1
|
Ray A, Atal S, Sharma S, Sampath A. Comparison of Glycated Hemoglobin (HbA1c) Values Estimated by High-Performance Liquid Chromatography and Spectrophotometry: A Pilot Study. Cureus 2024; 16:e56964. [PMID: 38665712 PMCID: PMC11044070 DOI: 10.7759/cureus.56964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Background Invasive blood sample collection followed by high-performance liquid chromatography (HPLC) based analysis is the gold standard for estimating glycated hemoglobin level or HbA1c currently. Spectrophotometry could be an alternative that holds the potential to be translated into a portable, non-invasive device for glycated hemoglobin level estimation. This study compares HbA1c values obtained from HPLC and spectrophotometry. Methods Venous blood samples were collected from both diabetic and non-diabetic participants in a cross-sectional study. The samples were subjected to both HPLC and spectrophotometry-based estimation of HbA1c%. The results obtained were compared, and the relationship between the two estimations were assessed. Results About 15 diabetic and non-diabetic individuals participated in the study and 28 samples were included in the final analysis. The Pearson's correlation coefficient was 0.65 (95% CI, 0.37-0.82), indicating that there was a strong positive association. This was further supported by the findings from linear regression analysis with a p-value of <0.001. Conclusions The positive correlation between the HPLC and spectrophotometric values supports the hypothesis that spectrophotometry could be an alternative to conventional HPLC for the measurement of HbA1c. This needs to be further validated through larger, well-powered studies.
Collapse
Affiliation(s)
- Avik Ray
- Epidemiology and Public Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Shubham Atal
- Pharmacology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Swati Sharma
- Pharmacology and Therapeutics, Cactus Communications, Mumbai, IND
| | - Ananyan Sampath
- Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| |
Collapse
|
2
|
McArdle PD, Greenfield SM, Rilstone SK, Narendran P, Haque MS, Gill PS. Carbohydrate restriction for glycaemic control in Type 2 diabetes: a systematic review and meta-analysis. Diabet Med 2019; 36:335-348. [PMID: 30426553 DOI: 10.1111/dme.13862] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 01/05/2023]
Abstract
AIM To conduct a systematic review and meta-analysis to evaluate the effect of carbohydrate restriction on glycaemic control in Type 2 diabetes. METHODS We searched Medline, EMBASE and CINAHL for the period between 1976 and April 2018. We included randomized controlled trials comparing carbohydrate restriction with a control diet which aimed to maintain or increase carbohydrate intake, and that reported HbA1c as an outcome and reported the amount of carbohydrate consumed during or at the end of the study, with outcomes reported at ≥3 months. RESULTS We identified 1402 randomized controlled trials, 25 of which met the inclusion criteria, incorporating 2132 participants for the main outcome. Definitions of low carbohydrate varied among the studies. The pooled effect estimate from meta-analysis was a weighted mean difference of -0.09% [95% CI -0.27, 0.08 (P = 0.30); I2 72% (P <0.001)], suggesting no effect on HbA1c of restricting the quantity of carbohydrate. A subgroup analysis of diets containing 50-130 g carbohydrate resulted in a pooled effect estimate of -0.49% [95% CI -0.75, -0.23 (P <0.001); I2 0% (P = 0.56)], suggesting a clinically and statistically significant effect on HbA1c in favour of low-carbohydrate diets in studies of ≤6 months' duration. CONCLUSIONS There was no overall pooled effect on HbA1c in favour of restricting carbohydrate; however, restriction of carbohydrate to 50-130 g per day had beneficial effects on HbA1c in trials up to 6 months. Future randomized controlled trials should be of >12 months' duration, assess pre-study carbohydrate intake, use recognized definitions of low-carbohydrate diets and examine reasons for non-adherence to prescribed diets in greater detail.
Collapse
Affiliation(s)
- P D McArdle
- Birmingham Community Nutrition, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - S M Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - S K Rilstone
- Imperial College Healthcare NHS Trust, London, UK
| | - P Narendran
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - M S Haque
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - P S Gill
- Warwick Medical School, University of Warwick, Coventry, UK
| |
Collapse
|
3
|
Jeon JY, Ko SH, Kwon HS, Kim NH, Kim JH, Kim CS, Song KH, Won JC, Lim S, Choi SH, Jang MJ, Kim Y, Oh K, Kim DJ, Cha BY. Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c. Diabetes Metab J 2013; 37:349-57. [PMID: 24199164 PMCID: PMC3816136 DOI: 10.4093/dmj.2013.37.5.349] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 08/27/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests. METHODS Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ≥126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ≥6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%. RESULTS When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ≥6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate. CONCLUSION We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.
Collapse
Affiliation(s)
- Ja Young Jeon
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chul Sik Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kee-Ho Song
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jong Chul Won
- Department of Internal Medicine, Mitochondrial Research Group, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Myoung-jin Jang
- Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Yuna Kim
- Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Kyungwon Oh
- Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Bong-Yun Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | | |
Collapse
|
4
|
Mallya M, Shenoy R, Kodyalamoole G, Biswas M, Karumathil J, Kamath S. Absorption spectroscopy for the estimation of glycated hemoglobin (HbA1c) for the diagnosis and management of diabetes mellitus: a pilot study. Photomed Laser Surg 2013; 31:219-24. [PMID: 23597421 DOI: 10.1089/pho.2012.3421] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to explore the possibility of using absorption spectroscopy technique for the estimation of glycated hemoglobin HbA1c (%). BACKGROUND DATA Glycated hemoglobin (HbA1c) is an important marker in the diagnosis and management of diabetes mellitus. Different assay techniques have been employed for the estimation of glycated hemoglobin, including ion exchange high performance liquid chromatography (HPLC), electrophoresis, affinity chromatography, immunoturbidimetric assay and colorimetric assays, which measure different glycated products and report using different units. Spectroscopic measurements have been shown to be very sensitive and nondestructive, and require very little quantity of material for analysis. In the present study, we have employed absorption spectroscopy technique for the estimation of glycated hemoglobin in hemolysate samples of diabetic patients. MATERIALS AND METHODS The blood samples of individuals with normal glycemic status and confirmed diabetic patients were collected from the Clinical Biochemistry Laboratory, Kasturba Hospital, Manipal. The absorption spectra of glycated hemoglobin (HbA1c) samples were recorded in the spectral range 200-850 nm using an optic fiber based Ocean Optics CHEMUSB4-UV-VIS single beam spectrophotometer. The parameter "area under the curve" of each baseline corrected absorption spectrum was used for the estimation of HbA1c (%). The glycated hemoglobin values obtained by this spectroscopic method were compared with the values reported by the standard ion exchange HPLC method. RESULTS A total of 30 absorption spectra were recorded from hemolysate samples with HbA1c (%) in the range 4-10.5%. A good correlation was observed between the glycated hemoglobin values obtained by the spectroscopic method and those obtained by the standard HPLC method. CONCLUSIONS It appears that the direct absorption spectroscopy of hemolysate samples, therefore, may be utilized as a supplementary technique for the estimation of HbA1c (%), even at the primary healthcare centers.
Collapse
Affiliation(s)
- Madhukar Mallya
- Department of Biochemistry, KMC International Center, Manipal University, Manipal, Karnataka, India
| | | | | | | | | | | |
Collapse
|
5
|
Sánchez-Mora C, Rodríguez-Oliva MS, Fernández-Riejos P, Mateo J, Polo-Padillo J, Goberna R, Sánchez-Margalet V. Evaluation of two HbA1c point-of-care analyzers. Clin Chem Lab Med 2011; 49:653-7. [DOI: 10.1515/cclm.2011.101] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
6
|
Comparison of IFCC and NGSP methods for determination of glycated haemoglobin using advanced regression techniques. OPEN CHEM 2010. [DOI: 10.2478/s11532-010-0096-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractThe objective of this work was a correct statistical comparison of two assay methods for determination of glycated haemoglobin HbA1c. The immunoturbidimetric determination of HbA1c was performed in two ways: using an automatic analyser Hitachi 912, calibrated according to the IFCC reference system (International Federation of Clinical Chemistry and Laboratory Medicine) and using an analyser Advia 1200 and the NGSP reference system (National Glycohaemoglobin Standardization Program). For statistical comparison of these two analytical methods several advanced regression methods were used, which respect random errors of both compared methods. Specifically, Deming regression with and without weights, orthogonal regression, and Passing-Bablok regression were employed. The results demonstrate that the investigated analytical assay methods do not correspond to each other. The summarized results indicate usefulness of better harmonisation of two existing reference systems.
Collapse
|
7
|
Kitzmiller JL, Wallerstein R, Correa A, Kwan S. Preconception care for women with diabetes and prevention of major congenital malformations. ACTA ACUST UNITED AC 2010; 88:791-803. [DOI: 10.1002/bdra.20734] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
8
|
Franklin CS, Aulchenko YS, Huffman JE, Vitart V, Hayward C, Polašek O, Knott S, Zgaga L, Zemunik T, Rudan I, Campbell H, Wright AF, Wild SH, Wilson JF. The TCF7L2 Diabetes Risk Variant is Associated with HbA1C Levels: a Genome-Wide Association Meta-Analysis. Ann Hum Genet 2010; 74:471-8. [DOI: 10.1111/j.1469-1809.2010.00607.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
9
|
Redelmeier DA, Kenshole AB, Ray JG. Motor vehicle crashes in diabetic patients with tight glycemic control: a population-based case control analysis. PLoS Med 2009; 6:e1000192. [PMID: 19997624 PMCID: PMC2780354 DOI: 10.1371/journal.pmed.1000192] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Accepted: 10/23/2009] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Complications from diabetes mellitus can compromise a driver's ability to safely operate a motor vehicle, yet little is known about whether euglycemia predicts normal driving risks among adults with diabetes. We studied the association between glycosylated hemoglobin (HbA1c) and the risk of a motor vehicle crash using a population-based case control analysis. METHODS AND FINDINGS We identified consecutive drivers reported to vehicle licensing authorities between January 1, 2005 to January 1, 2007 who had a diagnosis of diabetes mellitus and a HbA1c documented. The risk of a crash was calculated taking into account potential confounders including blood glucose monitoring, complications, and treatments. A total of 57 patients were involved in a crash and 738 were not involved in a crash. The mean HbA1c was lower for those in a crash than controls (7.4% versus 7.9%, unpaired t-test, p = 0.019), equal to a 26% increase in the relative risk of a crash for each 1% reduction in HbA1c (odds ratio = 1.26, 95% confidence interval 1.03-1.54). The trend was evident across the range of HbA1c values and persisted after adjustment for measured confounders (odds ratio = 1.25, 95% confidence interval 1.02-1.55). The two other significant risk factors for a crash were a history of severe hypoglycemia requiring outside assistance (odds ratio = 4.07, 95% confidence interval 2.35-7.04) and later age at diabetes diagnosis (odds ratio per decade = 1.29, 95% confidence interval 1.07-1.57). CONCLUSIONS In this selected population, tighter glycemic control, as measured by the HbA1c, is associated with an increased risk of a motor vehicle crash.
Collapse
|
10
|
Paisooksantivatana K, Kongsomgan A, Khupulsup K. NGSP and IFCC-derived NGSP HbA1c can be used interchangeably. Diabetes Res Clin Pract 2009; 85:e22-5. [PMID: 19560224 DOI: 10.1016/j.diabres.2009.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 05/06/2009] [Accepted: 06/02/2009] [Indexed: 10/20/2022]
Abstract
AIM To evaluate comparability of NGSP-certified method and IFCC-calibrated method. METHODS HbA1c was measured on two analyzers (n=50). Comparability was tested by Deming regression, bias estimation and Friedman test. RESULTS A strong correlation and good agreement between two methods was demonstrated. CONCLUSION NGSP and IFCC-derived NGSP HbA1c can be used interchangeably.
Collapse
Affiliation(s)
- K Paisooksantivatana
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
| | | | | |
Collapse
|
11
|
Rinaldi S, Rohrmann S, Jenab M, Biessy C, Sieri S, Palli D, Tumino R, Mattiello A, Vineis P, Nieters A, Linseisen J, Pischon T, Boeing H, Hallmans G, Palmqvist R, Manjer J, Wirfält E, Crowe FL, Khaw KTT, Bingham S, Tjønneland A, Olsen A, Overvad K, Lund E, Skeie G, Clavel-Chapelon F, Boutron-Ruault MC, de Lauzon-Guillain B, Ardanaz E, Jakszyn P, Ramon Quiros J, Chirlaque MD, Sanchez MJ, Dorronsoro M, Trichopoulou A, Lagiou P, Trichopoulos D, Bueno-de-Mesquita HB, van Duijnhoven FJB, Peeters PHM, Slimani N, Ferrari P, Byrnes GB, Riboli E, Kaaks R. Glycosylated hemoglobin and risk of colorectal cancer in men and women, the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev 2009; 17:3108-15. [PMID: 18990751 DOI: 10.1158/1055-9965.epi-08-0495] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Although large-scale prospective cohort studies have related hyperglycemia to increased risk of cancer overall, studies specifically on colorectal cancer have been generally small. We investigated the association between prediagnostic levels of glycosylated hemoglobin (HbA1c), a marker for average glucose level in blood, and colorectal cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort. One thousand and twenty-six incident colorectal cancer cases (561 men and 465 women) and 1,026 matched controls were eligible for the study. Multivariate conditional logistic regression was used to estimate odds ratios (ORS) adjusted for possible confounders. Increasing HbA1c percentages were statistically significantly associated with a mild increase in colorectal cancer risk in the whole population [OR, 1.10; 95% confidence interval (CI), 1.01,1.19 for a 10% increase in HbA1c]. In women, increasing HbA1c percentages were associated with a statistically significant increase in colorectal cancer risk (OR, 1.16; 95% CI, 1.01, 1.32 for a 10% increase in HbA1c) and with a borderline statistically significant increase in rectum cancer (OR, 1.22; 95% CI, 0.99,1.50 for a 10% increase in HbA1c). No significant association with cancer risk was observed in men. The results of the current study suggest a mild implication of hyperglycemia in colorectal cancer, which seems more important in women than in men, and more for cancer of the rectum than of the colon.
Collapse
Affiliation(s)
- Sabina Rinaldi
- IARC, 150, cours Albert Thomas, Lyon, 69372 Lyon Cedex 08, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Paisooksantivatana K, Kongsomgan A, Leohirun L, Atamasirikul K, Kunakorn M. HemoglobinA1c level in healthy Thai adults: reference interval and fasting plasma glucose. Diabetes Res Clin Pract 2009; 83:e43-6. [PMID: 19135277 DOI: 10.1016/j.diabres.2008.11.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Revised: 11/16/2008] [Accepted: 11/17/2008] [Indexed: 11/29/2022]
Abstract
AIM To establish reference interval of HbA1c IFCC in Thai. MATERIALS AND METHODS 699 whole blood samples were used. Samples had fasting plasma glucose >or=126 mg/dl (7.00 mmol/L), renal problem or hemoglobinopathy was excluded. RESULTS Reference interval of HbA1c IFCC was 2.90-4.90%. CONCLUSION Effect of age should be determined.
Collapse
Affiliation(s)
- Karan Paisooksantivatana
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
| | | | | | | | | |
Collapse
|
13
|
Woodcock A, Bain S, Charlton M, Bradley C. Extent of satisfaction with tablets and food-timing in sulphonylurea-treated diabetes. Diabetes Res Clin Pract 2007; 78:324-33. [PMID: 17517445 DOI: 10.1016/j.diabres.2005.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2005] [Revised: 04/21/2005] [Accepted: 07/01/2005] [Indexed: 10/23/2022]
Abstract
This study measured patient views about following tablet-taking and food-timing recommendations in Type 2 diabetes. Two new questionnaires were validated. Outpatients with Type 2 diabetes treated with sulphonylurea agents (n=131) completed the seven-item Diabetes Tablet Treatment Questionnaire (DTTQ) and nine-item Diabetes Food Timing Questionnaire (DFTQ). Mean glycosylated haemoglobin (HbA1c) was 7.8% (S.D. 1.8%). At least 74% had optimal DTTQ item scores for tablet-taking as recommended, difficulty taking tablets, side effects, perceived hypoglycaemia and willingness to continue current tablets, but 71% scored sub-optimally regarding recent hyperglycaemia. Under half scored optimally on DFTQ items concerning eating at recommended times, difficulty with food-timing, denying oneself food and guilt about eating. Principal components and reliability analyses identified a two-item tablet problem scale within the DTTQ (alpha 0.72) and a seven-item food-timing problem scale in the DFTQ (alpha 0.77). Satisfaction and adherence were not closely related to glycaemic control. Only scores for perceived hyperglycaemia (r=0.38), perceived hypoglycaemia (r=-0.24) and satisfaction to continue current tablets (r=-0.20) correlated significantly with HbA1c. Clinicians found that the DTTQ helped to raise tablet-taking issues otherwise missed in consultations. Both questionnaires can be used to guide the need for focussed discussion, educational intervention and/or treatment change and to evaluate their impact.
Collapse
Affiliation(s)
- A Woodcock
- Department of Psychology, Royal Holloway, University of London, Egham, Surrey TW20 0EX, England, UK.
| | | | | | | |
Collapse
|
14
|
Affiliation(s)
- Frank Q Nuttall
- Department of Veterans Affairs Medical Center, University of Minnesota, Minneapolis, Minnesota 55417, USA
| |
Collapse
|
15
|
Guerin A, Nisenbaum R, Ray JG. Use of maternal GHb concentration to estimate the risk of congenital anomalies in the offspring of women with prepregnancy diabetes. Diabetes Care 2007; 30:1920-5. [PMID: 17446531 DOI: 10.2337/dc07-0278] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We sought to determine the absolute risk of having a congenital anomaly in relation to periconceptional GHb concentration among women with prepregnancy diabetes. RESEARCH DESIGN AND METHODS Two reviewers independently retrieved all cohort studies through a systematic literature search between January 1985 and May 2006. For each study, the absolute risk of having a pregnancy affected by a major or minor structural anomaly (diagnosed either antenatally or up to 28 days after conception) was calculated according to the number of SDs of GHb above the mean for nondiabetic, nonpregnant control subjects. A multilevel logistic-normal model was used to pool the data, which were expressed in tabular and graphic formats. RESULTS In seven cohort studies, there were 117 anomalies among 1,977 pregnancies. At a periconceptional GHb concentration 0 SD above normal, the absolute risk of a pregnancy affected by a congenital anomaly was approximately 2% (95% CI 0.0-4.4). At 2 SD above normal, the risk was 3% (0.4-6.1), and at 8 SD it was approximately 10% (2.3-17.8). For each 1-SD unit increase in GHb, the associated risk of a congenital malformation increased by an odds ratio of 1.2 (95% CI 1.1-1.4). The risk in relation to A1C followed the same pattern. CONCLUSIONS Using data from a limited number of published studies, a practical aid was developed to optimize use of the GHb and A1C concentrations for estimating the absolute risk of a congenital anomaly in the offspring of women with prepregnancy diabetes.
Collapse
Affiliation(s)
- Andrea Guerin
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | | | | |
Collapse
|
16
|
Panteghini M, John WG. Implementation of haemoglobin A1c results traceable to the IFCC reference system: the way forward. Clin Chem Lab Med 2007; 45:942-4. [PMID: 17867982 DOI: 10.1515/cclm.2007.198] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
17
|
Smith SA, Montori VM, Isley WL, Burritt MF. Problems with measurements of hemoglobin A1c. Mayo Clin Proc 2006; 81:1130. [PMID: 16901036 DOI: 10.4065/81.8.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
18
|
The Globalization of Glycohemoglobin Measurement for Monitoring and for Diagnosis of Diabetes Mellitus. Are We There Yet? POINT OF CARE 2006. [DOI: 10.1097/00134384-200606000-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
19
|
|
20
|
|