scholarly journals The Ratio of Estimated Average Glucose to Fasting Plasma Glucose Level Is Superior to Glycated Albumin, Hemoglobin A1c, Fructosamine, and GA/A1c Ratio for Assessingβ-Cell Function in Childhood Diabetes

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Ji Eun Lee ◽  
Ji Woo Lee ◽  
Tatsuyoshi Fujii ◽  
Noriyoshi Fujii ◽  
Jong Weon Choi

Objective. This study investigated the use of the estimated average glucose to fasting plasma glucose ratio (eAG/fPG ratio) to screen forβ-cell function in pediatric diabetes.Methods. Glycated hemoglobin (HbA1c), glycated albumin (GA), fructosamine, insulin, and C-peptide levels were measured. The ratio of GA to HbA1c (GA/A1c ratio) was calculated, and the homeostasis model assessment ofβ-cell function (HOMA-β) was determined.Results. Median values of C-peptide, insulin, and HOMA-βlevels were significantly higher in patients with an increased eAG/fPG ratio than in those with a decreased eAG/fPG ratio. C-peptide and HOMA-βlevels were more closely correlated with the eAG/fPG ratio than with GA, HbA1c, the GA/A1c ratio, and fructosamine. In contrast, body mass index was significantly associated with GA, GA/A1c ratio, and fructosamine, but not with the eAG/fPG ratio and HbA1c levels. To test the diagnostic accuracies of the eAG/fPG ratio for identifying HOMA-β> 30.0% in patients with type 2 diabetes, the area under the ROC curve of the eAG/fPG ratio was significantly larger than that of the GA/A1c ratio [0.877 (95% CI, 0.780–0.942) versus 0.775 (95% CI, 0.664–0.865),P=0.039].Conclusions. A measurement of the eAG/fPG ratio may provide helpful information for assessingβ-cell function in pediatric patients with diabetes.

Diabetologia ◽  
1985 ◽  
Vol 28 (7) ◽  
pp. 412-419 ◽  
Author(s):  
D. R. Matthews ◽  
J. P. Hosker ◽  
A. S. Rudenski ◽  
B. A. Naylor ◽  
D. F. Treacher ◽  
...  

2014 ◽  
Vol 25 (2) ◽  
pp. 56-59
Author(s):  
Mahmudul Huque ◽  
Tofail Ahmed ◽  
Liaqat Ali ◽  
Rahelee Zinnat ◽  
Hajera Mahtab ◽  
...  

Diabetic vascular disease is conveniently divided into two main categories: microvascular diseases and macrovascular diseases. The changes involving the smallest blood vessels - the capillary and pre-capillary arteriolesare microvascular changes. The cross sectional case-control study was done on forty young diabetic patients for their platelet aggregation response to ADP, plasma fibrinogen and vWF in relation to the age and BMI matched 10 nondiabetic control subjects (Age in years : 23.7 ± 2.26 in control vs 24.33 ± 3.29 in subjects, and BMI in kg/m2. The lipid profile, C-peptide, C-peptide: glucose and other anthropometric measurements of the diabetic and control subjects were also measured to find out any possible correlation. The platelet aggregation with ADP in diabetics was found to be significantly higher (in diabetics 76.56 ± 16.92 percent compared to controls 62.90 ± 12.35 percents; (P< 0.27). Plasma fibrinogen and plasma von Willebrand factors were found to be significantly higher in young diabetics compared to the non-diabetic counterparts (Plasma fibrinogen in mg/l; 1075.90 ± 455.16 in control vs 1569.15 ± 731.42 in diabetic, P<0.048; plasma vWF in iu/ml; 1.372 ± 0.340 in control vs 1.884 ± 0.51 in diabetic, P<0.001). Fasting plasma glucose was higher and C-peptide - glucose ratio lower in diabetic subjects compared to the controls (Fasting plasma glucose in mmol/l; 3.48 ± 0.38 in control vs 16.02 ± 8.58 in diabetic; C-peptide-glucose ratio 0.426 ± 0.133 in controls vs 0.116 ± 0.105 in diabetics, P<.001). Thus hyperglycemia, endothelial dysfunction, elevated vWF and insulin resistance were supposed to be interlinked. DOI: http://dx.doi.org/10.3329/medtoday.v25i2.17920 Medicine Today 2013 Vol.25(2): 56-59


Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 68 ◽  
Author(s):  
Ioannis Ilias ◽  
Aristidis Diamantopoulos ◽  
Maria Pratikaki ◽  
Efthymia Botoula ◽  
Edison Jahaj ◽  
...  

Background and objectives: Critically and non-critically ill patients with SARS-CoV-2 infection (Covid-19) may present with higher-than-expected glycemia, even in the absence of diabetes. With this study we aimed to assess glucose, glycemic gap (GlyG) and insulin secretion/sensitivity measures in patients with Covid-19. Materials and Methods: We studied, upon admission, 157 patients with Covid-19 (84: in wards and 73: in intensive care units; ICU); 135 had no history of diabetes. We measured blood glucose upon admission as well as glycated hemoglobin (A1c), plasma insulin and C-peptide. We calculated the GlyG and the Homeostasis Model Assessment 2 (HOMA2) estimates of steady state beta cell function (HOMA2%B) and insulin sensitivity (HOMA2%S). Statistical assessment was done with analysis or the Kruskal-Wallis test. Results: Compared to patients in the wards without diabetes, patients with diabetes in the wards, as well as patients in the ICU (without or with diabetes) had higher admission glycemia. The GlyG was significantly higher in patients without diabetes in the ICU compared to patients without diabetes in the wards, while HOMA2%B based on glucose and insulin was significantly higher in the ICU patients compared to patients in the wards. Of all the parameters, HOMA2%S based on C-peptide/glucose was higher in survivors (n = 133). Conclusions: In our series of patients with Covid-19, a substantial number of patients with and without diabetes had admission hyperglycemia and those who were critically ill may have had compromised insulin secretion and lowered sensitivity to insulin. These findings lend credence to reports of association between Covid-19 and hyperglycemia/secondary diabetes.


Twin Research ◽  
2000 ◽  
Vol 3 (3) ◽  
pp. 148-151 ◽  
Author(s):  
Arthur B Jenkins ◽  
Katherine Samaras ◽  
David GP Carey ◽  
Paul Kelly ◽  
Lesley V Campbell

AbstractHomeostasis model assessment (HOMA) provides indices of insulin secretion (β) and insulin resistance (R) derived from fasting plasma glucose (FPG) and fasting plasma insulin (FPI) levels. However, these indices could not account for a significant heritability of fasting plasma glucose (FPG) (h2 = 0.75, P < 0.01) in a group of 214 female twins. This result is consistent with a misclassification between effects due to insulin secretion and resistance in the HOMA indices. We report here evidence of such misclassification in the HOMA indices and describe a minor modification to the model which corrects it. Direct measures of insulin resistance (euglycaemic clamp) and secretion (i.v. glucose bolus) were obtained in 43 non-diabetic subjects. Heritability was estimated by statistical modelling of genetic and environmental influences in data from 214 non-diabetic female subjects. Modified HOMA (HOMA′) indices were obtained from β′ = (Ln(FPI)–c)/FPG and R′ = (Ln(FPI)–c)* FPG where c is a constant derived from regression analysis of Ln(FPI) vs FPG. Indices from both models correlated with the direct measures similarly (r = 0.63 (R), 0.49 (R′), 0.45 (β), 0.39 (β′), all P < 0.01). Directly measured insulin resistance and secretion were not significantly correlated (r = 0.13, P = 0.21). However, unmodified HOMA- and R were strongly related (r = 0.78, P < 0.0001 vs 0.13) demonstrating substantial misclassification. The relationship between β′ and R′ (r = 0.13) was not different from that between the two direct measures and significant heritability of β′ (h2 = 0.68, P < 0.01) and R′ (h2 = 0.59, P < 0.05) was evident in the twin data. The proposed modification to HOMA significantly reduces misclassification and reveals separate components of insulin resistance and insulin secretion in the heritability of FPG. Twin Research (2000) 3, 148–151.


2015 ◽  
Vol 44 (6) ◽  
pp. 1927-1940 ◽  
Author(s):  
Marine Azevedo Da Silva ◽  
Aline Dugravot ◽  
Beverley Balkau ◽  
Ronan Roussel ◽  
Frédéric Fumeron ◽  
...  

Abstract Background : Use of antidepressants is seen to be a risk factor for type 2 diabetes, even though the underlying mechanisms remain unclear. We examined whether antidepressant use was associated with change in fasting plasma glucose, glycated haemoglobin (HbA1c), β-cell function (HOMA2-%B) and insulin sensitivity (HOMA2-%S) over time. Methods : Participants in the French D.E.S.I.R. cohort study included over 4700 men (48.1%) and women, free of diabetes, aged 30–65 years at baseline in 1994–96 (D.E.S.I.R. 0), who were followed for 9 years at 3-yearly intervals (D.E.S.I.R. 3, 1997–99; 6, 2000–02; 9, 2003–05). Antidepressant use, fasting plasma glucose, HbA1c, HOMA2-%B and HOMA2-%S were assessed concurrently at four medical examinations. Linear mixed models were used to examine the cross-sectional and longitudinal associations of time-dependent antidepressant use with changes in these four biological parameters. Results : Mean fasting plasma glucose and HbA1c increased whereas HOMA2-%B and HOMA2-%S decreased over the follow-up. In a fully adjusted model, there were no differences in: mean fasting plasma glucose ( β  = 0.01 mmol/l, P  = 0.702); HbA1c ( β  = 0.01 %, P  = 0.738); HOMA2-%B ( β  = 0.00, P  = 0.812); or HOMA2-%S ( β  =−0.01, P  = 0.791) at baseline (1994–96) between antidepressant users and non-users. The interaction term with time also suggested no differences in the annual change in: fasting plasma glucose ( β  = 0.00 mmol/l, P  = 0.322); HbA1c ( β  = 0.00 %, P  = 0.496); HOMA2-%B ( β  = 0.00, P  = 0.609); or HOMA2-%S ( β  = 0.00, P  = 0.332) between antidepressant users and non-users. Similar associations were observed in analyses of type and cumulative use of antidepressants over follow-up. Conclusion : Our longitudinal data show that use of antidepressants is not associated with altered glucose metabolism, suggesting that the association between antidepressant use and diabetes reported by previous studies may not be causal. Detection bias or clinical ascertainment bias may account for much of this apparent association.


2021 ◽  
pp. 1-4
Author(s):  
Gerald C Hsu ◽  

This paper describes the accuracy of using natural intelligence (NI) and artificial intelligence (AI) methods to predict three glucoses, fasting plasma glucose (FPG), postprandial plasma glucose (PPG), and daily average glucose, in comparison with the actual measured PPG by using the finger-piercing (Finger) method. The entire glucose database contains 7,652 glucoses (4 glucose data per day) over 1,913 days from 6/1/2015 through 8/27/2020


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