HbA1c Testing For Diagnosing And Monitoring Diabetes

HbA1c Testing for Diagnosing and Monitoring Diabetes

Diabetes, also known as diabetes mellitus, is a common metabolic disease that is characterized by frequent sessions of uncontrolled high blood sugar or hyperglycaemia caused by poor insulin production or increased resistance to insulin. The World Health Organization (WHO) has reported that 8.5% of the global population was affected by diabetes in 2014, or roughly 422 million people.1
Diabetes is divided into two main types, type 1 and type 2. Type 1 diabetes is manifested by complete deficiency of insulin production, which results in uncontrolled blood glucose levels, type 1 diabetes is generally diagnosed in early childhood so is often referred to as juvenile diabetes.
While type 2 diabetes, the most common type, is characterized by the under production of insulin or the body’s cells becoming resistant to the action of insulin as a result of environmental and genetic factors which often present in adult life, so this type of diabetes is often referred to as adult-onset diabetes.
FBG and OGTT diagnostic testing methods
Previously, the measurement of two-hour plasma glucose through an oral glucose tolerance test (OGTT) or fasting blood glucose (FBG) was the main diagnostic protocol for diabetes.2 To diagnose a patient as diabetic via FBG or OGTT, the diagnostic criteria are:
FBG ≥7.0 mmol/l, or
Two-hour plasma blood glucose concentration should be ≥11.1 mmol/l, two hours after injecting a 75g anhydrous glucose through an OGTT
While a good level of accuracy is afforded by both testing methods, these have their own limitations. For instance, the FBG test requires 8 hours Continue reading

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Fighting the diabetes epidemic the way public health has fought HIV

In the U.S. and other high-income countries, diabetes is a good news, bad news scenario. On one hand, people who have diabetes today fare better than they did 20 years ago. They are living longer and suffering fewer complications, such as heart disease, kidney disease, amputations, strokes, and blindness.
SEEBRI NEOHALER should not be initiated in patients with acutely deteriorating or potentially life-threatening episodes of COPD or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.
As with other inhaled medicines, SEEBRI NEOHALER can produce paradoxical bronchospasm that may be life threatening. If paradoxical bronchospasm occurs following dosing with SEEBRI NEOHALER, it should be treated immediately with an inhaled, short-acting bronchodilator; SEEBRI NEOHALER should be discontinued immediately and alternative therapy instituted.
Immediate hypersensitivity reactions have been reported with SEEBRI NEOHALER. If signs occur, discontinue immediately and institute alternative therapy. SEEBRI NEOHALER should be used with caution in patients with severe hypersensitivity to milk proteins.
SEEBRI NEOHALER should be used with caution in patients with narrow-angle glaucoma and in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema) and of urinary retention (e.g., difficult Continue reading

Diabetes: Fighting the epidemic the way public health has fought HIV

In the U.S. and other high-income countries, diabetes is a good news, bad news scenario. On one hand, people who have diabetes today fare better than they did 20 years ago. They are living longer and suffering fewer complications, such as heart disease, kidney disease, amputations, strokes, and blindness.
On the other hand, more people are developing diabetes than experts even projected, with some 29 million people in the U.S. living with the disease today. One in four people with diabetes remains unaware and almost 90 percent with prediabetes don't know their blood sugar is elevated. And the drop in complications is not enjoyed equally. Minorities, people with low incomes, and younger adults tend to suffer more than their white, affluent, and older counterparts.
"We have gotten very good at caring for and controlling diabetes, but we are lagging in prevention," says K.M. Venkat Narayan, Ruth and O.C. Hubert Professor of Global Health. "The science is there. We know exercise, a healthy diet, and weight loss are extremely effective in preventing diabetes in people at high risk, but we haven't been able to figure out how to translate and scale up the implementation of that knowledge into population-wide interventions that work. We also need to find ways to improve outcomes for disenfranchised populations."
Narayan and his team will be tackling these issues through the newly established Georgia Center for Diabetes Translation Research. The center is funded by a grant from National Institute of Diabetes and Digestive and Kidney Diseases that was awarded to a partnership of Emor Continue reading

Media Touts A New Study Blaming Diabetes Epidemic On Global Warming

The media is touting a new study claiming global warming could be, at least in part, to blame for the “diabetes epidemic” sweeping the globe.
“When it gets warmer, there is higher incidence of diabetes,” Lisanne Blauw, a Ph.D. candidate at the Netherlands-based Einthoven Laboratory and the study’s lead author, told The Huffington Post Tuesday.
“It’s important to realize global warming has further effects on our health, not only on the climate,” Blauw said.
Blauw and her colleagues wrote “the diabetes incidence rate in the USA and prevalence of glucose intolerance worldwide increase with higher outdoor temperature” based on a meta-analysis of 14 years of data on diabetes and temperature in U.S. states.
Researchers hypothesize “the global increase in temperature contributes to the current type 2 diabetes epidemic” since warmer weather could inhibit brown adipose tissue (BAT) that turns food into energy for the body.
That could reduce the body’s ability to metabolize glucose, making Type 2 diabetes more likely.
“Hot weather can be more difficult for people with diabetes,” Mona Sarfaty, director of the Consortium on Climate Change and Health, told Popular Science.
“The heat keeps people from being active, which means they expend less calories, which can lead to more weight gain,” Sarfaty said. “Also, people with diabetes often have kidney problems. Dehydration — which comes with heat — can worsen kidney problems when people are dehydrated.”
HuffPo, of course, mentioned climate scientists declared 2016 the hottest year on record.
“On t Continue reading

Accessing Insulin Pumps and CGM’s

The buzzword in diabetes care these days seems to be “Insulin Pump”. And there is a lot of frustration in the diabetes community about the lack of availability of them.
NOTE: If you have a child with type 1 diabetes age 6 years or younger; you should have access to an insulin pump almost immediately as per the HSE’s “ Model of Care for the Provision of Insulin Pumps for the treatment of Type 1 Diabetes in the Under Five Age Group” see here.
So, I thought I would pull together some of the information I have into a post to help people increase their odds of getting any piece of diabetes tech. Plus, dispel some myths around insulin pump therapy and accessibility.
Thank you to Davina Lyon from Diabetes T One for the suggestion for this post.
It might seem like some people have unlimited access to all of this technology but most people with type 1 diabetes in Ireland do not! Mostly people gain access to this tech by being knowledgeable, persistent and not being deterred. Oh, yes, and they also attend a diabetes clinic that offers all of this.
Firstly, The FreeStyle Libre is available to buy in Ireland since November 2016. So there is only one significant block to accessing this technology – affordability. The application process to have this device included on the Long Term Illness Scheme is ongoing and we will keep you informed. This website; http://www.freestylelibre.ie/ is where you can buy the Libre.
Whether it’s an Insulin Pump or a Continuous Glucose Monitor (CGM) that you’re after, or just curious about, here is my advice to you on finding out more;
Do you Continue reading