Prevalence of diabetes mellitus in Croatia

The aim of this study was to obtain an accurate estimate of diabetes prevalence in Croatia and additional estimates of impaired fasting glucose (IFG), undiagnosed diabetes, and insulin resistance.The study was part of the First Croatian Health Project. Field work included a questionnaire, anthropological measurements, and blood sampling. A nationally representative sample of 1653 subjects aged 18–65 years was analyzed.A total of 100 participants with diabetes were detected, among them 42 with previously unknown diabetes. The prevalence was 6.1% (95% CI: 4.59–7.64), with a significant difference by age. IFG prevalence (WHO-criteria) was 11.3%. The ratio of undiagnosed/diagnosed diabetes was 72/100, unevenly distributed by the regions. HOMA-IR was >1 in 40.4% of the subjects.This survey revealed a higher prevalence of diabetes than previously estimated, whereas that of IFG was as expected. A significant difference in the proportion of undiagnosed diabetes among the regions warrants attention.     

Prevalence of diabetes mellitus in north-western Tanzania

Summary The prevalence of diabetes mellitus in 3,145 Tanzanian Africans living in three different areas of the country was studied. Fasting capillary blood glucose concentrations were measured by Dextrometer and if the levels were 5.5 mmol/l an oral glucose tolerance test was performed. When using the 1980 WHO criteria [8] for diagnosis, the overall diabetic prevalence was 0.7%. Prevalence increased with age, and in the population 20 years of age it was 1.6%. In a rural area inhabitated by the Haya tribe, the prevalence in the population aged 20 years was 2.5%, and in a similar area populated by the Sukuma tribe it was 0.5%. In the urban area of Mwanza town it was 1.9%. Obesity was seen in 3.7% of the population and in 9.1% of the diabetic subjects. Sixty-eight percent of the diabetic patients were female compared with 53% in the general population. None of the diabetic patients discovered had any symptoms. Thus, the overall prevalence of diabetes in Tanzania is rather low but shows geographical variability and is strongly associated with age.     

中国城市中心医院糖尿病健康管理调查

目的　调查中国城市市级中心医院糖尿病控制管理和晚期并发症的状况。方法　在中国49家市级中心医院连续选取治疗一年以上的 2 2 48例糖尿病患者 ,通过回顾病历 ,门诊访谈 ,开展回顾 前瞻的大型调查 ,以收集患者的人口学资料、糖尿病类型及相关治疗、血糖控制及并发症、心血管危险因素和肾功能等资料 ,并采集指血在中心实验室以高压液相色谱法检测HbA1c。结果　入选的 2 2 48例患者年龄为 (61.3± 11.1)岁 ,发病年龄为 (5 2 .8± 11.1)岁 ,其中大部分 (97% )为 2型糖尿病患者。研究人群HbA1c为(7.7± 1.7) % ,2 5 .9%的患者血糖控制理想 (HbA1c<6.5 % )。 41.7%的患者在家中进行血糖自我或尿糖监测。平时作饮食控制和体育锻炼的患者分别为 72 .7%和 5 8.6%。发生率最高的并发症为神经病变 (3 6.2 % ) ,其次为白内障 (3 2 .2 % )和背景性视网膜病变 (2 3 .2 % )。多数 2型糖尿病患者 (62 .0 % )为超重 (BMI≥2 3kg/m2 )。结论　仅有 2 5 .9%的糖尿病患者血糖控制理想 ,因此 ,市级中心医院的糖尿病治疗和管理水平有必要进一步提高 ,包括大力宣传健康的生活方式和血糖自我监测的重要性 ,推广强化治疗 ,以期预防晚期并发症发生     

Performance of the Finnish Diabetes Risk Score (FINDRISC) and Modified Asian FINDRISC (ModAsian FINDRISC) for screening of undiagnosed type 2 diabetes mellitus and dysglycaemia in primary care

AimsTo evaluate the performance of FINDRISC and ModAsian FINDRISC for the screening of undiagnosed diabetes and dysglycaemia in primary care. To compare the performance of FINDRISC with the recommendations of the American Diabetes Association (ADA) and US Preventive Services Task Force (USPSTF) guidelines.MethodsThis cross-sectional study was carried out on 293 patients without a prior history of diabetes at a primary care clinic in Malaysia. Questions on body mass index and waist circumference were modified based on the Asian standard in ModAsian FINDRISC. Haemoglobin A1c of ≥6.5% (48 mmol/mol) was used to diagnose diabetes. Areas under the receiver operating curve (ROC-AUC) for FINDRISC and ModAsian FINDRISC were analyzed.ResultsThe prevalence of undiagnosed diabetes was 7.5% and prediabetes was 32.8%. The ROC-AUC of FINDRISC was 0.76 (undiagnosed diabetes) and 0.79 (dysglycaemia). There was no statistical difference between FINDRISC and ModAsian FINDRISC. The recommended optimal FINDRISC cut-off point for undiagnosed diabetes was ≥11 (Sensitivity 86.4%, Specificity 48.7%). FINDRISC ≥11 point has higher sensitivity compared to USPSTF criteria (72.7%) and higher specificity compared to the ADA (9.6%).ConclusionsFINDRISC is a useful diabetes screening tool to identify those at risk of diabetes in primary care in Malaysia.     

Effectiveness of a colour coded HbA1c graphical record in improving diabetes control in people with type 2 diabetes: a randomized control trial

We conducted a six-month randomized-controlled-trial to evaluate the effectiveness of a colour-coded HbA1c-graphical record in improving HbA1c level among type 2 diabetes patients. There was an improvement in the mean HbA1c knowledge score but the usage of the colour-coded HbA1c-graphical record did not produce reduction in the HbA1c level.     

2型糖尿病患者的血糖控制和医疗费用的多因素分析

目的　了解中国大城市 2型糖尿病 (T2DM )患者的血糖 (PG)和糖化血红蛋白 (HbA1c)及其控制情况 ,以及影响患者医疗费用的因素。　方法　对国内 11个大城市的T2DM患者抽样调查 ,收集其疾病控制和治疗费用数据 ,以及相关的影响因素。调查的 1111例T2DM患者中 ,门诊 6 5 8例 ,住院 4 5 3例 ,采用描述统计的方法分析患者的HbA1c和PG控制情况 ,用多因素模型分析医疗费用的主要影响因素。　结果　 6 8%患者的空腹血糖 (FPG)没有得到很好控制 ( >7.0mmol/L) ,4 2 %的HbA1c控制效果不佳 ( >7.5 % )。门诊医疗费用的多因素分析中医院级别 (P <0 .0 0 1)、并发症 (P<0 .0 0 1)和末次空腹静脉血糖控制水平 (P <0 .0 5 )是影响患者就诊费用的主要因素。住院医疗费用多因素分析结果显示 ,住院天数 (P <0 .0 0 1)、医院级别、并发症 (P <0 .0 0 1)、家庭人均收入是影响患者住院费用的主要因素。　结论　中国大城市中 5 0 %左右T2DM患者按照 ( 2 0 0 2年的治疗情况 )PG和HbA1c控制效果不佳 ,并发症和PG控制效果不好是T2DM患者医疗费增多的显著因素     

Efficacy and safety of lobeglitazone,a new Thiazolidinedione,as compared to the standard of care in type 2 diabetes mellitus: A systematic review and meta-analysis

AimThis systematic review and meta-analysis was conducted to evaluate the efficacy and safety of lobeglitazone as compared to the standard of care (SOC) in patients with type 2 diabetes mellitus (T2DM).MethodsDatabases were searched for relevant randomized controlled trials. The primary outcome was the comparison of the glycated hemoglobin (HbA1C) level after 24 weeks. Pooled mean differences and odds ratios were calculated using random-effects models.ResultsOf 267 studies that were screened, four were included. Treatment with adjunct lobeglitazone showed a reduction in the HbA1C level [mean difference: ?0.23% (95% CI: ?0.62 to 0.16); p = 0.24; i²: 87%; moderate GRADE (Grading of Recommendations Assessment, Development and. Evaluation) of evidence], fasting blood glucose level [mean difference: ?7.12 mg/dl (95% CI: ?20.09 to 5.85); p = 0.28; i²: 87%; moderate GRADE of evidence], and lipid profile as compared to those following treatment with the SOC; however, the changes were not statistically significant. The risk of hypoglycemia was significantly lower [odds ratio: 0.24 (95% CI: 0.08 to 0.70); p < 0.05; i²: 0%; moderate GRADE of evidence] without any significant difference in the risk of drug-related adverse events [odds ratio: 1.59 (95% CI: 0.87 to 2.93); p = 0.13; i²: 0%; moderate GRADE of evidence] following treatment with lobeglitazone as compared to those following treatment with the SOC.ConclusionTreatment with adjunct lobeglitazone showed changes in the blood glycemic status and lipid profile similar to SOC in patients with T2DM, and the results were not statistically significant. Lobeglitazone was well tolerated; its safety profile was comparable to SOC.     

Diabetic factors associated with gastrointestinal symptoms in patients with type 2 diabetes

AIM: To determine whether gastrointestinal (GI) symptoms are more frequent in type 2 diabetic patients and to examine which diabetic factors are associated with the symptoms. METHODS: Consecutive subjects with diabetes and age-/gender-matched normal controls were recruited for this study. GI symptoms were assessed using a structured questionnaire divided into two GI symptomcategories (upper and lower GI symptoms), and consisting of 11 individual symptoms. In the diabetic patient group, diabetic complication...     

The use of glycated haemoglobin (HbA1C) in determining glycemic control (and relevance of BMI) in diabetic patients in Ahmadu Bello University Teaching Hospital Zaria,Nigeria

This study was carried out to specifically investigate the local HbA1_C level and determine extent of (if any) variation from the WHO (World Health Organization) recommended threshold for the diagnosis of diabetes and prediabetes using blood glucose as a benchmark. In addition, we also looked to see what role BMI (Body Mass Index) plays among subjects used for the study.152 subjects were used for the study: 101 diabetic subjects and 51 non-diabetic control subjects. 5 mL of blood sample was collected from each of the subjects after about 8–10 h of overnight fasting. 3–4 mL of the sample was centrifuged and the serum analysed for glucose. The remaining 1–2 ml was transferred into EDTA bottles and analysed immediately for glycated haemoglobin (HbA1_C). The BMI (kg/m²) was calculated by dividing the weight in kilograms (kg) by the square of the height in metres (m²).For the BMI, no significant difference was observed between the diabetic subjects (mean = 25.75 kg/m²) and the non-diabetic control subjects (mean = 25.09 kg/m²). Thirty-seven (37) of the diabetic subjects and twenty-three (23) of the non-diabetic subjects had HbA1_C levels (mean = 6.96% and 6.29% respectively) that would imply either prediabetes or diabetes but were actually normal going by their fasting blood glucose (FBG) levels. A new chart for the interconversions between FBG and HbA1c and for predicting their expected values from each other was realized, drawn up and recommended for consideration in the management of diabetic patients along with the WHO recommended chart.There are a lot of normal individuals with HbA1c level that does not conform to (or that are simply higher than) what is regarded as the threshold for the onset of diabetes or prediabetes. Generally, the local (Nigerian) glycated haemoglobin (HbA1c) level can therefore be said to be distinctly higher for a given blood glucose range and should be taken as such in the management of diabetes in this environment. Being overweight or obese is not prerequisite to the development of diabetes or abnormal glycated haemoglobin level.     

2型糖尿病患者动态血糖变化与糖化血红蛋白水平的相关性分析

目的探讨2型糖尿病患者动态血糖变化与糖化血红蛋白(HbAlc)水平的相关性,为预防2型糖尿病并发症的发生提供参考。方法选取2009-05～2011-05收治的18例2型糖尿病患者,采用动态血糖监测系统(CGMS)观察2型糖尿病患者血糖变化与HbAl c的相关性。结果经Pearson分析显示,HbAlc与日内血糖水平呈正相关(P0.05),与餐后血糖波动幅度(PPGE)无明显相关性(P0.05)。结论 CGMS能详细显示日内血糖波动情况,HbAlc能反映日内整体血糖水平。     

城市居民体重指数与糖尿病和糖耐量低减关系的研究

目的 分析南宁市城市居民体重指数（BMI）与糖尿病（DM）发病的关系。方法 对南宁市样本区随机抽取5个街道社区（居委会）810户，每户抽取年龄在35-74岁的居民1人，共810人。分别检测体重、体重指数（BMI）、餐后12h空腹血糖（FPC）；按DM糖耐量低减（IGT）诊断标准分别计算各组的患病率并对照比较。结果 DM患病率以65-74岁组最高，达14．56％；IGT患病率以55-64岁组最高，达16．28％；BMI肥胖组DM、IGT患病率均比正常体重组高，分别高出8．49％及14．48％；不同性别DM、IGT患病率无明显差异。结论 南宁市城市居民DM与IGT的患病情况与年龄呈正比关系，提示超重和肥胖是DM的重要危险因素之一；DM及IGT在南宁市城市居民中已占有相当大的比例。     

昆明市2型糖尿病患者糖化血红蛋白相关因素分析

目的 探讨昆明市T2DM患者HbA1C与FPG、2hPG和血红蛋白（Hb）的关系,了解HbA1C的影响因素。方法选取昆明市居住5年以上的T2DM患者208例,对HbA,C与FPG、2hpG和Hb进行分析,将高血红蛋白和正常血红蛋白组FPG、2hPG和HbA1C进行比较。结果HbA1C与FPG、2hPG呈正相关,相关系数分别为0．87、0．89,HbA1C与FPG和2hPG的回归方程为Y-1．124＋0．334X,＋0．284x2。不同Hb水平间FPG、2hPG和HbA1C比较差异无统计学意义。结论影响HbA1c的主要因素是FPG和2hPG,Hb对FPG、2hPG和HbA1C的影响无统计学意义。     

Relationship between HbA1c and indices of glucose tolerance derived from a standardized meal test in newly diagnosed treatment naive subjects with Type 2 diabetes.

AIMS: To determine the relationship between HbA1c and other indices of glycaemic status derived during a standardized meal tolerance test (MTT) in newly diagnosed treatment-naive subjects with Type 2 diabetes (T2DM). METHODS: T2DM subjects (n = 262) consumed a standard MTT in the morning after a 10-h overnight fast. Frequent samples for plasma glucose (PG) were collected over the 4-h test period. The relationship between HbA1c and other glycaemic indices derived from the MTT were explored. The postprandial glucose exposure was calculated as the area under the incremental plasma glucose curve above the fasting level for the test period (AUC1). Excess hyperglycaemia was calculated as the AUC0-4 h above the arbitrary PG concentrations of 6.0 mmol/l (AUC2) and 5.5 mmol/l (AUC3), respectively [upper limit of fasting normoglycaemia according to World Health Organization (WHO) and American Diabetes Association (ADA), respectively]. Fasting hyperglycaemia was also estimated, being the difference between each of the above and the postprandial excursion. The participants were divided into three subgroups according to HbA1c (Group 1, 9.0%) and the relative contribution calculated of the postprandial glucose and fasting hyperglycaemia to the excess hyperglycaemia above the designated international thresholds for fasting plasma glucose. RESULTS: HbA1c was more strongly correlated with the fasting plasma glucose (r = 0.85, P < 0.001) than the overall postprandial glucose exposure (r = 0.539, P = 0.003). The contribution of fasting hyperglycaemia to excess hyperglycaemia using the WHO criteria for normal fasting plasma glucose for the three groups (Groups 1, 2 and 3) was 50.4%, 54.3% and 69.8%, respectively, and 57.8%, 58.8% and 71.4% using the ADA criteria. CONCLUSIONS: The contribution of fasting hyperglycaemia to excess hyperglycaemia increases as glycaemic control deteriorates, becoming dominant with an HbA1c in excess of 7.0%. These findings indicate which therapeutic approach needs to be adopted based on the HbA1c of the person with T2DM.     

Metabolic outcomes in patients with type 2 diabetes mellitus after metabolic management center

The Chinese Medical Doctor Association has initiated metabolic management center (MMC) program for 6 years since 2016 nationwide. It is worth investigating the level of control metabolic outcomes in patients with type2 diabetes (T2DM) after MMC model in Yan’an, northwest China. Patients with T2DM was admitted to MMC in Yan’an University Affiliated Hospital from November 2018 to July 2021. They were asked to revisit hospital every 3 months. Blood glucose, blood pressure and blood lipids at baseline were compared to its counterparts after 1 year MMC management. Glycosylated hemoglobin and low density lipoprotein cholesterol (LDL-C) level in T2DM patients after 1 year management were lower than their baseline level (glycosylated hemoglobin 7.74 ± 1.94% vs 8.63 ± 2.26%, P < .001; LDL-C 1.81 ± 0.73mmol/L vs 2.18 ± 1.49mmol/L, P < .001). Mean HOMA-β increased after management (65.89 ± 90.81% vs 128.38 ± 293.93%, P < .05). After 1 year of management, patients in high school or above group achieved higher control rate of body mass index than those in middle school or below group (71.82% vs 28.18%, P = .043). high density lipoprotein cholesterol control rate was higher in high income group (42.86% vs 34.97%, 16.28%, P = .012), while LDL-C control rate was higher in low-income group (97.67% vs 78.57%, 84.51%, P = .018). fasting plasma glucose control rate in new diagnosis group was higher than that of the middle and long course groups (71.43% vs 52.38%, 42.44%, P = .002). The comprehensive control rate increased from 9.83% at baseline to 26.15% after 1 year MMC management. The metabolic outcomes and their control rate in T2DM patients were improved after 1 year MMC management. It indicated that patients may achieve more benefits with MMC management.     

蚓激酶对糖尿病患者血液流变学、血糖及血脂的影响

目的了解蚓激酶对糖尿病患者的血液流变学、血糖和血脂的影响,以及对糖尿病并发症的防治作用。方法对76例2型糖尿病患者在血糖控制到FPG〈8mmol/L,2hPG〈11mmol/L后,随机分为蚓激酶组40例,对照组36例。蚓激酶组用蚓激酶60万单位口服,日3次,共8周。比较两组治疗前后血液流变学、血糖和血脂的差异。结果蚓激酶组的全血黏度、血浆比黏度、血浆纤维蛋白原浓度、血小板聚集率和甘油三酯均明显降低（P〈0.01）,两组空腹及餐后血糖下降无差异（P〉0.05）。结论蚓激酶对糖尿病患者的血脂,血液流变学指标均有不同程度的改善。     

糖化血红蛋白在糖尿病及空腹血糖受损诊断中的价值

目的 探讨HbA1c在糖尿病及IFG诊断中的意义。方法选取526名未诊断糖尿病及IFG者同时检测HbA1C和FPG。按ADA诊断标准（FI）G≥7．0mmol／L）、IFG标准（5．6mmol／L≤FPG46．9mmol／L）和2010年ADA新标准（HbA1c≥6．5％及5．7％≤HbA1c≤6．4％）将研究对象分组。以FPG为“金标准”,统计HbA1C诊断糖尿糖及IFG的敏感性（s）、特异性（Sp）、阳性似然比（＋ut）、阴性似然比（-LR）。结果HbA1c≥6．5％诊断糖尿病的s为96％,Sp为95％,＋LR为19．2,-LR为0．042;5．7N≤HbA1c≤6．4％诊断IFG的S为26％,sp为94％,＋LR为4．3,-LR为0．79。结论HbA1C诊断糖尿病有较高的诊断敏感性和特异性,在诊断IFG时特异性较高,而敏感性较低。     

HbA1c对中老年人糖尿病及糖调节受损诊断价值的探讨

目的 探讨HbA1c诊断中老年人糖尿病、糖调节受损的最佳切点.方法 采用整群随机抽样方法选取贵阳市云岩区40岁及以上,且居住5年以上的中老年人共8 803名.所有研究对象进行口服葡萄糖耐量试验(OG'TT)及检测HbA1c等指标.对HbA1c诊断糖尿病、糖调节受损的切点进行分析;按年龄分层分析HbA1c诊断糖尿病在不同年龄段的切点.结果 HbA1c诊断新发现糖尿病的切点为6.4％的特异性较高(86.8％),相应的敏感性为68.0％.HbA1c诊断糖调节受损的受试者工作曲线下面积偏低(0.558).40 ～49岁年龄组HbA1c诊断糖尿病的切点值最低,为6.1％;而70～岁年龄组HbA1c诊断糖尿病切点值最高,为6.6％.结论 中老年人群中HbA1c 6.4％为诊断糖尿病的最佳切点,HbA1 c不适合作为诊断糖调节受损的指标.     

肺结核合并糖尿病患者的T细胞亚群与血糖水平的相关分析

目的探讨肺结核合并2型糖尿病患者的血糖水平与T细胞亚群的相关性。方法回顾分析51例2002年1月～2004年12月入院的初治肺结核合并2型糖尿病患者,选择空腹血糖FBG和糖化血红蛋白HbAlc作为血糖水平的观察指标,T淋巴细胞亚群作为细胞免疫功能的指标,分别比较其相关性。结果T淋巴细胞亚群各值与单次的空腹血糖测量水平无明显相关性,P值均〉0．05;而CD3与HbAlc负相关,相关系数r值为-0．286,CD8与HbAlc正相关,r值为0．306,P值均〈0．05。结论肺结核合并2型糖尿病患者的细胞免疫功能与长期血糖控制水平有一定的关联,高HbAlc水平常伴随细胞免疫功能低下。提示长期高血糖状态会加重细胞免疫功能紊乱。