ABSTRACT- Introduction: Importance of measurement of glycated hemoglobin (HbA1c) has been recommended for
the diagnosis of diabetes and pre-diabetes. However, various epidemiological studies conducted different parts of the
universe have shown significant discordance between HbA1c and glucose-based tests. Glycated hemoglobin (HbA1c) is
assumed to be the gold standard for monitoring glycemic control in patients with diabetes mellitus disorder. The Glycated
hemoglobin (HbA1c) assay provided an accurate, precise measure of chronic glycemic levels, and associates with the risk
of diabetes complications.
Materials and Methods: This is a cross sectional prospective study. A total of 868 individuals attended to the medicine
outpatient clinic at Lord Buddha Koshi Medical College, Saharsa, Bihar between Jan 2016 to Dec 2016 were selected for
the study after screening a large cohort visited OPD. The results of FPG, OGTT, and HbA1c for 868 individual were
analyzed as well as all grouped as diabetic patients, glucose intolerant (pre-diabetes) patients, and non-diabetic patients
according to new ADA criteria for the diagnosis of diabetes.
Results: Diagnostic sensitivity of all diabetic criteria were 80.33% for A1c; 75% for OGTT and only 41.87% for FPG
respectively.
Conclusion: The proposed A1c diagnostic criteria have greater diagnostic than FPG and 2-h OGTT regarding a diagnosis
of diabetes mellitus disorder.
Key-words- Glycated Hemoglobin, Fasting Plasma Glucose, Oral glucose tolerances test (OGTT), Diabetes Mellitus,
and Pre- diabetes
The expediency of using glycated hemoglobin to assess the level of diabetes' compensation. Present-day parameters of carbohydrate metabolism' evaluation are presented.
ABSTRACT- Introduction: Importance of measurement of glycated hemoglobin (HbA1c) has been recommended for
the diagnosis of diabetes and pre-diabetes. However, various epidemiological studies conducted different parts of the
universe have shown significant discordance between HbA1c and glucose-based tests. Glycated hemoglobin (HbA1c) is
assumed to be the gold standard for monitoring glycemic control in patients with diabetes mellitus disorder. The Glycated
hemoglobin (HbA1c) assay provided an accurate, precise measure of chronic glycemic levels, and associates with the risk
of diabetes complications.
Materials and Methods: This is a cross sectional prospective study. A total of 868 individuals attended to the medicine
outpatient clinic at Lord Buddha Koshi Medical College, Saharsa, Bihar between Jan 2016 to Dec 2016 were selected for
the study after screening a large cohort visited OPD. The results of FPG, OGTT, and HbA1c for 868 individual were
analyzed as well as all grouped as diabetic patients, glucose intolerant (pre-diabetes) patients, and non-diabetic patients
according to new ADA criteria for the diagnosis of diabetes.
Results: Diagnostic sensitivity of all diabetic criteria were 80.33% for A1c; 75% for OGTT and only 41.87% for FPG
respectively.
Conclusion: The proposed A1c diagnostic criteria have greater diagnostic than FPG and 2-h OGTT regarding a diagnosis
of diabetes mellitus disorder.
Key-words- Glycated Hemoglobin, Fasting Plasma Glucose, Oral glucose tolerances test (OGTT), Diabetes Mellitus,
and Pre- diabetes
The expediency of using glycated hemoglobin to assess the level of diabetes' compensation. Present-day parameters of carbohydrate metabolism' evaluation are presented.
Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals. A1C testing should be performed routinely in all patients with diabetes. The frequency of A1C testing should be dependent on the clinical situation, the treatment regimen used, and the clinician’s judgment. Some patients with stable glycemia well within target may do well with testing only twice per year. Unstable or highly intensively managed patients (e.g., pregnant type 1 diabetic women) may require testing more frequently than every 3 months.
Please correct me if anything wrong and to improve myself.
Thanks & Regards
Niranjan
9790861629
Marketing Manager - Professional Services
HITECH DIAGNOSTICS
An HbA1c test is used to check diabetes or pre-diabetes conditions in patients. Pre-diabetes condition shows an increased blood sugar level that means a person is at risk for getting diabetes. In case a person already has diabetes, an HbA1c test can help the doctor to monitor their condition and blood sugar levels.
Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals. A1C testing should be performed routinely in all patients with diabetes. The frequency of A1C testing should be dependent on the clinical situation, the treatment regimen used, and the clinician’s judgment. Some patients with stable glycemia well within target may do well with testing only twice per year. Unstable or highly intensively managed patients (e.g., pregnant type 1 diabetic women) may require testing more frequently than every 3 months.
Please correct me if anything wrong and to improve myself.
Thanks & Regards
Niranjan
9790861629
Marketing Manager - Professional Services
HITECH DIAGNOSTICS
An HbA1c test is used to check diabetes or pre-diabetes conditions in patients. Pre-diabetes condition shows an increased blood sugar level that means a person is at risk for getting diabetes. In case a person already has diabetes, an HbA1c test can help the doctor to monitor their condition and blood sugar levels.
Learn about how Type II Diabetes affects your body. We discuss managing your Type II Diabetes through diet, exercise and healthy living. Also includes prevention and long term effects.
Type 2 diabetes management case study for reference. Diabetes management is important to prevent further damage to organs. this case study is simple illustration about diabetes management, dietary modification and lifestyle changes.
The worldwide explosion of obesity has resulted in an ever-increasing prevalence of type 2 diabetes. The importance of insulin resistance and β-cell dysfunction to the pathogenesis of type 2 diabetes was debated for a long time; many thought that insulin resistance was the main abnormality in type 2 diabetes, and that inability to secrete insulin was a late manifestation. This notion is now challenged. This presentation deals with the important contributing factors in the development of type 2 diabetes mellitus.
Shashikiran Umakanth made this presentation at the "First Endocrine Update Program” – ENDO EGYPT 2015, from 17-20 December 2015 in the Historic City of Luxor, Egypt. This endocrine update was organised by the Egyptian Association of Endocrinology , Diabetes and Atherosclerosis (EAEDA) in collaboration with the Endocrine Society, USA.
Welcome to Diabetes Freedom! A high-converting offer your health audiences will love. Super high EPCs from all types of health, weight loss and survival lists.
Diabetes Freedom is sweeping up volume traffic from Facebook and Native networks and converting super well from email lists. Thanks to the unique angle, it’s the ideal offer to generate curiosity for many millions of diabetic or prediabetic men and women.
A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes from carbohydrate, Protein and Lipid. It is the main source of energy used by the body. Insulin is a hormone that helps your body's cells use the glucose. Insulin is produced in the pancreas and released into the blood when the amount of glucose in the blood rises.
DIABETES MELLITUS AND Diabetes Ketoacidosis for ESR revision (002).pptxmaniacs36
At the end of this session, the students are able to
•Understand the potential presentation of type 1 diabetes.
•Plan the appropriate investigations and management of diabetes and challenges the children face.
•Explore the social implications of diabetes in children and potential issues with compliance.
This is a brief discussion on diabetes mellitus as medical emergency that can be encountered in any dental office.
What to do in such conditions is what I've briefly tried to explain over here.
Regards,
Dr. Abhishek Sharma
(M.D.S - 2016 Batch ; Oral & Maxillofacial Surgery)
A blood glucose test measures the level of glucose (sugar) in your blood. The test can involve a finger prick or a blood draw from your vein. Healthcare providers most commonly use blood glucose tests to screen for Type 2 diabetes, which is a common condition.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Natural birth techniques - Mrs.Akanksha Trivedi Rama University
Rhenea lyle type ii - diabetes mellitus group presentation section 2 q. 5-8
1. TYPE II - Diabetes Mellitus Through out this presentation you will find website and video links that can be opened to obtain more details on the topic if further information is desired. Double click on a link open or video to play.
2. Section II Key Labs Diagnostics Possible Procedures Patient Preparation Symptoms Medications
3. Key Labs for Diabetes Testing FBS – Fasting Blood Sugar (glucose) levels GTT – Glucose Tolerance Test PPBS – 2Hr. Post-Prandial Blood Sugar HbA1C – Hemoglobin Average Amount of glucose in a 2-3 month period. Lipid profile HDL, cholesterol, LDL, triglyceridesare recommended also
4. FBS The FBS – Fasting Blood Sugar or Fasting Plasma Glucose (FPG) test is the standard test for diagnosing diabetes. It is a simple blood test taken after 8-10 hours of fasting. In general, results indicate the following FPG levels are considered normal up to 100 mg/dL (or 5.5 mmol/L). Levels between 100 and 125 mg/dL (5.5 to 7.0 mmol/L) are referred to as impaired fasting glucose or pre-diabetes. These levels are considered to be risk factors for type 2 diabetes and its complications. Diabetes is diagnosed when FPG levels are 126 mg/dL (7.0 mmol/L) or higher. Might be ordered to help diagnose diabetes. Blood Glucose (BC) can be measured after 8-10 hours of fasting
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7. Levels between 140 mg/dL and 199 mg/dL are referred to as impaired glucose tolerance or pre-diabetes
8. Diabetes is diagnosed when OGTT levels are 200 mg/dL or higherThis test is often used for Gestational Diabetes Mellitus
9. FBG - Recommendations The FPG test is not always reliable, so a repeat test is recommended if the initial test suggests the presence of diabetes, or if the tests are normal in people who have symptoms or risk factors for diabetes. For example, people who take the test in the afternoon and show normal results may actually have abnormal levels that would be revealed if they are tested in the morning. The oral glucose tolerance test (OGTT)is more complex than the FPG and may over diagnose diabetes in people who do not have it. Some experts recommend it as a follow-up after FPG, if the latter test results are normal but the patient has symptoms or risk factors of diabetes.
10. Differences FBC & OGTT TestClick Screen to Start Video (duration - 1:01) clicking elsewhere will end the video follow the link at bottom of page incase the video dose not open http://www.youtube.com/watch?v=LduOMevISDw&feature=feedwll&list=WL
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13. HbA1C HbA IC - measures the concentration of glycated (also often called glycosylated) hemoglobin A1c. Hemoglobin is an oxygen-transporting protein found inside red blood cells (RBCs). There are several types of normal hemoglobin and many identified hemoglobin variants, but the predominant form – about 95-98% – is hemoglobin A. Hemoglobin A can be further subdivided, with one of the subcomponents known as hemoglobin A1c. As glucose circulates in the blood, some of it spontaneously binds to hemoglobin A. The glucose-hemoglobin molecules formed are said to be glycated. The higher the concentration of glucose in the blood, the more glycated hemoglobin is formed. Once the glucose binds to the hemoglobin, it remains there for the life of the red blood cell - normally about 120 days. The combination of glucose and hemoglobin A is referred to as HbA1c or A1c. A1c is produced on a daily basis and slowly cleared from the blood as older RBCs die and younger RBCs (with non-glycated hemoglobin) take their place (A1c and EAG).”
14. HbA1C cont. “Hemoglobin A1C and eAG calculation used to monitor the glucose control of diabetics over time. The goal of those with diabetes is to keep their blood glucose levels as close to normal as possible. This helps to minimize the complications caused by chronically elevated glucose levels, such as progressive damage to body organs like the kidneys, eyes, cardiovascular system, and nerves. The A1c test and eAG result give a picture of the average amount of glucose in the blood over the last few months. They can help the doctor know if the measures being taking to control diabetes are successful or need to be adjusted (A1c and EAG).” “A1c is frequently used to help newly diagnosed diabetics determine how elevated their uncontrolled blood glucose levels have been. It may be ordered several times while control is being achieved, and then several times a year to verify that good control is being maintained (A1c and EAG).
32. Risk factor assessmentPhysical examination Laboratory Lifestyle Examinations Two measurements of blood pressure, lying or sitting. Assessment for vascular bruits Heart murmur, Status of feet (including presence and quality of peripheral pulses) Calculation of the ankle/brachial index. Complete Medical History
37. If not treated these problems can lead to vision loss or complete blindness.
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39. Complications Uncontrolled Diabetes Leads to: Heart Disease Stroke Blindness Kidney failure Painful peripheral nerve damage Amputations Sweet Breath - Ketosis Acanthosis Nigricans Dark skin tags Encourage patients to: Report unusual sensations, numbness or pain Report digestive, urinary or sexual problems Avoid injury to areas with decreased sensation Take medications as directed Inspect feet daily & practice good foot care
40. Diabetic Neuropathy Diabetic neuropathy is a type of nerve damage that can occurs diabetes. High blood sugar can injure nerve fibers throughout the body, most often damaging nerves in the legs and feet. Depending on the affected nerves, symptoms range from pain to numbness in extremities to problems with the digestive system, urinary tract, blood vessels and heart. For some symptoms are mild; for others painful, disabling even fatal. Tight blood sugar control and a healthy lifestyle is the best way to prevent or slow the progress of Diabetic neuropathy’s and their serious complications.
44. Oral Medications Oral Medications Side Effects Sulfonylureas. These diabetes pills lower blood sugar by stimulating the pancreas to release more insulin Biguanides. These diabetes pills improve insulin's ability to move sugar into cells especially into the muscle cells. They also prevent the liver from releasing stored sugar. Thiazolidinediones. These diabetes pills improve insulin's effectiveness (improving insulin resistance) in muscle and in fat tissue. They lower the amount of sugar released by the liver and make fat cells more sensitive to the effects of insulin Alpha-glucosidase inhibitors, including Precose (acarbose) and Glyset (miglitol). These drugs block enzymes that help digest starches, slowing the rise in blood sugar. These diabetes pills may cause diarrhea or gas. They can lower hemoglobin A1c by 0.5%-1%. Meglitinides, including Prandin (repaglinide) and Starlix (nateglinide). These diabetes medicines lower blood sugar by stimulating the pancreas to release more insulin. Dipeptidyl peptidase IV (DPP-IV) inhibitors, including Januvia (sitagliptin) and Onglyza (saxagliptin). The DPP-IV inhibitors work to lower blood sugar in patients with type 2 diabetes by increasing insulin secretion from the pancreas and reducing sugar production. Combination therapy. There are several combination diabetes pills that combine two medications into one tablet. Side effects of first- and second-generation sulfonylureas include: Hypoglycemia (low blood sugar) Upset stomach Skin rash or itching Weight gain Side effects for biguanide medications include: Upset stomach (nausea, diarrhea) Metallic taste in mouth Side effects for thiazolidinediones are rare but may include: Elevated liver enzymes Liver failure Respiratory infection Headache Fluid retention Side effects for alpha-glucosidase inhibitors include: Stomach upset (gas, diarrhea, nausea, cramps) Side effects of meglitinides include: Hypoglycemia (low blood sugar) Stomach upset Information Source http://diabetes.webmd.com/guide/oral-medicine-pills-treat-diabetes?page=2
62. Lente – Humulin NPH Lente Lente (Humulin) is a human-made form of insulin the hormone produced naturally by the pancreas. Lente is an intermediate-acting insulin that starts working about 1.5 hours after it is injected Lente, improve A1C levels using insulin but are not achieving A1C goals Pramlintide injections taken with meals have been shown to modestly improve A1C levels without causing increased hypoglycemia or weight gain and even promote modest weight loss. Humulin® L, Novolin®L Lente insulin help patients meet basal insulin requirements between meals and overnight, fast acting onset peaks in 4-8 hours after injections stays in the system for 13 – 20 hours can be used once or twice a day (Berkowitz, 2002)”. Caution it can give nocturnal hypoglycemia when given at bedtime. Humulin, the trade name for human insulin made by Eli Lilly, there are various trade names available for this produce. Humulincomes in many preparations: NPH, Lente, UltraLente, Regular, 70/30, and others. NPH, (Neutral protamine hagedorn) onset 2-4 should be taken after food peaks in 4-12 hours, last 16-20 hours used in newly diagnosed diabetes, given subcutaneously as part of multi-dose regimen of short- and long-acting insulin.
63. Insulin Training Video 1 Duration 6:15 ** Video 2 Duration 9:46 Link to 1st video (6:15) if it fails to start http://www.youtube.com/watch?v=d4J2Ifex1ak&feature=related Link to video 2nd (9:46) if it fails to start http://www.youtube.com/watch?v=SA7yCKxzzr0&feature=related
78. A healthy BMI is desired for optimal healthVideo links - in-depth information http://digital.films.com/PortalPlaylists.aspx?aid=11739&xtid=8920 http://digital.films.com/PortalViewVideo.aspx?xtid=43644&loid=
79. Diet Details Vegetables provide vitamins, fiber and minerals. Vegetables are low in carbohydrate. Eat raw and cooked vegetables with little or no fat or steamed vegetables, Fewer vitamins are lost when veggies are steamed Eat raw or cooked fruits canned in their own juices preferably. Avoid those canned in syrup. Eat fruit rather than drinking fruit. Save high-sugar and high-fat fruit desserts for special occasions. (Limited amounts) Choose skim or low fat 1% dairy products & yogurts that are sweetened with a low-calorie sweetener. Choose cuts of meat that have little fat on them. Trim off all excess fat when cooking. Remove the skin from chicken and turkey broil, grill, roast, steam, microwaving or stir-fry. Opt for sugar-free desserts, limit the consumption of artificial sweeteners eat fruit for a sweet snack instead When eating out order small or child-sized servings or share desserts . To avoid overeating measure food consumed.
80. Daily Exercise Thirty minutes a day of moderate exercise is often enough to effect positive change Walking - Jogging Moderate Weight lifting Cycling – Jumping Rope
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82. Getting involved in group sports or inviting friends to join is great encouragement for staying active.
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84. Cited Sources "A1c and EAG." Lab Tests Online: Welcome! American Association for Clinical Chemistry, 6 Feb. 2009. Web. 01 June 2011. <http://www.labtestsonline.org/>. Berkowitz, K. (2002, August). Lantus? or Lente? The American Journal of Nursing, 8. Core Team, JQuery UI. "MEDS." Privacy Is an Occupation, Not a Choice... 2011. Web. 01 June 2011. <http://www.cputeknology.com/diabetesdocs.htm>. Dea, Tara L. "Pediatric Obesity Type 2 Diabetes." The American Journal of Maternal/Child Nursing 31.1 (2011): 42-48. Print. Department of Women and Infant Nursing OB/GYN Clinic,. (2009). Fasting Blood Sugar and Two Hour after Eating (Post-Prandial) Blood Sugar Test. Ohio: The Ohio State University Medical Center. Luna , B., & Feinglos, M. N. (2001, May 1). Oral Agents in Management of Type 2 Diabetes Mellitus. American Famliy Physician, 1747-1757. Freeland, Barbara S. "Using Human Insulin." American Journal of Nursing 98.3 (1998): 16. Print. "Glucose." Lab Tests Online: Welcome! American Association for Clinical Chemistry, 22 Mar. 2011. Web. 01 June 2011. <http://www.labtestsonline.org>. Manzella R.N, D. (2008, July 5). Oral Medications for Managing Type 2 Diabetes. About Guide.com. McCarron, K., & Riebel, T. (2008, September/October). Spotlight on type 2 Diabetes. Nursing made incrediabley easy, 44-54. McCarron, K., & Riebel, T. (n.d.). Understanding Type II Diabetes.
86. You Tube Videos Animated Type 2 Diabetes - http://www.youtube.com/watch?v=KYoV3RxwFD8&NR=1 Type 2 Diabetes - http://www.youtube.com/watch?v=KYoV3RxwFD8&feature=related Diabetes Patient Education Types of insulin - http://www.youtube.com/watch?v=SA7yCKxzzr0&feature=related How type 2 develops - http://www.youtube.com/watch?v=fe8uuc8m118&feature=related Insulin Education - http://www.youtube.com/watch?v=d4J2Ifex1ak&feature=related Diabetes Mellitus type 2 explanation - http://www.youtube.com/watch?v=y3l-rfxY_Ew&feature=related What is Type 2 Diabetes? - http://www.youtube.com/watch?v=nBJN7DH83HA&feature=related Diabetes Mellitus - http://www.youtube.com/watch?v=VLiTbb6MaEU&feature=related Diabetes Overview - http://www.youtube.com/watch?v=sTgBvJsHcCk Insulin Resistance - http://www.youtube.com/watch?v=YXFJWoHura8&feature=related Insulin, Glucose and You Lantus -http://www.youtube.com/user/WhyInsulin?v=_w7u6ZzlaFc&feature=pyv&ad=11398906891&kw=diabetes TYPE II (sugar diabetes) - http://www.youtube.com/watch?v=kZz5utFLhYQ&feature=related BNN Type-2 Diabetes - http://www.youtube.com/watch?v=j5rtJ4I3K2E&feature=related Type 2 Diabetes - http://www.youtube.com/watch?v=ZsTSoLhl3Y4&NR=1&feature=fvwp Information on foot care http://www.youtube.com/watch?v=_RkxiYJKZyE Pre-prandial - http://www.youtube.com/watch?v=qUCUa99pW8Q
87. Click Screen to Start Video ~ There are several video’s explaining Type II Diabetes to see selection of all three click on the box next to the play button on the bottom left corner once the video appears. Click on the video choice to pay Total Running Time of all is 9min 29 sec