Metabolic Control

Sub-Areas to Metabolic Control:

Traditional Medicine (1)

(Journal Article): Genital infections among girls with type 1 diabetes
 
[No indication of authors]
 
IN: Akush Ginekol (Sofiia) 2004; 43(4):21-25

ABSTRACT: The aim of the study was to investigate the relation between genital infections (frequency, etiology, clinical presentation) among girls with type 1 diabetes and some factors as age of the girls, duration and metabolic control of diabetes. Forty-three girls with type 1 diabetes and twelve healthy girls for controls were involved in the study. Methods used are: genital tract inspection, direct microscopy and cultures from genital discharge and urine. Glycaemic control in the diabetic girls was assessed by measuring total glycosylated haemoglobin. The results show vulvovaginal candidiasis in 27 (62.8%) in diabetic girls versus 2 (16.6%) in controls (p < 0.01). There was clear prevalence of non-albicans Candida species. Concomitant infection with bacterial pathogens were proved in only 6 (13.9%) of diabetic girls and 1 (8.5%) of the controls. The clinical presentation of genital candidiasis was vulvovaginitis and most of the affected diabetic girls (88.9%) were in puberty period. There was no relation between duration and metabolic control of diabetes and genital infections.

(Journal Article): Glycaemic control in a type 1 diabetes clinic for younger adults
 
Saunders SA, Wallymahmed M, MacFarlane IA (University Department of Diabetes and Endocrinology, Clinical Sciences Centre, University Hospital Aintree, Liverpool L9 7AL, United Kingdom, simon@simple5.freeserve.co.uk )
 
IN: QJM 2004; 97(9):575-580
Impact Factor(s) of QJM: 2.58 (2004), 2.395 (2003), 2.601 (2001)

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ABSTRACT: BACKGROUND: In the Diabetes Control and Complications Trial (DCCT, 1993) tight diabetes control (HbA1c <7%) was associated with significantly less microvascular complications compared to 'conventionally' treated type 1 patients. AIM: To assess the effectiveness of a dedicated young-adult type 1 diabetes clinic in achieving HbA1c levels <7% between 1991 and 2001. DESIGN: Retrospective review of case-notes. METHODS: All patients who attended the clinic in the first six years (1991 to 1996) were studied. All were offered at least two appointments per year. Case-notes were reviewed up to December 2001. RESULTS: We treated 386 type 1 patients (59.8% male, mean age 28.7 years, mean duration diabetes 9.5 years). After a mean follow-up of 7.7 years, 261 (67.6%) had attended in the past 2 years, 22 (5.8%) were known to have died, 11 (2.8%) had transferred to another clinic and 92 (23.8%) had repeatedly failed to attend appointments for 2 years. Over 11 years, the total mean (SD) HbA1c was 9.19% (1.3). Only 3.4% of patients achieved an average HbA1c of <7% during the study period, and 80% of patients had average HbA1c levels of >8%. DISCUSSION: Despite regular specialist physician, specialist diabetes nurse and dietician input, encouragement of multiple daily insulin injections and repeatedly following-up failed appointments (including home visits), fewer than 1:20 patients achieved the DCCT target of mean HbA1c <7%. Tight diabetes control is rare in a routine clinic setting.

(Journal Article): Lens fluorescence and metabolic control in type 1 diabetic patients: a 14 year follow up study
 
Kessel L, Sander B, Dalgaard P, Larsen M (Department of Ophthalmology, Herlev Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark, line.kessel@dadlnet.dk )
 
IN: Br J Ophthalmol 2004; 88(9):1169-1172
Impact Factor(s) of Br J Ophthalmol: 2.0 (2004), 2.099 (2003), 1.942 (2001)

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ABSTRACT: BACKGROUND/AIMS: In this prospective study the authors followed the post-translational modification of the proteins of the lens of the eye by fluorometry over a period of 14 years in patients with type 1 diabetes mellitus. METHODS: Twenty patients were examined at 6 years (baseline) and 20 years (follow up) after onset of diabetes mellitus. Glycaemic levels were assessed from HbA1c measured at regular intervals from the onset of diabetes mellitus. RESULTS: Lens fluorescence at follow up was significantly related to mean HbA1c during the study period and to lens fluorescence at baseline (p<0.0001). Sixty per cent of the variation in rate of increase in lens fluorescence during the study period was statistically attributable to glycaemia levels. CONCLUSION: The results confirm that the rate of fluorophore accumulation in the lens of adult diabetic patients is increased in proportion to glycaemic control. This parameter alone is, however, not sufficient to explain the entire variation in lens fluorophore accumulation. Consequently, lens fluorescence must be influenced by other factors before initiation and during the study period, and possibly even before onset of diabetes mellitus. The underlying mechanism could be a variation in susceptibility to lens protein denaturation by glycation.

(Journal Article): "Low Dose" Metformin Improves Hyperglycemia Better Than Acarbose in Type 2 Diabetics
 
Yajima K, Shimada A, Hirose H, Kasuga A, Saruta T (Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan, asmd(at)st.itc.keio.ac.jp )
 
IN: Rev Diabetic Stud 2004; 1(2):89-94
Impact Factor(s) of Rev Diabetic Stud: 0.125 (2006)

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ABSTRACT: OBJECTIVES: "High dose" metformin therapy (2,550 mg/day) is reported to improve glycemic control in type 2 diabetic patients with obesity (body mass index (BMI) >= 30). Some have reported that metformin therapy, even in low doses (500-750 mg/day), improves glycemic control in non-obese type 2 diabetic patients (BMI approximately 25). However, it is unclear whether "low dose" metformin improves glycemic control better than acarbose in non-obese type 2 diabetic patients, which has been shown to improve glycemic control in type 2 diabetes with obesity. METHODS: We randomly divided 22 non-obese type 2 diabetic patients (mean BMI approximately 25) into two groups (A=11, B=11). Group A was treated with "low dose" metformin (500-750 mg/day) for 3 months, and switched to acarbose (150-300 mg/day) for another 3 months. Group B was treated with acarbose first, and then switched to "low dose" metformin. RESULTS: "Low dose" metformin significantly decreased the fasting plasma glucose (FPG) and HbA1c level in both groups A and B, whereas acarbose decreased HbA1c levels in group B but not in group A. Overall, "low dose" metformin significantly decreased HbA1c (p=0.0165) levels as compared to acarbose. CONCLUSION: In conclusion, "low dose" metformin therapy improved glycemic control better than acarbose in non-obese diabetics.

TYPE OF PUBLICATION: Original article

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