Glycated hemoglobin A₁c (HbA₁c) and diabetes: a new era?
ABSTRACT Abstract In January 2011 the American Diabetes Association (ADA) published the latest guidelines for the diagnosis and treatment of diabetes mellitus (DM)(1,2). Despite some controversies, glycated hemoglobin A(1c) (HbA(1c)), an established marker of long-term glycemia traditionally used to assess the quality of DM management, remained an independent criterion for the diagnosis of DM, and indeed now appears to be well established in the USA. This has far-reaching implications for clinical practice worldwide.
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ABSTRACT: We assessed the prevalence of unrecognized diabetes mellitus (DM) in patients with acute coronary syndrome (ACS) as determined by elevated glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), and random plasma glucose (RPG) levels. This prospective study recruited 583 patients admitted with ACS without previous diagnosis of DM during 1-year period. Glycosylated hemoglobin was checked for most patients especially those with high values of FPG and or RPG. Patients were classified according to their glycemic state into 123 (21.1%) with DM, 82 (14.1%) with prediabetes, and 57(9.8%) with stress hyperglycemia, while 321 (55%) were classified as nondiabetics. Glycosylated hemoglobin estimation in the setting of ACS was helpful in the diagnosis of DM to eliminate the effect of stress-induced hyperglycemia that might accompany this condition.Angiology 04/2012; 64(1). DOI:10.1177/0003319711434054 · 2.37 Impact Factor
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ABSTRACT: We evaluated mean platelet volume (MPV; an indicator of vascular risk) and platelet distribution width in patients with stable chronic obstructive pulmonary disease (COPD; n = 85). We also included a control group of 34 smokers without airflow limitation. Mean platelet volume was significantly higher in patients with COPD (10.69 ± 1.0 vs 9.96 ± 1.10 fL, P < .001) than in the smoker controls. White blood cell (WBC) count was also significantly higher in patients with COPD than in the smoker controls (10 642 ± 1247 vs 7136 ± 1887/μL, P < .001). There was a correlation between MPV and WBC in patients with COPD, especially in those at stage III (r = .530, P = .004) and IV (r = .389, P = .023). Mean platelet volume did not correlate with any indices of COPD severity. In patients with COPD, MPV and WBC levels are higher than those of smokers with normal pulmonary function and are significantly correlated. Whether these effects relate to vascular risk in patients with COPD remain to be established.Angiology 10/2012; 64(7). DOI:10.1177/0003319712461436 · 2.37 Impact Factor
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ABSTRACT: Many countries are facing an obesity epidemic and an associated increase in Type 2 diabetes (T2D). T2D and its complications are major causes of morbidity and mortality worldwide. To tackle this growing problem a concerted effort on multiple fronts will be required. Early intervention has been demonstrated to prevent or even reverse disease progression, therefore risk assessment to target limited resources to those at greatest risk will improve the cost efficacy of health budgets. A clearer understanding of the pathogenesis at the molecular level may provide us with new therapeutic targets, while improved monitoring of disease and response to treatment will provide for a personalized medicine approach to maximize health outcomes. Metabolomics is a powerful approach to unravel the complex relationships between metabolism, obesity and progression to T2D and, at the same time, has potential as a clinical tool for risk assessment and monitoring of disease.Journal of Clinical Lipidology 12/2012; 7(6):641. DOI:10.2217/clp.12.75 · 3.59 Impact Factor