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Results for “Glycemic Control”

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At least 667 records · Page 37Linked to original sources

PubMed1993

Drug interactions in diabetic patients. The risk of losing glycemic control.

Any number of prescription and over-the-counter medications, including diuretics and salicylates, can affect glycemic control in diabetic patients. In addition, patients being treated with either insulin or sulfonylurea risk hypoglycemic coma or death if they ingest large quantities of alcohol. The authors of this article discuss the medications most likely to be a problem and provide lists of agents associated with hypoglycemia and hyperglycemia.

Alcohol Drinking↗

PubMed1997

Effects of glycemic control on saliva flow rates and protein composition in non-insulin-dependent diabetes mellitus.

OBJECTIVE: The objective of this study was to determine whether improvements in the level of diabetic control in a group of subjects with poorly controlled non-insulin-dependent diabetes mellitus influence salivary output and composition. STUDY DESIGN: Repeated whole unstimulated and stimulated parotid saliva samples were collected from diabetic patients attending an outpatient diabetes education program and a matched nondiabetic control group. Saliva was analyzed for flow rates, parotid protein concentration and composition, and amylase activity. Subjective responses to questions about salivary hypofunction were tested. RESULTS: There were no significant differences in whole unstimulated and stimulated parotid flow rates or stimulated parotid protein concentration and composition between diabetics and the control group. Amylase activity was higher in diabetics and decreased with improved glycemic control. Subjects reporting taste alterations had higher mean blood glucose levels than subjects with normal taste sensation. CONCLUSIONS: Poorly controlled non-insulin-dependent diabetes mellitus has no influence on saliva output, although amylase activity may be elevated, and there may be taste alterations.

Adult↗

PubMed1983

Evidence of beneficial effects of strict glycemic control on diabetic vascular complications--a prospective study with artificial devices.

This prospective study was undertaken to examine whether glycemic normalization could have beneficial on the course of diabetic vascular complications in 6 insulin-dependent diabetics. A significant amelioration of glycemic regulation was achieved by intensive glycemic control with artificial devices and multiple injections for 3 months, which also resulted in an improvement in conduction velocity, a regression in retinovascular permeability and a decrease in urinary total protein excretion. These results indicate that even after short-term treatment, glycemic near-normalization can have a beneficial effect on the early stage of diabetic vascular complications.

Blood Glucose↗

PubMed1991

Low-glycemic index foods improve long-term glycemic control in NIDDM.

OBJECTIVE: To compare high- and low-glycemic index (GI) diets in the treatment of non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Sixteen subjects with well-controlled NIDDM and normal lipid profile, 10 of whom continued oral hypoglycemic medication, participated in the study. A diet that emphasized low-GI foods (e.g., porridge, pasta) was compared with a high-GI diet (e.g., processed cereals, potatoes). The GI of the low-GI diet was 15% lower than the high-GI diet (77 +/- 3 vs. 91 +/- 1) but otherwise similar in macronutrient composition and fiber, as determined by a 4-day weighed record. The diets were instituted under instruction from a dietitian who visited subjects at home on a weekly basis. Body weight was maintained within 1-2 kg. RESULTS: Glycemic control was improved on the low-GI diet compared with the high-GI diet (statistically significant findings, P less than 0.05). Mean glycosylated hemoglobin at the end of the low-GI diet was 11% lower (7.0 +/- 0.3%) than at the end of the high-GI diet (7.9 +/- 0.5%), and the 8-h plasma glucose profile was lower (area under the curve above fasting 128 +/- 23 vs. 148 +/- 22 mmol.h-1.L-1, respectively). Mean fasting plasma glucose, total cholesterol triglycerides, and lipoproteins did not show important differences. CONCLUSIONS: A low-GI diet gives a modest improvement in long-term glycemic control but not plasma lipids in normolipidemic well-controlled subjects with NIDDM.

Blood Glucose↗

PubMed1993

Social support and glycemic control in non-insulin dependent diabetes mellitus patients: gender differences.

The influence of perceived social support on glycemic control was studied in 76 newly diagnosed NIDDM patients. As a group perceived social support was high overall and no difference was seen between men and women. Males tended to have better fasting blood glucose values (fB-values) than females at the end of the first year of duration (p < 0.07). When dichotomized into high and low supported groups by gender, males with high social support had better fB-values than highly supported females (p < 0.01). Males with high satisfaction regarding social support had better fB-values than the female group and the low supported male group (p < 0.05). Males reporting high emotional, informative or practical support had better fB-values than highly supported females (p < 0.05). The effect of gender and social support is discussed.

Aged↗

PubMed1995

Toward improved glycemic control in diabetes. What's on the horizon?

It has now been firmly established that maintenance of good glycemic control can prevent or retard the development of the microvascular complications of type I (insulin-dependent) diabetes. Although not yet definitively established, it is likely that optimal control of plasma glucose will also assist in the prevention of such problems in type II (non-insulin-dependent) diabetes. While a limited range of therapeutic agents for the treatment of hyperglycemia is currently available, a number of newer therapies are currently undergoing evaluation. In this review, we provide an overview of such treatments and assess their likely place in the therapeutic armamentarium over the next few years.

Diabetes Complications↗

PubMed1988

Glycemic control and raised serum alanine aminotransferase activity in treated diabetes mellitus.

The prevalence of raised serum liver-associated enzyme activity in stabilised, treated diabetic outpatients without concurrent hepatobiliary disease was investigated using a retrospective computer search of biochemical data. The frequency of raised alanine aminotransferase, aspartate aminotransferase, or gamma glutamyl transferase activity found among diabetic, general medical and respiratory outpatients was compared with that found in apparently healthy controls. It was established that a raised activity of any of the three enzymes occurred with a similar frequency in each outpatient group. However, only with alanine aminotransferase did the frequency of elevation (7.1%) in the patients with previously diagnosed hepatobiliary disease exceed that of healthy controls. A raised alanine aminotransferase activity in diabetic outpatients was associated with good glycemic control (hemoglobin A1 less than 8%, p less than 0.02) and treatment with oral hypoglycaemic agents (p less than 0.001).

Alanine Transaminase↗

PubMed2006

Predictors of glycemic control on insulin pump therapy in children and adolescents with type I diabetes.

OBJECTIVE: To determine variables predictive of glycemic control in a large population of pediatric patients with type 1 diabetes on continuous subcutaneous insulin infusion (CSII). METHODS: Charts of patients on CSII for > or =1 year were reviewed. "Good" control was a priori defined as HbA1c < or =9% in patients under 12 years of age, and < or =8% in patients over 12 years. RESULTS: Ninety-three patients were identified (57 girls and 36 boys). Their mean age at pump start was 11.6+/-3.1 years with duration of diabetes of 4.7+/-3.1 years. Average time on pump therapy was 2.4+/-0.8 years. HbA1C decreased from 8.7+/-0.9% prior to pump therapy to 8.3+/-0.6% while on CSII (p < 0.01). Despite analysis of a large number of possible predictors, only number of basal rates (4.4 versus 3.4) and younger age (10.0 years versus 13.1 years) correlated with good control. CONCLUSION: Only younger age and use of more basal rates were predictive of good diabetes control in children using CSII. Decisions regarding which pediatric patients are most appropriate for CSII must continue to be individualized.

Adolescent↗

PubMed1996

Prevalence of diabetic retinopathy in relation to age at onset of the diabetes, treatment, duration and glycemic control.

To study the frequency of diabetic retinopathy in relation to age at diagnosis, treatment, duration of diabetes and glycemic control as measured by means of HbA1c levels, we performed a cross-sectional, registered-based study in the Helsingborg area of southern Sweden, comprising 2232 diabetic patients. Of the known diabetic population < 75 years old, approximately 70% were estimated to be included. We graded retinopathy according to the alternative classification of the Wisconsin study. With an age at diagnosis < 30 years (19% of patients) the prevalence of retinopathy was 64%, whereas with an age at diagnosis > or = 30 years the prevalence of retinopathy was 57% in insulin-treated, and 26% in non-insulin treated patients. Levels of glycated hemoglobin and duration of diabetes were associated with retinopathy in the group with younger onset. In the older-onset group, there was a relationship between retinopathy and duration of diabetes and insulin treatment; glycated hemoglobin had a relationship which was of borderline significance with any retinopathy, but clearly significant with the pooled group: severe non-proliferative, proliferative retinopathy and/or macular edema. Hyperglycemia and duration of diabetes were thus associated with retinopathy in both younger- and older-onset diabetes, but hyperglycemia less so in the older-onset group.

Adult↗

PubMedDate not supplied

Prospective study on influence of psychosocial factors on glycemic control in Japanese patients with type 2 diabetes.

The authors prospectively assessed the causal relationship between psychosocial factors and glycemic control in 256 Japanese outpatients with Type 2 diabetes. Using structural-equation modeling, they first developed a causal model in which glycosylated hemoglobin (HbA(1c)) at 6 months after assessment was influenced by the baseline psychosocial factors. Then, the reliability of the causal model was investigated with measurement of HbA(1c) at 12 months after baseline. Self-efficacy directly reinforced adherence, and adherence had a direct association with future HbA(1c). Other psychosocial factors, including social support, diabetes-related distress, daily burden, and emotion-focused coping prospectively influenced HbA(1c) indirectly through self-efficacy.

Adaptation, Psychological↗

PubMed2005

Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies.

Previous analyses regarding effects of periodontal treatment on glycemic control included studies where causal association might not be assumed, or the results were reported non-quantitatively. We initiated this meta-analysis of 10 intervention studies to quantify the effects of periodontal treatment on HbA1c level among diabetic patients, to explore possible causes for the discrepant reports, and to make recommendations for future studies. Data sources were MEDLINE (January, 1980, to January, 2005), the EBMR, Cochrane Register, and bibliographies of the published articles. Three investigators extracted data regarding intervention, outcomes, and effect size. A total of 456 patients was included in this analysis, with periodontal treatment as predictor and the actual change in hemoglobin A1c level as the outcome. The weighted average decrease in actual HbA1c level was 0.38% for all studies, 0.66% when restricted to type 2 diabetic patients, and 0.71% if antibiotics were given to them. However, none was statistically significant.

Anti-Bacterial Agents↗

PubMed1997

Glycemic control and prevention of retinopathy in Japanese NIDDM patients. A 10-year follow-up study.

OBJECTIVE: To examine glycemic control for the prevention of retinopathy in early diagnosed Japanese NIDDM patients. RESEARCH DESIGN AND METHODS: There were 137 patients with NIDDM but without retinopathy who first visited our facility from 1983-1985. Their age at diagnosis ranged from 30-65 years, with a disease duration of < 3 years. The optic fundi were examined at least annually. The prevalence of retinopathy in the 10th year after registration in the study was compared in four groups stratified by mean HbA1c values for 10 years. Multiple logistic regression analysis was used to assess the relationship between retinopathy and covariates. RESULTS: None of the patients with a mean HbA1c < 6% had retinopathy. The prevalence of retinopathy was 17.2% in the group with a mean HbA1c of 6-6.9%, 14.3% in the group with a mean HbA1c of 7-7.9%, 41.9% at a mean HbA1c of 8-8.9%, and 54.8% when the mean HbA1c exceeded 9%. The prevalence of retinopathy increased with the increase in the mean HbA1c values over 10 years (trend, P < 0.005). Multiple logistic regression analysis revealed that mean HbA1c was the only significant risk factor for the development of retinopathy. CONCLUSIONS: Our results support the concept that an early diagnosis and better control lessen the risk for the development of retinopathy in Japanese NIDDM patients.

Adult↗

PubMed2005

Glycemic control, atherosclerosis, and risk factors for cardiovascular disease in individuals with diabetes: the atherosclerosis risk in communities study.

OBJECTIVE: Glycemic control (HbA(1c) [A1C]) is strongly associated with microvascular disease in individuals with diabetes, but its relation to macrovascular disease and atherosclerosis is less clear. This study examines the relationship between A1C, carotid intima-media thickness (IMT), and traditional cardiovascular risk factors in individuals with diabetes. RESEARCH DESIGN AND METHODS: A cross-sectional study of 2,060 people with diagnosed and undiagnosed (unrecognized) diabetes in the Atherosclerosis Risk in Communities study was performed. RESULTS: LDL and HDL cholesterol, plasma triglycerides, and waist-to-hip ratio were significantly associated with A1C after multivariable adjustment. African Americans with undiagnosed and diagnosed diabetes had significantly elevated A1C values compared with whites, even after adjustment for potentially confounding factors. There was a graded association between A1C and carotid IMT. In a fully adjusted model in individuals with undiagnosed diabetes, the odds ratio (OR) of being in the highest quartile of IMT versus the lowest was 2.46 (95% CI 1.16-5.03, comparing the highest quartile of A1C to the lowest). In people with diagnosed diabetes, the comparable OR was 2.62 (1.36-5.06). CONCLUSIONS: This study identified several important associations between A1C and known risk factors for cardiovascular disease and suggested that A1C is independently related to carotid IMT. Chronically elevated glucose levels may contribute to the development of atherosclerosis in people with diabetes, independent of other risk factors.

Aged↗

PubMed2002

Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population.

OBJECTIVE: We investigated the association between glycemic control of type 2 diabetes mellitus (type 2 DM) and severe periodontal disease in the US adult population ages 45 years and older. METHODS: Data on 4343 persons ages 45-90 years from the National Health and Nutrition Examination Study III were analyzed using weighted multivariable logistic regression. Severe periodontal disease was defined as 2 + sites with 6 + mm loss of attachment and at least one site with probing pocket depth of 5 + mm. Individuals with fasting plasma glucose > 126 mg/dL were classified as having diabetes; those with poorly controlled diabetes (PCDM) had glycosylated hemoglobin > 9% and those with better-controlled diabetes (BCDM) had glycosylated hemoglobin <or= 9%. Additional variables evaluated in multivariable modeling included age, ethnicity, education, gender, smoking status, and other factors derived from the interview, medical and dental examination, and laboratory assays. RESULTS: Individuals with PCDM had a significantly higher prevalence of severe periodontitis than those without diabetes (odds ratio = 2.90; 95% CI: 1.40, 6.03), after controlling for age, education, smoking status, and calculus. For the BCDM subjects, there was a tendency for a higher prevalence of severe periodontitis (odds ratio = 1.56; 95% CI: 0.90, 2.68). CONCLUSION: These results provide population-based evidence to support an association between poorly controlled type 2 diabetes mellitus and severe periodontitis.

Aged↗

PubMed1991

Multifactorial origin of hypoglycemic symptom unawareness in IDDM. Association with defective glucose counterregulation and better glycemic control.

To assess potential relationships between unawareness of hypoglycemic symptoms and both defective glucose counterregulation and therapy-associated altered glycemic thresholds, symptoms and hormonal responses to hypoglycemia were quantitated during standardized insulin infusion tests in 41 patients with insulin-dependent diabetes mellitus (IDDM). The glycemic thresholds for both neurogenic and neuroglycopenic symptoms (and those for both epinephrine and pancreatic polypeptide release) were at lower plasma glucose concentrations in both patients with defective (n = 9, 22%) and those with adequate glucose counterregulation and, among the latter, in patients with lower compared with higher glycosylated hemoglobin levels. The data are consistent with the concept that both defective glucose counterregulation and improved glycemic control contribute to excessive hypoglycemia in IDDM by reducing awareness of symptoms of developing hypoglycemia and by impairing physiological defenses against hypoglycemia. Thus, hypoglycemic symptom unawareness is multifactorial in origin and may be partly reversible.

Awareness↗

PubMed1998

The effect of short periods of caloric restriction on weight loss and glycemic control in type 2 diabetes.

OBJECTIVE: To determine whether an intermittent very-low-calorie diet (VLCD) improves weight loss and glycemic control more than moderate caloric restriction alone. RESEARCH DESIGN AND METHODS: Individuals with type 2 diabetes (n = 54) who were > or = 20% over ideal body weight participated in a 20-week behavioral weight control program. Subjects were randomized to either a standard behavioral therapy (SBT) group or to one of two VLCD groups. SBT subjects received a 1,500-1,800 kcal/day diet throughout. Both VLCD groups followed a VLCD for 5 consecutive days during week 2, followed by either intermittent VLCD therapy for 1 day/week for 15 weeks (1-day) or for 5 consecutive days every 5 weeks (5-day), with a 1,500-1,800 kcal/day diet at other times. RESULTS: Both VLCD groups lost more weight than the SBT group over the 20 weeks (P = 0.04). Although the groups did not differ in fasting plasma glucose (FPG) changes at 20 weeks, more subjects in the 5-day group attained a normal HbA1c when compared with the SBT group (P = 0.04). This benefit was independent of the effects of weight loss. The best predictor of overall change in FPG and HbA1c was the FPG response during the first 3 weeks of the program. CONCLUSIONS: Periodic VLCDs improved weight loss in diabetic subjects. A regimen with intermittent 5-day VLCD therapy seemed particularly promising, because more subjects in this group attained a normal HbA1c. Moreover, the glucose response to a 3-week period of diet therapy predicted glycemic response at 20 weeks, and it was a better predictor of the 20-week response than initial or overall weight loss.

Adult↗

PubMed2000

Maternal and fetal serum lipid and lipoprotein concentrations and compositions in type 1 diabetic pregnancy: relationship with maternal glycemic control.

The aim of this study was to determine maternal and fetal lipoprotein profiles in type 1 diabetic pregnancies differing in glycemic control. Serum lipid, apolipoprotein, and lipoprotein lipid concentrations were investigated in mothers with poorly controlled or well-controlled type 1 diabetes as reflected by hemoglobin A1c(HbA1c) concentrations performed by isolab column chromatography and in their macrosomic (body wt = 4650 +/- 90 g) or appropriate-for-gestational-age newborns (body wt = 3616 +/- 68 g), and these levels were compared with those in healthy mothers and in their control newborns (body wt = 3290 +/- 45 g). In mothers with well-controlled diabetes and in their infants, serum lipid, apolipoprotein, and lipoprotein lipid concentrations were comparable to those in control mothers and in their control newborns. Mothers with poorly controlled diabetes presented higher serum triglyceride and apoprotein B-100 (apo B-100) levels but lower apo A-I and HDL3 cholesterol and phospholipid levels as compared with control values. In their macrosomic newborns, all serum lipid, apolipoprotein, and lipoprotein lipid levels were higher than those in control newborns. Maternal HbA1c and triglyceride levels in late gestation were significant predictors of fetal lipids and lipoproteins in the poorly controlled diabetes group. In conclusion, when under good metabolic control, type 1 diabetes did not affect maternal and fetal lipid levels. However, when under poor metabolic control, type 1 diabetes is associated with maternal and fetal lipoprotein abnormalities.

Adult↗

PubMed2003

A telephone-delivered intervention to improve glycemic control in type 2 diabetic patients.

This study was performed to investigate the effect of a telephone-delivered intervention on glycemic control and body mass index in Korean type 2 diabetic patients. 38 patients were randomly selected, with 20 assigned to a telephone group and 18 to a control group. The goal of the intervention was to keep blood glucose concentrations close to the normal range. The intervention was applied to the telephone group for 12 weeks. It consisted of continuous education and reinforcement of diet, exercise and medication adjustment, as well as frequent self-monitoring of blood glucose levels. Telephone intervention was performed twice per week for the first month, and then weekly for the second and third months. Subjects were requested to write self- management logs, including blood glucose, diet and an exercise diary. The diet diaries were analyzed by a dietitian, and subjects instructed about the results by telephone counseling or mail. All medication adjustments were communicated to the subjects' diabetes specialist. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and 2-hour postprandial glucose were measured before, and after, the intervention. Patients in the telephone group had a mean decrease of 1.2%, with those in the control group having a mean increase of 0.6%, in HbA1c. There were no significant differences in the body mass index (BMI) between the two groups. These findings indicated that a telephone-delivered intervention would improve HbA1c, but would not affect BMI.

Blood Glucose↗