scholarly journals Prevalence of Abnormal Glucose Regulation according to Different Diagnostic Criteria in Ischaemic Stroke without a History of Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Xinmiao Zhang ◽  
Qiuyan Shi ◽  
Huaguang Zheng ◽  
Qian Jia ◽  
Xingquan Zhao ◽  
...  

We aimed to investigate the prevalence and distribution of abnormal glucose regulation, including prediabetes and newly diagnosed diabetes, according to different criteria in ischaemic stroke patients without a history of diabetes. Data were derived from a representative cohort across China. Prediabetes was defined as fasting plasma glucose (FPG) 5.6–6.9 mmol/L or 2-hour oral glucose tolerance test (OGTT) 7.8–11.0 mmol/L or haemoglobin A1c (HbA1c) 5.7–6.4%. Newly diagnosed diabetes was defined as FPG ≥ 7.0 mmol/L, 2 h OGTT ≥ 11.1 mmol/L or HbA1c ≥ 6.5%. Among 1251 ischaemic stroke patients, 471 (37.5%) were detected as prediabetes and 539 (43.1%) were detected as newly diagnosed diabetes. Prediabetes was present in 118 (9.4%), 290 (23.2%) and 314 (25.1%) stroke patients, and newly diagnosed diabetes was present in 138 (11.0%), 370 (29.6%), and 365 (29.2%) stroke patients, based on FPG, 2 h OGTT, and HbA1c criteria, respectively. Dependency on FPG alone would have missed 74.9% of patients in the prediabetes range and 74.4% of patients in the diabetes range. Our study demonstrated a high prevalence of prediabetes and diabetes in ischaemic stroke patients without a history of diabetes. OGTT and HbA1c helped detect the majority of prediabetes and newly diagnosed diabetes in ischaemic stroke patients.

2018 ◽  
Vol 27 (9) ◽  
pp. 2327-2335 ◽  
Author(s):  
Yacouba Njankouo Mapoure ◽  
Hamadou Ba ◽  
Chia Mark Ayeah ◽  
Caroline Kenmegne ◽  
Henry Namme Luma ◽  
...  

2020 ◽  
Author(s):  
Maryam Kabootari ◽  
Samaneh Asgari ◽  
Seyedeh Maryam Ghavam ◽  
Fereidoun Azizi ◽  
Farzad Hadaegh

Abstract Background: To assess the association between fasting plasma glucose (FPG) and 2-h post challenge plasma glucose (2h-PCPG) as continuous or categorical variables with risk of recurrent cardiovascular disease (CVD) and incident diabetes among subjects with history of previous CVD. Methods: In a prospective population-based cohort, a total of 335 Iranians aged ≥30 years, with history of CVD and free of known diabetes were included. Prediabetes was defined as impaired fasting glucose (IFG) according to the criteria of the American Diabetes Association (ADA) [IFG-ADA; FPG: 5.6-6.9 mmol/L], the World Health Organization (WHO) expert group (IFG-WHO; FPG: 6.1-6.9 mmol/L) and impaired glucose tolerance [IGT: 2h-PCPG: 7.8-11.0 mmol/L]. Cox’s proportional hazard models adjusted for traditional risk factors were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) of different glucose intolerance for outcomes of interest. Results: During a median follow-up of 15.8 (IQR, 10.7-16.5) years, 178 CVD (hard event including death, myocardial infarction and stroke=69) events occurred. Regarding FPG, only IFG-ADA was associated with significant higher risk of hard CVD in the fully adjusted model (HR, 1.73, 95% CI: 1.04-2.89). Moreover, newly diagnosed diabetes (FPG≥7 mmol/L) was an independent risk of CVD (2.11: 1.22-3.66). Focusing on 2h-PCPG, subjects with newly diagnosed diabetes (2h-PCPG ≥ 11.1 mmol/L) had moderately increased risk of hard coronary heart disease (2.02:0.91-4.47, P=0.08). The multivariate HRs (95% CI) associated with 1 SD increase in FPG and 2h-PCPG was 1.16 (1.01–1.33) and 1.19 (1.02–1.38) for CVD, respectively. Among population free of diabetes at baseline (n=270), IFG-ADA, IFG-WHO and IGT were significantly associated with incident diabetes in multivariate analysis (all HRs > 4, P< 0.001); significant associations were also found for FPG and 2h-PCPG as continuous variables (all HRs for 1-SD increase > 2, all P < 0.001). Conclusions: Among subjects with stable CVD, both FPG and 2h-PCPG as continuous variables was associated with higher risk of recurrent CVD. However, only IFG-ADA was independent predictor of hard CVD events. Also, newly diagnosed diabetes, using FPG criteria, was associated with a significant risk of CVD. IFG-ADA, IFG-WHO and IGT were all significant predictors of incident diabetes.


2021 ◽  
Author(s):  
Michael Fang ◽  
Elizabeth Selvin

<b>Objective:</b> To assess the prevalence of and trends in complications among US adults with newly diagnosed diabetes. <p><b>Research design and methods:</b> We included 1,486 nonpregnant adults (aged≥20 years) with newly diagnosed diabetes (diagnosed within the past 2 years) from the 1988-1994 and 1999-2018 National Health and Nutrition Examination Survey. We estimated trends in albuminuria (albumin-to-creatinine ratio≥30 mg/g), reduced estimated glomerular filtration rate (eGFR<60 ml/min/1.73 m<sup>2</sup>), retinopathy (any retinal microaneurysms or blot hemorrhages), and self-reported cardiovascular disease (history of congestive heart failure, heart attack, or stroke).</p> <p><b>Results: </b>From 1988-1994 to 2011-2018, there was a significant decrease in the prevalence of albuminuria (38.9 to 18.7%, p-for-trend<0.001), but no change in the prevalence of reduced eGFR (7.5 to 9.9%, p-for-trend=0.30), retinopathy (1988-1994 to 1999-2008 only; 13.2 to 12.1%, p-for-trend=0.86), or self-reported cardiovascular disease (19.0 to 16.5%, p-for-trend=0.64). There were improvements in glycemic, blood pressure, and lipid control in the population, and these partially explained the decline in albuminuria. Complications were more common at the time of diabetes diagnosis for adults who were older, lower income, less educated, and obese.</p> <p><b>Conclusion:</b> Over the past three decades, there have been encouraging reductions in albuminuria and risk factor control in adults with newly diagnosed diabetes. However, the overall burden of complications around the time of diagnosis remains high.</p>


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bhuvnesh Aggarwal ◽  
Gautam Shah ◽  
Mandeep S Randhawa ◽  
A M Lincoff ◽  
Stephen G Ellis ◽  
...  

Background: A significant proportion of patients presenting with ST segment elevation myocardial infarction (STEMI) have newly diagnosed diabetes mellitus (DM). Hypothesis: Our aim was to identify patients with previously undiagnosed DM and compare their outcomes to those with known DM and without DM after STEMI. Methods: Consecutive patients undergoing primary PCI for STEMI at our center between Jan 2005 - Dec 2012 were included. Routinely performed admission Glycated hemoglobin (HbA1c) was utilized to identify patients with previously undiagnosed DM (HbA1c ≥ 6.5 and no history of DM or diabetes therapy). Patients were compared for in-hospital and long-term mortality based on follow up data from our institutional PCI registry. Results: 1,734 consecutive patients underwent primary PCI for STEMI and follow up data was available for 1,566 (90%) patients. Mean age was 60 years and 67.3% were males. A quarter of the patients (24.3%, n = 382) had prior history of DM and 8% (n=95) of the remainder had undiagnosed DM. Median follow up was 35 months. Mortality was comparable in patients with known DM and newly diagnosed DM both in hospital (11.2% vs. 12.5%, p=0.87) and at long term follow up (Figure 1, 2). Mortality was significantly worse with both groups when compared with patients with no DM (In-hospital mortality 5.6%; p<0.001 for both groups). Conclusions: One in twelve patients presenting with STEMI have previously undiagnosed DM. Cardiologists have a unique opportunity for identification and initiation of diabetic therapy in this vulnerable population. Patients with newly diagnosed DM have similar short and long-term outcomes when compared with patients with a prior history of DM.


PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 137-138
Author(s):  
Kathleen L. Wishner ◽  
Lynda K. Fisher ◽  
Dinesh Kumar

Systemic insulin allergy is rare and usually occurs in adults with diabetes mellitus following reinstitution of insulin therapy.1,2 The present case is unusual in that the systemic symptoms appeared 23 days after initial continuous treatment with insulin in a very young child. CASE REPORT An 18-month-old boy was seen by his pediatrician six weeks after a severe episode of varicella, with a monilial diaper rash and a three-week history of polyuria, polydipsia, polyphagia, and weight loss. The blood glucose concentration was 534 mg/100 ml and serum ketones were present. Diabetes mellitus was diagnosed. He was hospitalized and insulin therapy was instituted without incident; the patient was discharged on a daily mixed dose of regular and isophane (NPH) insulins (single-peak, beef-pork mixture, Eli Lilly & Co).


2016 ◽  
pp. 65-68
Author(s):  
O. Halushko ◽  

The objective: to study the origin and characteristics of the flow of electrolyte abnormalities in patients with acute stroke (OR) on a background of concomitant diabetes mellitus (DM) and the possibility of their correction. Patients and methods. Electrolyte disturbances that occur in patients with acute stroke (AS) is one of the reasons complications of AS. Concomitant diabetes mellitus (DM) affects the severity of stroke and increased mortality rates. Analysis of 416 patients with the treatment of AS was conducted. All patients were divided into three groups: 1) patients with established diabetes before the stroke, 2) patients with newly diagnosed diabetes and 3) patients without diabetes. The second phase was conducted a pilot study with an analysis of the frequency of magnesium and phosphate metabolic disorders in the patients with AS (20 patients with AS on a background of diabetes and 10 stroke patients without diabetes). Results. In general, the different types of electrolyte disorders were observed in 73.9% patients with AS, while in patients with underlying disorders of carbohydrate metabolism, these violations occurred significantly more often than patients without such. In particular, carbohydrate metabolism occurred in 82 (81.2%) and 36 (83.7%) patients 1 and 2 groups versus 134 (65.4%) in the control group (p<0.05). Hypomagnesemia (less than 0.8 mmol/L) was observed in 2 of 10 patients (20%) in AS without carbohydrate disturbances and in 6 of 20 patients (30%) in AS with concomitant diabetes. Hypophosphatemia (phosphate levels less than 0,8 mmol/L) was found in patients without diabetes and AS in 2 patients with concomitant DM or newly diagnosed diabetes. Following the correction of oral medication containing phosphates and magnesium blood electrolyte levels was stabilized and that coincided with the improvement of the patients and the degree of disability. Conclusion: Electrolyte disorders are fairly common problem in patients with concomitant diabetes and AS. In patients with impaired carbohydrate metabolism observed significantly higher frequency (more than 81,2% of patients) occurrence of electrolyte disorders than patients without them. Conclusion. In the case of AS on a background of diabetes electrolyte disturbances occur significantly more frequently than in patients without such comorbid disorders. Key words: stroke, electrolytes, sodium, potassium, chloride, magnesium, phosphate.


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