scholarly journals International Comparison of C-Peptide Measurements

2007 ◽  
Vol 53 (4) ◽  
pp. 784-787 ◽  
Author(s):  
Hsiao-Mei Wiedmeyer ◽  
Kenneth S Polonsky ◽  
Gary L Myers ◽  
Randie R Little ◽  
Carla J Greenbaum ◽  
...  
Keyword(s):  
Interval Estimate ◽  
C Peptide ◽  
Method Effect ◽  
Patients With Diabetes ◽  
Heparin Plasma ◽  
Assay Methods ◽  
The Mean ◽  
The Impact ◽  
Single Laboratory ◽  
Comparability Of Results

Abstract Background: C-peptide measurement has been widely used as a marker of insulin secretion in patients with diabetes. We assessed the comparability of C-peptide results obtained with different methods and by different laboratories and determined whether C-peptide results could be harmonized by normalization with a WHO reference reagent or with plasma. Methods: We sent 16 different heparin plasma samples to 15 laboratories in 7 countries. The samples were analyzed with 10 different assay methods. A WHO C-peptide standard was also sent to each laboratory and used to determine the feasibility of normalizing results. To assess the impact of calibrator matrix on the comparability of results, we also used the mean results of all laboratories for 4 of the samples to normalize the remaining sample results. Results: Between-laboratory variability increased with increasing C-peptide concentrations. Normalization of results with WHO reference reagents did not improve comparability, but normalization with samples significantly improved comparability among laboratories and methods. The 95% confidence interval estimate for the SD for the lab/method effect (0.0–0.061) using sample-normalized values did not overlap with the 95% CI estimate with the raw data (0.090–0.225). Conclusions: C-peptide results generated by different methods and different laboratories do not always agree, especially at higher concentrations of C-peptide. These data support the concept of using a single laboratory for multisite studies and support efforts to harmonize C-peptide measurements by use of calibrators prepared in the sample matrix.

scholarly journals SUN-620 Gender Difference in the Outcome of Patients with Diabetes Admitted for Hyperosmolar Hyperglycemia. from the National Inpatient Sample

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Fatima Ahmed ◽  
Ashraf Abugroun ◽  
Manar Elhassan ◽  
Berhane Seyoum
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Lower Risk ◽  
Female Gender ◽  
Secondary Outcome ◽  
National Inpatient Sample ◽  
Patients With Diabetes ◽  
Hyperosmolar Hyperglycemic State ◽  
The Mean ◽  
The Impact

Abstract Objective: There is paucity of literature on the impact of gender on outcomes of hyperosmolar hyperglycemic state (HHS) among adult patients with diabetes. The aim of this study was to evaluate the effect of gender on the outcome of these patients. Methodology: The National Inpatient Sample (NIS) was queried for all patients who were admitted with a diagnosis of hyperosmolar hyperglycemic state (HHS) during the years 2005-2014. The primary outcomes of the study were all-cause mortality, acute myocardial infarction (MI), and acute stroke. The secondary outcomes were acute kidney injury (AKI), rhabdomyolysis, acute respiratory failure (ARF), need for mechanical ventilation (MV), length of stay (LOS), and total cost of stay. Results: Overall, 188,725 patients were admitted for HHS. Mean age of males was 53.7, standard error of the mean (SEM: 0.13), and of females was 58.5 (SEM: 0.15), p<0.001. Females were (43.9%), Caucasians were 37.4% while African Americans were 35.2%. Total mortality was 1.1%, MI was 1.3% and stroke was 1.1%. Most common secondary outcome was AKI seen in 31.3% followed by ARF seen in 2.9% of total. The mean cost was 7887 $ (SEM: 84.6) and mean LOS was 4.1 days (SEM: 0.03). Both males and females had equivalent rates of mortality, stroke, ARF and need for mechanical ventilation. Compared to males, females had significantly higher risk for MI 1.6% vs 1.1%, p<0.001, lower risk for AKI 29.3% vs 32.9%, p<0.001, lower risk for rhabdomyolysis 1.1% vs 2%, p<0.001 and higher LOS 4.3 vs 3.9 days, p<0..01 and higher total costs 8165.6 $ vs 7669.3 $, p < 0.001. On multivariable analysis, female gender was independently predictive for higher risk for MI with adjusted odds ratio (aOR) 1.34 [95%CI: 1.08-1.67] p=0.01 and lower risk for rhabdomyolysis with aOR 0.52 [95%CI: 0.42-0.63] p<0.001 and lower risk for AKI with aOR 0.74 [95%CI: 0.7-0.78] p<0.001. In addition, female gender correlated with higher cost and length of stay. Conclusion: Females with hyperosmolar hyperglycemic state are at higher risk for MI and lower risk for AKI and rhabdomyolysis.

scholarly journals Oral health care among patients with diabetes in Australia: A snapshot

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Poudel ◽  
R Griffiths ◽  
V W Wong ◽  
A Arora ◽  
J R Flack ◽  
...  
Keyword(s):  
Oral Health ◽  
Health Information ◽  
Diabetes Care ◽  
Health Knowledge ◽  
Dry Mouth ◽  
Care Providers ◽  
Oral Health Knowledge ◽  
Patients With Diabetes ◽  
The Mean ◽  
The Impact

Abstract Background Diabetes increases the risk of periodontal disease, which in turn negatively impact on diabetes control and complications. Therefore, awareness about the diabetes-oral health link and dental problems is important for people with diabetes. This study aimed to assess self-reported oral health status and knowledge of people living with diabetes. Methods A survey was conducted among patients who attended four public diabetes clinics in Sydney, Australia. The questionnaire included 10 knowledge items and a validated Oral Health Impact Profile (OHIP-14) scale. A convenience sample of 200 patients were recruited. The data were analysed using SPSS software with descriptive and Pearson's Chi-Squared tests reported. Results The mean age of participants was 62.4(±13.5) years. More than half were males (54.5%), born overseas (64%), not working (73%) and had type 2 diabetes (88%). More than half (55.1%) of the patients reported having one or more dental problems and this was negatively associated with their oral health-related quality of life (p < 0.001). The most common dental problems were: gaps between teeth, pain in teeth and dry mouth. Only 46.2% of the participants had adequate oral health knowledge (> the mean correct score 5.2 (±2.6). The main areas with poor knowledge were around the impact of gum disease on blood glucose levels (29.6%), effects of dry mouth on tooth decay (33.8%) and the link between diabetes and teeth and gums (44.5%). Only 13% of the patients reported receiving oral health information from diabetes care providers (diabetes educator, general practitioner/diabetes specialist and dietitian/nutritionist). Receiving oral health information was found to be significantly associated with higher oral health knowledge scores (p < 0.05). Conclusions Considering that a majority of patients with diabetes have dental problems and inadequate oral health knowledge, diabetes care providers should take the opportunity to educate patients about oral health risks. Key messages People living with diabetes found to have dental problems and inadequate oral health knowledge. Considering that diabetes and dental problems adversely affect each other, it is crucial to educate patients about good oral hygiene and regular dental visit.

scholarly journals Hypertriglyceridemia and Its Association with HbA1c Test: A ProspectiveIn VivoControlled Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Rene Rodriguez-Gutierrez ◽  
Leonardo G. Mancillas-Adame ◽  
Giselle Rodríguez-Tamez ◽  
Alejandro Diaz Gonzalez-Colmenero ◽  
Ricardo Cesar Solis-Pacheco ◽  
...  
Keyword(s):  
High Performance ◽  
Controlled Study ◽  
Admission Diagnosis ◽  
Acute Elevation ◽  
Patients With Diabetes ◽  
Index Hospital ◽  
The Mean ◽  
Clinically Significant ◽  
The Impact

Background. Hypertriglyceridemia and hyperglycemia coexist in 30-60% of patients with diabetes. The impact of hypertriglyceridemia regarding HbA1c assay reliability remains uncertain. Therefore, we conducted a prospectivein vivocontrolled study with the aim of defining the association between triglyceride levels and HbA1c.Methods. A total of 44 patients with an index-hospital admission diagnosis of diabetic ketoacidosis or hypertriglyceridemia-induced pancreatitis, as a model for acute elevation of triglycerides, were recruited. Blood samples were drawn for the measurement of HbA1c, triglycerides, glucose, and hemoglobin at baseline and subsequently 24 and 48 hours after admission. HbA1c analysis was performed with high-performance liquid chromatography Bio-Rad D10 (NGSP approved).Results. All patients completed the study protocol. A difference between mean triglycerides from day 0 (baseline) to day 2 of 1567.2 mg/dL was observed. We found a difference between mean serum HbA1c from days 0 to 2 of 0.09% [1 mmol/mol] (p=0.004). Moreover, a weak correlation between the mean difference of HbA1c and triglycerides from baseline to day 2 was found to be statistically significant (r=0.256,p=0.015). None of these findings, however, are clinically significant.Conclusion. Triglycerides do not impair the interpretation of HbA1c assay. Patients and clinicians can now be confident that hypertriglyceridemia is not an important factor when interpreting HbA1c results.

scholarly journals Impact of a “Pharmacist First” innovative workflow plan in patients with hypertension and/or diabetes

2021 ◽  
pp. 171516352110164
Author(s):  
Randy So ◽  
Yazid Al Hamarneh ◽  
Carlene Oleksyn ◽  
Mary Purschke ◽  
Ross Tsuyuki
Keyword(s):  
Blood Pressure ◽  
Laboratory Tests ◽  
Primary Outcome ◽  
Control Group ◽  
Workflow Model ◽  
Patients With Diabetes ◽  
The Mean ◽  
The Impact

Usual community pharmacy workflow, whereby patients might see a pharmacist at the end of the dispensing process, is not conducive to proactive patient-centred care. The objective of this study was to evaluate the impact of the “Pharmacist First” (P1st) workflow model on blood pressure and glycemic control in patients with hypertension and/or diabetes. This retrospective review was set in 2 community pharmacies that use the P1st model in the Greater Edmonton Region. The population entailed patients with hypertension and/or type 1 or 2 diabetes who received care via the P1st workflow model. The P1st workflow model places the patient in immediate contact with the pharmacist. The pharmacist first assesses prescription appropriateness, reviews relevant laboratory tests, discusses chronic disease control and addresses any questions or concerns the patient has before passing the prescription to be filled by a technician. This allows issues or concerns to be identified and addressed up front, rather than waiting until the prescription is filled and the patient is ready to leave the pharmacy. The primary outcome assessed in this study was change in blood pressure and/or A1C from baseline to the last follow-up visit. We reviewed 215 patient records. The mean age was 69.4 years (standard deviation 12.5), 51.2% of patients were male, 57.7% had hypertension, 5.6% had diabetes, and 36.7% had both. Median follow-up time was 4.2 months (interquartile range 2.5 -9.3). In 203 patients with hypertension, systolic blood pressure was reduced from 139.83 mmHg to 131.26 mmHg ( p < 0.001) and diastolic blood pressure from 80.26 mmHg to 76.86 mmHg ( p < 0.001). In 87 patients with diabetes, A1C changed from 7.4% to 7.2% ( p = ns). The P1st workflow model demonstrated significant improvements in blood pressure. Further investigation is needed to evaluate the effectiveness of this model with a control group, longer follow-up and evaluation of the patient experience.

scholarly journals The Impact of Serum C-peptide Level on Bone Mineral Density in Postmenopausal Type 2 Diabetic Women.

2019 ◽  
Vol 6 (9) ◽  
pp. 166-172
Author(s):  
Berna İmge Aydoğan ◽  
Adile Begüm Bahçecioğlu Mutlu ◽  
Çağlar Keskin ◽  
Funda Seher Özalp Ateş ◽  
Sevim Güllü
Keyword(s):  
Bone Mineral Density ◽  
Mineral Density ◽  
C Peptide ◽  
Total Hip ◽  
Peptide Level ◽  
Hip Bmd ◽  
The Mean ◽  
The Impact ◽  
Type 2 Diabetic

Objective: Recent studies suggested that c-peptide had biological activity on bone metabolism. We aimed to evaluate the impact of c-peptide level on bone mineral density (BMD) in postmenopausal type 2 diabetic women. Methods: Thirty-five insulin naïve type 2 diabetic postmenopausal women were included in our prospective cohort study. Fasting and random c-peptide, parathyroid hormone (PTH), vitamin D, insulin, alkaline phosphatase level (ALP) levels and BMD were evaluated. Results: The mean age of patients was 61.8±8.56 years. The mean fasting c-peptide, random c-peptide and insulin levels were 3.0±1.24, 7.7±3.7 and 13.9±11.2 µIU/ml, respectively. The mean femoral neck (FN-BMD) and total lumbar spine bone mineral density (L-BMD) were 0.787±0.127 and 0.919±0.122 g/cm2, respectively. C-peptide level was associated with total hip BMD (p<0.05) but this relation disappeared after regression analysis adjusted for confounders. A negative correlation between PTH level and FN-BMD was found (p=0.01). Total hip BMD and L-BMD were negatively correlated with age (p=0.01 and p=0.02, respectively). A positive association between DPP4 inhibitor treatment and total hip BMD was observed (p=0.03). Conclusions: We observed a positive association between total hip BMD and serum c-peptide level. However, this relationship disappeared in multiple linear regression analysis. Further studies are necessary to evaluate the impact of c-peptide level on the risk of osteoporosis in T2DM.

scholarly journals SUN-625 The Impact of Age on Outcomes of Hyperosmolar Hyperglycemia Among Adult Patients with Diabetes. from the National Inpatient Sample

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Fatima Ahmed ◽  
Ashraf Abugroun ◽  
Manar Elhassan ◽  
Berhane Seyoum
Keyword(s):  
Middle Age ◽  
Age Groups ◽  
Adverse Outcomes ◽  
Older Age ◽  
National Inpatient Sample ◽  
Total Cost ◽  
Patients With Diabetes ◽  
The Mean ◽  
Secondary Outcomes ◽  
The Impact

Abstract Objective: There is paucity of literature on the impact of age on outcomes hyperosmolar hyperglycemic state (HHS) among adult patients with diabetes. The aim of the study was to evaluate the effect of age on the outcome of patients admitted for the management of HHS. Methodology: The National Inpatient Sample (NIS) was queried for all patients who were admitted with a diagnosis of HHS during the years 2005-2014. The primary outcomes of the study were all-cause mortality, acute myocardial infarction (MI), and acute stroke. The secondary outcomes were acute kidney injury (AKI), rhabdomyolysis, acute respiratory failure (ARF), need for mechanical ventilation (MV) length of stay (LOS), and total cost of stay. Results: Overall, 188,725 patients were admitted for HHS. Mean age was 55.9, standard error of the mean (SEM): 0.1. Majority were of middle age. Females were (43.9%), Caucasians were 37.4% while African Americans were 35.2%. Total mortality was 1.1%, MI was 1.3% and stroke was 1.1%. Most common secondary outcome was AKI seen in 31.3% followed by ARF seen in 2.9% of total. The mean cost was 7887 $ (SEM: 84.6) and mean LOS was 4.1 days (SEM: 0.03). Young age was defined as age ≤ 35 years, middle age was &gt; 35 and ≤ 65 years, old age was &gt; 65 years. Mortality was 0.3 %, 0.6%, 2.5% in young, middle and older aged groups respectively. Similarly, higher age correlated with increased risk for MI, stroke and all secondary outcomes. On multivariable analysis, age was an independent predictor for all adverse outcomes. Compared to young patients, middle and older age groups had higher odds for mortality with adjusted odds ratio (aOR) 2.23 [95%CI:1.10-4.52], p=0.03 and aOR 7.35 [95%CI: 3.27-16.53], p&lt;0.001 respectively, higher risk for stroke with aOR 9.32 [95%CI: 2.92-29.7], p&lt;0.001 and aOR 17.46 [95%CI:5.23-58.3], p&lt;0.001 and higher risk for MI aOR 5.18 [95%CI:2.15-12.51], p&lt;0.00 and aOR 5.80 [95%CI:2.27-14.80], p&lt;0.00 for middle and older age groups respectively. In addition, compared to the younge age group, the risk for rhabdomyolysis, AKI, ARF, MV, total cost and LOS was significantly higher among middle and older age groups respectively. Conclusion: Age is an important determinant for adverse outcomes among patients with hyperosmolar hyperglycemic sate.

Asteroid and Comet Impact Speeds upon Mars: Significance for Panspermia and the Supply of Organics

1997 ◽  
Vol 161 ◽  
pp. 197-201 ◽  
Author(s):  
Duncan Steel
Keyword(s):  
Probability Distributions ◽  
Regions Of Interest ◽  
Significant Fraction ◽  
Organic Chemicals ◽  
Impact Speed ◽  
The Mean ◽  
The Impact

AbstractWhilst lithopanspermia depends upon massive impacts occurring at a speed above some limit, the intact delivery of organic chemicals or other volatiles to a planet requires the impact speed to be below some other limit such that a significant fraction of that material escapes destruction. Thus the two opposite ends of the impact speed distributions are the regions of interest in the bioastronomical context, whereas much modelling work on impacts delivers, or makes use of, only the mean speed. Here the probability distributions of impact speeds upon Mars are calculated for (i) the orbital distribution of known asteroids; and (ii) the expected distribution of near-parabolic cometary orbits. It is found that cometary impacts are far more likely to eject rocks from Mars (over 99 percent of the cometary impacts are at speeds above 20 km/sec, but at most 5 percent of the asteroidal impacts); paradoxically, the objects impacting at speeds low enough to make organic/volatile survival possible (the asteroids) are those which are depleted in such species.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

A Collaborative Study Designed to Establish the 4th International Standard for Heparin

1984 ◽  
Vol 52 (02) ◽  
pp. 148-153 ◽  
Author(s):  
D P Thomas ◽  
A D Curtis ◽  
T W Barrowcliffe
Keyword(s):  
Collaborative Study ◽  
International Standard ◽  
Thrombin Inhibition ◽  
Freeze Dried ◽  
Assay Methods ◽  
The Mean ◽  
International Collaborative ◽  
International Collaborative Study

SummaryAn international collaborative study, in which 22 laboratories participated, was carried out to establish a replacement for the International Standard for Heparin. A total of 248 assays were analyzed, including APTT, thrombin inhibition and anti-Xa assays, as well as pharmacopoeial assays. Overall, there was less than 5% difference in the mean potency estimates of the candidate preparations, by all assay methods. The freeze-dried preparation 82/502 demonstrated the closest parallelism by bioassay to the existing standard and was established by WHO as the 4th International Standard for Heparin, with an assigned unitage of 1780 i.u. per ampoule.

Percutaneous Coronary Intervention in Patients with Diabetes and Multivessel or Left Main Disease – a Review

2012 ◽  
Vol 7 (1) ◽  
pp. 37
Author(s):  
Donald E Cutlip ◽  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Statistical Significance ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Metal Stents ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Patients With Diabetes ◽  
The Impact

Coronary artery disease in patients with diabetes is frequently a diffuse process with multivessel involvement and is associated with increased risk for myocardial infarction and death. The role of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with diabetes and multivessel disease who require revascularisation has been debated and remains uncertain. The debate has been continued mainly because of the question to what degree an increased risk for in-stent restenosis among patients with diabetes contributes to other late adverse outcomes. This article reviews outcomes from early trials of balloon angioplasty versus CABG through later trials of bare-metal stents versus CABG and more recent data with drug-eluting stents as the comparator. Although not all studies have been powered to show statistical significance, the results have been generally consistent with a mortality benefit for CABG versus PCI, despite differential risks for restenosis with the various PCI approaches. The review also considers the impact of mammary artery grafting of the left anterior descending artery and individual case selection on these results, and proposes an algorithm for selection of patients in whom PCI remains a reasonable strategy.

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