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Diabetes Mellitus Type 2 (DM2)/Adult Onset Diabetes
Published in Charles Theisler, Adjuvant Medical Care, 2023
Because diabetes accelerates atherosclerosis, long-term complications include heart and blood vessel damage (heart attack, heart failure, and stroke), nerve damage (neuropathy), kidney damage (nephropathy), eye damage (retinopathy), and peripheral vascular disease with reduced blood flow to the legs and feet possibly leading to amputations. There is also an increased risk for vascular dementia.2 Poor glycemic control leads to an increase in the severity of the aforementioned complications.3
The approach to revision procedures
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Joseph A. Weiner, Wellington K. Hsu
Glycated hemoglobin (HbA1c) can be used to diagnose and monitor diabetes and poor glycemic control. Both the American Diabetes Association and American Association of Clinical Endocrinologists advocate the use of HbA1c > 6.5% to diagnose DM.57 Koutsoumbelis et al. reported that a clinical diagnosis of diabetes prior to surgery significantly increased the risk for postoperative infection after instrumented lumbar fusion.24 Recent work has further demonstrated that both controlled and uncontrolled diabetic patients undergoing degenerative lumbar spine surgery have an increased risk of postoperative infection.58
Gestational Diabetes
Published in Emmanuel C. Opara, Sam Dagogo-Jack, Nutrition and Diabetes, 2019
Surveillance of blood glucose values is required to determine glycemic control. Unfortunately, there is insufficient data to delineate the optimal frequency of blood glucose testing in women with GDM. The general recommendation is for daily glucose monitoring four times a day—fasting and after each meal (14). Tight metabolic control occurs when fasting blood glucose levels are less than or equal to 95 mg/dL; 1-hour levels are less than or equal to 140 mg/dL; or 2-hour levels are less than or equal to 120 mg/dL.
Association between smoking and glycemic control in men with newly diagnosed type 2 diabetes: a retrospective matched cohort study
Published in Annals of Medicine, 2022
Hon-Ke Sia, Chew-Teng Kor, Shih-Te Tu, Pei-Yung Liao, Jiun-Yi Wang
Alcohol consumption was defined as more than once weekly within the preceding year. Leisure-time physical activity was classified as regular (≥30 min/day, ≥3 days/week), occasional (less rigorous than regular exercise), or no exercise. A four-point Likert scale was used by a certified diabetes educator to assess the following fours variables of self-care. Knowledge regarding glycemic control was defined as an understanding of the need for and the ways to control blood glucose. Willingness towards DSM was defined as the motivation to learn self-management techniques. Medication adherence was defined as taking the medication regularly at the dose recommended by the physician during the past week. Performing self-monitoring of blood glucose (SMBG) was defined as self-assessment of blood glucose levels using a glucometer more than once per week. Data were merged into simple dichotomies (i.e. top-two-box vs. bottom-two-box) and categorised as either adequate (yes) or inadequate (no) for analysis.
The relationship between poor glycaemic control at different time points of gestational diabetes mellitus and pregnancy outcomes
Published in Journal of Obstetrics and Gynaecology, 2022
Hong-Bin Xu, Min-Hui Li, Xiao-Fang Tang, Jing Lu
FPG was defined as the blood glucose detected from venous blood following at least 8 h of overnight fasting (Marathe et al. 2017). Glycaemic control is the technique of supervising the blood glucose level of diabetic patients at optimum level (Marathe et al. 2017). The target values of glycaemic control were 3.3–5.3 mmol/L for FPG and 4.4–6.7 mmol/L for 2-h PPG. If the glycaemic control does not reach the target value after diet, exercise or after the use of insulin, it is considered that the glycaemic control is poor. Good glycaemic control was defined if the patients had 4 and 7 mmol/L of FPG upon measurement of three consecutive visits. The observed adverse pregnancy outcomes were: HDCP, PROM, postpartum haemorrhage (PPH), macrosomia, low-birth weight infants, premature delivery, neonatal jaundice, neonatal asphyxia and indicators of insulin use; male newborns and caesarean section were also observed. The general information of each group included age, pregnancy times, parity, antenatal BMI value and new born weight (NBW). Adverse pregnancy outcome was declared by the occurrence of HDCP, PROM, PPH and macrosomia, premature birth, low birth weight, neonatal asphyxia and neonatal jaundice, otherwise there was no adverse pregnancy outcome. Prenatal BMI refers to the body mass index before delivery, which refers to weight divided by the square of height (kg/m2).
Increased risk of adverse cardiovascular events by strict glycemic control after percutaneous coronary intervention (HbA1c < 6.5% at 2 years) in type 2 diabetes mellitus combined with acute coronary syndrome: a 5-years follow-up study
Published in Current Medical Research and Opinion, 2021
Tiangui Yang, Peng Fu, Jie Chen, Xi Fu, Changlu Xu, Xiaoxia Liu, Tiesheng Niu
With the extensive application of a drug-eluting stent, the occurrence of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) cannot be ignored. In particular, it is urgent to solve in-stent restenosis and acute stent thrombosis. Studies have demonstrated that1–4 smoking history, diabetes mellitus, hyperlipidemia, long coronary lesions, multiple stents, poor stent expansion, and severe plaque burden on lesions are the risk factors for MACE after PCI. The incidence rate of cardiac insufficiency, in-stent restenosis, acute thrombosis, and adverse cardiovascular events and the adverse prognosis increased in acute coronary syndrome (ACS) patients with type 2 diabetes mellitus who had persistent hyperglycemia after PCI, compared with patients with better blood-glucose control5,6. Accordingly, guidelines recommend glycemic control that has a target hemoglobin A1c (HbA1c) level below 7.0% or 6.5% in the management of diabetes, however, there are differences in guidelines in different countries or regions7,8.