Home About us Contact
|
Home About us Contact | ||
|
|
||
Diagnosed Type 2 Diabetes (diagnosed + type_2_diabetes)
Selected AbstractsRelationship between mean blood glucose and glycated haemoglobin in Type 2 diabetic patientsDIABETIC MEDICINE, Issue 2 2008K. Makris Abstract Aims To correlate the values of MBG to HbA1c in Greek patients with Type 2 diabetes and/or metabolic syndrome. Methods We followed up 140 Greek adult patients: 92 patients with Type 2 diabetes treated with insulin or oral glucose-lowering medication, and 48 patients with newly diagnosed Type 2 diabetes or metabolic syndrome not receiving any treatment. MBG was calculated for each patient from self-measurements of blood glucose using a portable glucometer, made six times a day (before eating and 2 h after a meal), three times a week for 1 month. HbA1c was determined by HPLC at 0 and 12 weeks. Results, HbA1c at 0 (x) and 12 weeks (y) correlated strongly (y = 0.790x + 1.115, r = 0.92), confirming that the patient's glycaemic status remained stable during the whole period of follow-up. Linear regression was performed on MBG values; HbA1c at 12 weeks, sex, age, body mass index (BMI) and patient status (Type 2 diabetes treated or not) were used as independent variables. None of the independent variables reached statistical significance in the model, with the exception of HbA1c at 12 weeks. The final model was: MBG (mg/dl) = (34.74 × HbA1c) , 79.21, r = 0.93; or MBG (mmol/l) = 1.91 × HbA1c , 4.36, r = 0.93. Conclusions Our results establish for the first time a strong correlation between MBG and HbA1c in Type 2 diabetic patients and support the idea of expressing HbA1c results as MBG. This will help patients to gain a clearer interpretation of the result, with less confusion. This simplification will allow every person with diabetes using home glucose-monitoring to understand his or her own target level. [source] Alveolar bone loss associated with glucose tolerance in Japanese menDIABETIC MEDICINE, Issue 9 2003T. Marugame Abstract Aims Type 2 diabetes is known to affect alveolar bone loss (ABL). The purpose of this study was to examine whether impaired glucose tolerance (IGT) is associated with ABL, as is diabetes. Methods A case,control study was performed with 664 Japanese men aged 46,57 years. Panoramic radiographs revealed 513 severe ABL cases, 22 moderate ABL cases, and 129 controls with good alveolar bone. Diabetes status was classified into normal glucose tolerance (NGT), impaired fasting glucose (IFG), IGT, and newly diagnosed diabetes according to the fasting plasma glucose and 75-g oral glucose tolerance test (OGTT). Diabetes under treatment was excluded. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained from ordinal logistic regression analysis. Statistical adjustment was made for total cholesterol, HDL-cholesterol, triglyceride, rank in the Self Defence Forces (SDF), cigarette-years, alcohol use, body mass index, previous 10 years' brushing habits and instrument use other than toothbrush, and history of periodontal treatment. Results A significant, approximately three-fold increase in the crude OR (crude OR = 3.28; 95% CI = 1.16,9.27) and non-significant 2.6-fold increase in the adjusted OR (adjusted OR = 2.55; 95% CI = 0.86, 7.54) of ABL was observed among men with newly diagnosed Type 2 diabetes compared with the reference group (NGT combined with IFG). However, there was no association between IGT and ABL (adjusted OR = 0.99; 95% CI = 0.59,1.64). Conclusions Type 2 diabetes, but not IGT, was positively associated with ABL. Preventive maintenance against periodontitis is important in middle-aged men with diabetes. [source] Factors affecting uptake of an education and physical activity programme for newly diagnosed type 2 diabetesEUROPEAN DIABETES NURSING, Issue 1 2008MPH Postgraduate Research Associate, S Visram BA Hons Abstract Background: Intensive lifestyle intervention involving weight reduction and moderate physical activity has been shown to help regulate, and even prevent, type 2 diabetes. Aim: This study sought to explore factors affecting uptake of an education and physical activity programme for those diagnosed with type 2 diabetes. Method: Focus group discussions were conducted with individuals who completed the programme and semi-structured interviews were conducted with those who declined the invitation to attend. Data were analysed using a thematic framework approach and key similarities and differences between the groups were identified. Results: The 11 programme participants studied appeared to have received clearer messages about the severity of unmanaged diabetes, whereas the 10 non-attenders studied felt that co-morbidities posed greater risks to their health. There were major concerns among both groups about undertaking exercise, and strategies for diabetes management focused heavily on dietary modification. Conclusion: The findings of this study suggest that fears and lack of understanding about both diabetes and exercise can act as barriers to engaging in physical activity. These findings are supported by the literature and highlight the need for more tailored programmes of lifestyle intervention for those with type 2 diabetes. Copyright © 2008 FEND [source] A combination of HbA1c, fasting glucose and BMI is effective in screening for individuals at risk of future type 2 diabetes: OGTT is not neededJOURNAL OF INTERNAL MEDICINE, Issue 3 2006M. NORBERG Abstract. Objective., To identify a screening model that predicts high risk of future type 2 diabetes and is useful in clinical practice. Design and methods., Incident case-referent study nested within a population-based health survey. We compared screening models with three risk criteria and calculated sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and attributable proportion. We used fasting plasma glucose (FPG) alone or with an oral glucose tolerance test (OGTT), glycosylated haemoglobin A (HbA1c) (normal range 3.6,5.3%), body mass index (BMI), triglycerides and family history of diabetes (FHD). Setting., Participants in a health survey at all primary care centres (n = 33 336) and subjects with diagnosed type 2 diabetes in primary and hospital care (n = 6088) in Umeå during 1989,2001. Subjects., Each of the 164 subjects who developed clinically diagnosed type 2 diabetes (median time to diagnosis of 5.4 years) and 304 sex- and age-matched referents without diabetes diagnosis. Results., Screening models with at least one criterion present had sensitivities of 0.90,0.96, specificities of 0.43,0.57 and PPVs of 8,9%. Combinations of the criteria, FPG , 6.1 mmol L,1 (capillary plasma), HbA1c , 4.7% and BMI , 27 in men and BMI , 30 in women, had sensitivities, specificities and PPVs of 0.66%, 0.93% and 32%, and 0.52%, 0.97% and 46% respectively. Using FHD as one of three risk criteria showed comparable results. Addition of triglycerides or OGTT did not improve the prediction. Conclusions., The combination of HbA1c, FPG and BMI are effective in screening for individuals at risk of future clinical diagnosis of type 2 diabetes. OGTT or FHD is not necessary. [source] The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic reviewJOURNAL OF INTERNAL MEDICINE, Issue 1 2004M. G. Wulffelé Abstract. Background., The UKPDS 34 showed that intensive treatment with metformin significantly reduces macrovascular end-points and mortality in individuals with newly diagnosed type 2 diabetes compared with intensive treatment with insulin or sulphonylurea derivatives, despite similar glycaemic control. How this should be explained is as yet unclear. We hypothesized that metformin may have a glucose-lowering independent effect on blood pressure and lipid profile. In order to test this hypothesis we systematically reviewed the literature and pooled the data obtained in a meta-analysis. Methods., Included were randomized-controlled trials in patients with type 2 diabetes mellitus and metformin treatment lasting at least 6 weeks. To identify all eligible trials we conducted electronic searches using the bibliographic databases Medline and Embase, contacted the manufacturer and checked obtained publications for cross-references. Results., Forty-one studies (3074 patients) provided data on blood pressure and/or lipid profile. When compared with control treatment, metformin associated effects on systolic and diastolic blood pressure and HDL cholesterol were small and statistically not significant [,1.09 mmHg 95% confidence interval (,3.01,0.82), P = 0.30; ,0.97 (,2.15,0.21) mmHg, P = 0.11 and +0.01 (,0.02,0.03) mmol L,1, P = 0.50, respectively]. Compared with control treatment, however, metformin decreased plasma triglycerides, total cholesterol and LDL cholesterol significantly [,0.13 (,0.21,,0.04) mmol L,1, P = 0.003; ,0.26 (,0.34,,0.18) mmol L,1, P < 0.0001 and ,0.22 (,0.31,,0.13) mmol L,1, P < 0.00001, respectively]. We found no indications for publication bias. Of note, glycaemic control as assessed by HbA1c was better with metformin than with control treatment [,0.74 (,0.84,,0.65) percentage point; P < 0.00001]. When studies were subdivided into tertiles according to increasing difference in glycaemic control between metformin and control treatment, it appeared that in case of near similar glycaemic control metformin had no effect versus control treatment on triglycerides, whereas still there was a significant effect on total and LDL cholesterol. Conclusions., This meta-analysis of randomized-controlled clinical trials suggests that metformin has no intrinsic effect on blood pressure, HDL cholesterol and triglycerides in patients with type 2 diabetes. This drug, however, independent of its effect on glycaemia, reduces total and LDL cholesterol significantly, but the reductions in these variables are relatively small. [source] Cardiovascular disease and risk factors in persons with type 2 diabetes diagnosed in a large population screening: The Nord-Trøndelag Diabetes Study, NorwayJOURNAL OF INTERNAL MEDICINE, Issue 6 2000T. Claudi Abstract. Claudi T, Midthjell K, Holmen J, Fougner K, Krüger Ø, Wiseth R (University of Tromsø/Rønvik Health Center, Bodø; National Institute of Public Health, Community Medicine Research Unit, Verdal; University Hospital of Trondheim; and Norwegian University of Science and Technology, Trondheim, Norway). Cardiovascular disease and risk factors in persons with type 2 diabetes diagnosed in a large population screening: The Nord-Trøndelag Diabetes Study, Norway. J Intern Med 2000; 248: 493,501. Objective. To study cardiovascular status and risk factors in persons with newly diagnosed type 2 diabetes and controls in a large population. Design. Case,control study. Setting. Population screening Subjects. The screening of 74 499 individuals (88.1%), aged 20 years and older, in Nord-Trøndelag County, Norway, during 1984,86 detected 428 persons with undiagnosed diabetes according to the 1980 WHO criteria, of whom 205 attended a clinical follow-up examination assessing cardiovascular status and risk factors. Methods. For each of 205 cases, one control person matched by age and sex underwent the same clinical examination. Lipids, body mass index, waist/hip ratio, blood pressure, pulse rate, blood pressure medication, kidney function, cardiovascular disease, family history and lifestyle were recorded. Results. At the screening prior to the diagnosis of diabetes, those with diabetes reported poorer general health, less physical activity, more siblings with diabetes and more frequent use of antihypertensive medication. They had higher body mass index, systolic and diastolic blood pressure and pulse rate compared with controls. At the clinical evaluation, diabetics had higher urine albumin levels, increased waist/hip ratio, and higher total cholesterol/HDL cholesterol ratios than the controls. They also reported a greater incidence of angina pectoris and had more ECG changes. Conclusions. Diabetics presented with more cardiovascular risk factors, angina pectoris and ECG changes than the controls, and they had an established metabolic syndrome more often than controls. These results suggest that prevention of cardiovascular disease in diabetics requires earlier diagnosis of the diabetes. [source] | ||||||||||