Hemoglobin A1c

血红蛋白 A1c
  • 文章类型: Journal Article
    医生对II型糖尿病(T2DM)治疗指南的良好依从性可以改善患者的治疗结果。在这次回顾中,横断面研究,我们在Thumbay学术健康中心评估了患有动脉粥样硬化性心血管疾病(ASCVD)或发展为ASCVD高风险的成年患者(年龄≥18岁)对T2DM治疗循证指南的依从性。阿拉伯联合酋长国(阿联酋)。
    相关数据来自患者的医疗记录,评估,并根据美国糖尿病协会和欧洲糖尿病研究协会的2018年糖尿病指南进行了比较。
    共有218名患者(186名男性和32名女性)被纳入分析。其中,122种被处方为钠-葡萄糖共转运蛋白2(SGLT2)抑制剂或胰高血糖素样肽1(GLP-1)受体激动剂,34种被处方为两者。对指南的总体依从性为56%,这受到体重指数(BMI)的显著影响,血红蛋白A1c(HbA1c)水平,和估计平均葡萄糖(eAG)。
    在治疗HbA1c和eAG水平升高的患者时,对指南的依从性明显较高,提示内科医生更有可能给这类患者开SGLT2抑制剂或/和GLP-1受体激动剂.医师对指南的依从性与患者的BMI以及HbA1c和eAG水平显着相关。据我们所知,这是阿联酋首次针对糖尿病及其危险因素进行的研究.
    Good adherence by physicians to treatment guidelines for type II diabetes mellitus (T2DM) could improve therapy outcome for patients. In this retrospective, cross-sectional study, we assessed physicians\' adherence to evidence-based guidelines for T2DM management in adult patients (aged ≥18 years) with either confirmed atherosclerotic cardiovascular disease (ASCVD) or those at high risk of developing ASCVD at the Thumbay Academic Health Center, United Arab Emirates (UAE).
    Relevant data was obtained from patients\' medical records, assessed, and compared based on the 2018 diabetes guidelines of the American Diabetes Association and European Association for the Study of Diabetes.
    A total of 218 patients (186 males and 32 females) were included in the analysis. Of these, 122 were prescribed either sodium-glucose co-transporter-2(SGLT2) inhibitors or glucagon-like peptide 1 (GLP-1) receptor agonists and 34 were prescribed both. The overall adherence to the guidelines was 56%, which was significantly influenced by body mass index (BMI), hemoglobin A1c (HbA1c) levels, and estimated average glucose (eAG).
    Adherence to guidelines was significantly high when treating patients with elevated levels of HbA1c and eAG, suggesting that physicians are more likely to prescribe SGLT2 inhibitors or/and GLP-1 receptor agonists to such patients. Physicians\' adherence to guidelines was significantly correlated with patients\' BMI and the levels of HbA1c and eAG. To the best of our knowledge, this is the first study conducted on diabetes and its risk factors in UAE.
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  • 文章类型: Journal Article
    UNASSIGNED: HbA1C has been a known predictor and diagnostic test for diabetes type 2. However, this test has not yet been widely studied in GDM and more importantly no cutoff point has been defined for HbA1C in GDM. We investigated the efficacy of screening during first and second trimester of pregnancy and defined appropriate cutoff points according to HbA1C and FBS for predicting maternal GDM among women with none to minimal previously known risk factors.
    UNASSIGNED: This is a prospective multi-centered cohort study. Individuals were evaluated at first trimester, at 20-24 weeks and 24-28 weeks of gestation. GDM tests were done during visits and accuracy of each of these measurements was evaluated.
    UNASSIGNED: Overall, 356 entered the study, among which 25 individuals and 30 individuals developed GDM during 20-24 and 24-28 weeks of gestation, respectively. HbA1C measured during first trimester at a cut-off of 5.35% predicted GDM of 24-28 weeks with an accuracy of 85.6%, sensitivity of 80%, and specificity of 80%. Furthermore, at a cut-off of 5.75% measured at 20-24 weeks, HbA1C predicted GDM with an accuracy of 94.5%, sensitivity of 97%, and specificity of 96%.
    UNASSIGNED: Screening programs during first trimester and at 20-24 weeks of pregnancy, using HbA1C, can significantly aid in the early prediction of GDM, even among women with no to minimal previously known risk factors, which shows a need for revision in current guidelines.
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  • 文章类型: Journal Article
    OBJECTIVE: To describe adherence to clinical practice guidelines for the treatment of childhood type 1 diabetes and identify associated patient and system level factors.
    METHODS: This prospective cohort study used population-based administrative data to describe individuals aged 1-24 years who had been diagnosed with type 1 diabetes at <20 years of age (1472 unique individuals and 5883 person-years over a 7-year period) living in British Columbia, Canada. The outcome measure was proportion \'at goal,\' which was defined as having optimal adherence (3 diabetes-related physician visits/year, 3 hemoglobin A1c (HbA1c) tests/year, 1 glucagon prescription dispensed/year, and appropriate screening for diabetes-related comorbidity [ie, hypothyroidism] and complications [ie, retinopathy and nephropathy]), or good adherence to guidelines (2 diabetes-related physician visits/year, 2 HbA1c tests/year, and appropriate screening for diabetes-related comorbidity and complications). Statistical methods included descriptive statistics and logistic regression modeling.
    RESULTS: Fifty-four percent person-years had poor adherence to guidelines (<2 diabetes-related physician visits and HbA1c tests/year) and 7.4% had optimal adherence. The proportion of person-years at goal was higher in females vs males (41.0% vs 37.6%; P = .007). Individuals 4-years post-diagnosis of diabetes were 78% less likely to be at goal compared with the year of diagnosis (P < .0001).
    CONCLUSIONS: The treatment of pediatric type 1 diabetes likely does not meet national and international standards. Future studies should explore facilitators and barriers to adherence to guidelines among health care providers, patients, and families, and whether adherence to guidelines is associated with glycemic control.
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