Two-third of the world's population lives in the Asia Pacific region where prevalence of diabetes has reached epidemic proportion.With China and India being the most populous nations on the globe,it is believed th...Two-third of the world's population lives in the Asia Pacific region where prevalence of diabetes has reached epidemic proportion.With China and India being the most populous nations on the globe,it is believed that over 150 million diabetes reside in the region with more than 95%being of type 2 diabetes mellitus(T2DM).Furthermore,other Pacific islands in the region have high rales of T2DM including Tonga.Fiji.French Polynesia,and Nauru.The latter has the highest prevalence of T2DM per population in the world.Over the past two decades,in Australia and New Zealand,the prevalence of T2DM has more than doubled,mainly amongst the Aboriginal and Torres Strait Islander and Maori peoples respectively.With the increasing prevalence of dialietes in the Asia Pacific region coupled with the limited number of resources,use of a reliable and effective mode of diagnosis for T3DVI is warranted.Yet to date,only New Zealand has adopted the American Diabetes Association recommendation of using hemoglobin A1C in the diagnosis of the disease.The aim of this review is to discuss the clinical usefulness of hemoglobin A1C and highlight its diagnostic role in the Asia Pacific region where T2DM is increasingly encountered.展开更多
Background The role of chronic hyperglycaemia as a coronary artery disease （CAD） risk factor is well-known, and the glycemic variability is still a matter of debate. The aim of this study was to investigate the asso...Background The role of chronic hyperglycaemia as a coronary artery disease （CAD） risk factor is well-known, and the glycemic variability is still a matter of debate. The aim of this study was to investigate the association of admission glycemic excursion and hemoglobin Alc （HbA1c） with the presence and severity of CAD in patients with undiagnosed diabetes mellitus （DM）. Methods We studied 286 newly diagnosed DM patients without prior revascularization undergoing coronary angiography for suspected ischaemic chest pain. Patients were grouped into those with CAD and without CAD according to angiographic results. The severity of CAD was assessed using the Gensini score. Glycemic variability, indicated as the mean amplitude of glycemic excursions （MAGE）, was determined by a continuous glucose monitoring system. Serum levels of HbA1c and high-sensitive C-reactive protein （hs-CRP） as well as plasma concentrations of fasting glucose, lipids and creatinine were measured in all patients. Predictors of CAD were determined using multivariate Logistic regression model and receiver-operating characteristic （ROC） curves. Results The newly diagnosed DM patients with CAD were older, and more were male and current cigarette smokers compared with the patients without CAD. The CAD group had significantly higher levels of MAGE and HbA1c. Individuals with high levels of HbA1c （〉7%） or MAGE （〉3.4 mmol/L） had also significantly higher CAD prevalence. Logistic regression analysis revealed that high MAGE level and high HbA1c level were independent predictors for CAD. The area under the receiver-operating characteristic curve for MAGE （0.606, P=0.005） was superior to that for HbA1c （0.582, P=0.028）. Gensini score closely correlated with age, MAGE, HbA^c, hs-CRP, creatinine and total cholesterol. Multivariate analysis indicated that age （P 〈0.001）, MAGE （P 〈0.001）, HbA1c （P=0.022） and hs-CRP （P=0.005） were independent determinants for Gensini score. Conclusions Both admission glycemic excursion and chronic hyperglycaemia are associated with the severity of CAD in newly diagnosed DM patients. MAGE displays a significant value in predicting CAD in patients with undiagnosed diabetes even more than HbA1c.展开更多
Objective To recommend an index named glucose safety control index （GSCI） to evaluate the efficacy and safety for insulin regimens. Data sources We searched databases for primary studies published in English. The ma...Objective To recommend an index named glucose safety control index （GSCI） to evaluate the efficacy and safety for insulin regimens. Data sources We searched databases for primary studies published in English. The main search concepts were type 2 diabetes, insulin treatment, premixed insulin, premixed insulin analogs, basal inuslin, basal inuslin analogs, bolus insulin, bolus insulin analogs, safety and efficacy.展开更多
基金Supported by Australia's James Cook University Faculty Research(Grant No.JCL-ECR 6250-2013)
文摘Two-third of the world's population lives in the Asia Pacific region where prevalence of diabetes has reached epidemic proportion.With China and India being the most populous nations on the globe,it is believed that over 150 million diabetes reside in the region with more than 95%being of type 2 diabetes mellitus(T2DM).Furthermore,other Pacific islands in the region have high rales of T2DM including Tonga.Fiji.French Polynesia,and Nauru.The latter has the highest prevalence of T2DM per population in the world.Over the past two decades,in Australia and New Zealand,the prevalence of T2DM has more than doubled,mainly amongst the Aboriginal and Torres Strait Islander and Maori peoples respectively.With the increasing prevalence of dialietes in the Asia Pacific region coupled with the limited number of resources,use of a reliable and effective mode of diagnosis for T3DVI is warranted.Yet to date,only New Zealand has adopted the American Diabetes Association recommendation of using hemoglobin A1C in the diagnosis of the disease.The aim of this review is to discuss the clinical usefulness of hemoglobin A1C and highlight its diagnostic role in the Asia Pacific region where T2DM is increasingly encountered.
文摘Background The role of chronic hyperglycaemia as a coronary artery disease （CAD） risk factor is well-known, and the glycemic variability is still a matter of debate. The aim of this study was to investigate the association of admission glycemic excursion and hemoglobin Alc （HbA1c） with the presence and severity of CAD in patients with undiagnosed diabetes mellitus （DM）. Methods We studied 286 newly diagnosed DM patients without prior revascularization undergoing coronary angiography for suspected ischaemic chest pain. Patients were grouped into those with CAD and without CAD according to angiographic results. The severity of CAD was assessed using the Gensini score. Glycemic variability, indicated as the mean amplitude of glycemic excursions （MAGE）, was determined by a continuous glucose monitoring system. Serum levels of HbA1c and high-sensitive C-reactive protein （hs-CRP） as well as plasma concentrations of fasting glucose, lipids and creatinine were measured in all patients. Predictors of CAD were determined using multivariate Logistic regression model and receiver-operating characteristic （ROC） curves. Results The newly diagnosed DM patients with CAD were older, and more were male and current cigarette smokers compared with the patients without CAD. The CAD group had significantly higher levels of MAGE and HbA1c. Individuals with high levels of HbA1c （〉7%） or MAGE （〉3.4 mmol/L） had also significantly higher CAD prevalence. Logistic regression analysis revealed that high MAGE level and high HbA1c level were independent predictors for CAD. The area under the receiver-operating characteristic curve for MAGE （0.606, P=0.005） was superior to that for HbA1c （0.582, P=0.028）. Gensini score closely correlated with age, MAGE, HbA^c, hs-CRP, creatinine and total cholesterol. Multivariate analysis indicated that age （P 〈0.001）, MAGE （P 〈0.001）, HbA1c （P=0.022） and hs-CRP （P=0.005） were independent determinants for Gensini score. Conclusions Both admission glycemic excursion and chronic hyperglycaemia are associated with the severity of CAD in newly diagnosed DM patients. MAGE displays a significant value in predicting CAD in patients with undiagnosed diabetes even more than HbA1c.
基金This work was supported by a grant from the National Natural Science Foundation of China （No. 81000334）.
文摘Objective To recommend an index named glucose safety control index （GSCI） to evaluate the efficacy and safety for insulin regimens. Data sources We searched databases for primary studies published in English. The main search concepts were type 2 diabetes, insulin treatment, premixed insulin, premixed insulin analogs, basal inuslin, basal inuslin analogs, bolus insulin, bolus insulin analogs, safety and efficacy.
