Use of high-normal levels of haemoglobin A1Cand fasting plasma glucose for diabetes screening and for prediction: a meta-analysis

2013 ◽  
Vol 29 (8) ◽  
pp. 680-692 ◽  
Author(s):  
Satoru Kodama ◽  
Chika Horikawa ◽  
Kazuya Fujihara ◽  
Reiko Hirasawa ◽  
Yoko Yachi ◽  
...  
Keyword(s):  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Meta Analysis ◽  
Diabetes Screening ◽  
Fasting Plasma

scholarly journals Noninvasive Type 2 Diabetes Screening: Superior sensitivity to fasting plasma glucose and A1C

Diabetes Care ◽  
2007 ◽  
Vol 30 (5) ◽  
pp. 1120-1124 ◽  
Author(s):  
J. D. Maynard ◽  
M. Rohrscheib ◽  
J. F. Way ◽  
C. M. Nguyen ◽  
M. N. Ediger
Keyword(s):  
Type 2 Diabetes ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Diabetes Screening ◽  
Fasting Plasma

scholarly journals Efficacy and safety of short- and long-acting GLP-1 receptor agonists on a background of basal insulin in type 2 diabetes: A meta-analysis

2020 ◽  
Author(s):  
Jessica Annalena Huthmacher ◽  
Juris J. Meier ◽  
Michael A. Nauck
Keyword(s):  
Body Weight ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Basal Insulin ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Short Acting ◽  
Fasting Plasma ◽  
Long Acting

<b>Background/Purpose.</b> To compare efficacy and safety of short- and long-acting GLP-1 receptor agonists (GLP-1 RAs), both used in combination with basal insulin in patients with type 2 diabetes.<b></b> <p><b> </b></p> <p><b>Data Sources/Study Selection.</b><b><i> </i></b>Randomized controlled trials comparing the co-administration of short- or long-acting GLP-1 RAs and basal insulin with basal insulin ± placebo were identified (PubMed search). Of 974 identified publications 14 clinical trials were included. Eight trials examined short-acting and six long-acting GLP-1 RAs.<b></b></p> <p><b> </b></p> <p><b>Data Extraction/Data Synthesis.</b> Differences in HbA<sub>1c</sub>, fasting plasma glucose, body weight and adverse events were compared between studies using short- or long-acting GLP-1 RAs by random-effects meta-analysis.</p> <p><b> </b></p> <p><b>Limitations. </b>Relatively small numbers of available publications, some heterogeneity regarding protocols and differences in the GLP-1 RA compound used.</p> <p><b> </b></p> <p><b>Conclusions.</b> Long-acting GLP-1 RAs more effectively reduced HbA<sub>1c</sub> (∆ - 6 mmol/mol, [95 % CI - 10; - 2], p= 0.007), fasting plasma glucose (∆ - 0.7 mmol/l [- 1.2; - 0.3] p= 0.007) and body weight (∆ - 1.4 kg [- 2.2; - 0.6] p= 0.002) and raised the proportion of patients achieving an HbA<sub>1c</sub> target < 7.0% (< 53 mmol/mol; p= 0.03) more than the short-acting ones. Patients reporting symptomatic (p= 0.048), but not severe hypoglycemia (p= 0.96) were fewer with long- vs. short-acting GLP-1 RAs added to insulin. The proportion of patients reporting nausea (- 52 %; p < 0.0001) or vomiting (- 36 %; p= 0.0002) was lower with long-acting GLP-1 RAs.<b> </b>Overall, GLP-1 RAs improved HbA<sub>1c</sub>, fasting plasma glucose and body weight when added to basal insulin. However, long-acting GLP-1 RAs were significantly more effective for glycemic and body weight control and displayed better gastro-intestinal tolerability. </p>

scholarly journals Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies

2019 ◽  
Author(s):  
Lingyun Ma ◽  
Daohuang Luo ◽  
Ting Yang ◽  
Songtao Wu ◽  
Min Li ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Plasma Insulin ◽  
Combined Therapy ◽  
Meta Analysis ◽  
Somatostatin Analogues ◽  
Glycosylated Haemoglobin ◽  
Fasting Plasma ◽  
Fasting Plasma Insulin

Abstract Background: Acromegaly is a rare, chronic and severe disease . Drug therapy including somatostatin analogues , dopamine receptor agonists and growth hormone receptor antagonists are commonly used to treat patients who do not responde to surgery. T he use of combination therapy with PEG and SAs has become more common over the last decade . We performed this study t o accurately evaluate the effect of combination therapy of somatostatin analogues (SAs) with pegvisomant (PEG) on acromegalic patients. Methods: PubMed, EMBASE, The Cochrane Library, and ClinicalTrials.gov were searched for relevant studies. Prospective clinical trials treating acromegaly with the co-administration of SAs and PEG were included. We performed a meta-analysis by using Stata 12.1 . Sensitivity analysis was conducted to explore heterogeneity. Results: Eight studies were included in this meta-analysis. The overall rate of serum insulin-like growth factor 1 (IGF-1) normalization was 75% (95% CI: 50%–93%; I 2 =93.60%). The combination therapy did not significantly change patients’ fasting plasma glucose (ES: 0.011 mmol*L -1 ; 95% CI: − 0.374 to 0.397 mmol*L -1 ; P=0.954) or glycosylated haemoglobin (ES: -0.106%; 95% CI: − 0.302% to 0.089%; P=0.285) while decreasing the fasting plasma insulin (ES: −21.487 pmol*L-1; 95% CI: −35.713 to -7.260 pmol*L-1; P=0.003). Elevation of liver enzyme levels was found in 14% (95% CI: 10% to 19%) of the patients. Conclusions: Combined therapy of SAs and PEG effectively normalized IGF-1 levels in most of the patients whose IGF-1 level was greater than the upper limit of normal after high dose SAs monotherapy. The combination therapy significantly decreased patients’ fasting plasma insulin. However, improved fasting plasma glucose or glycosylated haemoglobin was not found during the combination therapy. Moreover, elevated liver enzyme levels were observed in a small number of patients, which suggests a need for liver function monitoring. Trial registration We have our protocol registered in PROSPERO. (Registration number: CRD42019115549)

Prevalence and risk factors of undiagnosed diabetes mellitus among gastroenterological patients: a HbA1c-based single center experience

2021 ◽  
Author(s):  
Thorben Fründt ◽  
Niko Schröder ◽  
Angelique Hölzemer ◽  
Hans Pinnschmidt ◽  
Jocelyn de Heer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Liver Cirrhosis ◽  
Risk Factor ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Medication Use ◽  
Undiagnosed Diabetes ◽  
Diabetes Screening ◽  
Fasting Plasma

Abstract Background Diabetes mellitus is a major risk factor for microvascular disease, leading to chronic kidney injury or cardiovascular disease, but there is a tremendous proportion of patients worldwide who suffer from undiagnosed diabetes. Until now, little is known about the prevalence of undiagnosed diabetes in gastroenterology inpatients. Objective To improve detection of undiagnosed diabetes, a routine screening procedure for gastroenterology inpatients, based on hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) measurement, was established. Methods We conducted a retrospective analysis of the implemented diabetes screening. Diabetes mellitus was diagnosed according to the guideline of the German Diabetes Association in patients with an HbA1c of ≥6.5% anld/or fasting plasma glucose (FPG) ≥126 mg/dL. Univariate and multivariate analyses were performed to identify independent risk factors for undiagnosed diabetes. Results Within a 3-month period, 606 patients were eligible for a diabetes screening. Pre-existing diabetes was documented in 120 patients (19.8 %), undiagnosed diabetes was found in 24 (3.9%), and 162 patients (26.7%) met the definition for prediabetes. Steroid medication use, age, and liver cirrhosis due to primary sclerosing cholangitis (PSC) were identified as risk factors for undiagnosed diabetes. Conclusion The prevalence of undiagnosed diabetes in gastroenterology inpatients is markedly elevated in comparison to the general population, and a substantial number of inpatients are in a prediabetic status, underlining the need for diabetes screening. In addition to previously described risk factors of patient age and steroid medication use, we identified PSC-related liver cirrhosis (but not liver cirrhosis due to another etiology) as an independent risk factor for undiagnosed diabetes.

Sign in / Sign up

Export Citation Format

Share Document