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Obstetric Outcomes after Recurrent Pregnancy Loss
Published in Howard J.A. Carp, Recurrent Pregnancy Loss, 2020
Rakefet Yoeli-Ullman, Howard J.A. Carp, Shali Mazaki-Tovi
Cozzolino et al. [40] performed a retrospective cohort study investigating adverse pregnancy outcomes in women with RPL (n = 53) compared to a control group of couples attending a low-risk antenatal unit (n = 65) (see Table 18.4). Women with previous RPL had a significantly increased risk of gestational diabetes with 12 cases (22.6%) in the study group and 3 cases (4.6%) in the control group (OR 6.04; 95% CI 1.60–22.76; p = 0.007). Romero et al. [41] used fructosamine as an indicator of mean blood glucose in a study including 117 women with unexplained RPL, and no more than one live birth, and 117 age-matched controls with at least one full-term uncomplicated pregnancy and no more than one pregnancy loss. The mean fructosamine concentration was higher in women with RPL (224.1 ± 28.79 μmol/mL) compared with controls (188.9 ± 19.3 μmol/mL, P < 0.001). This difference persisted when RPL patients and controls were stratified according to BMI. However, the proportion of women with elevated fructosamine (>285 μmol/L) was similar in RPL patients and controls.
Biochemistry
Published in Michael McGhee, A Guide to Laboratory Investigations, 2019
Use of the fructosamine assay has replaced that of HbA1C (in some laboratories) for monitoring the control of diabetes, because it is less expensive and it reflects average blood glucose levels over the preceding 2 weeks.
Management of Diabetes Mellitus in Sub-Saharan Africa
Published in Emmanuel C. Opara, Sam Dagogo-Jack, Nutrition and Diabetes, 2019
Olufemi A. Fasanmade, Amie A. Ogunsakin, Sam Dagogo-Jack
Most tertiary centers have point-of-care HbA1c measurement capability. Given the high prevalence of nutritional anemia, sickle cell disease, and sickle trait in the region that often leads to false HbA1c results, fructosamine assays ought to be more widely available to inform local experience, research, and practice. Despite these limitations, adherence of patients to the medications and glucose monitoring is considerable, with 60% being adherent to hypoglycemic medications and knowing their latest blood glucose readings.30 Very few patients carry out self-monitoring of blood glucose (SMBG). Insulin pump therapy, continuous glucose monitoring, and more recent or emerging diabetes technologies, such as closed-loop systems, are conspicuously absent.
Crassocephalum rubens (Juss. Ex Jacq.) S. Moore improves pancreatic histology, insulin secretion, liver and kidney functions and ameliorates oxidative stress in fructose-streptozotocin induced type 2 diabetic rats
Published in Drug and Chemical Toxicology, 2022
Olajumoke A. Oyebode, Ochuko L. Erukainure, Olakunle Sanni, Md.Shahidul Islam
Maintaining glucose homeostasis is very important in T2D in order to reduce any risk of micro or macro-vascular complications (Chawla et al. 2016). Treatment with CRAQ showed promising improvement in glucose tolerance abilities of the plant (Figure 2(b)) especially at the high dose of 300 mg/kg bw. This activity might be due to lower insulin resistance and increased insulin secretion that would induce glucose uptake by the peripheral tissues. In addition, the high dose of the extract reduced HOMA-IR index (for insulin resistance), and also improved the HOMA-β (for β-cell function) score (Table 3 and Figure 3). Homeostatic model assessment (HOMA) is a technique used for estimating insulin resistance and β-cell function from fasting blood glucose levels and insulin concentration (Wallace et al. 2004). Plants that reduce HOMA-IR scores have been reported to contain potent antidiabetic activities (Vianna et al. 2011). The reduced fructosamine level in the CRAQ-treated groups also portrays an antidiabetic effect of the extract (Table 3). Fructosamine is a marker of glucose control showing average serum glycaemic level, in some cases it is regarded as more efficient in detecting early response to treatment (Nansseu et al. 2015).
Selection of abstracts from Baylor Scott & White Health Central Texas Scholars Day
Published in Baylor University Medical Center Proceedings, 2021
Angela D. Rutherford, Wendy Hegefeld, William Culp, Patrick Lowry, Hania Janek, Shekhar Ghamande, Megan Newman, Austin Metting, J. Scott Thomas, V. Maxanne Flores, Niraj Vora, Christian Cable
Hemoglobin (Hb) A1c is an important tool for diagnosis and management of diabetes mellitus. However, Hb variants can interfere with laboratory assays and lead to inaccurate results. This study describes a case of a patient being managed for type 2 diabetes mellitus who was found to have erroneous HbA1c values secondary to Hb Wayne, a rare Hb variant. HbA1c measurement was conducted by Biorad Variant II high-performance liquid chromatography and Siemens DCA point-of-care immunoassay. Additional investigation was completed by fructosamine analysis, chromatography, electrophoresis cascade (Mayo Clinical Laboratories), and mass spectrometry (Mayo Clinical Laboratories). Analysis of HbA1c throughout the previous 3 years via immunoassay with Biorad Variant II yielded results of 9.7% to 10.6%, which were inconsistent with point-of-care testing with Siemens DCA analyzer of 5% to 6% and fasting blood glucose readings of 80 to 95. Fructosamine was within the normal range, at 233 to 251. Hb electrophoresis cascade and mass spectrometry confirmed the presence of Hb Wayne variant. Although Hb Wayne is often clinically silent, falsely elevated HbA1c results could lead to unnecessary medical interventions that could cause patient harm. This variation in results highlights the importance of utilizing additional measurements such as glucose readings and evaluating for Hb variants when results are discordant.
Beyond self-monitored plasma glucose and HbA1c: the role of non-traditional glycaemic markers in gestational diabetes mellitus
Published in Journal of Obstetrics and Gynaecology, 2018
Neuza Mendes, Rogério Tavares Ribeiro, Fátima Serrano
Serum fructosamine results from the covalent attachment between a sugar (such as glucose or fructose) to total serum proteins, primarily albumin, therefore, forming ketoamines. It provides information on blood glucose levels over the foregoing 2–4 weeks, therefore, being a short-term marker (Ahmed and Furth 1992; Selvin et al. 2014). Fructosamine does not seem to be affected by haemoglobin characteristics. Nevertheless, and unlike HbA1c or GA, it is influenced by dilutional anaemia, which frequently develops during pregnancy. Because 60–70% of serum protein is albumin, conditions that affect the metabolism of the later, as nephritic syndrome or hyperthyroidism, can also interfere with fructosamine levels (Ford et al. 1987; Sako et al. 1989; Constanti et al. 1992). Its measurement is rapid, inexpensive, precise and technically simple. Even so, it is not routinely used in clinical practice. Nonetheless, fructosamine has been pointed out as a marker of exposure (the period of exposure and glucose variability) and a marker of risk (predictor of what will occur) in diabetes (Shafi et al. 2013; Parrinello and Selvin 2014; Ribeiro et al. 2016). It is currently used in populations where HbA1c is thought to inaccurately reflect glycaemia, including haemoglobinophaties and severe kidney disease (Shipman et al. 2014). Indeed, fructosamine and GA have been both cross-sectionally and prospectively associated with microvascular, macrovascular and all cause morbidity and mortality in dialysis patients, whereas many studies have reported no association of HbA1c with these outcomes (Kumeda et al. 2008; Yamada et al. 2008; Mittman et al. 2010; Murea et al. 2012).