Prediction of glucose response to weight loss in patients with non-insulin-dependent diabetes mellitus

Article Abstract:

Weight loss is an important aspect of therapy for obese patients with non-insulin-dependent diabetes mellitus (NIDDM). However, blood glucose levels do not always improve after weight loss. Factors that might predict the ability of diet therapy to improve blood glucose levels were assessed in 135 obese patients with NIDDM, who lost at least 9.1 kilograms (kg; 20.0 pounds or lbs.) of body weight. After losing weight, the patients' blood glucose levels were tested and they were subdivided into two groups. Measurements revealed that blood glucose was an average of 7 millimoles per liter in 55 of 135 patients, who were classified as responders; their blood glucose levels had begun to improve after only a slight loss of weight. Eighty of 135 patients were nonresponders; their blood glucose levels measured an average of 18.3 millimoles per liter following weight loss. Improvement in blood glucose levels after weight loss was best predicted by a blood glucose level of 10 millimoles per liter or less after a 2.3 kg (5.0 lbs) and 4.5 kg (9.9 lbs) weight loss. Many patients with NIDDM do not have improved blood glucose levels after weight loss. The effectiveness of diet therapy can be predicted on the basis of blood glucose levels after a 2.3 (5.0 lbs) and 4.5 kg (9.9 lbs) weight loss. It is recommended that patients with NIDDM who remain hyperglycemic (have high blood glucose levels) after losing weight, be considered for treatment with insulin or oral hypoglycemic agents, which lower blood glucose levels. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Physiological aspects, Type 2 diabetes, Weight loss, Body weight, Diet therapy

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A comparison of home glucose monitoring with determinations of hemoglobin A-1c, total glycated hemoglobin, fructosamine, and random serum glucose in diabetic patients

Article Abstract:

In diabetes mellitus, patients either produce insufficient insulin or their insulin is ineffective, resulting in high blood levels of the sugar glucose. Random blood glucose levels do not necessarily reflect average blood glucose levels. In an attempt to determine how well or poorly controlled the blood sugar of a given diabetic might be, a clinician might order certain blood tests that represent average blood glucose levels over several weeks. These include the tests for hemoglobin A-1c, total glycated hemoglobin, and the newer fructosamine assay. Alternatively, the physician may have the patient monitor his blood sugar at home at various times of the day, and keep a record of those readings. Which of these several techniques is the most useful measure of glucose control is not yet established. A group of 17 diabetics were recruited to have these measuring techniques compared. All were supposed to check their sugars at home four times per day, but few managed to do so that often. They were seen every two weeks, and had their levels of glycated hemoglobin, hemoglobin A-1c, and fructosamine measured. The study showed that the results of any of the later three tests correlated well with average home glucose measurements. As the fructosamine assay is the easiest and quickest to perform, it may come to be the preferred testing method for assessment of overall glucose control. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Development and progression, Medical tests, Blood sugar monitoring, Blood glucose test

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Impact of glucose self-monitoring on glycohemoglobin values in a veteran population

Article Abstract:

The prognosis of patients with diabetes mellitus depends on the how effectively sugar (glucose) in their blood can be controlled. Blood glucose can be self-monitored with strips or meters, or by blood tests for glycohemoglobin, which is high in uncontrolled diabetics. To see whether glucose control improved or diabetic complications were reduced with self-monitoring of blood glucose, the effects of self-monitoring in 21 diabetic patients were compared with those in 17 unmonitored patients. The age, duration of diabetes, other concurrent illness, number of hospitalizations and complications of diabetes did not vary widely among the patients. Self-monitoring of blood glucose levels did not offer improved glucose control when used alone. The results of this study did not justify the added cost of self-monitoring. To improve glucose control, other methods such as adjusting insulin dosages, altering life styles, and effecting changes in behavior and patient education should be used in addition to self-monitoring. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Equipment and supplies, Control, Glucose, Self-care, Health, Self care (Health), Glycosylated hemoglobin, Self-examination, Medical, Self examination (Medical)

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