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Azathioprine Immunotherapy for Insulin Dependent Diabetes: U. S. Trials
Published in George S. Eisenbarth, Immunotherapy of Diabetes and Selected Autoimmune Diseases, 2019
Silverstein Janet, Maclaren Noel
As a group, the treatment group had better metabolic status than the controls at 1 year (Table 2). Although mean HgbA1C levels appeared to be lower in the group receiving immunotherapy than the control group (6.9 vs. 8.7%), the difference was not statistically significant, p <0.11. However, the mean insulin dose required to maintain these levels of glycohemoglobin was significantly greater in the control group than in the immunosuppressed group at 1 year (0.42 vs. 0.66 U/kg/day: p <0.001). The Sustacal-stimulated mean peak serum C-peptide level was higher in the treatment group than in the controls (0.52 vs. 0.26 pmol/ml: p <0.05). Metabolic status, as measured by the peak serum C-peptide/glucose ratios after oral Sustacal stimulation, was analyzed further using a repeated measures analysis of covariance. The higher the ratio, i.e., the higher the C-peptide or lower the blood glucose responses to Sustacal, the better the metabolic state. Patients treated with azathioprine plus prednisone exhibited better C-peptide to glucose ratios than the controls (2.45 vs. 0.79, p <0.01). The control group had its best responses at 3 months and gradually deteriorated thereafter. Peak C-peptide/glucose responses to Sustacal in the patients in the treatment group also declined between 3 and 6 months; however, their metabolic status stabilized thereafter (Table 2).
Managing Diabetes without Weight Gain
Published in David Heber, Zhaoping Li, Primary Care Nutrition, 2017
A hemoglobin A1c (HbA1c) level of 6.5% or higher. The test should be performed in a laboratory using a method that is certified by the National Glycohemoglobin Standardization Program (NGSP) and standardized or traceable to the Diabetes Control and Complications Trial (DCCT) reference assay.
Stages of Chronic Illness 1
Published in Len Sperry, Behavioral Health, 2013
He complained that the ADA diet excluded most of his “native foods” and he disliked doing blood sugar checks. Glycohemoglobin levels remained high despite the diet, exercise, and medication regimen. An endocrine consultation recommended an insulin pump. A week ago he was hospitalized again for “blacking out” on the job. Jesse’s diabetes has worsened, his family is distraught, and medical professionals label him as noncompliant. Not surprisingly, his depression has worsened.
Unexpected HbA1c results in the presence of three rare hemoglobin variants
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Jianfeng Xu, Zhijuan Zhong, Yukui Deng
In many previous studies regarding interference of Hb variants on the measurement of HbA1c, a boronate affinity HPLC method was used as a comparative method because it is unlikely to have interference based on the fact that glycated and non-glycated Hb are separated regardless of Hb species [8,10,24]. According to the latest National Glycohemoglobin Standardization Program (NGSP) criterion, an acceptable bias for HbA1c expressed in NGSP units was defined as within ± 5.0% (relative difference) when compared with the comparative method [7]. In the present study, using Premier Hb9210 as a comparative method, unacceptable biases, representing significant interference of the Hb variants, were found for Variant II Turbo 2.0 and Bio-Rad D100. In contrast, the results from the Roche immunoassay correlated well with those from Hb9210, and both corresponded well to glycated albumin and OGTT. In all cases, HbA1c measured by Variant II Turbo 2.0 showed markedly high values, whereas HbA1c measured by D100 showed low values. This is because each HPLC instrument utilizes its specific weak cation exchange column and reagents, which leads to the differences in the exact retention time and the relative position of each Hb variant.
Cardiometabolic disease, depressive symptoms, and sleep disorders in middle-aged adults with functional disabilities: NHANES 2007–2014
Published in Disability and Rehabilitation, 2020
Daniel G. Whitney, Edward A. Hurvitz, Mark D. Peterson
Cardiovascular disease was defined as having systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥80 mmHg (based on the American College of Cardiology and the American Heart Association 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults [28]) obtained from the Blood Pressure Examination file, or an existing diagnosis or historical record of the following morbidities from the Medical Conditions Questionnaire: congestive heart failure, coronary heart disease, myocardial infarction, or stroke. Diabetes was defined as having glycated hemoglobin values ≥5.7% (based on the Clinical Practice Recommendations placing values of 5.7–6.4% at “increased risk for future diabetes” or ≥6.5% as a “diagnosis of diabetes” [29]) obtained from the Glycohemoglobin Laboratory file, having an existing diagnosis of diabetes or having been told by a doctor that they have prediabetes or are at risk for diabetes from the Diabetes Questionnaire.
Effect of Dietary Insulinemia on All-Cause and Cause-Specific Mortality: Results From a Cohort Study
Published in Journal of the American College of Nutrition, 2020
Mohsen Mazidi, Niki Katsiki, Dimitri P. Mikhailidis, Maciej Banach
A digital scale was used to measure weight to the nearest 100 g and a fixed stadiometer to measure height to the nearest mm. Body mass index (BMI) was calculated as weight in kg divided by the square of height in m. Waist circumference (WC) was measured at the iliac crest to the nearest mm, using a steel tape (36). A blood specimen was drawn from the participant’s antecubital vein. Glycated hemoglobin (HbA1c) was measured using a Tosoh A1C 2.2 Plus Glycohemoglobin Analyzer (Tosoh Bioscience, San Francisco, California). Fasting blood glucose (FBG) was measured by a hexokinase method using a Roche/Hitachi 911 Analyzer and Roche Modular P Chemistry Analyzer (New Jersey) (37). Other laboratory test details are available in the NHANES Laboratory/Medical Technologists Procedures Manual (38). Hypertension (HTN) was diagnosed in individuals with systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg and in participants on antihypertensive medication (39). Type 2 diabetes mellitus (T2DM) was defined as a self-reported history of diabetes or FBG ≥126 mg/dL (40).