Comparative Evaluation of Fructosamine and Hba1c As a Marker of Glycemic Control in Type 2 Diabetes: a Hospital Based Study
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2015 Prediabetes Data Summary
The Georgia Department of Public Health Prediabetes Data Summary Diabetes is the 6th leading cause of death among adults and over 800,000 people live with diabetes in Georgia.1 Individuals with prediabetes have an increased risk of developing Type 2 diabetes, heart disease and stroke. Moreover, individuals with prediabetes often possess cardiovascular risk factors such as hypertension, obesity and high cholesterol. Prediabetes almost always occurs among individuals who eventually develop Type 2 diabetes.2 In Type 2 diabetes, the body does not use insulin properly which causes blood glucose (sugar) levels to be higher than normal. Approximately 450,000 adults in Georgia have prediabetes. Prediabetes (also known as borderline diabetes) is a medical condition that occurs when blood glucose levels are higher than normal, but are not high enough to be diagnosed as diabetes.3 Test results among individuals diagnosed with prediabetes include: A1C test value: 5.7% - 6.4% Impaired fasting blood glucose (IFG) levels: 100-125 mg/dl OR Two- hour Oral Glucose Tolerance Test (OGTT) value: 140 mg/dl – 199 mg/dl Making healt hy lifestyle choices, such as eating healthy foods, being physically active and maintaining a healthy weight, may help to bring blood glucose (sugar) levels down to normal and decrease the risk of developing Type 2 diabetes Table 1. Demographic Characteristics among Prediabetics, Georgia, 2013 Demographic Characteristics Percent (%) 95% CI State Total 7.9 (7.2, 8.9) Sex Male 7.8 (6.8, 9.5) Female 7.9 (6.9, 9.1) Race/Ethnicity -
Glossary of Common Diabetes Terms
Glossary of Common Diabetes Terms A1C: a test that reveals exactly how well your blood sugar (glucose) has been controlled over the previous three months Beta cells: cells found in the pancreas that make insulin Blood glucose: also known as blood sugar, glucose comes from food and is then carried through the blood to deliver energy to cells Blood glucose meter: a small medical device used to check blood glucose levels Blood glucose monitoring: the simple blood test used to check the amount of glucose in the blood; a tiny drop of blood, taken by pricking a finger, is placed on a test strip and inserted in the meter for reading Diabetes: the shortened name for diabetes mellitus, the condition in which the pancreas doesn’t produce enough insulin or your body is unable to use insulin to move glucose into cells of the body Diabetic retinopathy: the eye disease that occurs in someone with diabetes when the small blood vessels of the retina become swollen and leak liquid into the retina, blurring vision; it can sometimes lead to blindness Gestational diabetes: the diabetes some women develop during pregnancy; it typically subsides after the baby is delivered, but many women who have had gestational diabetes may develop type 2 diabetes later in life Glucagon: the hormone that is injected into a person with diabetes to raise their blood glucose level when it’s very low (hypoglycemia) Glucose: blood sugar that gives energy to cells Hyperglycemia: also known as high blood glucose, this condition occurs when your blood glucose level is too high; -
CANINE INSULINOMA: DIAGNOSIS, TREATMENT, & STAGING Eliza Reiss Grant, DVM, and Kristine E
Peer Reviewed PRACTICAL ONCOLOGY CANINE INSULINOMA: DIAGNOSIS, TREATMENT, & STAGING Eliza Reiss Grant, DVM, and Kristine E. Burgess, DVM, Diplomate ACVIM (Oncology) Tufts University An insulinoma is a malignant pancreatic tumor that DIAGNOSIS inappropriately secretes excessive insulin, resulting in Aside from a histologic confirmation of insulinoma, profound hypoglycemia.1 no currently available diagnostic test provides a de- Pancreatic tumors are classified as: finitive diagnosis of insulinoma. Existing techniques • Exocrine, which includes adenocarcinomas of may help increase suspicion for an insulin-secreting ductular or acinar origin tumor but, with most diagnostic testing, it is im- • Endocrine, which arise from the islets of perative to interpret all results in the context of the Langerhans. coexisting clinical signs. Insulinomas are functional neuroendocrine tumors that originate in the beta cells of the islets Differential Diagnosis of Langerhans.1 A complete work-up, including careful patient history, physical examination, bloodwork, and PRESENTATION diagnostic imaging tests, should be performed to Signalment rule out other causes of hypoglycemia, such as Any breed of dog can be affected, but large sepsis, hepatic failure, adrenal cortical insufficiency, breeds tend to be overrepresented.1 While, in toxin ingestion, and other forms of neoplasia. humans, insulinomas affect females far more frequently than males, there is no apparent sex Laboratory Tests predilection in dogs.1-3 Dogs also commonly Blood Glucose present with a malignant variant, while humans A simple fasting blood glucose level of less than often have a benign adenoma (80%).1 Insulino- 40 mg/dL can suggest hyperinsulinemia, although ma is rare in cats.4 careful monitoring of a fasted dog with suspected insulinoma is strongly recommended due to high Clinical Signs risk for seizure activity. -
Food Fact Sheet
Food Fact Sheet Diabetes - Type 2 What is Type 2 diabetes? Diabetes is a condition where the amount of glucose (sugar) in your blood is too high because your body cannot use it properly. In Type 2 diabetes this happens because your pancreas doesn’t produce enough of the hormome insulin (that helps glucose enter body cells) and/or the insulin that is produced does not work correctly (insulin resistance). The importance of good blood glucose control 2 Reduce your portion sizes to help you reduce and People with Type 2 diabetes need to control their maintain a healthy weight. blood glucose. It is also important to look after your A portion is: heart health. Making changes to your lifestyle, diet and • a fist size of potatoes, bread, pasta or other activity level can be key to reducing the risk of diabetes starchy carbohydrates causing you problems now and in the future. • a palm size of meat/fish or poultry What can you eat? • two handfuls of vegetables or salad • a cupped-handful of fruit People with diabetes should eat a healthy diet, the • top of your thumb size of oil or fat spread. same as somebody without diabetes. It should be low Try using a smaller plate, filling half of your plate with in saturated fat, high in fibre and include a variety of vegetables and avoiding second helpings. fruit and vegetables. 3 Carbohydrates are used for energy so include some The eatwell guide in your diet each day. Opt for wholegrain options, fruits and vegetables, beans, pulses, low fat milk and The eatwell guide represents the main food groups and yoghurt. -
Metformin for Prediabetes
FACT SHEET FOR PATIENTS AND FAMILIES Metformin for Prediabetes What is metformin? Metformin [met-FORE-min] is a medication that is often prescribed for prediabetes in order to help prevent type 2 diabetes. It is taken by mouth (orally) as a pill. Like other prediabetes medications, it works best when you follow the rest of your treatment plan, like improving your nutrition by eating more fruits and vegetables, being physically active every day, and in most cases, losing weight. What does it do? Metformin helps lower your blood glucose (blood sugar). It does this by: Does metformin cause hypoglycemia • Decreasing the amount of glucose released by your (low blood glucose)? liver. Less glucose enters into your bloodstream. No. Metformin doesn’t cause hypoglycemia by itself. • Increasing the ability of your muscles to use glucose But combined with other medications, vigorous for energy. As more glucose is used, more glucose exercise, or too little food, it can make your blood leaves your bloodstream. glucose drop too low. Why is metformin important Since low blood glucose can be dangerous, make sure for my health? that you and your family know the symptoms. These include feeling shaky, sweaty, hungry, and irritable. Metformin can’t cure your prediabetes. But, by If you have these symptoms, take some quick-acting helping control your blood glucose, it can help sugar. Good sources are 3 or 4 glucose tablets, a half- prevent type 2 diabetes, especially among those at cup of fruit juice or regular soda, or a tablespoon of highest risk for developing type 2 diabetes. -
Prediabetes: What Is It and What Can I Do?
Prediabetes: What Is It and What Can I Do? What is prediabetes? Weight loss can delay or prevent diabetes. Prediabetes is a condition that comes before Reaching a healthy weight can help you a lot. diabetes. It means your blood glucose levels are If you’re overweight, any weight loss, even higher than normal but aren’t high enough to be 7 percent of your weight (for example, losing called diabetes. about 15 pounds if you weigh 200), may lower your risk for diabetes. There are no clear symptoms of prediabetes. You can have it and not know it. If I have prediabetes, what does it mean? It means you might get type 2 diabetes soon or down the road. You are also more likely to get heart disease or have a stroke. The good news is that you can take steps to delay or prevent type 2 diabetes. How can I delay or prevent type 2 diabetes? You may be able to delay or prevent type 2 diabetes with: Daily physical activity, such as walking. Weight loss, if needed. Losing even a few pounds will help. Medication, if your doctor prescribes it. If you have prediabetes, these steps may bring your blood glucose to a normal range. But you are still at a higher risk for type 2 diabetes. Regular physical activity can delay or prevent diabetes. Being active is one of the best ways to delay or prevent type 2 diabetes. It can also lower your weight and blood pressure, and improve cholesterol levels. Ask your health care team about activities that are safe for you. -
What Everyone Needs to Know About Prediabetes
diaTribe.org provides free cutting-edge diabetes insights and actionable tips for people with diabetes. Our mission is to help individuals better understand their diabetes and to make our readers happier & healthier. What Everyone Needs to Know about Prediabetes: Symptoms, Diagnosis, Prevention, and more! What is prediabetes? Prediabetes is a condition where blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. This occurs when the body has problems in processing glucose properly, and sugar starts to build up in the bloodstream instead of fueling cells in muscles and tissues. Insulin is the hormone that tells cells to take up glucose, and in prediabetes, people typically initially develop insulin resistance (where the body’s cells can’t respond to insulin as well), and over time the ability to produce sufficient insulin is reduced (if no actions are taken to reverse the situation). People with prediabetes also commonly have high blood pressure as well as abnormal blood lipids (e.g. cholesterol.) These often occur prior to the rise of blood glucose levels. What are the symptoms of prediabetes? People typically do not have symptoms of prediabetes, which is partially why up to 90% of people don’t know they have it. The ADA reports that some people with prediabetes may develop symptoms of type 2 diabetes, though even many people diagnosed with type 2 diabetes show little or no symptoms initially at diagnosis. These symptoms include: Urinating often Blurry vision Feeling very thirsty Feeling very hungry, even Cuts/bruises that Tingling, pain, or though you are eating are slow to heal numbness in the hands/ feet Extreme fatigue /diaTribeNews @diaTribeNews diaTribe.org “ People typically do not have symptoms of prediabetes, which is partially why up to 90% of people don’t know they have it.” Who is at risk of developing prediabetes? Overweight and obese adults (a BMI >25 kg/m2) are at significantly greater risk for developing prediabetes, as well as people with a family history of type 2 diabetes. -
Diabetic Ketoacidosis Diabetic Ketoacidosis (DKA) Is a Serious Problem That Can Happen in People with Diabetes
Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) is a serious problem that can happen in people with diabetes. DKA should be treated as a medical emergency. This is because it can lead to coma or death. If you have the symptoms of DKA, get medical help right away. DKA happens more often in people with type 1 diabetes. But it can happen in people with type 2 diabetes. It can also happen in women with diabetes during pregnancy (gestational diabetes). DKA happens when insulin levels are too low. Without enough insulin, sugar (glucose) can’t get to the cells of your body. The glucose stays in the blood. The liver then puts out even more glucose into the blood. This causes high blood glucose (hyperglycemia). Without glucose, your body breaks down stored fat for energy. When this happens, acids called ketones are released into the blood. This is called ketosis. High levels of ketones (ketoacidosis) can be harmful to you. Hyperglycemia and ketoacidosis can also cause serious problems in the blood and your body, such as: • Low levels of potassium (hypokalemia) and phosphate • Damage to kidneys or other organs • Coma What causes diabetic ketoacidosis? In people with diabetes, DKA is most often caused by too little insulin in the body. It is also caused by: • Poor management of diabetes • Infections such as a urinary tract infection or pneumonia • Serious health problems, such as a heart attack • Reactions to certain prescribed medicines including SGLT2 inhibitors for treating type 2 diabetes • Reactions to illegal drugs including cocaine • Disruption of insulin delivery from an insulin pump Symptoms of diabetic ketoacidosis DKA most often happens slowly over time. -
Am I at Risk for Gestational Diabetes?
Am I at risk for gestational diabetes? U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES NATIONAL INSTITUTES OF HEALTH Eunice Kennedy Shriver National Institute of Child Health and Human Development What is gestational diabetes? Gestational diabetes (pronounced jess-TAY-shun-ul die-uh-BEET-eez) is a type of high blood sugar that only pregnant women get. In fact, the word “gestational” means pregnant. If a woman gets high blood sugar when she’s pregnant, but she never had high blood sugar before, she has gestational diabetes. Between 2 percent and 10 percent of U.S. pregnancies are affected by the condition every year,1 making it one of the top health concerns related to pregnancy. If not treated, gestational diabetes can cause problems for mothers and babies, some of them serious. But there is good news. Most of the time, gestational diabetes goes away after the baby is born. The changes in your body that cause gestational diabetes normally occur only when you are pregnant. After the baby is born, your body goes back to normal and the condition goes away. Gestational diabetes is treatable, and the best outcomes result from careful management and control of blood sugar levels. The best way to control gestational diabetes is to find out you have it early and start treatment quickly. Treating gestational diabetes—even if you don’t have any symptoms or your symptoms are mild— greatly reduces health problems for mother and baby. Why do some women get gestational diabetes? Usually, the body breaks down much of the food you eat into a type of sugar, called glucose (pronounced GLOO-kos). -
Serum Fructosamine and Subsequent Breast Cancer Risk: a Nested Case-Control Study in the ORDET Prospective Cohort Study
Cancer Epidemiology, Biomarkers & Prevention 271 Short Communication Serum Fructosamine and Subsequent Breast Cancer Risk: A Nested Case-Control Study in the ORDET Prospective Cohort Study Mary Platek,1 Vittorio Krogh,6 Andrea Micheli,6 Richard Browne,5 Elisabetta Meneghini,6 Sabina Sieri,6 Holger J. Schu¨ nemann,2 Valeria Pala,6 Maddalena Barba,1 Gregory E. Wilding,3 Franco Berrino,6 and Paola Muti 4 Departments of 1Exercise and Nutrition Sciences, 2Medicine, 3Biostatistics, and 4Social and Preventive Medicine, 5Clinical Science Laboratory, University at Buffalo, State University of New York, Buffalo, New York; and 6Epidemiology Unit, Instituto Nazionale Per lo Studio e la Cura dei Tumori, Via Venezian, Milan, Italy Abstract There is evidence that abnormal glucose metabolism may follow-up, 144 breast cancer cases were identified and four contribute to the risk of breast cancer. The measurement of matched controls were selected from the cohort; serum markers of glucose metabolism could help to identify women fructosamine levels were measured in both groups at baseline. at risk for breast cancer. Serum fructosamine is one such Adjusted odds ratios (OR) for the highest tertile of serum marker. In this study, we investigated whether prediagnostic fructosamine compared to the lowest was 1.60 [95% con- serum fructosamine was associated with breast cancer. fidence interval (CI), 0.95-2.73]. In premenopausal women, the Between 1987 and 1992, 10,786 women ages 35 to 69 were OR was 1.58 (95% CI, 0.76-3.40) and in postmenopausal recruited in Italy for a prospective study. Women with a women, the OR was 1.60 (95% CI, 0.76-3.48). -
Fructosamine Interpretive Summary
Fructosamine Interpretive Summary Description: Fructosamine is a complex of glucose and protein that can be used to assess the average blood glucose concentration in a dog or cat over the previous 2-3 weeks. It is used in the diagnosis and management of diabetes mellitus. Decreased Fructosamine Common Causes Prolonged hypoglycemia o Insulin overdose o Insulinoma Decreased albumin (dog) or total protein (cat) Hyperthyroidism Uncommon Causes Increased serum triglycerides Azotemia Sample handling – storage at room temperature Related Findings Prolonged hypoglycemia o Insulinoma . Normal to increased serum insulin with concurrent decreased blood glucose . Increased insulin:glucose ratio . Pancreatic mass may be seen on ultrasound (cats>dogs) . A decreased fructosamine is not diagnostic for insulinoma but can increase clinical suspicion Hyperthyroidism o Increased T4, free T4 and free T4 by equilibrium dialysis Increased Fructosamine Common Causes Diabetes Mellitus Hemolysis (certain methodologies) Insulin overdose with Somogyi rebound effect Uncommon Causes Hypothyroidism Increased albumin (dog) or total protein (cat) Related Findings Diabetes Mellitus o Increased blood glucose o Glucose in urine +/- ketones Generated by VetConnect® PLUS: Fructosamine Page 1 of 2 Additional Information Physiology Fructosamine correlates with the patient’s average blood glucose concentration over the last 2-3 weeks. o Fructosamine is not affected by short-term increases in serum glucose such as those that occur with excitement, stress or intravenous dextrose administration. Fructosamine is a ketoamine that is formed by an irreversible, nonenzymatic linking of glucose to proteins (most often albumin and IgG). o Formation of fructosamine is related to the degree and duration of hyperglycemia. o Removal of fructosamine from the blood is dependent on the loss or degradation of the parent molecule (albumin). -
1,5-Anhydroglucitol (1,5-Ag) and Its Usefulness in Clinical Practice
Medical and Biological Sciences, 2012, 26/3, 11-17 REVIEW / PRACA POGLĄDOWA Anna Maria Dąbrowska, Jerzy S. Tarach, Maria Kurowska 1,5-ANHYDROGLUCITOL (1,5-AG) AND ITS USEFULNESS IN CLINICAL PRACTICE 1,5-ANHYDROGLUCITOL (1,5-AG) I JEGO ZASTOSOWANIE W PRAKTYCE KLINICZNEJ Department of Endocrinology, Medical University, Lublin, Poland Head: Prof. dr hab. med. Andrzej Nowakowski Summary 1,5-anhydroglucitol (1,5-AG) is a major polyol in human In clinical practice, 1,5-AG is a good marker of short-term serum, structurally similar to D-glucose. The 1,5-AG pool can episodes of hyperglycaemia such as postprandial be determined by the balance between oral intake and urinary hyperglycaemia and other short term glycaemia excursions, excretion. It is derived mainly from dietary sources with a for example during pregnancy or in pre-conception, before half-life of about 1-2 weeks. 1,5-AG is not metabolized, operations and after glycaemia-related therapeutic changes. It whereas it is excreted in urine and nearly 99.9% of it is has been also reported as a marker of first-ever cardiovascular reabsorbed by the kidneys. When serum glucose level exceeds disease, a clinical test to differentiate subtypes of diabetes and the renal threshold for glucosuria, urinary glucose suppresses to monitor type 1 diabetes in children. Despite small tubular reabsorbing of 1,5-AG, leading to a loss of it in the limitations such as end-stage renal disease or liver cirrhosis, urine and a rapid reduction of this polyol in serum levels. which should be taken into consideration when interpreting Therefore, the plasma 1,5-AG concentration indirectly reflects levels of 1,5-AG, it seems to be a useful and sensitive marker episodes of hyperglycaemia.