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Complications
Glycated Albumin Is a More Useful Glycation Index than HbA1c for Reflecting Renal Tubulopathy in Subjects with Early Diabetic Kidney Disease
Ji Hye Huh, Minyoung Lee, So Young Park, Jae Hyeon Kim, Byung-Wan Lee
Diabetes Metab J. 2018;42(3):215-223.   Published online May 2, 2018
DOI: https://doi.org/10.4093/dmj.2017.0091
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  • 52 Download
  • 9 Web of Science
  • 10 Crossref
AbstractAbstract PDFPubReader   
Background

The aim of this study was to investigate which glycemic parameters better reflect urinary N-acetyl-β-D-glucosaminidase (uNAG) abnormality, a marker for renal tubulopathy, in subjects with type 2 diabetes mellitus (T2DM) subjects with normoalbuminuria and a normal estimated glomerular filtration rate (eGFR).

Methods

We classified 1,061 participants with T2DM into two groups according to uNAG level—normal vs. high (>5.8 U/g creatinine)—and measured their biochemical parameters.

Results

Subjects with high uNAG level had significantly higher levels of fasting and stimulated glucose, glycated albumin (GA), and glycosylated hemoglobin (HbA1c) and lower levels of homeostasis model assessment of β-cell compared with subjects with normal uNAG level. Multiple linear regression analyses showed that uNAG was significantly associated with GA (standardized β coefficient [β]=0.213, P=0.016), but not with HbA1c (β=−0.137, P=0.096) or stimulated glucose (β=0.095, P=0.140) after adjusting confounding factors. In receiver operating characteristic analysis, the value of the area under the curve (AUC) for renal tubular injury of GA was significantly higher (AUC=0.634; 95% confidence interval [CI], 0.646 to 0.899) than those for HbA1c (AUC=0.598; 95% CI, 0.553 to 0.640), stimulated glucose (AUC=0.594; 95% CI, 0.552 to 0.636), or fasting glucose (AUC=0.558; 95% CI, 0.515 to 0.600). The optimal GA cutoff point for renal tubular damage was 17.55% (sensitivity 59%, specificity 62%).

Conclusion

GA is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with T2DM with normoalbuminuria and normal eGFR.

Citations

Citations to this article as recorded by  
  • Glucagon-Like Peptide 1 Receptor Agonist Improves Renal Tubular Damage in Mice with Diabetic Kidney Disease
    Ran Li, Dunmin She, Zhengqin Ye, Ping Fang, Guannan Zong, Yong Zhao, Kerong Hu, Liya Zhang, Sha Lei, Keqin Zhang, Ying Xue
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 1331.     CrossRef
  • Use of glycated albumin for the identification of diabetes in subjects from northeast China
    Guo-Yan Li, Hao-Yu Li, Qiang Li
    World Journal of Diabetes.2021; 12(2): 149.     CrossRef
  • Diabetic Kidney Disease, Cardiovascular Disease and Non-Alcoholic Fatty Liver Disease: A New Triumvirate?
    Carolina M. Perdomo, Nuria Garcia-Fernandez, Javier Escalada
    Journal of Clinical Medicine.2021; 10(9): 2040.     CrossRef
  • Empagliflozin reduces high glucose-induced oxidative stress and miR-21-dependent TRAF3IP2 induction and RECK suppression, and inhibits human renal proximal tubular epithelial cell migration and epithelial-to-mesenchymal transition
    Nitin A. Das, Andrea J. Carpenter, Anthony Belenchia, Annayya R. Aroor, Makoto Noda, Ulrich Siebenlist, Bysani Chandrasekar, Vincent G. DeMarco
    Cellular Signalling.2020; 68: 109506.     CrossRef
  • Glycated Plasma Proteins as More Sensitive Markers for Glycemic Control in Type 1 Diabetes
    Lina Zhang, Qibin Zhang
    PROTEOMICS – Clinical Applications.2020;[Epub]     CrossRef
  • Glycated albumin and its variability: Clinical significance, research progress and overall review
    Dongjun Dai, Yifei Mo, Jian Zhou
    Obesity Medicine.2020; 19: 100256.     CrossRef
  • Hepatic fibrosis is associated with total proteinuria in Korean patients with type 2 diabetes
    Eugene Han, Yongin Cho, Kyung-won Kim, Yong-ho Lee, Eun Seok Kang, Bong-Soo Cha, Byung-wan Lee
    Medicine.2020; 99(33): e21038.     CrossRef
  • Increasing waist circumference is associated with decreased levels of glycated albumin
    Yiting Xu, Xiaojing Ma, Yun Shen, Yufei Wang, Jian Zhou, Yuqian Bao
    Clinica Chimica Acta.2019; 495: 118.     CrossRef
  • Glucometabolic characteristics and higher vascular complication risk in Korean patients with type 2 diabetes with non-albumin proteinuria
    Yongin Cho, Yong-ho Lee, Eun Seok Kang, Bong-soo Cha, Byung-wan Lee
    Journal of Diabetes and its Complications.2019; 33(8): 585.     CrossRef
  • Association of urinary acidification function with the progression of diabetic kidney disease in patients with type 2 diabetes
    Huanhuan Zhu, Xi Liu, Chengning Zhang, Qing Li, Xiaofei An, Simeng Liu, Lin Wu, Bo Zhang, Yanggang Yuan, Changying Xing
    Journal of Diabetes and its Complications.2019; 33(11): 107419.     CrossRef
Clinical Care/Education
Improvement of Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus under Insulin Treatment by Reimbursement for Self-Monitoring of Blood Glucose
Young Shin Song, Bo Kyung Koo, Sang Wan Kim, Ka Hee Yi, Kichul Shin, Min Kyong Moon
Diabetes Metab J. 2018;42(1):28-42.   Published online September 28, 2017
DOI: https://doi.org/10.4093/dmj.2018.42.1.28
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  • 5 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy.

Methods

Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up <7%.

Results

HbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P<0.001) in all the study subjects (n=409). Among them, 35.5% (n=145) showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (P<0.001), fasting C-peptide (P=0.016), and daily dose of insulin/body weight (P=0.024) showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022).

Conclusion

The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.

Citations

Citations to this article as recorded by  
  • Immunogenicity and Efficacy of Insulin Glargine Biosimilar Ezelin versus Originator Insulin Glargine in Patients with Type 2 Diabetes
    Tri Juli Edi Tarigan, Adisti Dwijayanti, Susie Setyowati, Melva Louisa
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 107.     CrossRef
  • Insulin Glargine U100 Utilization in Patients with Type 2 Diabetes in an Italian Real-World Setting: A Retrospective Study
    Luca Degli Esposti, Valentina Perrone, Stefania Saragoni, Valerio Blini, Stefano Buda, Rosella D’avella, Gina Gasperini, Fabio Lena, Francesca Fanelli, Luca Gazzi, Francesco Giorgino
    Journal of Diabetes Research.2019; 2019: 1.     CrossRef
  • Self-Monitoring of Blood Glucose in Patients with Insulin-Treated Type 2 Diabetes Mellitus
    Kyung-Soo Kim
    Diabetes & Metabolism Journal.2018; 42(1): 26.     CrossRef
Clinical Care/Education
Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
Hun-Sung Kim, Hyunah Kim, Hae-Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong-Yun Cha
Diabetes Metab J. 2017;41(3):187-194.   Published online May 12, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.3.187
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AbstractAbstract PDFPubReader   
Background

When patients with diabetes mellitus (DM) are first referred to a hospital from primary health care clinics, physicians have to decide whether to administer an oral hypoglycemic agent (OHA) immediately or postpone a medication change in favor of diabetes education regarding diet or exercise. The aim of this study was to determine the effect of diabetes education alone (without alterations in diabetes medication) on blood glucose levels.

Methods

The study was conducted between January 2009 and December 2013 and included patients with DM. The glycosylated hemoglobin (HbA1c) levels were evaluated at the first visit and after 3 months. During the first medical examination, a designated doctor also conducted a diabetes education session that mainly covered dietary management.

Results

Patients were divided into those who received no diabetic medications (n=66) and those who received an OHA (n=124). Education resulted in a marked decrease in HbA1c levels in the OHA group among patients who had DM for <1 year (from 7.0%±1.3% to 6.6%±0.9%, P=0.0092) and for 1 to 5 years (from 7.5%±1.8% to 6.9%±1.1%, P=0.0091). Those with DM >10 years showed a slightly lower HbA1c target achievement rate of <6.5% (odds ratio, 0.089; P=0.0024).

Conclusion

For patients who had DM for more than 5 years, higher doses or changes in medication were more effective than intensive active education. Therefore, individualized and customized education are needed for these patients. For patients with a shorter duration of DM, it may be more effective to provide initial intensive education for diabetes before prescribing medicines, such as OHAs.

Citations

Citations to this article as recorded by  
  • Management Status of Patients with Type 2 Diabetes Mellitus at General Hospitals in Korea: A 5-Year Follow-Up Study
    Jin Hee Jung, Jung Hwa Lee, Hyang Mi Jang, Young Na, Hee Sun Choi, Yeon Hee Lee, Yang Gyo Kang, Na Rae Kim, Jeong Rim Lee, Bok Rye Song, Kang Hee Sim
    The Journal of Korean Diabetes.2022; 23(1): 64.     CrossRef
  • Effect of Voluntary Participation on Mobile Health Care in Diabetes Management: Randomized Controlled Open-Label Trial
    Da Young Lee, Seung-Hyun Yoo, Kyong Pil Min, Cheol-Young Park
    JMIR mHealth and uHealth.2020; 8(9): e19153.     CrossRef
  • Developing a multi-center clinical data mart of ACEI and ARB for real-world evidence (RWE)
    Hun-Sung Kim, Sue Hyun Lee, Tong Min Kim, Ju Han Kim
    Clinical Hypertension.2018;[Epub]     CrossRef
Clinical Care/Education
Diabetes Camp as Continuing Education for Diabetes Self-Management in Middle-Aged and Elderly People with Type 2 Diabetes Mellitus
So Young Park, Sun Young Kim, Hye Mi Lee, Kyu Yeon Hur, Jae Hyeon Kim, Moon-Kyu Lee, Kang-Hee Sim, Sang-Man Jin
Diabetes Metab J. 2017;41(2):99-112.   Published online March 3, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.2.99
  • 4,129 View
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  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Despite the established benefits of diabetes camps for the continuing education of children with type 1 diabetes mellitus, little is known about the long-term metabolic benefits of diabetes camps for middle-aged and elderly people with type 2 diabetes mellitus (T2DM), especially in terms of glycosylated hemoglobin (HbA1c) variability.

Methods

The 1-year mean and variability of HbA1c before and after the diabetes camp was compared between the participants of the diabetes camp (n=57; median age 65 years [range, 50 to 86 years]; median diabetes duration 14 years [range, 1 to 48 years]). Additional case-control analysis compared the metabolic outcomes of the participants of the diabetes camp and their propensity score-matched controls who underwent conventional diabetes education (n=93).

Results

The levels of HbA1c during the first year after the diabetes camp were comparable to those of the matched controls (P=0.341). In an analysis of all participants of the diabetes camp, the 1-year mean±standard deviation (SD) of HbA1c decreased (P=0.010 and P=0.041) after the diabetes camp, whereas the adjusted SD and coefficient of variance (CV) of HbA1c did not decrease. The adjusted SD and CV significantly decreased after the diabetes camp in participants whose 1-year mean HbA1c was ≥6.5% before the diabetes camp (n=40) and those with a duration of diabetes less than 15 years (n=32).

Conclusion

The 1-year mean and SD of HbA1c decreased after the diabetes camp, with significant reduction in the adjusted SD and CV in those with higher baseline HbA1c and a shorter duration of diabetes.

Citations

Citations to this article as recorded by  
  • Older adults’ experiences of being at a senior summer camp—A phenomenographic study
    Veronika Wallroth, Kjerstin Larsson, Agneta Schröder
    Qualitative Social Work.2022; 21(5): 956.     CrossRef
  • Pushing for miracles, pulling away from risk: An ethnographic analysis of the force dynamics at Senior Summer Camps in Sweden
    Gabriella Nilsson, Lisa Ekstam, Janicke Andersson
    Journal of Aging Studies.2018; 47: 96.     CrossRef
Clinical Care/Education
Practical Focus on American Diabetes Association/European Association for the Study of Diabetes Consensus Algorithm in Patients with Type 2 Diabetes Mellitus: Timely Insulin Initiation and Titration (Iran-AFECT)
Mohammad Ebrahim Khamseh, Gholamreza Yousefzadeh, Zahra Banazadeh, Sahar Ghareh
Diabetes Metab J. 2017;41(1):31-37.   Published online October 25, 2016
DOI: https://doi.org/10.4093/dmj.2017.41.1.31
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AbstractAbstract PDFPubReader   
Background

The aim of this study was to evaluate the safety and effectiveness of insulin glargine in a large population from a variety of clinical care in Iranian people with type 2 diabetes mellitus (T2DM) and to measure the percentage of patients achieving glycosylated hemoglobin (HbA1c) <7% by the end of 24 weeks of treatment in routine clinical practice.

Methods

This study was a 24 week, observational study of patients with T2DM, for whom the physician had decided to initiate or to switch to insulin glargine. The safety and efficacy of glargine were assessed at baseline and at week 24.

Results

Seven hundred and twenty-five people with T2DM (63% female) including both insulin naïve and prior insulin users were recruited in this study. The mean age of the participants was 54.2±11.2 years, and the mean HbA1c level was 8.88%±0.93% at baseline. By the end of the study, 27% of the entire participants reached to HbA1c target of less than 7% and 52% had HbA1c ≤7.5%. No serious adverse event was reported in this study. Furthermore, overall hypoglycemia did not increase in prior insulin users and the entire cohort. In addition, body weight did not change in participants while lipid profile improved significantly.

Conclusion

Treatment with insulin glargine could improve glycemic control without increasing the risk of hypoglycemic events in people with T2DM. In addition, a significant clinical improvement was observed in lipid profile.

Brief Report
Epidemiology
Glycosylated Hemoglobin Threshold for Predicting Diabetes and Prediabetes from the Fifth Korea National Health and Nutrition Examination Survey
Sangmo Hong, Jun Goo Kang, Chul Sik Kim, Seong Jin Lee, Cheol-Young Park, Chang Beom Lee, Sung-Hee Ihm
Diabetes Metab J. 2016;40(2):167-170.   Published online April 5, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.2.167
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AbstractAbstract PDFPubReader   

We aimed to estimate the threshold level of glycosylated hemoglobin (HbA1c) for the fasting plasma glucose of 100 and 126 mg/dL in the Korean adult population, using the 2011 Korea National Health and Nutrition Examination Survey. A total of 4,481 participants over 19 years of age without diabetic medications and conditions to influence the interpretation of HbA1c levels, such as anemia, renal insufficiency, liver cirrhosis, and cancers, were analyzed. A point-wise area under the receiver operating characteristic curve was used to estimate the optimal HbA1c cutoff value. A HbA1c threshold of 6.35% was optimal for predicting diabetes with a sensitivity of 86.9% and a specificity of 99.1%. Furthermore, the threshold of HbA1c was 5.65% for prediabetes, with a sensitivity of 69.3% and a specificity of 71%. Further prospective studies are needed to evaluate the HbA1c cutoff point for diagnosing prediabetes and diabetes in the Korean population.

Citations

Citations to this article as recorded by  
  • The Cutoff Value of HbA1c in Predicting Diabetes and Impaired Fasting Glucose
    Seyoung Kwon, Youngak Na
    The Korean Journal of Clinical Laboratory Science.2017; 49(2): 114.     CrossRef
  • Cutoff Point of HbA1c for Diagnosis of Diabetes Mellitus in Chinese Individuals
    Bing Wang, Ming-Chuan Liu, Xin-Yu Li, Xu-Han Liu, Qiu-Xia Feng, Lu Lu, Zhu Zhu, Ying-Shu Liu, Wei Zhao, Zheng-Nan Gao, Noel Christopher Barengo
    PLOS ONE.2016; 11(11): e0166597.     CrossRef
Original Articles
The Association of Serum Cystatin C with Glycosylated Hemoglobin in Korean Adults
Eun Hee Sim, Hye Won Lee, Hyun Ju Choi, Dong Wook Jeong, Seok Man Son, Yang Ho Kang
Diabetes Metab J. 2016;40(1):62-69.   Published online November 27, 2015
DOI: https://doi.org/10.4093/dmj.2016.40.1.62
  • 3,254 View
  • 32 Download
  • 6 Web of Science
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AbstractAbstract PDFPubReader   
Background

Cystatin C has been known to be associated not only with early renal impairment but also with the incidence of diabetic conditions (prediabetes plus diabetes). However, it is not clear whether cystatin C levels are associated with the prevalence of diabetic conditions in Asian populations. We evaluated this association using glycosylated hemoglobin (HbA1c) levels as the definition of diabetes in Korean adults.

Methods

We analyzed data from 1,559 Korean adults (937 men and 622 women) with available serum cystatin C and HbA1c values.

Results

The serum cystatin C levels in subjects with prediabetes and diabetes were significantly increased (0.91±0.14 mg/L in prediabetes and 0.91±0.17 mg/L in diabetes vs. 0.88±0.13 mg/L in patients with normal glucose levels, P=0.001). At increasing cystatin C levels, the prevalence of subjects with prediabetes (30.2% vs. 14.6%, P<0.001) and those with diabetes (10.6% vs. 8.0%, P<0.001) significantly increased in the group with the highest cystatin C levels. The group with the highest cystatin C levels had a significantly increased odds ratio (OR) for the presence of diabetic conditions compared to the group with the lowest values in total subjects (OR, 2.35; 95% confidence interval [CI], 1.54 to 3.58; P<0.001) and in women (OR, 4.13; 95% CI, 1.97 to 8.65; P<0.001), though there was no significant increase after adjusting for multiple variables.

Conclusions

Higher levels of serum cystatin C are associated with an increased prevalence of diabetic conditions in Korean adults. Our findings may extend the positive association of cystatin C with diabetes incidence to an Asian population.

Citations

Citations to this article as recorded by  
  • Prognostic significance of serum cystatin C in acute brainstem infarctions patients
    H. Li, B. Zhang, Z. Huang, H. Wu, B. Qin, L. Zhou, Z. Lu, F. Qin
    Revue Neurologique.2024;[Epub]     CrossRef
  • Cardiovascular risk assessment in prediabetic patients in a hypertensive population: The role of cystatin C
    Rafael Garcia-Carretero, Luis Vigil-Medina, Inmaculada Mora-Jimenez, Cristina Soguero-Ruiz, Rebeca Goya-Esteban, Javier Ramos-Lopez, Oscar Barquero-Perez
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2018; 12(5): 625.     CrossRef
  • Characteristics of Dapagliflozin Responders: A Longitudinal, Prospective, Nationwide Dapagliflozin Surveillance Study in Korea
    Eugene Han, Ari Kim, Sung Jae Lee, Je-Yon Kim, Jae Hyeon Kim, Woo Je Lee, Byung-Wan Lee
    Diabetes Therapy.2018; 9(4): 1689.     CrossRef
  • Cystatin C as a Predictor for Diabetes according to Glycosylated Hemoglobin Levels in Korean Patients
    Eon Ju Jeon, Ji Hyun Lee
    Diabetes & Metabolism Journal.2016; 40(1): 32.     CrossRef
  • Prevalence of Reduced Kidney Function by Estimated Glomerular Filtration Rate Using an Equation Based on Creatinine and Cystatin C in Metabolic Syndrome and Its Components in Korean Adults
    Yang Ho Kang, Dong Wook Jeong, Seok Man Son
    Endocrinology and Metabolism.2016; 31(3): 446.     CrossRef
  • Letter: The Association of Serum Cystatin C with Glycosylated Hemoglobin in Korean Adults (Diabetes Metab J 2016;40:62-9)
    Kyung-Soo Kim
    Diabetes & Metabolism Journal.2016; 40(2): 171.     CrossRef
  • Response: The Association of Serum Cystatin C with Glycosylated Hemoglobin in Korean Adults (Diabetes Metab J 2016;40:62-9)
    Yang Ho Kang
    Diabetes & Metabolism Journal.2016; 40(2): 173.     CrossRef
Obesity and Metabolic Syndrome
The Usefulness of the Glycosylated Hemoglobin Level for the Diagnosis of Gestational Diabetes Mellitus in the Korean Population
Ah Jeong Ryu, Hyuk Jin Moon, Joo Ok Na, Yeo Joo Kim, Sang Jin Kim, Sang Il Mo, Jeong Ran Byun
Diabetes Metab J. 2015;39(6):507-511.   Published online November 23, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.6.507
  • 3,439 View
  • 34 Download
  • 12 Web of Science
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AbstractAbstract PDFPubReader   
Background

An oral glucose tolerance test (OGTT) is the current method used for screening and diagnosis of gestational diabetes mellitus (GDM). OGTT is a relatively complicated procedure and is expensive. Thus, new strategies that do not require fasting or more than a single blood draw may improve the diagnosis of GDM and increase the rate of GDM testing. We investigated the utility of monitoring glycosylated hemoglobin (HbA1c) levels for the diagnosis of GDM.

Methods

The data from 992 pregnant women with estimated gestational ages ranging from 24 to 28 weeks were retrospectively reviewed. There were 367 women with plasma glucose levels ≥140 mg/dL 1 hour after a 50-g OGTT. GDM was diagnosed according to the Carpenter-Coustan criteria for a 3-hour 100 g OGTT. A HbA1c assessment was performed at the same time.

Results

We enrolled 343 women in this study, and there were 109 women with GDM. The area under the curve the receiver operating characteristic curve for HbA1c detection of GDM was 0.852 (95% confidence interval, 0.808 to 0.897). A HbA1c cutoff value ≥5.35% had maximal points on the Youden index (0.581). The sensitivity was 87.2% and the specificity was 70.9% for diagnosing GDM. A threshold value ≥5.35% indicated that 163 patients had GDM and that 68 (41.7%) were false positive. The positive predictive value was 58.3% at this threshold value.

Conclusion

Despite substantial progress in methodology, HbA1c values cannot replace OGTT for the diagnosis of GDM.

Citations

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  • Predelivery HbA1c levels and their relationship with adverse perinatal outcomes in women with normal 75-g OGTT
    Xiaoxia Tang, Jin Wei, Zifeng Jiang, Shaohua Wu
    Archives of Gynecology and Obstetrics.2023;[Epub]     CrossRef
  • The diagnostic value of glycosylated hemoglobin for gestational diabetes mellitus in Asian populations: A systematic review and meta‐analysis
    Jiani Zhang, Fan Zhou, Tingting Xu, Jinfeng Xu, Yaqian Li, Li Lin, Qi Cao, Xiaodong Wang
    Journal of Obstetrics and Gynaecology Research.2022; 48(4): 902.     CrossRef
  • The role of first-trimester HbA1c in the early detection of gestational diabetes
    Mehrnaz Valadan, Zeinab Bahramnezhad, Fatemeh Golshahi, Elham Feizabad
    BMC Pregnancy and Childbirth.2022;[Epub]     CrossRef
  • Glycaemic Variability and Risk Factors of Pregnant Women with and without Gestational Diabetes Mellitus Measured by Continuous Glucose Monitoring
    Martina Gáborová, Viera Doničová, Ivana Bačová, Mária Pallayová, Martin Bona, Igor Peregrim, Soňa Grešová, Judita Štimmelová, Barbora Dzugasová, Lenka Šalamonová Blichová, Viliam Donič
    International Journal of Environmental Research and Public Health.2021; 18(7): 3402.     CrossRef
  • A Review on Research Progress in the Application of Glycosylated Hemoglobin and Glycated Albumin in the Screening and Monitoring of Gestational Diabetes
    Xinyan Liu, Na Wu, Abdulrahman Al-Mureish
    International Journal of General Medicine.2021; Volume 14: 1155.     CrossRef
  • Evaluation of the Combination of HbA1C with Hematocrit for Early Screening of Gestational Diabetes Mellitus
    Ali Reza Norouzi, Mahsa Siavashi, Fatemeh Norouzi, Maryam Talayeh, Somayyeh Noei Teymoordash
    Journal of Obstetrics, Gynecology and Cancer Research.2021; 6(4): 217.     CrossRef
  • The accuracy of haemoglobin A1c as a screening and diagnostic test for gestational diabetes: a systematic review and meta-analysis of test accuracy studies
    Chiamaka Esther Amaefule, Archana Sasitharan, Princee Kalra, Stamatina Iliodromoti, Mohammed S.B. Huda, Ewelina Rogozinska, Javier Zamora, Shakila Thangaratinam
    Current Opinion in Obstetrics & Gynecology.2020; 32(5): 322.     CrossRef
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    Na Han, Hai-Yan Fang, Jie-Xuan Jiang, Qian Xu
    American Journal of Physiology-Endocrinology and Metabolism.2020; 318(5): E723.     CrossRef
  • Reliability of glycosylated hemoglobin in the diagnosis of gestational diabetes mellitus
    Duria A. Rayis, Abdel B. A. Ahmed, Manal E. Sharif, Amir ElSouli, Ishag Adam
    Journal of Clinical Laboratory Analysis.2020;[Epub]     CrossRef
  • Mid‐trimester glycosylated hemoglobin levels (HbA1c) and its correlation with oral glucose tolerance test (World Health Organization 1999)
    Devanshi Dubey, Shipra Kunwar, Uma Gupta
    Journal of Obstetrics and Gynaecology Research.2019; 45(4): 817.     CrossRef
  • The utility of HbA1c combined with haematocrit for early screening of gestational diabetes mellitus
    Kui Wu, Yan Cheng, Tingting Li, Ziwen Ma, Junxiu Liu, Qingying Zhang, Haidong Cheng
    Diabetology & Metabolic Syndrome.2018;[Epub]     CrossRef
  • The Cutoff Value of HbA1c in Predicting Diabetes and Impaired Fasting Glucose
    Seyoung Kwon, Youngak Na
    The Korean Journal of Clinical Laboratory Science.2017; 49(2): 114.     CrossRef
  • Diagnosing gestational diabetes mellitus: implications of recent changes in diagnostic criteria and role of glycated haemoglobin (HbA1c)
    Fahmy W Hanna, Christopher J Duff, Ann Shelley-Hitchen, Ellen Hodgson, Anthony A Fryer
    Clinical Medicine.2017; 17(2): 108.     CrossRef
  • Utility of Glycated Haemoglobin in Gestational Diabetes Mellitus: Present and Future
    Rajesh Rajput, Deepak Jain
    EMJ Diabetes.2016; : 84.     CrossRef
Review
The Optimal Cutoff Value of Glycated Hemoglobin for Detection of Diabetic Retinopathy
Jung Min Kim, Dong-Jun Kim
Diabetes Metab J. 2015;39(1):16-26.   Published online February 16, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.1.16
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AbstractAbstract PDFPubReader   

With standardization of measurement of glycated hemoglobin (A1C), the International Expert Committee Report in 2009 and the American Diabetes Association in 2010 recommended incorporating A1C ≥6.5% into the previous diagnostic criteria using fasting plasma glucose and/or 2-hour plasma glucose. Whereas the association of A1C with cardiovascular diseases and other diabetic microvascular complications was linear without evidence of a distinct threshold, several studies suggested a threshold value for A1C in diabetic retinopathy (DR). In studies about the optimal cutoff value for A1C in DR, the A1C values range from 5.2% to 7.8%. There are several possible reasons why these values for DR differ so widely (differences in the definition and/or methods for DR, variation in statistical methods, differences in study population, differences in exclusion criteria, and difference in methods for measuring A1C). With these wide variations in the study method, drawing a conclusive cutoff value for A1C in DR is impossible. In published studies, the cutoff values for moderate or severe DR were higher than those for any or mild DR (6.4% to 7.0% vs. 5.5% to 6.5%).

Citations

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  • What Difference Does a Diagnosis Make?
    Mattan Alalouf, Sarah Miller, Laura R. Wherry
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Original Articles
The Glycated Albumin to Glycated Hemoglobin Ratio Might Not Be Associated with Carotid Atherosclerosis in Patients with Type 1 Diabetes
Wonjin Kim, Kwang Joon Kim, Byung-Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
Diabetes Metab J. 2014;38(6):456-463.   Published online December 15, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.6.456
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AbstractAbstract PDFPubReader   
Background

The ratio of glycated albumin to glycated hemoglobin (GA/A1c) is known to be elevated in subjects with type 2 diabetes mellitus (T2DM) who had decreased insulin secretion. Additionally, the carotid intima media thickness (IMT) is greater in T2DM patients with higher GA/A1c ratios. We investigated whether increased GA/A1c ratio and IMT are also associated in type 1 diabetes mellitus (T1DM), which is characterized by lack of insulin secretory capacity.

Methods

In this cross-sectional study, we recruited 81 T1DM patients (33 men, 48 women; mean age 44.1±13.0 years) who underwent carotid IMT, GA, and HbA1c measurements.

Results

The mean GA/A1c ratio was 2.90. Based on these results, we classified the subjects into two groups: group I (GA/A1c ratio <2.90, n=36) and group II (GA/A1c ratio ≥2.90, n=45). Compared with group I, the body mass indexes (BMIs), waist circumferences, and IMTs were lower in group II. GA/A1c ratio was negatively correlated with BMI, urine albumin to creatinine ratio (P<0.001 for both), and both the mean and maximal IMT (P=0.001, both). However, after adjusting the confounding factors, we observed that IMT was no longer associated with GA/A1c ratio.

Conclusion

In contrast to T2DM, IMT was not significantly related to GA/A1c ratio in the subjects with T1DM. This suggests that the correlations between GA/A1c ratio and the parameters known to be associated with atherosclerosis in T2DM could be manifested differently in T1DM. Further studies are needed to investigate these relationships in T1DM.

Citations

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  • Glycated Albumin and Glycated Albumin/HbA1c Predict the Progression of Coronavirus Disease 2019 from Mild to Severe Disease in Korean Patients with Type 2 Diabetes
    Jeongseon Yoo, Youngah Choi, Shin Ae Park, Ji Yeon Seo, Chul Woo Ahn, Jaehyun Han
    Journal of Clinical Medicine.2022; 11(9): 2327.     CrossRef
  • Variability in glycated albumin levels predicts the progression of diabetic nephropathy
    Su Bin Park, Sang Soo Kim, In Joo Kim, Yoon Jeong Nam, Kang Hee Ahn, Jong Ho Kim, Yun Kyung Jeon, Bo Hyun Kim, Sang Heon Song, Ihm Soo Kwak, Eun Kyung Lee, Yong Ki Kim
    Journal of Diabetes and its Complications.2017; 31(6): 1041.     CrossRef
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  • Determinants of Preclinical Atherosclerosis Are Different in Type 1 and Type 2 Diabetic Women
    P. PIŤHOVÁ, K. ŠTECHOVÁ, J. PIŤHA, V. LÁNSKÁ, M. KVAPIL
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  • Characteristics Predictive for a Successful Switch from Insulin Analogue Therapy to Oral Hypoglycemic Agents in Patients with Type 2 Diabetes
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  • Glycated albumin and the risk of micro- and macrovascular complications in subjects with Type 1 Diabetes
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  • Glycated Albumin Levels in Patients with Type 2 Diabetes Increase Relative to HbA1cwith Time
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Effectiveness of 3-Day Continuous Glucose Monitoring for Improving Glucose Control in Type 2 Diabetic Patients in Clinical Practice
Soo Kyoung Kim, Hye Jeong Kim, Taehun Kim, Kyu Yeon Hur, Sun Wook Kim, Moon-Kyu Lee, Yong-Ki Min, Kwang-Won Kim, Jae Hoon Chung, Jae Hyeon Kim
Diabetes Metab J. 2014;38(6):449-455.   Published online December 15, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.6.449
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AbstractAbstract PDFPubReader   
Background

The aim of this study was to investigate whether adjusting diabetic treatment regimens according to the information obtained from a continuous glucose monitoring system (CGMS) might lead to improved glycemic control in patients with type 2 diabetes.

Methods

We reviewed the medical charts of 172 patients who used the CGMS for 1 year starting in December 2008 and the records of 1,500 patients who visited their regular outpatient clinics during December 2008. Of these patients, a total of 65 CGMS patients and 301 regular outpatients (control group) were enrolled in the study after propensity score matching. There were no differences in baseline glycated hemoglobin (HbA1c), age, and duration of diabetes between the CGMS and the control groups after propensity score matching. The changes in the HbA1c levels from baseline to 6 months were calculated.

Results

The CGMS group showed a significant improvement in the HbA1c level compared to the control group at 3 months (7.9%±1.6% vs. 7.4%±1.2%, P=0.001) and at 6 months (7.4%±1.2% vs. 7.9%±1.6%, P=0.010). There were significant differences in the treatment modality changes between the CGMS group and the control group.

Conclusion

Using a 3-day CGMS was advantageous for improving glucose control in patients with type 2 diabetes and may help these patients to optimize glycemic control in clinical practice.

Citations

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  • Biological and Clinical Impacts of Glucose Metabolism in Pancreatic Ductal Adenocarcinoma
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    George Grunberger, Jennifer Sherr, Myriam Allende, Thomas Blevins, Bruce Bode, Yehuda Handelsman, Richard Hellman, Rosemarie Lajara, Victor Lawrence Roberts, David Rodbard, Carla Stec, Jeff Unger
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Assessment of the Association between Mean Hemoglobin A1c Levels for 5 Years and Coronary Artery Disease by Coronary Angiography in Nondiabetic Patients
Jae-Joon Kim, Ji-Hoon Kang, Ja-Jun Goo, Kyoung-Nyoun Kim, Ja-Young Lee, Mi-kyung Kim, Tae Ik Kim
Diabetes Metab J. 2014;38(1):58-63.   Published online February 19, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.1.58
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AbstractAbstract PDFPubReader   
Background

The effects of glucose on cardiovascular events or mortality in nondiabetic patients has been recently reported. However, since atherosclerosis can be formed over a long period of time, it is necessary to devote several years to unveil the relationship between the two factors. Here, we attempted to find out the relationship between the mean hemoglobin A1c (HbA1c) level and HbA1c variability for 5 years and coronary artery disease (CAD) by using coronary angiography (CAG) to assess nondiabetic patients.

Methods

We reviewed patients who performed CAG who were followed up for at least 5 years after the initial diagnosis. The fasting blood test was performed annually for glucose and HbA1c level. CAD was defined as more than 50% of luminal narrowing. The severity of CAD was divided into two groups depending on whether no vessels were involved or one more vessel were involved (CAD(-) or CAD(+), respectively).

Results

The patients in CAD(+) group had higher mean HbA1c level for 5 years than CAD(-) group (5.71±0.40 vs. 5.86±0.68; P=0.04). Mean HbA1c was a significant predictor for CAD in multiple regression (odds ratio, 2.224; P=0.028). The percentage of patients with CAD was significantly higher in patients with >6.2% of mean HbA1c levels compared to patients with <6.2% of mean HbA1c levels (P<0.019).

Conclusion

When the mean HbA1c levels were above 6.2%, the risk of CAD was higher. Also this study shows that HbA1c level can be one of the predictors for CAD even if the patients do not have diabetes.

Citations

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  • Impact of a comprehensive cardiac rehabilitation programme versus coronary revascularisation in patients with stable angina pectoris: study protocol for the PRO-FIT randomised controlled trial
    Joyce M. Heutinck, Iris A. De Koning, Tom Vromen, Robert-Jan M. Van Geuns, Dick H.J. Thijssen, Hareld M.C. Kemps, Eddy M. Adang, Johanna M. Geleijnse, Pieter van Gorp, Arnoud W. J. van ‘t Hof, Veronica R. Janssen, Harald T. Jorstad, Roderik A. Kraaijenhag
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Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c
Ja Young Jeon, Seung-Hyun Ko, Hyuk-Sang Kwon, Nan Hee Kim, Jae Hyeon Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Soo Lim, Sung Hee Choi, Myoung-jin Jang, Yuna Kim, Kyungwon Oh, Dae Jung Kim, Bong-Yun Cha
Diabetes Metab J. 2013;37(5):349-357.   Published online October 17, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.5.349
  • 6,553 View
  • 70 Download
  • 110 Crossref
AbstractAbstract PDFPubReader   
Background

Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests.

Methods

Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ≥126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ≥6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%.

Results

When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ≥6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate.

Conclusion

We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.

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Hemoglobin A1c May Be an Inadequate Diagnostic Tool for Diabetes Mellitus in Anemic Subjects
Jung Il Son, Sang Youl Rhee, Jeong-taek Woo, Jin Kyung Hwang, Sang Ouk Chin, Suk Chon, Seungjoon Oh, Sung Woon Kim, Young Seol Kim
Diabetes Metab J. 2013;37(5):343-348.   Published online October 17, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.5.343
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AbstractAbstract PDFPubReader   
Background

Recently, a hemoglobin A1c (HbA1c) level of 6.5% has been determined to be a criterion for diabetes mellitus (DM), and it is a widely used marker for the diagnosis of DM. However, HbA1c may be influenced by a number of factors. Anemia is one of the most prevalent diseases with an influence on HbA1c; however, its effect on HbA1c varies based on the variable pathophysiology of anemia. The aim of this study was to determine the effect of anemia on HbA1c levels.

Methods

Anemic subjects (n=112) and age- and sex-matched controls (n=217) who were drug naive and suspected of having DM were enrolled. The subjects underwent an oral glucose tolerance test and HbA1c simultaneously. We compared mean HbA1c and its sensitivity and specificity for diagnosing DM between each subgroup.

Results

Clinical characteristics were found to be similar between each subgroup. Also, when glucose levels were within the normal range, the difference in mean HbA1c was not significant (P=0.580). However, when plasma glucose levels were above the diagnostic cutoff for prediabetes and DM, the mean HbA1c of the anemic subgroup was modestly higher than in the nonanemic group. The specificity of HbA1c for diagnosis of DM was significantly lower in the anemic subgroup (P<0.05).

Conclusion

These results suggest that the diagnostic significance of HbA1c might be limited in anemic patients.

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Low Levels of Physical Activity Are Associated with Increased Metabolic Syndrome Risk Factors in Korean Adults
Dong Hoon Lee, Yoon Myung Kim, Yoonsuk Jekal, Sukyung Park, Kyong-Chol Kim, Masayo Naruse, Sun Hyun Kim, Sang-Hwan Kim, Ji-Hye Park, Mi Kyung Lee, Sang Hui Chu, Justin Y. Jeon
Diabetes Metab J. 2013;37(2):132-139.   Published online April 16, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.2.132
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AbstractAbstract PDFPubReader   
Background

Low levels of physical activity (PA) are strongly associated with the development of metabolic syndrome (MetS) and chronic diseases. However, few studies have examined this association in Koreans. The primary purpose of this study was to examine the associations between PA and MetS risks in Korean adults.

Methods

A total of 1,016 Korean adults (494 males and 522 females) participated in this study. PA levels were assessed using the International PA Questionnaire. MetS risk factors were determined using clinically established diagnostic criteria.

Results

Compared with the highest PA group, the group with the lowest level of PA was at greater risk of high triglyceride (TG) in males (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.07 to 3.24) and of hemoglobin A1c ≥5.5% in females (OR, 1.75; 95% CI, 1.00 to 3.04) after adjusting for age and body mass index. Compared with subjects who met the PA guidelines, those who did not meet the guidelines were more likely to have low high density lipoprotein cholesterol in both males (OR, 1.69; 95% CI, 1.11 to 2.58), and females (OR, 1.82; 95% CI, 1.20 to 2.77). Furthermore, those who did not meet the PA guidelines were at increased risk of high TG levels in males (OR, 1.69; 95% CI, 1.23 to 2.86) and abnormal fasting glucose (OR, 1.93; 95% CI, 1.17 to 3.20) and MetS (OR, 2.10; 95% CI, 1.15 to 3.84) in females.

Conclusion

Increased levels of PA are significantly associated with a decreased risk of abnormal MetS components.

Citations

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Diabetes Metab J : Diabetes & Metabolism Journal