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Background and Objective: Acute myocardial infarction (AMI) is a serious and life-threatening disease caused by a sudden blockage of blood flow in the heart muscle. According to the contradictory results in studies investigating the levels of chemerin (with the role of enhancing inflammation) and omentin-1 (with anti-inflammatory properties) in patients with diabetes, this study aims to compare the levels of omentin-1 and chemerin in patients with acute myocardial infarction (AMI) with and without diabetes and its relationship with vascular lesions, HbA1c, blood pressure, CRP and serum creatinine. Methods: In this cross-sectional study, a total of 80 AMI patients were randomly included in this study with the age range of 37-79 years old, categorized according to the presence (26 patients) or absence (54 patients) of diabetes and the number of arteries with lesions. The levels of omentin-1 and chemerin were measured using ELISA kits, and correlations between the adipokines and other parameters were evaluated using Pearson correlation analysis. ROC curve analysis was performed to assess the diagnostic value of omentin-1 and chemerin in distinguishing AMI patients with and without diabetes. Findings: The demographic characteristics of patients of the two groups, including age, systolic and diastolic blood pressure showed non-significant differences. The levels of omentin-1 were not significantly different between AMI patients with and without diabetes, while chemerin levels were significantly higher in AMI patients with diabetes (1.212±0.232) as compared to the AMI patients without diabetes (0.72±0.116) (p

Zhenzhen Liu, Mingxi Shao, Jun Ren, Yichao Qiu, Shengjie Li, Wenjun Cao Department of Clinical Laboratory, Eye and Ear Nose Throat (ENT) Hospital, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of ChinaCorrespondence: Shengjie Li; Wenjun Cao, Department of Clinical Laboratory, Eye and Ear Nose Throat (ENT) Hospital, Shanghai Medical College, Fudan University, Fenyang Road 83th, Shanghai, People’s Republic of China, Tel/Fax +86 21-64377134-2510 ; +86 21-64377134-2662, Email lishengjie6363020@163.com; wgkjyk@aliyun.comPurpose: We aimed to investigate the association between lipid profiles and diabetic retinopathy (DR).Patients and Methods: This case-control study, which was conducted between November 2019 and August 2021, comprised 309 patients with DR, 186 patients with diabetes mellitus, and 172 healthy controls. Serum cholesterol (CHOL), triglyceride (TRIG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), small dense LDL-C (SDLDL-C), apolipoprotein A (APOA), APOB, APOE and lipoprotein (a)(LPA) levels were assessed. Patients were divided into two groups according to median age and glycated hemoglobin (HbA1c) level. Linear and logistic regression analyses were performed to assess the association between lipid levels and DR.Results: CHOL, TRIG, HDL-C, APOB, APOE, and SDLDL-C levels were significantly higher in the DR group than in the healthy control group, and TRIG levels were lower in the DR group than in the DM group (P < 0.05), especially in the ≤ 57-year-old and the HbA1c ≤ 7.2% subgroups. Linear regression analyses showed that CHOL, TRIG, APOA, APOB, APOE, and SDLDL-C levels were associated with HbA1c levels. Multivariable logistic regression analyses indicated that CHOL (odds ratio [OR] = 1.32, 95% confidence interval [CI] = 1.112– 1.566), TRIG (OR = 1.269, 95% CI = 1.030– 1.563), HDL-C (OR = 43.744, 95% CI = 17.12– 111.769), APOB (OR = 7.037, 95% CI = 3.370– 14.695), APOE (OR = 1.057, 95% CI = 1.038– 1.077), and SDLDL-C (OR = 14.719, 95% CI = 8.304– 26.088) levels were risk factors for DR (P < 0.05).Conclusion: Increased lipid levels were risk factors for DR, and lipid level control should be strengthened, especially in younger adults or in patients with HbA1c ≤ 7.2%.Keywords: lipids, dyslipidemia, diabetes mellitus, diabetic retinopathy, younger population, HbA1c

Sunil Mamtora, 1 Panayiotis Maghsoudlou, 1, 2 Hani Hasan, 1 Wenrui Zhang, 3 Mohamed El-Ashry 1 1Department of Ophthalmology, Great Western Hospital, Swindon SN3 6BB, UK; 2Department of Developmental Biology, University College London, London WC1E 6BT, UK; 3Department of Ophthalmology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UKCorrespondence: Panayiotis MaghsoudlouUniversity College London, London, UKTel +44 020 7242 9789Fax +44 020 7905 2000Email p.maghsoudlou@ucl.ac.ukBackground/Aims: Effective management of diabetic retinopathy requires multidisciplinary input. We aimed to evaluate the impact of point of care (POC) HbA1c testing as a tool to identify patients most in need of specialist diabetologist input and assess the accuracy and determinants of patients’ insight into their glycaemic and blood pressure control.Methods: Forty-nine patients with diabetic retinopathy were recruited from the eye clinic at Great Western Hospital. Patients completed a questionnaire and POC HbA1c and blood pressure values were measured. Statistical analysis was completed with SPSS v23.Results: Mean age was 64.4 years, median interval since the last formal HbA1c reading was 10.2 months and the mean POC HbA1c was 64.1 mmol/mol. HbA1c significantly correlated with the degree of retinopathy. Of the patients, 81.6% had POC readings above the levels recommended by the National Institute for Health and Care Excellence, with only 16.3% having insight into this. Insight to HbA1c levels was predicted by age but not by duration of disease. Fourteen patients (33.3%) identified with high HbA1c readings were referred to secondary diabetic services and 88.8% of patients felt that the test was useful and likely to improve their diabetic control.Conclusion: The majority of patients had poor insight into their diabetes control, with sub-optimal treatment and follow-up. Poor insight is high in younger patients, suggesting that POC HbA1c testing is particularly important in educating younger patients who may be Type 1 diabetics with more severe disease. POC HbA1c represents a cost-effective, reproducible and clinically significant tool for the management of diabetes in an outpatient ophthalmology setting, allowing the rapid recognition of high-risk patients and appropriate referral to secondary diabetic services.Keywords: diabetic retinopathy, glycemic control, point of care testing, HbA1c

Allah Bukhsh,1,2 Tahir Mehmood Khan,1,2 Muhammad Sarfraz Nawaz,3 Hafiz Sajjad Ahmed,4 Kok Gan Chan,5,6 Learn-Han Lee,1,2,7–10 Bey-Hing Goh1,2,7–10 1School of Pharmacy, Monash University, Jalan Lagoon Selatan 45700, Selangor, Malaysia; 2Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, 54000, Lahore, Pakistan; 3Department of Pharmacy, Quaid-i-Azam University Islamabad, Pakistan; 4Capital Hospital Islamabad, Pakistan; 5International Genome Centre, Jiangsu University, Zhenjiang, China; 6Division of Genetics and Molecular Biology, Faculty of Science, Institute of Biological Sciences, University of Malaya, Kuala Lumpur, Malaysia; 7Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia; 8Novel Bacteria and Drug Discovery Research Group, Microbiome and Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia; 9Biofunctional Molecule Exploratory Research Group, School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia; 10Center of Health Outcomes Research and Therapeutic, Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Mueang Phayao, Thailand Objective: Association of various self-care activities on glycemic control of people with diabetes (PWD) in Pakistan is yet to be explored. The current study aimed to evaluate the association of various diabetes-related self-care activities with glycated hemoglobin (HbA1c) levels and to examine the predictive relationship of patients’ demographic variables with their self-care activities.Patients and methods: A cross-sectional study was conducted on adult PWD (N=218) who were diagnosed with type 2 diabetes mellitus of at least 1 year duration. Self-care activities were examined by using the Urdu version of Diabetes Self-management Questionnaire. Linear regression analysis was conducted to examine the significant predictors for diabetes-related self-care activities and glycemic control.Results: Mean age of the patients was 50.77±13.3 years. Poor glycemic control (HbA1c ≥7%) was observed in majority of the patients (83%). Linear regression analysis revealed that glucose management (β=-0.44; 95% CI -0.438, -0.209; P

BACKGROUND: Serum glucose levels can get close to a normal level by an appropriate diet. The present study aims to investigate the effect of low-calorie diets (1200, 1500, 1800 Kcal) on glucose and lipid levels, and HbA1C serum levels of newly diagnosed type II diabetic patients. MATERIALS AND METHODS: This prospective cross-sectional study was conducted among 68 patients with type II diabetes mellitus, whose disease was recently diagnosed. The study criteria included fasting blood glucose higher than 126 mg/dL, HbA1c higher than 7% and BMI higher than 25. Fasting blood glucose levels, 2-hour post-prandial blood sugar and blood lipids were measured before and after intervention. Then, the patients were trained by an expert. After completing the questionnaires, the data were analyzed. RESULTS: In this study, the mean fasting blood glucose level in patients who used 1200, 1500 and 1800 kcal diets decreased significantly after intervention (p

Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by pancreatic β-cell destruction and considered to be correlated with oxidative stress. This study aimed to investigate the association of oxidative stress [superoxide dismutase (SOD) and malondialdehyde (MDA) levels], inflammation [interleukin 10 (IL-10)], and glycemic control (HbA1c) in pediatric T1DM patients. This study included 25 T1DM subjects and 25 healthy control subjects and was designed as a cross- sectional study. SOD, MDA, and IL-10 levels were measured by ELISA. We obtained that that IL-10 and SOD levels were significantly decreased in the T1DM group, but MDA and HbA1c levels were significantly elevated in the T1DM group. IL-10 levels were positively correlated with SOD levels and negatively correlated with MDA and HbA1c. SOD levels were negatively correlated with HbA1c levels. MDA was positively correlated with HbA1c levels. IL-10 and SOD levels were significantly decreased, but MDA and HbA1c levels were significantly elevated in the T1DM group.

Background: Digital interventions may assist patients with type 2 diabetes in improving glycemic control. We aimed to synthesize effect sizes of digital interventions on glycated hemoglobin (HbA1c) levels and to identify effective features of digital interventions targeting patients with poorly controlled type 2 diabetes.Materials and Methods: MEDLINE, ISI Web of Science, and PsycINFO were searched for randomized controlled trials (RCTs) comparing the effects of digital interventions with usual care. Two reviewers independently assessed studies for eligibility and determined study quality, using the Cochrane Risk of Bias Assessment Tool. The Behavioral Change Technique Taxonomy V1 (BCTTv1) was used to identify BCTs used in interventions. Mean HbA1c differences were pooled using analysis of covariance to adjust for baseline differences and pre-post correlations. To examine effective intervention features and to evaluate differences in effect sizes across groups, meta-regression and subgroup analyses were performed.Results: Twenty-three arms of 21 RCTs were included in the meta-analysis (n = 3787 patients, 52.6% in intervention arms). The mean HbA1c baseline differences ranged from -0.2% to 0.64%. The pooled mean HbA1c change was statistically significant (-0.39 {95% CI: [-0.51 to -0.26]} with substantial heterogeneity [I2 statistic, 80.8%]) and a significant HbA1c reduction was noted for web-based interventions. A baseline HbA1c level above 7.5%, β = -0.44 (95% CI: [-0.81 to -0.06]), the BCTs "problem solving," β = -1.30 (95% CI: [-2.05 to -0.54]), and "self-monitoring outcomes of behavior," β = -1.21 (95% CI: [-1.95 to -0.46]) were significantly associated with reduced HbA1c levels.Conclusions: Digital interventions appear effective for reducing HbA1c levels in patients with poorly controlled type 2 diabetes. [ABSTRACT FROM AUTHOR]

We report a second occurrence of hemoglobin (Hb) Tyne, [β5 (A2) Pro>Ser] HBB:c.16C>T(p.Pro6Ser), which like the first case was associated with normal hematology. We verified the variant was mildly unstable by showing it was greatly enriched in isopropanol precipitates. This minor instability accounts for the slightly decreased expression of the new β chain. The variant was picked up as an interfering component on HbA1c testing using cation exchange high performance liquid chromatography (HPLC). However, this may be an advantage in detecting electrophoretically silent variants. Furthermore, this report also highlights the importance of uneven or sloping baselines on HPLC, which could reflect the presence of a variant hemoglobin even in the presence of normal electrophoresis and full blood count. 我们报告了第二例血红蛋白(Hb) Tyne [β5 (A2) Pro>Ser] HBB:c.16C>T(p.Pro6Ser)的出现，其与第一例一样伴随血象正常。我们通过将该变体在异丙醇沉淀物中的显著富集证实了其有轻度不稳定性。这种微小的不稳定性可用来说明新β链表达的轻微下降。该变体在使用阳离子交换高效液相色谱（HPLC）的HbA1c检测中作为干扰成分检出。然而，在检测电泳沉默变体方面这可能使一个优势。此外，本报告还强调了不平或倾斜的基线对HPLC的重要性，这会反映出血红蛋白变异体的存在，即使电泳和全血计数正常。

Glycosylated hemoglobin (GHb) is routinely used to monitor glycemic control over past 2-3 months in diabetics. As per the recommendations of the American Association of Clinical Endocrinologist, 2007 values should be maintained below 7% to prevent the risk of chronic complications. We report a case of a 55-year old female patient with spuriously low HbA1c values by high-performance liquid chromatography. Suspecting the presence of any abnormal hemoglobin, capillary zone electrophoresis was done which identified the presence of Hb variant corresponding to -Hb N Seattle. Our case highlights that clinical laboratories should be aware of limitations of their HbA1c assay methods as well as rule out any possible interfering Hb variants. 糖化血红蛋白(GHB)在糖尿病方面被常规用于监测过去2-3个月血糖控制。 根据美国临床内分泌医师学会2007年的建议，这个值应该被维持在7%以下，以防止慢性并发症的风险。 我们报告了一例55岁女性患者使用高效液体相色谱法测定假性低HbA1c值的病例。 因怀疑存在有某种异常血红蛋白，我们进行了毛细血管区带电泳，识别出存在对应于-Hb N Seattle的Hb变异体。 我们的病例强调了临床实验室应该意识到其HbA1c测定方法的局限性，并排除任何可能引起干扰的Hb变异体。

Objective: Diabetes mellitus is the most common chronic endocrine disease worldwide. Intensive glycemic control plays an important role in decreasing morbidity and mortality rate of the disease. Preclinical studies have shown that biotin has an essential role in regulating blood glucose and serum lipid metabolism. This study aims to evaluate the effect of biotin on glycemic control and plasma lipids concentrations in type 1diabetic patients.Methods: This randomized double-blind placebo-controlled clinical trial study was conducted 70 type 1 diabetic patients with an age range 5-25 years old with poorly controlled (glycosylated hemoglobin ≥8%). Subjects were randomly allocated into two groups. In the intervention group biotin (40 microgram/kg) was administered plus daily insulin, while the control group received placebo plus daily insulin regimen for three months. Laboratory tests including glycosylated hemoglobin (HbA1c), fasting blood sugar and plasma lipids were measured at the base and after 3 months.Results: In this study, seventy patients were evaluated, 35 were allocated to each group. There were no statistically significant differences between age, gender, duration of diabetes, BMI and BP between the two groups (p>0.05). HbA1c in the intervention (biotin) group was 9.84±1.80 at base and after 3 months treatment, it declined to 8.88±1.73 (p

Aims/hypothesis. To determine risk factors related to the incidence and progression of diabetic retinopathy over 6 years from diagnosis of Type II (non-insulin-dependent) diabetes mellitus. Methods. This report describes 1919 patients from within the United Kingdom Prospective Diabetes Study (UKPDS), with retinal photographs taken at diagnosis and 6 years later and with complete data available. Photographs were centrally graded for lesions of diabetic retinopathy using the modified Early Treatment of Diabetic Retinopathy Study Final scale. Risk factors were assessed after 3 months diet from the time of diagnosis of diabetes. Patients were seen every 3 months in a hospital setting. Biochemical measurements were done by a central laboratory. End points of vitreous haemorrhage and photocagulation were confirmed by independent adjudication of systematically collected clinical data. The main outcome measures were incidence and progression of retinopathy defined as a two-step Early Treatment of Diabetic Retinopathy Study (ETDRS) final scale change. Results. Of the 1919 patients, 1216 (63 %) had no retinopathy at diagnosis. By 6 years, 22 % of these had developed retinopathy, that is microaneurysms in both eyes or worse. In the 703 (37 %) patients with retinopathy at diagnosis, 29 % progressed by two scale steps or more. Development of retinopathy (incidence) was strongly associated with baseline glycaemia, glycaemic exposure over 6 years, higher blood pressure and with not smoking. In those who already had retinopathy, progression was associated with older age, male sex, hyperglycaemia (as evidenced by a higher HbA1 c) and with not smoking. Conclusion/interpretation. The findings re-emphasise the need for good glycaemic control and assiduous treatment of hypertension if diabetic retinopathy is to be minimised. [Diabetologia (2001) 44: 156–163] [ABSTRACT FROM AUTHOR]

Objective: Our study investigated the association between the level of HbA1c (glycated hemoglobin) at admission and the prognosis of aneurysmal subarachnoid hemorrhage (SAH)., Methods: A total of 510 patients treated with neuro-intervention for aneurysmal SAH and with data for admission HbA1c (glycated hemoglobin) were included. Favorable clinical outcome was defined as modified Rankin Scale (mRS) score of 0-2 at 3 months. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cutoff value of HbA1C for unfavorable clinical outcomes. Logistic regression was used to evaluate the association between HbA1C level and outcomes., Results: The optimal cutoff value of HbA1C was identified as 6.0% (P < 0.001), and patients with a high HbA1C (≥ 6.0%) had a lower prevalence of favorable clinical outcomes than patients with low HbA1C (< 6.0%) (P < 0.001). High HbA1C (≥ 6.0%) was independently associated with unfavorable clinical outcome (OR 2.84; 95% CI: 1.52-5.44; P = 0.004). The risk of unfavorable clinical outcome was significantly increased in patients with HbA1C (≥ 7.0%, < 8%) and HbA1C (≥ 8.0%) compared with lower baseline HbA1C (≥ 6.0%, < 7%) values (OR 2.17; 95% CI: 1.87-5.13; P = 0.011 and OR 4.25; 95% CI: 3.17-8.41; P = 0.005)., Conclusion: Our study showed that HbA1C could be an independent predictor of worse outcomes following neuro-intervention for aneurysmal SAH. High HbA1C (≥ 6.0%) was associated with unfavorable clinical outcomes, and gradual elevation of HbA1C contributed to an increase in the risk of worse clinical outcomes after SAH., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: It is important to assess how well patients respond to their medical treatments by observing the results that appear during the clinical treatments. As such, the clinical treatments and results must obtain information on how effective recommended treatments were for patients with diabetes., Objective: This study examines how patients with diabetes mellitus responded towards their clinical treatments, where the probability distribution of patients and the types of treatment received were derived from the Rasch probabilistic model., Methods: This is a retrospective study wherein data were collected from patients' medical records at a local public hospital in Selangor, Malaysia. Clinical and demographic information such as fasting blood glucose, hemoglobin A1c (HbA1c), family history, type of diabetes (type 1 or type 2), types of medication (oral or insulin), compliance with treatments, gender, race and age were chosen as the agents of measurement., Results: The use of Rasch analysis in the present study helped to compare the patients' responses towards the DM treatments and identify the types of treatment they received. Results from the Wright map show that a majority of the diabetes mellitus patients who were diagnosed with type 2 diabetes have no controlled readings of HbA1c during their first and second visits to the medical center. However, patients with a family history of diabetes mellitus who took oral medication have controlled readings of fasting blood glucose based on the probabilistic outcomes of the treatment received by the patients., Conclusion: Controlled readings were found only in the readings of fasting blood glucose during the first and second visits, followed by family history, types of medication received, and compliance with the treatment. This study has recommended that type 2 patients with diabetes without a family history of diabetes mellitus need to exercise more control over the readings of HbA1c., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Unhealthy western dietary patterns lead to over-consumption of fat and advanced glycation end-products (AGEs), and these account for the developments of obesity, diabetes, and related metabolic disorders. Certain amino acids (AAs) have been recently demonstrated to improve glycemia and reduce adiposity. Therefore, our primary aims were to examine whether feeding an isoleucine-enriched AA mixture (4.5% AAs; Ile: 3.0%, Leu: 1.0%, Val: 0.2%, Arg: 0.3% in the drinking water) would affect adiposity development and prevent the impairments of glycemic control in rats fed with the fat/AGE-containing diet (FAD). Methods: Twenty-four male Sprague-Dawley rats were assigned into 1) control diet (CD, N = 8), 2) FAD diet (FAD, N = 8), and 3) FAD diet plus AA (FAD/AA, N = 8). After 9-weeks intervention, the glycemic control capacity (glucose level, ITT, and HbA1c levels), body composition, and spontaneous locomotor activity (SLA) were evaluated, and the fasting blood samples were collected for analyzing metabolic related hormones (insulin, leptin, adiponectin, and corticosterone). The adipose tissues were also surgically collected and weighed. Results: FAD rats showed significant increases in weight gain, body fat %, blood glucose, HbA1c, leptin, and area under the curve of glucose during insulin tolerance test (ITT-glucose-AUC) in compared with the CD rats. However, the fasting levels of blood glucose, HbA1c, leptin, and ITT-glucose-AUC did not differ between CD and FAD/AA rats. FAD/AA rats also showed a greater increase in serum testosterone. Conclusion: The amino acid mixture consisting of Ile, Leu, Val, and Arg showed clear protective benefits on preventing the FAD-induced obesity and impaired glycemic control., Competing Interests: Competing Interests: The authors have declared that no competing interest exists.