Glycemic Control and Diabetic Complications—Is the Predominant Current Rationale Rational?
2
Citation
5
Reference
10
Related Paper
Citation Trend
Abstract:
Although the level of glycated hemoglobin (HbA 1C ) reflects chronic glycemic control, treatment-induced decreases in HbA 1C in patients who have established diabetes do not always predict beneficial clinical outcomes. Clinical outcomes are dramatically influenced by the history of previous glycemic control, the extent of current clinical complications, and the side effects of therapeutic agents. Rational approaches to the intensity of glycemic control in individual patients should take these factors into consideration, as well as in setting an appropriate goal for the HbA 1C target.Keywords:
Glycated hemoglobin
Although the level of glycated hemoglobin (HbA 1C ) reflects chronic glycemic control, treatment-induced decreases in HbA 1C in patients who have established diabetes do not always predict beneficial clinical outcomes. Clinical outcomes are dramatically influenced by the history of previous glycemic control, the extent of current clinical complications, and the side effects of therapeutic agents. Rational approaches to the intensity of glycemic control in individual patients should take these factors into consideration, as well as in setting an appropriate goal for the HbA 1C target.
Glycated hemoglobin
Cite
Citations (2)
The aim of the study was to compare two continuous glucose monitoring (CGM) systems, intermittently scanned CGM (isCGM) and real-time CGM (rtCGM), to determine which system achieved better glycemic control in pediatric patients.We carried out a retrospective cohort study of children and adolescents with type 1 diabetes, and compared the time in range (70-180 mg/dL), time below range (<70 mg/dL) and time above range (>180 mg/dL), and estimated glycated hemoglobin levels between patients on isCGM and rtCGM.Of the 112 participants, 76 (67.9%) used isCGM and 36 (32.1%) used rtCGM for glycemic management. Patients on rtCGM had significantly greater time in range (57.7 ± 12.3% vs 52.3 ± 12.3%, P = 0.0368), and had significantly lower time below range (4.3 ± 2.7% vs 10.2% ± 5.4%, P < 0.001) than those on isCGM, but there was no significant difference in the time above range (37.4 ± 12.9% vs 38.0% ± 12.5%, P = 0.881) or the glycosylated hemoglobin A1c levels (7.4 ± 0.9% vs 7.5 ± 0.8%, P = 0.734) between the two groups.Pediatric patients with type 1 diabetes on rtCGM also showed more beneficial effects for increase of time in range, with a notable reduction of time below range compared with those on isCGM. Real-time CGM might provide better glycemic control than isCGM in children with type 1 diabetes.
Glycated hemoglobin
Target range
Diabetes management
Cite
Citations (11)
Objective: To investigate the Glycosylated hemoglobin1c(HbA1c) test for diagnosis of diabetes,efficacy evaluation and prediction of complications in clinical value.Methods: Choose patients with type 2 diabetes mellitus(T2DM group) 250 cases and healthy subjects(control group) 150 patients,measured by fasting plasma glucose(FPG),2 hour plasma glucose(2hPG) and glycated hemoglobin(HbA1c),then compared analysis of HbA1c and FPG,2hPG relationship,and analyzed the relationship between HbA1c and the diabetes related complications.Results: Diabetes group FPG,2hPG and HbA1c were significantly higher than control group(P 0.01);H bA1c levels in the diabetic complications group were significantly higher than patients with no complications(P 0.05).There were high correlation between H bA1c level and the incidence of complications of diabetes(P 0.01).Conclusion: Detection of H bA1c levels in diabetic patients has important clinical value in the diagnosis,evaluation of efficacy,and it was important to control the glycated hemoglobin levels for the prevention of diabetes complications.
Glycated hemoglobin
Glycated haemoglobin
Glycosylated haemoglobin
Cite
Citations (0)
Glycated hemoglobin
Lipid Profile
Cite
Citations (2)
Introduction:Remogliflozin etabonate is the latest addition to the Sodium glucose co-transporter-2 (SGLT2) inhibitor class of drugs which is a potent and selective inhibitor of SGLT2.A real world non-randomized, single centre, retrospective study was done to assess changes in glycemic and extra glycemic parameters of type 2 diabetes mellitus (T2DM) patients who were well controlled (HbA1c ≤ 7%) with other SGLT2 inhibitors (Dapagliflozin and Empagliflozin), but had difficulty to afford the high cost of therapy from out of pocket expenditure and voluntarily requested for a switchover for economic reasons. Materials and methods:Retrospective observation of the variations in glycemic and extra glycemic parameters including blood pressure, body weight, lipid profile and eGFR of 32 patients was recorded, when they were initiated on Remogliflozin etabonate, replacing other SGLT2 inhibitors (19 were on Empagliflozin and 13 were on Dapagliflozin).The data was tabulated for a total of three visits (First -initial, Second -at three months from initial and Third-at six months from initial), after which analysis was done.Results: There were no significant changes in HbA1c value from baseline after initiation of remogliflozin etabonate from dapagliflozin and empagliflozin.There was also no significant reduction of blood pressure, body weight and eGFR from baseline for patients switched from Dapagliflozin.However, the change in blood pressure and body weight was statistically significant for patients switched from Empagliflozin (p<0.01). Conclusion:Remogliflozin etabonate given as 100 mg twice daily is non-inferior to Empagliflozin 10 mg / Dapagliflozin 10 mg given as once daily to patients of T2DM as far as their glycemic goals are concerned with favourable extra glycemic benefit and cost burden reduction of more than 50%.
Variation (astronomy)
Cite
Citations (0)
According to this study: In non-insulin-treated patients who have type 2 diabetes, structured self-monitoring of blood glucose leads to clinically significant improvements in glycated hemoglobin. Patients with suboptimal glycemic control derive the most benefit from self-monitoring.
Glycated hemoglobin
Blood Glucose Self-Monitoring
Self-Monitoring
Blood glucose monitoring
Lead (geology)
Glycated haemoglobin
Cite
Citations (2)
Continuous glucose monitoring (CGM) provides comprehensive assessment of daily glucose measurements for patients with diabetes and can reveal high and low blood glucose values that may occur even when a patient’s A1C is adequately controlled. Among the measures captured by CGM, the percentage of time in the target glycemic range, or “time in range” (typically 70–180 mg/dL), has emerged as one of the strongest indicators of good glycemic control. This review examines the shift to using CGM to assess glycemic control and guide diabetes treatment decisions, with a focus on time in range as the key metric of glycemic control.
Target range
Blood Glucose Self-Monitoring
Blood glucose monitoring
Cite
Citations (5)
Cite
Citations (0)
Vascular complications of diabetes result from long lasting unsatisfactory glycemic control. We usually assess glycemic control based on the value of glycated hemoglobin HbA1c. The glycated hemoglobin test, however, says nothing about short-term glycemic fluctuations. Recently, continuous monitoring of glycemia has enabled us an in-depth assessment of changes in glucose concentrations, called glycemic variability. Together with the research of short-term glycemic variability, also the study of long-term fluctuations in glycemic control based on HbA1c variability has now intensified. Glycemic variability may be related to oxidation stress, endothelial dysfunction and inflammation, the factors traditionally associated with vascular damage. This overview summarizes the recent findings in the field of glycemic variability and its possible association with microvascular complications in patients with type 1 and type 2 diabetes.Key words: glycemic variability, HbA1c variability, microvascular complications, type 1 and type 2 diabetes mellitus.
Glycated hemoglobin
Cite
Citations (7)
In this study, we investigated which predictors from people with type 1 diabetes at initiation of intensive treatment that increase the risk of not achieving glycemic target. Data from a clinical trial with type 1 diabetes people (n=460) were used in a logistic regression model to analyze the effect of the predictors on achievement of glycemic target. Results indicate that age, smoking, glycated hemoglobin, 1,5-anhydroglucitol and fluctuation from continuous glucose monitoring are predictors of achievement of glycemic target, which can be used in an algorithm to predict people who fail to achieve glycemic target.
Glycated hemoglobin
Cite
Citations (0)