Glycosylation end products, advanced/metabolism; Diabetes mellitus/complications; Autofluorescence, lens; Diabetic retinopathy

Study of serum Zinc status among type 2 diabetes mellitus patients

Background: Both microvascular and macrovascular complications in diabetes are related to oxidative stress. Zinc which has antioxidant property, delays diabetic complications. The present study was conducted with the objective to study the relationship between serum Zinc level and HbA1C level in newly diagnosed type 2 diabetes mellitus and to compare serum Zinc level with its risk factors.Methods: The present study was a cross sectional study, conducted on 100 patients attending the outpatient department at Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai during the period from May 2015 to October 2015. Of them 50 were newly diagnosed type 2 diabetics and considered as diabetic group and other 50 were considered as controls, who attended the master health check-up. All patients were subjected to thorough general and systemic examination. Under strict aseptic precautions blood sample was collected from all the patients and the serum was investigated for creatinine, urea, zinc, HbA1c, cholesterol, triglycerides and fasting blood glucose. The data obtained were analysed using Microsoft excel software. Correlation was found out in SPSS by using regression equation.Results: The body mass index (BMI) and mean systolic blood pressure (SBP) was significantly higher (p&lt;0.001) in diabetic group as compared to controls. Serum levels of HbA1C and fasting blood glucose (FBG) levels were found to be significantly higher in diabetic group than in controls (p&lt;0.001). Serum zinc levels were significantly higher in control group (p&lt;0.001). Mean zinc value decreases with increase in HbA1c, FBG, BMI, SBP, DBP, triglycerides and cholesterol and the difference was statistically significant (p value &lt;0.01). The relation between Pearson correlation coefficient for zinc and the above parameters were higher in diabetics than controls.Conclusions: Lower serum zinc levels were found to be responsible for the development of macrovascular complications in type-2 diabetics. Hence there is a need for zinc supplementation in diabetic patients to prevent long term complications associated with it.

Influence of glycosylated hemoglobin on the choroidal thickness.

The aim of the study reported here was to assess the influence of serum HbA1c levels on foveal choroidal thickness in diabetic patients. A total of 122 eyes from 122 patients who had type 2 DM were studied in this prospective, cross-sectional study. Patients were divided into three groups: 43 patients (43 eyes) without diabetic retinopathy (NDR), 39 patients (39 eyes) with diabetic retinopathy and no macular edema (DR/ME-), 40 patients (40 eyes) with diabetic retinopathy and macular edema (DR/ME+). Central foveal thicknesses and subfoveal choroidal thicknesses were noted. Subfoveal choroidal thickness measurement was taken perpendicularly from the outer part of the retinal pigment epithelial layer to the line corresponding to the choroidal-scleral junction. Serum glycosylated hemoglobin (HbA1c) levels were evaluated. No significant differences in age, gender, pseudophakia were observed between the groups. There was no significant difference in HbA1c value among the three diabetic groups. Mean foveal choroidal thickness was 270.09±42.41 in NDR group, 243.18±30.21 in DR/ME- group and 250.90±40.06 in DR/ME+ group. Mean foveal choroidal thickness in NDR group was significantly different from DR/ME- group. There was no statistically significant difference between the other groups among foveal choroidal thicknesses. There was no correlation between HbA1c and foveal choroidal thickness. Multiple regression analyses of two diabetic retinopathy groups showed no significant correlation between foveal choroidal thickness and HbA1c and also no significant correlation between foveal choroidal thickness and duration of diabetes. Serum HbA1c levels were not correlated with foveal choroidal thickness. Choroidal thickness is effected by several factors as axial length, age and systemic diseases.

Effect of Dietary Magnesium Intake on Serum Levels of C-reactive Protein and Lipid Profile in Patients with Type II Diabetes

Introduction: Diabetes is a chronic disease with changes in micro-nutrients, including decrease of magnesium levels, increase of inflammation and impair of lipid metabolism. The aim of this study was to investigate the effect of magnesium on the lipid profile, blood sugar and inflammation in patients with diabetes type 2. Materials & methods: This interventional study was performed on 40 patients with type II diabetes (16 men and 24 women). Cases were divided randomly into two groups: treatment group 200 mg magnesium daily for a month and control group placebo received. Immediately before and after the treatment period blood samples were taken to determine the FBS, HbA1C, magnesium and lipid profile. Findings: In this study, there was a negative correlation between serum levels of magnesium and CRP. Also an inverse relationship between magnesium and serum levels of HbA1c were observed. In treatment group mean of glucose (FBS) and glycosylated hemoglobin (HbA1C) both decreased significantly (p less-than 0.001). In treatment group serum TG and LDL decreased significantly (p less-than 0.05) and HDL levels increased (p less-than 0.001). Discussion & conclusions: The results showed that oral administration of magnesium in patients with diabetes type II reduces inflammation, improves lipid profile and regulates blood sugar. It seems that oral magnesium intake for a month can be effective in correcting the lipid profile of patients with type II diabetes.

Premenapozal Kadınlarda Myoma Uteri Gelişimi Üzerine Visseral/Trunkal Yağ Oranının ve İnsülin Direncinin Etkisinin Değerlendirilmesi

Objectives: Within the scope of this study, we aimed to analyze the effect of visceral and truncal fat rate and insulin resistance on myoma uteri progression in premenopausal women. Materials and Methods: 100 patients, who have been applied to the gynecology department with myoma diagnosis and 50 control patients who had no myomas and had similar properties with the patient group were included in the study. Anthropometric measures, pre-prandial serum glucose, HbA1c, insulin, LDL-cholesterol, triglyceride, HDL-cholesterol and total cholesterol levels were studied. All statistical analyses were performed with SPSS 16.0 statistical soft-ware and a level of p < 0.05 is accepted statistically significant. Results: Truncal fat rate of the patient group is found higher than the control group (p=0.014). Mean HbA1c was higher and statistically significant (p< 0.001) in the patient group. Mean HDL-C was found significantly lower in the patient group (p= 0.001). Conclusion: In our study, higher levels of truncal fat rate in the patient group can be inferred to the production of estrogen in truncal fat tissue due to increased aromatase activity and thus myoma frequency was increased. We have also determined in this study that higher HbA1c levels in patient group caused an increase in the risk of myoma up to 3.5 times. Normal values of HOMA-IR suggest that insulin resistance is not a risk factor for the development of myoma. It is believed that there is a negative correlation between hyperlipidemia and myoma.

Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression.

Background and AimGlycated hemoglobin (HbA1c) is a long-term measure of glucose control. Although recent studies demonstrated a potential association between HbA1c levels and the risk of atrial fibrillation (AF), the results have been inconsistent. The aim of this meta-analysis is to evaluate the utility of HbA1c level in predicting AF.MethodsPubMed and the Cochrane Library databases were searched for relevant studies up to March 2016. Prospective cohort studies and retrospective case-control studies were included. Relative risk (RR) or odds ratio (OR) with 95% confidence intervals (CIs) of AF development were determined for different HbA1c levels. The random effect model was conducted according to the test of heterogeneity among studies. Subgroup analyses and meta-regression models were carried out to identify potential sources of heterogeneity.ResultsEight prospective cohort studies with 102,006 participants and 6 retrospective case-control studies with 57,669 patients were finally included in the meta-analysis. In the primary meta-analysis, HbA1c levels were not associated with an increased risk of AF whether as a continuous (RR, 1.06; 95% CI, 0.96–1.18) or categorical variable (RR, 0.99; 95% CI, 0.83–1.18). Nevertheless, prospective studies showed about 10% increased risk of AF with elevated HbA1c levels both as a continuous (RR, 1.11; 95% CI, 1.06–1.16) and as a categorical variable (RR, 1.09; 95% CI, 1.00–1.18). In subgroup analyses, pooled results from studies with longer follow-up durations, published after 2012, aged < 63 years, with exclusion of cardiac surgery patients demonstrated an increased risk of AF for every 1% increase in HbA1c levels, while studies conducted in the United States with longer follow-up (more than 96 months), larger sample size and higher quality score (≥6) showed an increased risk of AF for higher HbA1c level as a categorical variable.ConclusionsElevated serum HbA1c levels may be associated with an increased risk of AF, but further data are needed. Serum HbA1c levels might be considered as a potential biomarker for prediction of AF.

Impact of poor glycemic control of type 2 diabetes mellitus on serum prostate-specific antigen concentrations in men.

BackgroundTo evaluate the impact of poor glycemic control of type 2 diabetes mellitus (T2DM) on serum prostate-specific antigen (PSA) concentrations in men.MethodsWe performed a prospective analysis of 215 consecutive patients affected by erectile dysfunction (ED). ED was evaluated using the IIEF-5 questionnaire and the poor glycemic control (PGC) of T2DM was assessed according to the HbA1c criteria (International Diabetes Federation). Patients were divided into PGC group (HbA1c ≥ 7%) and control group (CG) (HbA1c < 6%). Correlations between serum HbA1c levels and various variables were evaluated and multivariate logistic regression analyses were carried out to identify variables for PGC.ResultsWe compared 110 cases to 105 controls men ranging from 44 to 81 years of age, lower PSA concentrations were observed in men with PGC (PGC mean PSA: 0.9 ng/dl, CG mean PSA: 2.1 ng/dl, p < 0.001). Also mean prostate volume was 60% was smaller among men with PGC compared with men with CG (PGC mean prostate volume: 26 ml, CG prostate volume: 43 ml, p < 0.001). A strong negative correlation was found between serum HbA1c levels and serum PSA (p < 0.001 and r = −0.665) concentrations in men with PGC. We also found at the multivariate logistic regression model that PSA, prostate volume and peak systolic velocity were independent predictors of PGC.ConclusionOur results suggest that there is significant impact of PGC on serum PSA levels in T2DM. Poor glycemic control of type 2 diabetes was associated with lower serum PSA levels and smaller prostate volumes.

Preoperative Hemoglobin A1c and the Occurrence of Atrial Fibrillation Following On-pump Coronary Artery Bypass Surgery in Type-2 Diabetic Patients.

We investigated the association of the preoperative hemoglobin A1c (HbA1c) with occurrence of postoperative atrial fibrillation (POAF) in type-2 diabetic patients who underwent isolated coronary artery bypass grafting. We prospectively studied 708 type-2 diabetes patients [433 men ([61.2%)], candidate for isolated coronary artery bypass grafting. Biochemistry profile was measured on the day of operation. All patients were telemonitored for 72 hours after operation for the occurrence of atrial fibrillation. The role of HbA1c as a predictor for the occurrence of atrial fibrillation was then evaluated. A total of 109 (15.3%) patients developed POAF. Patients in the atrial fibrillation group tended to be older, with prolonged longer diabetes, and have renal failure, chronic obstructive pulmonary disease, and hypertension. In the univariable and multivariable regression model, HbA1c was not a predictor for POAF. Serum level of HbA1c could not be used as a predictor for the development of POAF.

Correlation of long-term glycemic control as measured by glycated hemoglobin with serum angiopoietin-like 6 protein levels in type 2 diabetes mellitus patients.

AIMS:Angiopoietin-like growth factors (ANGPTLs) regulate glucose, lipid homeostasis, and insulin sensitivity. This study aimed to find whether long-term glycemic control (glycated hemoglobin [HbA1c]) has any correlation with serum ANGPTL6 levels in patients of type 2 diabetes mellitus.MATERIALS AND METHODS:It was an open-label, observational, prospective clinical study. Sixty-five participants (41 diabetic patients receiving daily dose of oral metformin for a minimum of 3 months and 24 matched controls) completed the study. A single venous blood sample was taken from each participant to determine serum HbA1c and serum ANGPTL6 levels. Comparison of serum ANGPTL6 levels according to the HbA1c levels, in groups A, B, and C ranging from 6.5%–8%, 8.1%–9.5%, and >9.5%, respectively, was done using Kruskal–Wallis H-test followed by pairwise comparisons.RESULTS:Serum HbA1c and serum ANGPTL6 levels were raised significantly (P < 0.05) in diabetic patients when compared with control participants. A positive correlation was observed between serum HbA1c and serum ANGPTL6 levels (r = 0.88, 95% confidence interval 0.81, 0.92). Mean ANGPTL6 level for Group A (n = 20) was 394.3 pg/ml, for Group B (n = 8) 692.8 pg/ml, and for Group C (n = 13) 896.2 pg/ml.CONCLUSIONS:Serum ANGPTL6 levels were significantly higher in type 2 diabetic patients in comparison with healthy controls. Poor glycemic control in diabetes mellitus as reflected by higher serum HbA1c levels is associated with raised serum ANGPTL6 levels.

A comparative study of event-related potential P300 between normal individuals and individuals with prediabetes

Background: Prediabetes is the early stage of Type 2 diabetes mellitus. Altered glucose metabolism, atherosclerosis, and inflammation of blood vessels are seen in prediabetes. This may lead to neurodegeneration and cognitive decline. Event-related potential P300 can easily detect cognitive decline before the appearance of any neurological manifestations. Aims and Objective: The aim of this study is to assess and compare the P300 latencies in normal subjects and individuals with prediabetes. Materials and Methods: The study included 25 individuals with prediabetes and 25 healthy controls between the age group of 20 and 50 years. After obtaining informed consent, the study subjects were evaluated by history, general physical, and systemic examination. Serum HbA1c level was estimated. P300 was recorded using the standard auditory oddball paradigm from the vertex (Fz, Cz, and Pz) in response to stimuli presented monaurally through head phones. The peak latencies of P300 of target stimuli were calculated. Results: Mean P300 latency in normal individuals was 305.15 ms ± 27.80 and in individuals with prediabetes 383.98 ms ± 22.02 which is statistically significant (P ˂ 0.05). Conclusion: Increase in P300 latencies indicates the existence of a cognitive decline in individuals with prediabetes compared to healthy individuals.

A Case Control Study of Levels of Serum Magnesium and HbA1c among Patients with Type 2 Diabetes

A Case Control Study of Levels of Serum Magnesium and HbA1c among Patients with Type 2 Diabetes