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Purpose: To determine whether the use of worksite health and wellness clinics reduced hemoglobin A1c (HbA1c) for prediabetic and diabetic employees. Design: Hemoglobin A1c values were compared between clinic users and matched non-users. Setting: The Wonderful Company’s (TWC’s) agricultural and packaging sites in Central California. Sample: TWC’s 2016 to 2017 employees who used clinics (n = 445, defined below) and clinic non-users (n = 217) who had HbA1c screening and worked at TWC for 3 or more months each year. Intervention: A unique worksite health and wellness clinic that offers multidisciplinary primary medical care in synergy with TWC’s overall wellness programs. Measures: Exposure was clinic use, defined by frequency and patterns of visits. Hemoglobin A1c was the outcome of interest. Analysis: Users and non-users were propensity score matched using the 2016 employee data including HbA1c, and then 2017 HbA1c values were compared between the 2 groups. Results: The 2017 HbA1c of diabetic employees was lower among clinic users compared to non-users (7.42 vs 8.53, P < .001). Differences in HbA1c among prediabetics or diabetics and prediabetics aggregated were not statistically significant, despite TWC’s population-level data showing a reduction in prediabetes prevalence. The clinic impact results were robust to multivariate analyses and an alternative definition of utilization. Conclusion: The implementation of TWC’s Health and Wellness clinics was associated with reductions in HbA1c among diabetics, but further research is needed on prediabetics.

Background: Chronic pancreatitis is a heterogeneous disease which leads to endocrine and exocrine dysfunction. Diabetes in chronic pancreatitis is important. Diabetes can develop by consequences of other diseases too. Aim: To assess the magnitude of Diabetes in Chronic Pancreatitis subjects. Materials and Methods: A cross sectional study was done among chronic pancreatitis subjects. The age group studied was between 25-60 years. The study period was 6 months. The sample size was based on case records. HbA1c levels were measured at 0th day (registration), 3rd month and 6th month. Data was collected with regard to alcohol consumption and smoking habits. Results: The study group ranged between 25 to 60 years, 60 was males and 3 females. The HbA1C levels were measured and subjects classified. A total of 53 subjects were diabetic. 8 subjects were started on OHA and 45 subjects on insulin. The HbA1C levels were measured again at the end of 3rd month. The subject’s on OHA there was not much of reduction in HbA1C levels so they were stated on insulin. At the end of 6 months there was significant decrease in HbA1C levels when compared to OHA. Conclusion: Our study suggests that diabetes is common in chronic pancreatitis. Diabetes in chronic Pancreatitis was more in smokers. This study also suggests insulin therapy is more effective than OHA in chronic pancreatitis Keywords: Chronic pancreatitis (CP), Oral hypoglycaemic agents (OHA), Insulin.

Periodontitis and diabetes are complex chronic diseases, linked by an established bidirectional relationship. Risk for periodontitis is increased two to three times in people with diabetes compared to individuals without, and the level of glycaemic control is key in determining risk. In people who do not have diabetes, periodontitis is associated with higher glycated haemoglobin (HbA1c) and fasting blood glucose levels, and severe periodontitis is associated with increased risk of developing diabetes. In people with type 2 diabetes, periodontitis is associated with higher HbA1c levels and worse diabetes complications. Treatment of periodontitis in people with diabetes has been shown to result in improved glycaemic control, with HbA1c reductions of 3-4 mmol/mol (0.3-0.4%) in the short term (3-4 months) post-treatment. Given that treatment of periodontitis results in clinically relevant reductions in HbA1c, the dental team has an important role in the management of patients with diabetes. Improved interprofessional working in relation to diabetes and periodontitis has been advocated by professional and scientific organisations, though practical and systemic barriers make this challenging. This paper reviews current evidence linking periodontitis and diabetes, and considers the role of the dental team in the wider context of management of patients with diabetes and periodontitis.

Objectives: The study anticipates to appraise HbA1c levels after three months of sitagliptin addition (100mg/day) to patients already using conventional oral antidiabetics in patients of type II diabetes mellitus who have a meager retort to these existing anti diabetics. Study Design: Mainly cross sectional prospective multicenter, open labeled study. Setting: Department of Medicine University medical diagnostic center & District Head Quarter Hospital Sargodha. Period: January 2017 to June 2017. Material & Methods: 100 inadequately controlled diabetics using different types of oral anti diabetics were chosen and an especially designed performa was accomplished. In our study we gave preference to those patients who were on preexisting oral anti diabetics and now dipeptidyl peptidase 4 inhibitors were added for the first time. The patients were instructed (at the baseline visit) to report during the subsequent visit about glycemic control. Patients were not clued-up that glycosylated hemoglobin control was the main seek of the study, so there was no chance for Pygmalion effect. Results: Levels of glycosylated hemoglobin were significantly reduced after three months of treatment compared to baseline, with a mean alteration in HbA1c level from baseline of −0.77% (range, −0.68 to − -0.86%) in the entire study population at three months. The percentage of patients who achieved an HbA1c level of

Background The impact of different glycemic control conditions on in‐hospital and long‐term outcomes among patients with acute coronary syndrome (ACS) is less well defined. Hypothesis Diabetes mellitus (DM) with different admission hemoglobin A1c (HbA1c) levels (different glycemic control) could affect outcomes among Chinese patients hospitalized as ACS. Methods We categorized 8961 Chinese ACS patients into one of the following three groups: “no DM” (group 1, n = 3773; no DM history and admission HbA1c

Background The information about macular and retinal nerve fibre layer (RNFL) thickness in women with gestational diabetes mellitus (GDM) is scarce. GDM is a risk factor for development of type 2 diabetes mellitus. Purpose The purpose of this study was to evaluate mean macular and RNFL thickness in pregnant women with GDM in a teaching institution in Malaysia. We also analyzed the association of age, HbA1c level, duration of GDM, type of treatment, family history, previous history of GDM and spherical equivalent with the macular and RNFL thickness. Patients and Methods This was a prospective and cross-sectional study involving 78 pregnant women with GDM, 72 healthy pregnant and 70 healthy non-pregnant women. The study was conducted in Hospital Universiti Sains Malaysia from 2016 to 2018. Macular and RNFL thickness were measured during the third trimester using spectral-domain optical coherence tomography. Age, HbA1c level, duration of GDM, type of treatment, family history, previous history of GDM and spherical equivalent were analysed. Results The mean macular thickness was 236.08 (16.44) µm, 237.26 (22.42) µm and 240.66 (20.95) µm for GDM, healthy pregnant, and healthy non-pregnant women. The mean RNFL thickness was 97.27 (9.14) µm, 99.83 (12.44) µm and 97.97 (10.07) µm for GDM, healthy pregnant, and healthy non-pregnant women. There was no significant difference in the mean macular and RNFL thickness in pregnant women with GDM when compared to the control groups (p>0.05). Age, HbA1c, duration of diabetes, treatment received, history of GDM and spherical equivalent did not show significant association with mean macular and retinal thickness (p>0.05). Conclusion Pregnant women with GDM have similar thickness of the macular and RNFL with the healthy pregnant and healthy non-pregnant women. Age, HbA1c, duration of diabetes, treatment received, history of GDM and spherical equivalent showed no significant association with mean macular and retinal thickness in pregnant women with GDM.

New joint clinical recommendations for the treatment of patients with type 2 diabetes of the european (EASD) and american (ADA) diabetes associations and the european society for cardiology (ESC) implement the evidence from clinical cardiovascular endpoint studies into daily clinical practice. The individual patient profile and it´s cardiovascular risk rather than HbA1c levels alone dominate treatment strategies. In case of high oder very high cardiovascular risk GLP-1-receptor agonists or SGLT-2-inhibitors are the preferred choice, the latter especially in patients with chronic heart failure or increased risk, respectively.

Objective: The aim of this study is to investigate the effects of the HbA1c level and the duration of diabetes mellitus on the corneal endothelium morphology and to compare between healthy individuals and diabetes mellitus patients with non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. Material and methods: Ninety patients who applied to the Health Sciences University Ulucanlar Eye Training and Research Hospital between January 2016 and January 2017 were included in this prospective randomized study. In the study, 45 diabetes mellitus patients and 45 healthy individuals were evaluated. The diabetes patients were compared in terms of HbA1c level, diabetes mellitus duration, corneal endothelial cell density, coefficient of variation, standard deviation, and hexagonality with healthy control group. Results: A statistically significant difference was found in the endothelial cell densitometer, coefficient of variation, and standard deviation measurements between the diabetes mellitus patients and the control (healthy) group. But, there was no statistically significant difference between 6A (hexagonality) and central corneal thickness measurements. There was a negative correlation between HbA1c levels and diabetes mellitus times and endothelial cell densitometer values in the patients with diabetes mellitus diagnosis and standard deviation values in the positive direction. There was a statistically significant difference between diabetes mellitus patients with the diagnosis of non-proliferative diabetic retinopathy and proliferative diabetic retinopathy in the endothelial cell densitometer and standard deviation values. But there was not any statistically significant difference between coefficient of variation, 6A, and central corneal thickness values. Conclusion: The endothelial cell densitometer in diabetes mellitus patients with retinopathy is lower than that in healthy individuals. There is a negative correlation between retinopathy severity and corneal endothelial cell density. Diabetes affects negatively not only vascular tissues but also avascular cornea.

Amaç: Tip 2 diabetes mellitus insülin eksikliği ya da insülin etkisindekidefektler nedeniyle gelişen sürekli tıbbi bakım gerektiren, kronik birmetabolizma hastalığıdır. Çalışmada, tip 2 diabetes mellituslu hastalarınklinik ve laboratuvar bulgularının değerlendirilmesi ve bulguların literatüreşliğinde tartışılması amaçlanmıştır.Gereç ve Yöntem: Bu çalışma hastanemiz genel dahiliye polikliniğine,3 yılda ‘tip 2 diyabetes mellitus’’ tanı kodu ile kaydedilen, 18 yaş üstütoplam 186 hastanın değerlendirildiği tanımlayıcı kesitsel bir araştırmadır.Bulgular: Çalışmamıza 186 hasta dahil edildi (Yaş ortalaması59,7±11,5 yıl). Hastalarının hastalık süresi 1-27 yıl aralığında olup ortancası9 yıldı ve %37,1’inde (n:69) hastalık süresi 10 yıldan fazla idi. HastalarınHbA1c ortalaması %7,9±1,7, ortalama HDL düzeyi 46,2±10,9 mg/dL, ortanca LDLdüzeyi 117 mg/dL idi. Tip 2 diabetes mellitus hastalarının %55,9’inde (n:104) HbA1c düzeyi %7 ve üzeri idi, LDL kolesterol düzeyi 100 veüzeri olan hasta oranı %58 (n:108) idi. Sonuç: Diyabetli hastaların risk faktörlerini azaltmaya yönelik yeni sağlıkpolitikalarının planlanması, diyabete bağlı gelişebilecek komplikasyonlarınerken saptanması ve tedavi maliyetlerinin azaltılması için muhakkak dahaayrıntılı incelenip multidisipliner bir yaklaşımla tedavi edilmesigerekmektedir., Aim: Type 2 diabetes mellitus isa chronic metabolic disease requiring continuous medical care due to insulindeficiency or insulin-effect defects. The aim of this study is to evaluate theclinical and laboratory findings of type 2 diabetes mellitus patients anddiscuss the findings in the light of literature.Materialand Method: This study is a descriptive cross-sectional study with 186 patients overthe age of 18 who were enrolled in three years in the general internal medicineoutpatient clinic of our hospital with the diagnosis code 'type 2 diabetesmellitus. Results: 186 patients were includedin the study (mean age 59.7±11.5 years). The disease duration of the patientswas 1-27 years, the median was 9 years and 37.1% (n: 69) of them had a diseaseduration of over 10 years. The mean HbA1c of the patients was 7.9±1.7%, themean HDL level was 46.2 ± 10.9 mg/dL, and the median LDL level was 117 mg/dL.In 55.9% (n: 104) of type 2 diabetes mellitus patients, HbA1c level was 7% andabove, and the percentage of the patients with LDL cholesterol level of 100 andabove was 58% (n: 108). Result: New health care policies tomitigate the risk factors of diabetic patients should be planned and suchfactors should be examined in depth for the early detection of diabetes-relatedcomplications and reduction in treatment costs and treated with amultidisciplinary approach. ry approach.

Introduction Black patients have higher HbA1c than Whites even after adjustment for mean blood glucose (MBG). Decreased iron status has been associated with increased HbA1c independently of glucose. We hypothesized that decreased iron status might account for higher HbA1c in Black patients. Methods Pediatric patients with T1D in the Diabetes Center at Children's Hospital of New Orleans who self-identified as either Black or White were recruited for the study. At the time of their clinic visit labs were obtained for ferritin (Fer), soluble transferrin receptor (sTfR), HbA1c, and CBC. MBG was derived from patient's home glucose meter records over the last 30 days. Total body iron (TBI) and sTfr/log10 Fer (R/lFer) were calculated. Results A total of 80 (35 Blacks/45 Whites; 41 female/39 male) patients were recruited. Unadjusted levels of HbA1c, MBG, sTfR, Fer, RDW-CV, and RDW-SD were all higher in Blacks than Whites. TBI and R/lFer were not different between groups. Fer was correlated with Hb, MBG but not HbA1c. sTfR was correlated with HbA1c, MCV, MCH, and RDW-SD. In multiple variable analysis with HbA1c as the dependent variable, race and MBG were statistically significant in the model. However, measures of iron status: Fer, sTfR, R/lFer and TBI were not statistically influential. Conclusion After adjustment for race, MBG and RDW-CV, iron indices were not statistically significant independent predictors of HbA1c levels. These observations indicate that factors besides iron status and CBC indices contribute to MBG-independent racial disparity in HbA1c.

Meningiomas are among the most common primary brain tumors. There is a growing need for novel ways of differentiating between benign (World Health Organization [WHO] grade I) and atypical (WHO grade II) meningiomas as well as for novel markers of the tumor's future behavior. A difference between glucose metabolism in atypical and benign meningiomas is well known. However, a significant correlation between the systemic metabolic status of the patient and the meningioma WHO grade has not yet been established. Our aim was to compare the WHO grades of intracranial meningiomas with the patient's HbA1c levels as a more reliable marker of the chronic systemic metabolic status than the fasting blood glucose value, which is usually looked at. We retrospectively analyzed 15 patients and compared their meningioma WHO grade with their preoperative HbA1c values. Our results show that patients with benign intracranial meningiomas have significantly lower HbA1c value. Conversely, patients with atypical intracranial meningiomas have higher HbA1c values. Furthermore, we showed that the proliferation factor Ki67 was statistically strongly correlated with the HbA1c value (p

Although a meta-analysis previously suggested a positive relationship between diabetes and intraocular pressure (IOP), the interrelationships among diabetes, IOP, and other ocular biometric parameters remain unclear. The present study investigated the relationships of diabetes, haemoglobin A1c (HbA1c), and serum glucose with IOP and ocular hypertension (IOP > 21 mmHg) in non-glaucomatous Japanese adults living in Chikusei City. Diabetes was defined as a self-reported history of diabetes, the use of antidiabetic medication, or HbA1c levels ≥6.5%. Among 6,786 enrolled participants aged 40 years and above, 734 were classified as diabetic (10.8%). After adjusting for several confounders, the IOP values were significantly higher in participants with diabetes than in those without diabetes (14.4 ± 0.1 vs. 13.9 ± 0.1 mmHg, P

Background: Complex changes of glycemia that occur in diabetes are not fully captured by any single measure. The Comprehensive Glucose Pentagon (CGP) measures multiple aspects of glycemia to genera...

Background : HbA1c is one of the parameters that can be useful for diagnosing diabetes mellitus that can occur in obesity. Monocyte as an inflammatory cell is widely studied in relation to diabetes mellitus and obesity. The purpose of this study is to analyze the correlation between HbA1c levels and monocyte percentage in obesity. Methods : A Cross-sectional study of 30 medical students at a private laboratory in Semarang on March – April 2017 was done. The monocyte percentage included incomplete blood count was examined with the Sysmex XS-800i hematology analyzer, while HbA1c level w as examined with Hemocue HbA1c 501 System . Spearman test was done for analyzing data with p

We experienced two cases of Hb Andrew-Minneapolis with high or low-normal HbA1c levels depending on the measurement method. Case 1 was a 25-year-old male, and case 2 was a 32-year-old pregnant woman. Both cases showed normal glucose tolerance levels and glycated albumin within the reference range. In both cases, the high-performance liquid chromatography (HPLC) method (standard mode) showed high HbA1c levels of 6.8% and 6.5%, respectively, while the HbA1c levels measured by immunoassay were low normal at 4.6% in both cases. Globin gene analysis detected heterozygous β-chain mutations (β144Lys → Asn) in both cases, which resulted in the diagnosis of Hb Andrew-Minneapolis. In case 1, a high-resolution HPLC chromatogram showed multiple abnormal peaks; two unknown peaks in addition to variant hemoglobin (HbX0) and glycation products of variant hemoglobin (HbX1c) were observed after in vitro glycation reaction. Although the details of unknown peaks were not identified, those might be modified hemoglobin associated with variant hemoglobin. The presence of unknown peaks could cause high HbA1c levels measured by HPLC (standard mode). Furthermore, the HbA1c level measured by immunoassay was increased to 4.9% within the reference range after adjustment for modified hemoglobin in case 1. Consequently, the high HbA1c levels measured by HPLC (standard mode) and the low-normal HbA1c level measured by immunoassay might be due to modified hemoglobin associated with variant hemoglobin.

Background: Recently epidemiological studies have shown that type 2 diabetes mellitus is great a risk factor for cardiovascular mortality. Electrolyte abnormalities are commonly encountered in chronic diabetes mellitus type 2 patients. Aim: The aim of this study was to estimate serum electrolyte levels & HbA1C levels among Sudanese diabetic Patients with macrovascular complications in Khartoum State, Sudan. Materials & Methods: In this case, control hospital based study conducted in Khartoum state. Hundred subjects were involved; fifty were type 2 diabetes patients and fifty healthy subjects control group sex and age matched. Serum Na and K levels were estimated by Automated Biochemistry Analyzer (Easylyte electrolyte) and HbA1C by Automated Biochemistry Analyzer (Mindary Bs380). Result: The mean serum level of sodium and potassium in type 2 diabetes patients was significantly decreased (137.7 ± 4.05 vs 139.8 ± 3.62 mmol/l, p = 0.008 and 3.60 ± 0.20 vs 3.92 ± 0.22 mmol/l, p = 0.03 respectively). Whereas, HA1C level showed significant increases in the test group when compared with reference group (9.68 ± 1.24 vs 5.44% ± 0.42%, p = 0.000). Across gender, our study observed no significant alteration in serum Na and K levels (p > 0.05) in type 2 diabetic patients. Furthermore, serum Na+ level was significantly correlated with K+ (R = 0.369, p = 0.008). Whereas, both Na+ and K+ were in significantly correlated with patients age, HbA1c (%), and duration of DM (p > 0.05). In contrast, HA1C is significantly correlated with the duration of diabetes (R = 0.425, p = 0.002). Conclusion: Our study revealed significant alterations in electrolyte levels in type 2 diabetes mellitus and proper hyperglycemic control with evaluation of electrolyte levels can reduce the complication accompanied with electrolyte disbalance in type 2 DM.

BACKGROUND: Type 1 diabetes is the third most common chronic disease among teenagers. In Saudi Arabia, there is a gap of knowledge regarding hemoglobin A1C (HbA1c) concentration levels, and adherence to regular follow-up visits by patients. The aim of this study was to determine the mean glycosylated hemoglobin (HbA1c) levels in diabetic children who have been diagnosed with type 1 diabetes and were being followed up at a tertiary care center in Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted among all diabetic children treated at King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia. Data were retrieved and analysed during the period from September to December 2018. Diabetic patients of

AimTo determine the risk of adverse outcomes across the spectrum of glycated haemoglobin (HbA1c) levels among hospitalized COVID-19 patients with and without diabetes.Materials and methodsDanish nationwide registries were used to study the association between HbA1c levels and 30-day risk of all-cause mortality and the composite of severe COVID-19 infection, intensive care unit (ICU) admission and all-cause mortality. The study population comprised patients hospitalized with COVID-19 (3 March 2020 to 31 December 2020) with a positive polymerase chain reaction (PCR) test and an available HbA1c ≤ 6 months before the first positive PCR test. All patients had at least 30 days of follow-up. Among patients with diabetes, HbA1c was categorized as 64 mmol/mol. Among patients without diabetes, HbA1c was stratified into ResultsWe identified 3295 hospitalized COVID-19 patients with an available HbA1c (56.2% male, median age 73.9 years), of whom 35.8% had diabetes. The median HbA1c was 54 and 37 mmol/mol among patients with and without diabetes, respectively. Among patients with diabetes, the standardized absolute risk difference of the composite outcome was higher with HbA1c 64 mmol/mol (15.1% [95% CI 6.2% to 24.0%]), compared with HbA1c 59 to 64 mmol/mol (reference). Among patients without diabetes, the standardized absolute risk difference of the composite outcome was greater with HbA1c ConclusionsPatients with COVID-19 and HbA1c 64 mmol/mol had a higher associated risk of the composite outcome. Similarly, among patients without diabetes, varying HbA1c levels were associated with higher risk of the composite outcome.

© 2022, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.Introduction: In this study, we aimed to investigate the relationship between postoperative mortality, morbidity, hospital stay and development of postoperative complications with the glycosylated hemoglobin (HbA1c) level and low left ventricular ejection fraction (LVEF) in diabetic and non-diabetic patients who underwent elective coronary artery bypass (CABG) surgery. Methods: The medical records of patients who underwent CABG at our clinic between January 2015 and December 2019 were retrospectively analyzed. All patients were divided into two groups according to their diabetes mellitus (DM) diagnosis. Diabetic patients were also divided into two groups according to their HbA1c levels. The HbA1c threshold value was 7%. All patients were divided into two groups in terms of LVEF. The LVEF threshold value was 40%. Results: We analyzed 393 patients, of which 304 (77.4%) were male and 177 (45.04%) patients were diabetic. For lower LVEF and HbA1c values, we found no relationship between postoperative mortality, prolonged intensive care unit (ICU) stay and development of postoperative complications. Deep surgical site infection (DSSI) was found to be more common in diabetic patients who had a higher HbA1c value. Length of hospital stay was longer in diabetic patients with HbA1c levels

Background This study was conducted to evaluate the diabetes education efficiency of individuals over 65 years old in Turkey, which has the highest prevalence of diabetes in Europe. Methods We retrospectively evaluated 320 patients who attended Turkey diabetes self-management group education program (TDSMEP) between 2016 and 2020 in a secondary hospital. Participants who have been followed up for a maximum of 9 months are grouped as over 65 years old and under. Results Of the 320 patients, 114 formed the geriatric group and 206 the non-geriatric group. After the training, the number of patients who had HbA1c ≤7% increased significantly in both the geriatric (28.1%-45.6%) and non-geriatric (19.9%-42.2%) (p = 0.001) groups. After the training, similar HbA1c goals were achieved in the geriatric and non-geriatric groups. The most significant HbA1c decrease was observed at the 3rd month of follow-up and remained stable until the 9th month. In logistic regression analysis, the factors affecting HbA1c failure (HbA1c >7%) after training in the geriatric group were long diabetes duration (OR = 1.07, 95% CI = 1.02-1.13, p = 0.01), high basal HbA1c levels (OR = 1.31, 95% CI = 1.03-1.67, p = 0.03), and low education level (OR = 3.88, 95% CI = 1.54-9.76, p = 0.001). Conclusions This is the first study to evaluate the effectiveness of TDSMEP for geriatric individuals whose HbA1c ≤7% increased from 28% to 45.6% during follow-up after the training. TDSMEP is recommended for all adult age groups, regardless of age range.

Background: Measuring glycosylated hemoglobin (HbA1c) is a simple way to assess patients with prediabetes or diabetes mellitus. It has been shown that HbA1c level predicts prognosis in patients with coronary artery disease (CAD) and the incidence of diabetes mellitus. However, the prognostic significance of HbA1c level in Asian patients with prediabetes and CAD is not yet clear. Our study aimed to determine the relationship between HbA1c level and major adverse cardiovascular events (MACE) in patients with prediabetes and CAD. Methods: We enrolled 1367 patients with prediabetes and CAD in the final analysis, and grouped them according to the HbA1c level. Primary end points included nonfatal myocardial infarction, hospitalization for unstable angina, and ischemia-driven revascularization. Cox proportional-hazards regression analysis was used to determine the relationship between HbA1c level and MACE after our accounting for confounding factors. Results: A total of 1367 patients (age 58.8 ± 10.3 years; 71.6% men) were included. During 43 months of follow-up, 197 patients experienced at least one primary end point event. Multivariate Cox proportional-hazards regression analysis showed in comparison of HbA1c levels that the hazard ratio for primary end points was 4.110, with a 95% confidence interval of 2.097–6.011 (P Conclusions: HbA1c level positively correlated with MACE, demonstrating it is a valuable indicator for independently predicting MACE in Asian patients with prediabetes and CAD.

INTRODUCTION: Asthma is a major health concern globally. Asthma, the common chronic disease in children creates not only a myriad of physical, emotional and social problems for the child and the family but also a nancial burden on the family. Though many drugs are available for treatment of asthma, steroid therapy remains the mainstay of treatment and control of recurrent attacks and long-term outcome. The safest and most effective choice for this is inhaled corticosteroids. Adverse effects following prolonged use of systemic corticosteroids are well established on carbohydrate metabolism. Patients on moderate to severe doses of Inhaled corticosteroid (ICS) may have similar effects on carbohydrate metabolism when used for prolonged period. HbA1c levels indicate blood glucose levels concentration in the preceding 8-12 weeks. There is denite evidence of raised Plasma glucose levels with the use of ICS but very scanty literature studying the levels of HbA following use of ICS is available specially in pediatric age group.Some studies do not show signicant rise in plasma 1c glucose or HbA1c The present study was planned to see if there is any change in blood glucose and HbA1c in patients who were on prolonged use of ICS i.e. more than 4 months of moderate to high dose 200 µg to 800 µg and more of inhaled corticosteroid per day were included. RESULT : Correlation between HbA1c levels and duration of Budesonide used.It is seen that cases using budesonide for upto 6 months and upto 600 µmg per day and for less than 6 month had mean HbA1c levels of 5.24+0.80% and those using more than 600µgm per day and for more than 6 month had mean HbA1c level of 5.611+.38%. It is seen that as the dose and duration increase HbA1c level also increase. The difference was not statistically signicant.

Objective: Hybrid closed-loop (HCL) devices can achieve tight glycemic control but are rarely used in pregnancy, which remains an off-label indication. We present a case of a pregnant patient with type 1 diabetes mellitus (T1DM) who used the Medtronic MiniMed 670G HCL system. Methods: MiniMed 670G includes an advanced automode option (HCL therapy), which our patient used from the first trimester to the end of the pregnancy. Results: An unplanned pregnancy was detected in the T1DM patient, with a glycated hemoglobin level of 8.7 mmol/L (7.1%). The patient started sensor-augmented pump therapy at week 13. Subsequently, she entered automode (HCL) at week 16. The time in range (3.7-7.8 mmol/mol, 63-140 mg/dL) increased from 46.8% to 51.3% after HCL initiation. The glycated hemoglobin level remained close to 48 mmol/mol (6.5%) until the end of the pregnancy. Furthermore, the time under range (

Background Glycated hemoglobin (HbA1c) is a commonly used indicator of glycemic control in diabetes mellitus. Uncontrolled diabetes can lead to cardiovascular complications. Ischemic strokes are often complicated by hemorrhagic transformation, which is the conversion of an infarcted area into an area of hemorrhage. The purpose of this study is to determine the association of raised HbA1c levels with the occurrence of hemorrhagic transformation in ischemic stroke. Methods This is a prospective, single-center cohort study of patients admitted to the Neurology and Medicine wards between June 1 and November 30, 2019. Inclusion criteria included adult patients who were admitted with acute ischemic stroke and had been tested for HbA1c on presentation. There were 110 ischemic stroke patients enrolled in our database. An HbA1c level >53 mmol/mol was considered raised. A comparison was done between the group with raised HbA1c levels and the group with target levels of HbA1c for the occurrence of hemorrhagic transformation. Brain imaging was used to diagnose hemorrhagic transformation. Results Out of 110 study participants with ischemic stroke, 70 (63.6%) patients had a history of prior known diabetes. The mean HbA1c levels were 7.44 ± 1.79%. A total of 77% of diabetic patients had raised HbA1c levels (>7%). Hemorrhagic transformation was seen in 21 (19.1%) patients, of whom only 38% (n=8) had raised HbA1c levels. The association between raised HbA1c and hemorrhagic transformation was not found to be statistically significant (p = 0.225). Conclusion In this study of patients with ischemic stroke, raised HbA1c levels were not found to be associated with hemorrhagic transformation. There is a need for larger scale studies to find out the cause and mechanism of hemorrhagic transformation in ischemic stroke.

Glycosylated hemoglobin A1c (HbA1c) level has strong relevance to microvascular disorders, which are also thought to be the current main aspect of sudden sensorineural hearing loss (SSNHL), so we aim to elucidate the association of the HbA1c level with the severity, types, and prognosis of SSNHL. In this study, comparative analyses based on propensity score matching of the severity, types, and prognosis of SSNHL with the HbA1c level in 116 patients diagnosed as SSNHL were conducted, where they were divided into diabetes mellitus (DM) group and non-DM group. We finally found that, among patients with SSNHL, diabetic patients had a higher HbA1c level, more severe hearing loss, and poorer prognosis than non-diabetic patients. The HbA1c level was found to be significantly correlated with the severity and types of SSNHL, while no strong relevance was found between the higher HbA1c level and the poorer prognosis of SSNHL.

Flash glucose monitoring (FGM) and real-time continuous glucose monitoring (RT-CGM) are increasingly used in clinical practice, with improvements in HbA1c and time in range (TIR) reported in clinical studies. We aimed to evaluate the impact of FGM and RT-CGM use on glycaemic outcomes in adults with type 1 diabetes (T1DM) under routine clinical care. We performed a retrospective data analysis from electronic outpatient records and proprietary web-based glucose monitoring platforms. We measured HbA1c (pre-sensor vs. on-sensor data) and sensor-based outcomes from the previous three months as per the international consensus on RT-CGM reporting guidelines. Amongst the 789 adults with T1DM, HbA1c level decreased from 61.0 (54.0, 71.0) mmol/mol to 57 (49, 65.8) mmol/mol in 561 people using FGM, and from 60.0 (50.0, 70.0) mmol/mol to 58.8 (50.3, 66.8) mmol/mol in 198 using RT-CGM (p &lt, 0.001 for both). We found that 23% of FGM users and 32% of RT-CGM users achieved a time-in-range (TIR) (3.9 to 10 mmol/L) of &gt, 70%. For time-below-range (TBR) &lt, 4 mmol/L, 70% of RT-CGM users and 58% of FGM users met international recommendations of &lt, 4%. Our data add to the growing body of evidence supporting the use of FGM and RT-CGM in T1DM.

Saudi Arabia ranks among the top ten in type 1 diabetes (T1D) prevalence. The psychological burden, including depression, among T1D children, affects short-term and long-term outcomes. In Saudi Arabia, studies on depression among T1D children are limited. We determined the prevalence of depression among T1D children and adolescents in the Saudi Arabia-Qassim region and investigated risk factors for depressive symptoms. This quantitative cross-sectional study was conducted among T1D children and adolescents in the outpatient clinic of Maternity and Children Hospital, Buraydah, Saudi Arabia, between October 2020 and April 2021. Using a validated questionnaire translated into Arabic, we interviewed patients during clinic appointment. Questionnaires on sociodemographic characteristics, clinical data, and Clinical Depression Inventory scale were used to measure depression. There were 148 T1D respondents (children: 58.1%, adolescents: 41.9%). More than half were females (53.4%), with most Saudis (94.6%). Depression prevalence among children and adolescents was 27%. Mild, moderate, and severe depression occurred in 80%, 12.5%, and 7.5% of depressed patients, respectively. Factors significant for depression were female sex (p = 0.014), uncontrolled HbA1c level (p = 0.037), and longer diabetes duration (p = 0.013). Depression among children and adolescents was more prevalent in this study than in previous reports. Early detection of depression will improve diabetes control and quality of life.

ObjectiveTo assess magnitude of diabetic ketoacidosis (DKA) among type-1 diabetics and to identify associated risk factors.MethodsA cross-sectional study was conducted among 236 type-1 diabetics in Makkah Al-Mukarramah City, Saudi Arabia.ResultsAmong participants, 59.3% were males, 44.1% were diabetic for more than 5 years, while 70.8% reported past history of DKA. The main causes of DKA were “first presentation of the disease” (40.9%), and “discontinued treatment” (37%). The HbA1c among 53.6% was above 9%. Almost all cases who experienced DKA were hospitalised (98.8%). Out of them, 9 (5.4%) suffered complications. Female patients were more likely to suffer from episodes of DKA than males (76% and 68.3%, respectively). Most patients whose parents’ highest education was primary level had DKA more frequently than those whose parents’ had postgraduate education. Patients with unemployed fathers had significantly higher frequency of DKA (p=0.004). Ketoacidosis was significantly more frequent among patients with parents’ consanguinity (pConclusionMost type-1 diabetics experience DKA, mainly with their first presentation of disease or due to discontinuation of treatment. DKA tends to occur more frequently among female patients, those with less educated parents or when their parents are relatives.ADVANCES IN KNOWLEDGEThis study rang a warning bell towards parents’ consanguinity among type-1 diabetics as a risk factor for diabetic ketoacidosis.The current search revealed the lack of public’s awareness about type-1 diabetes and its complications as well as their low compliance towards its treatment, since diabetic ketoacidosis occurred mainly at the first presentation of the disease among diabetics, or due to treatment discontinuation.APPLICATION TO PATIENT CAREThis study indicated the importance of raising the public’s awareness regarding early symptoms of diabetes among their children so as to be ready to seek medical advice as early as possible before the occurrence of complications.Health education messages should be repeatedly broadcast via mass media explaining the hazards associated with consanguineous marriages.Health care providers should stress to diabetic patients and/or their caregivers the importance of compliance to treatment.

Background: The diabetics' lack of awareness about self-care and false beliefs in this care are the reasons for their admission to hospitals. The present study aimed to "determine the impact of using education based on the theory of planned behavior on self-care and glycosylated hemoglobin (HbA1c) levels in patients with Type 2 Diabetes".Methods: The present quasi-experimental study examined 60 patients with type 2 diabetes who were randomly classified into intervention and control groups. In the intervention group, self-care education was held based on the theory of planned behavior. The data were collected using a three-part questionnaire consisting of demographic and clinical information, and questions about constructs of the theory of planned behavior, and the Summary of Diabetes Self Care Activities by Robert at three stages: pre-test, post-test, and follow-up.Results: The mean scores of constructs of the theory of planned behavior, as well as self-care behaviors after the educational intervention (immediately and after three months), increased significantly in the intervention group compared to before the intervention and the control group. Furthermore, the mean amount of glycosylated hemoglobin in the intervention group was significantly lower than before the intervention and the control group three months after the educational intervention.Conclusion: Education based on the theory of planned behavior was effective in improving the patients' self-care behavior and HbA1c index. Therefore, we suggest all medical centers use the theory of planned behavior as an effective educational model with easy and low-cost implementation power to improve diabetics' self-care behavior and health.

Introduction Diabetes is a global issue that currently affects 425 million people worldwide. One observable microvascular complication of this condition is a change in the foveal avascular zone (FAZ). In this study, we used optical coherence tomography angiography (OCT-A) to investigate the effect of diabetes on the FAZ. Materials and methods Eleven diabetic and eleven non-diabetic participants took part in this study. Participants in both groups were matched for age (p = 0.217) and sex (p = 0.338), and had no history of ocular disease. Macular OCT-A scans of participants' right and left eyes were taken. Glycosylated haemoglobin (HbA1c ) and blood glucose levels were also measured. The FAZ area was manually segmented at the levels of the superficial capillary plexus (FAZSCP ) and deep capillary plexus (FAZDCP ). Results There was a strong relationship between the FAZ area of participants' right and left eyes (p ≤ 0.001) in both diabetic and non-diabetic groups. In the diabetic group, the FAZSCP (p = 0.047) and FAZDCP (p = 0.011) areas was significantly larger than in the non-diabetic group. Moreover, multiple linear regression analysis predicted a 0.07-mm2 increase in diabetic individuals' FAZSCP and FAZDCP areas for every 1% increase in their HbA1c level. Conclusions Our findings indicate that there is enlargement of the FAZ in diabetic individuals compared with non-diabetic individuals. In the diabetic group, this enlargement appears to be correlated with HbA1c level. OCT-A imaging could, therefore, be a useful tool to monitor the FAZ and identify potential early microvasculopathy in diabetes.

A clinical decision report using: Fulcher G, Roberts A, Sinha A, Proietto J. What happens when patients require intensification from basal insulin? A retrospective audit of clinical practice for the treatment of type 2 diabetes from four Australian centres. Diabetes Research and Clinical Practice, 2015;108(3):405–413. https://doi.org/10.1016/j.diabres.2015.03.004 for a patient with uncontrolled type 2 diabetes.

Background Heart failure (HF) with improved or recovered ejection fraction (EF, HFrecEF) has been recognized as a new type of HF with different underlying clinical phenotype, pathophysiology and prognosis. However, few studies have analyzed the relationship between type 2 diabetes and HFrecEF, and the impact of glycemic level on myocardial function recovery. Purpose In the present study, we sought to investigate the relation between HbA1c level and HFrecEF in patients with type 2 diabetes. Methods A total of 796 HF patients with reduced left-ventricular ejection fraction (LVEF, Results HF patients with type 2 diabetes had significantly lower rates of LVEF recovery when having higher versus lower HbA1c levels in the baseline (the lowest tertile: 62.4%, intermediate tertile: 50.4%, the highest tertile: 46.8%; P Conclusions Our study suggests that optimal glycemic control is an independent predictor for incidence of HFrecEF in patients with type 2 diabetes. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China, Shanghai Municipal Commission of Health and Family Planning

Theoretically, pancreas transplant alone in uremic (PTAU) patients could also be one of the options for those waiting for both pancreas and kidney grafts, but it has never been reported. There were 160 cases of pancreas transplant in this study, including 16% PTAU. The 5-year patient survival was 66.2% after PTAU, 94.5% after SPK, 95.8% after PAK, and 95.4% after PTA. Rejection of pancreas graft was significantly lower in PTAU group (3.8%), followed by 16.7% in pancreas after kidney transplant (PAK), 29.8% in simultaneous pancreas and kidney transplant (SPK) and 37.0% in pancreas transplant alone (PTA). Fasting blood sugar and serum HbA1c levels after PTAU were not significantly different from those by other subgroups. The 5-year death-censored pancreas graft survival was 100% after PTAU and PAK, and 97.0% after SPK and 77.9% after PTA. However, the 5-year death-uncensored pancreas graft survival was 67.0% after PTAU, 100% after PAK, 91.3% after SPK, and 74.0% after PTA. The superior graft survival in the PTAU group was achieved only if deaths with a functioning graft were censored. In conclusion, given the inferior patient survival outcome, PTAU is still not recommended unless SPK and PAK is not available. Although PTAU could be a treatment option for patients with diabetes complicated by end-stage renal disease (ESRD) in terms of surgical risks, endocrine function, and immunological and graft survival outcomes, modification of the organ allocation policies to prioritize SPK transplant in eligible patients should be the prime goal.

Purpose: To determine the relationship between HbA1c and severity of retinopathy in diabetic patients. Study Design: Cross sectional study. Place and Duration of Study: Eye department of DHQ-UTH Gujranwala, from July 2020 to Dec 2020. Methods: An observational cross-sectional study including 100 patients was conducted at eye department of DHQ-UTH Gujranwala from January 2018 to December 2018. After approval from institutional review board, written informed consent with demographic variables was collected from every patient. Patients of either gender between 40-80 years of age with both types I and type II diabetes were included in this study. Complete ophthalmic examination including Best Corrected Visual Acuity, slit lamp biomicroscopy, Goldmann Applanation tonometry and fundus examination carried out. Diabetic retinopathy was classified from grade 0 to grade 5. Results: Out of 100 patients, 46 (46%) were males and 54 (54%) were females. Mean age was 60 ± 2.4 years with a range of 40 – 80 years among males and 40 – 70 years among females. Forty patients presented with grade 1 diabetic retinopathy and 4% presented with grade 5. Thirty two patients had good glycemic control while 20% had glycemic control of grade III. Patients with grade 4 diabetic retinopathy had the worst glycemic control of HbA1c level of 11.5. Conclusion: This study concluded that patients with poor glycemic control had severe diabetic retinopathy as compared to the patients with good diabetic control. There is a direct relation between HbA1c level and severity of diabetic retinopathy. Key Words: HbA1C, Diabetic retinopathy, Non proliferative diabetic retinopathy, Proliferative diabetic retinopathy, Vitreous hemorrhage.

OBJECTIVE: Sensor-augmented pump (SAP) therapy reportedly improves glycemic control and quality of life. However, there is limited information on changes in awareness of hypoglycemia and quality of life (QOL) after starting SAP therapy in Japanese patients with type 1 diabetes. The aim of this study was to evaluate glycemic control, awareness of hypoglycemia, and QOL after initiation of SAP therapy in these patients. METHODS: The study included 20 patients with type 1 diabetes who started SAP therapy. HbA(1c) levels, values derived from continuous glucose monitoring [including percentages of time in target range (70–180 mg/dL), time below range ( 180 mg/dL)], the Diabetes Treatment Satisfaction Questionnaire score, and the Clarke score were compared between baseline and after 3 and 6 months of SAP therapy. RESULTS: There was a significant decrease in HbA(1c) at 3 and 6 months after starting on the SAP (p 180 mg/dL) at the two time points (p = 0.0069 and p = 0.0042, respectively). There was no significant change in time below range (

Coronavirus disease 2019 (COVID-19) has been found to be associated with mucormycosis in few parts of the world, especially India. It is important to look for reasons for this upsurge of cases so that other countries may take proper steps to prevent it. A prospective clinico-demographic study was conducted in SMS Medical College, Jaipur, India from April to May 2021. All patients (235) with COVID associated mucormycosis (CAM) were studied in detail with reference to their diabetic status and steroid intake during treatment of COVID-19. Steroid usage was in 84.3% of patients with methylprednisolone being the most commonly used steroid (66.8%). Majority of the patients had taken steroids for 7-14 days. Diabetes was found in 204 patients and 42.1% of patients were newly diagnosed during/after COVID-19 treatment. The HbA1c levels of diabetic patients ranged from 6.0% to 16.3%. This is perhaps the biggest study in the world shows that the triad of COVID-19, diabetes and steroid usage is a major contributing factor towards mucormycosis. Proper steps should be taken to prevent CAM.

Background: Emerging data highlight the interactions of preadmission glycemia, reflected by admission HbA1c levels, glycemic control during critical illness, and mortality. The association of preadmission insulin treatment with outcomes is unknown. Methods: This observational cohort study includes 5245 patients admitted to the medical-surgical intensive care unit of a university-affiliated teaching hospital. Three groups were analyzed: patients with diabetes with prior insulin treatment (DM-INS, n = 538); patients with diabetes with no prior insulin treatment (DM-No-INS, n = 986); no history of diabetes (NO-DM, n = 3721). Groups were stratified by HbA1c level: 8.0%. Results: Among the three strata of HbA1c, mean blood glucose (BG), coefficient of variation (CV), and hypoglycemia increased with increasing HbA1c, and were higher for DM-INS than for DM-No-INS. Among patients with HbA1c < 6.5%, mean BG ≥ 180 mg/dL and CV > 30% were associated with lower severity-adjusted mortality in DM-INS compared to patients with mean BG 80-140 mg/dL and CV < 15%, ( P = .0058 and Conclusions: Significant differences in mortality were found among patients with diabetes based on insulin treatment and HbA1c at home and post-admission glycemic control. Prospective studies need to confirm an individualized approach to glycemic control in the critically ill.

Objective It is unclear whether relatively low glycated haemoglobin (HbA1c) levels are beneficial or harmful for the long-term health outcomes among people without diabetes. We aimed to investigate the association between low HbA1c levels and mortality among the US general population. Methods This study includes a nationally representative sample of 39 453 US adults from the National Health and Nutrition Examination Surveys 1999–2014, linked to mortality data through 2015. We employed the parametric g-formula with pooled logistic regression models and the ensemble machine learning algorithms to estimate the time-varying risk of all-cause and cardiovascular mortality by HbA1c categories (low, 4.0 to Results Over a median follow-up of 7.5 years, 5118 (13%) all-cause deaths, and 1116 (3%) cardiovascular deaths were observed. Logistic regression models and machine learning algorithms showed nearly identical predictive performance of death and risk estimates. Compared with mid-level HbA1c, low HbA1c was associated with a 30% (95% CI, 16 to 48) and a 12% (95% CI, 3 to 22) increased risk of all-cause mortality at 5 years and 10 years of follow-up, respectively. We found no evidence that low HbA1c levels were associated with cardiovascular mortality risk. The diabetes group, but not the prediabetes group, also showed an increased risk of all-cause mortality. Conclusions Using the US national database and adjusting for an extensive set of potential confounders with flexible modelling, we found that adults with low HbA1c were at increased risk of all-cause mortality. Further evaluation and careful monitoring of low HbA1c levels need to be considered.

The purpose of this study was to evaluate specifically the relationship between glycated haemoglobin (HbA1c) levels and retinal optical coherence tomography (OCT) and OCT angiography (OCTA) parameters in type 1 Diabetes Mellitus (DM). A total of 478 type 1 DM patients and 115 controls were included in a prospective OCTA trial (ClinicalTrials.gov NCT03422965). Subgroup analysis was performed for controls, no diabetic retinopathy (DM-no DR) and DR patients (DM-DR), and HbA1c levels. OCT and OCTA measurements were compared with HbA1c levels (current and previous 5 years). DM-no DR patients with HbA1c levels &gt, 7.5% showed lower VD than DM-DR and controls (20.16 vs. 20.22 vs. 20.71, p &lt, 0.05), and showed a significant correlation between HbA1c levels and FAZc (p = 0.04), after adjusting for age, gender, signal strength index, axial length, and DM disease duration. DM-DR patients with HbA1c &gt, 7.5% presented greater CRT than DM-no DR and controls (270.8 vs. 260 vs. 251.1, p &lt, 0.05) and showed a significant correlation between HbA1c and CRT (p = 0.03). In conclusion, greater levels of HbA1c are associated with OCTA changes in DM-no DR patients, and with structural OCT changes in DM-DR patients. The combination of OCTA and OCT measurements and HbA1c levels may be helpful to identify patients at risk of progression to greater stages of the diabetic microvascular disease.

Background The coronavirus disease 2019 (COVID-19) pandemic caused a halt to in-person ambulatory care. We evaluated how the reduction in access to care affected HbA1c testing and patient HbA1c levels. Methods HbA1c data from 11 institutions were extracted to compare testing volume and the percentage of abnormal results between a pre-pandemic period (January-June 2019, period 1) and a portion of the COVID-19 pandemic period (Jan-June 2020, period 2). HbA1c results greater than 6.4% were categorized as abnormal. Results HbA1C testing volumes decreased in March, April and May by 23, 61 and 40% relative to the corresponding months in 2019. The percentage of abnormal results increased in April, May and June (25, 23, 9%). On average, we found that the frequency of abnormal results increased by 0.31% for every 1% decrease in testing volume (p Conclusion HbA1c testing volume for outpatients decreased by up to 70% during the early months of the pandemic. The decrease in testing was associated with an increase in abnormal HbA1c results.

Ning Liu,1 Li Xing,1 Weipu Mao,1– 3 Shuqiu Chen,1 Jianping Wu,1 Bin Xu,1 Ming Chen1– 3 1Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, 210009, People’s Republic of China; 2Surgical Research Center, Institute of Urology, Southeast University Medical School, Nanjing, 210009, People’s Republic of China; 3Department of Urology, Nanjing Lishui District People’s Hospital, Zhongda Hospital Lishui Branches, Southeast University, Nanjing, 211200, People’s Republic of ChinaCorrespondence: Ming Chen; Weipu MaoDepartment of Urology, Affiliated Zhongda Hospital of Southeast University, No. 87 Dingjiaqiao, Hunan Road, Gulou District, Nanjing, 210009, People’s Republic of ChinaTel/Fax +86-13913009977; +86-18621571327Email mingchenseu@126.com; maoweipu88@163.comObjective: The purpose of this study was to evaluate the associations between blood glucose and hemoglobin A1c (HbA1c) levels with the degree of stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) in women.Methods: We conducted a cross-sectional study of female participants in the National Health and Nutrition Examination Survey (NHANES) database between 2007 and 2012. Univariate and multivariate logistic regressions were used to assess the relationship between blood glucose and HbA1c levels and the degree of SUI and UUI.Results: A total of 3821 participants were enrolled in the study, of whom 2421 (63.4%) had no SUI, 1133 (29.7%) had monthly SUI, 267 (7.0%) had weekly SUI; 2883 (75.5%) had no UUI, 735 (19.2%) had monthly UUI, 203 (5.3%) had weekly UUI. The levels of blood glucose and HbA1c were positively correlated with SUI and UUI, and increased with increasing degree of UUI. Multivariate logistic regression showed that there was a positive association between blood HbA1c level and degree of SUI.Conclusion: Our study found that blood glucose and HbA1c levels can be used as indicators of SUI and UUI severity in women.Keywords: blood glucose, hemoglobin A1c, national health and nutrition examination survey, stress urinary incontinence, urgency urinary incontinence

We evaluated trajectories of glycated hemoglobin (HbA1c) levels and body mass index z-scores (BMIz) for 5 years after diagnosis among Korean children and adolescents with type 1 diabetes (T1D) or type 2 diabetes (T2D) using the common data model. From the de-identified database of three hospitals, 889 patients p p p

Background The study aimed to evaluate whether the presence of DKA at diabetes diagnosis was associated with poorer metabolic control during a 5-year follow-up. Methods The study included children treated due to newly diagnosed T1D complicated with DKA between 2010 and 2014 with a complete 5-year follow-up. In every case we performed individual matching for age, gender and BMI with a person without DKA (nDKA) on recognition. We collected data regarding treatment modality, HbA1C, total daily insulin dose, basal insulin and BMI-SDS. Results 85 children at the median age of 7.93 years had DKA at diabetes diagnosis. The median pH was 7.19.Continuous subcutaneous insulin infusion (CSII) was used in 87% of participants in each group. No differences in HbA1C level (7,3%vs7,2%;p = .413) were noted after 5 years of disease duration. The severity of ketoacidosis exerted no significant effect on HbA1C. The method of insulin delivery at baseline was significantly associated with HbA1C levels after 5 years of observation, βCSII = − 1.46,95%CI[− 2.01 to − 0.92],p Conclusions The presence of DKA at diabetes diagnosis is not associated with deteriorated long-term metabolic control in children using modern technologies. The early implementation of CSII into diabetes treatment may change the effect of DKA and lead to a long-term HbA1C improvement.

AIM To investigate temporal changes in glycaemic control and the use of antihyperglycaemic therapies in females and males with type 2 diabetes from 2013 to 2019. METHODS Data from adult patients with type 2 diabetes (n = 11 930; 44.9% females, mean [SD] age of 62.9 [12.9] years) were analysed from the 2013 to 2019 biennial cross-sectional Australian National Diabetes Audit. RESULTS Mean HbA1c remained similar throughout the years examined and between the sexes (7.8%-8.3%, 62-67 mmol/mol; P > .05). The number of antihyperglycaemic agents used by both sexes increased from 2013 to 2019 (P

Aims To investigate the relationship between single therapeutic interventions and indicators of glycemic control in the PRISMA trial, a large study comparing the effects of intensive structured SMBG (ISM) vs. active control (AC) in non-insulin-treated type 2 diabetes (T2D). Methods Information was collected at four time points, corresponding to months 3, 6, 9, and 12 and visits 2, 3, 4, and 5, respectively. Data on therapeutic interventions, HbA1c levels and the number of hypoglycemic episodes at each visit were analyzed. Results Intensification of drug therapy occurred in 20.3% vs. 15.6%, and no change in 71.8% vs. 78.7% of visits for the ISM and AC groups, respectively. On the other hand, de-intensification and redistribution of drugs and/or drug dose occurred in a similar proportion of visits. Intensification of drug therapy in both groups was associated with significant reductions in HbA1c vs. the previous visit, while de-intensification of therapy led to a significant increase in HbA1c in the AC group only. Conclusions. Our data strongly support that structured SMBG has clinical value in reducing HbA1c in non-insulin-treated T2D and suggest that this clinical benefit may be mediated by more appropriate and timely changes in drug therapy.

Frequent fluctuations of hemoglobin A1c (HbA1C) values predict patient outcomes. However, data regarding prognoses depending on the long-term changes in HbA1C among patients after acute myocardial infarction (AMI) are scarce. We evaluated the prognostic significance of HbA1C levels and changes among diabetic patients (n = 4066) after non-fatal AMI. All the results of HbA1C tests up to the 10-year follow-up were obtained. The changes (∆) of HbA1C were calculated in each patient. The time intervals of ∆HbA1C values were classified as rapid (&lt, one year) and slow (≥one year) changes. The outcome was all-cause mortality. The highest mortality rates of 53.8% and 35.5% were found in the HbA1C &lt, 5.5–7% and ∆HbA1C = −2.5–(−2%) categories. A U-shaped association was observed between HbA1C and mortality: adjOR = 1.887 and adjOR = 1.302 for HbA1C &lt, 5.5% and ≥8.0%, respectively, as compared with 5.5–6.5% (p &lt, 0.001). Additionally, ∆HbA1C was associated with the outcome (U-shaped): adjOR = 2.376 and adjOR = 1.340 for the groups of &lt, −2.5% and ≥2.5% ∆HbA1C, respectively, as compared to minimal ∆HbA1C (±0.5%) (p &lt, 0.001). A rapid increase in HbA1C (but not decrease) was associated with a greater risk of mortality. HbA1C values and their changes are significant prognostic markers for long-term mortality among AMI-DM patients. ∆HbA1C and its timing, in addition to absolute HbA1C values, should be monitored.