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Blood Glucose Testing (blood + glucose_testing)
Selected AbstractsScreening and diagnosis of prediabetes: where are we headed?DIABETES OBESITY & METABOLISM, Issue 2007K. G. M. M. Alberti It is currently estimated that more than 300 million people have impaired glucose tolerance (IGT), putting them at increased risk for type 2 diabetes mellitus (T2DM) and its adverse consequences. In addition, many others are at risk on the basis of a family history of T2DM, obesity, dyslipidaemia and hypertension. Screening for risk should include both blood glucose testing in high-risk populations and prescreening (e.g. by questionnaire, waist circumference measurement) to identify high-risk individuals in overall low-risk populations; these individuals should then undergo glucose testing. Fasting plasma glucose measurement cannot diagnose IGT; the preferred definite test for diagnosis is oral glucose tolerance testing. [source] Factors affecting improved glycaemic control in youth using insulin pumpsDIABETIC MEDICINE, Issue 10 2010J. Wilkinson Diabet. Med. 27, 1174,1177 (2010) Abstract Aims, The purpose of this study was to evaluate factors associated with insulin pump therapy resulting in lower HbA1c levels in young people with Type 1 diabetes mellitus. Methods, Insulin pumps were downloaded from 150 youth (81 male), ages 5,20 years. Consecutive insulin pump downloads, 3 months apart, were available for 85 (43 male) of the 150 youth and changes in pump use were correlated with changes (, 0.5%, , 6 mmol/mol) in HbA1c levels. Results, Using cross-sectional data, lower HbA1c values correlated with use of more frequent daily insulin boluses (r = ,0.46, P < 0.0001) and more frequent blood glucose checks/day (r = ,0.35, P < 0.0001). Young people with HbA1c levels < 7.5% (58 mmol/mol) vs. values of 7.5,9.0% (58-75 mmol/mol) or , 9.0% (75 mmol/mol) tested blood glucose more frequently/day (P < 0.0001), bolused more frequently/day (P < 0.0001), reported more grams of carbohydrates eaten/day (P < 0.05) and had a higher per cent bolus insulin/day (P < 0.05) compared with the , 9.0% of youth. Using longitudinal data, 48 of 85 patients had a change in HbA1c level of , 0.5% (6 mmol/mol) between downloads (24 improved). Increased bolus insulin (OR = 1.15, P = 0.03) and time of temporary basal rate use (OR = 1.017, P = 0.01) predicted , 0.5% (6 mmol/mol) decrease in HbA1c in logistic regression. Conclusions, This study emphasizes the importance of blood glucose testing, of bolus insulin administration and of an increase in the time of temporary basal rate use in relation to improving glycaemic control. [source] Assessing diabetic control , reliability of methods available in resource poor settingsDIABETIC MEDICINE, Issue 3 2002A. P. Rotchford Abstract Aims and methods To examine the reliability of random venous or capillary blood glucose testing, random urine glucose testing, and a current symptom history in predicting a high HbA1c in Type 2 diabetic patients taking oral hypoglycaemic agents in a poorly controlled rural African population. Results For a cut-off point for HbA1c of , 8%, for random venous plasma glucose of , 14 mmol/L (present in 47.2% of subjects), specificity was 97.1% (95% CI 85.1,99.9), sensitivity 56.8% (48.8,64.5) and positive predictive value (PPV) 98.9% (94.2,99.9). HbA1c, 8% is predicted by a random capillary blood glucose of 17 mmol/L (present in 28.4% of subjects) with specificity 100% (90.0,100.0), PPV 100% (93.7,100.0) and sensitivity of 34.3% (27.2,42.1). HbA1c, 8% is predicted by the presence of heavy glycosuria (, 55 mmol/L) (present in 35.6%) with specificity 94.1% (80.3,99.3), sensitivity of 41.9% (34.1,49.9) and PPV 97.1% (89.9,99.6). Polyuria/nocturia (present in 31.3%) was the only symptom found to be associated with poor control, with a specificity for predicting HbA1c of , 8% of 81.5% (61.9,93.7), PPV 89.1% (76.4,96.4) and sensitivity 30.6% (22.9,39.1). Conclusions Where resources are short, random glucose testing can be used to detect a significant proportion of those with the worst control with a high degree of specificity enabling primary care staff to modify treatment safely. Where facilities are limited capillary blood or urine testing with reagent strips, may be substituted for venous plasma testing in the laboratory. A symptom history was insufficient to replace biochemical testing, but where this is unavailable, urinary symptoms may be helpful. Diabet. Med. 19, 195,200 (2002) [source] Type 1, tents, take-aways and toilets: how to manage at a music festivalPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 7 2010J Charlton BSc, PgCTLHE Abstract Maintaining optimal glycaemic control in people with type 1 diabetes is challenging. Attending a weekend music festival encompasses lifestyle activities that increase the challenge. These include: increased exercise, and changes in eating and alcohol consumption. The practicalities of blood glucose monitoring and insulin injections are also a consideration. The aim of this project was to identify realistic problems for people with type 1 diabetes attending a music festival, and to review current written advice and available literature in order to provide relevant information. No literature was identified. Fifty people with type 1 diabetes aged 18,40 years were randomly selected and sent a questionnaire enquiring about experiences. Thirteen responded (26%). The mean duration of diabetes was 11.7 years (range 1.5,28 years). All 13 respondents had attended a music festival; of these, 46% had attended one for the first time. Some of the concerns included: hypoglycaemia (31%), lack of food (23%), losing insulin and equipment (23%), and maintaining blood glucose levels (23%). Anxieties regarding hypoglycaemia resulted in 38% running blood glucose levels higher than normal. Thirty-eight percent experienced hypoglycaemia, the reasons being: increased activity (38%), eating less carbohydrate (8%), and reduced blood glucose testing (8%). Twenty-three percent attended the first aid tent: 15% regarding injections and 8% for non-diabetic reasons. An information leaflet regarding managing diabetes when attending a festival has been designed which includes feedback and tips from patients. The leaflet was evaluated by 50 people with type 1 diabetes, and 20 health care professionals. Currently, negotiations are underway with Diabetes UK, T in the Park festival organisers and the St Andrew's Ambulance Service to have an advice stand at the festival. Copyright © 2010 John Wiley & Sons. [source] Postnatal testing for diabetes in Australian women following gestational diabetes mellitusAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2009Melinda K. MORRISON Background:, Postnatal blood glucose testing is recommended for reclassification of glucose tolerance following a pregnancy affected by gestational diabetes mellitus (GDM); however, there are limited data on the postnatal follow-up sought by Australian women. Aims:, To describe postnatal diabetes testing patterns in Australian women following a pregnancy affected by GDM and identify factors associated with return for follow-up testing in accordance with the Australasian Diabetes in Pregnancy Society (ADIPS) guidelines. Methods:, A cross-sectional self-administered survey of 1372 women diagnosed with GDM between 2003 and 2005, sampled from the National Diabetes Services Scheme database. Results:, Postnatal diabetes testing was reported by 73.2% of survey respondents with 27.4% returning for an oral glucose test tolerance at six to eight weeks post-GDM pregnancy. Using logistic regression analysis, factors associated with appropriate postnatal testing were receiving individualised risk reduction advice (odds ratio (OR) 1.41 (1.08,1.84)) or written information (OR 1.35 (1.03,1.76)) and in two-way interactions, being under the care of an endocrinologist and not tertiary educated (OR 2.09 (1.49,2.93)) as well as seeing an obstetrician and diabetes educator during pregnancy (OR 1.72 (1.19,2.48)). Every five years increase in age reduced the likelihood of a woman returning for testing by 17%. Conclusions:, Specialist diabetes care in non-tertiary educated women, or a team approach to management with diabetes education and obstetric care may act to reinforce the need for postnatal diabetes testing in accordance with the ADIPS guidelines. Individualised follow up from a health professional and provision of written information following a GDM pregnancy may also encourage return for postnatal testing in this high-risk group. [source] | ||||||||||