These results suggest that oxidative stress might be implicated in promoting a state of low-grade systemic inflammation in elderly patients with type II diabetes.
Objective
Reliable identification of individuals at risk for developing diabetes is critical to instituting preventative strategies. Studies suggest that the accuracy of using A1c as a sole diagnostic criterion for diabetes may be variable across different ethnic groups. We postulate that there will be lack of concordance between A1c and the Oral Glucose Tolerance Test (OGTT) for diagnosing prediabetes across Hispanic and Non-Hispanic White (NHW) populations.
Research Design and Methods
218 asymptomatic adults at risk for Type 2 Diabetes (T2D) were assessed with A1c and OGTT for the diagnosis of prediabetes. Glucose homeostasis status was assigned as no diabetes (A1c < 5.7%), prediabetes (A1c 5.7% – 6.4%), and T2D (A1c > 6.4%). Inclusion criteria were age > 18 years and at least one of the following: a family history of diabetes, a history of gestational diabetes, Hispanic ethnicity, non-Caucasian race, or obesity. Subjects received a fasting 75-gram OGTT and A1c on the same day. Bowker’s Test of Symmetry was employed to determine agreement between the tests.
Results
Data from 99 Hispanic patients and 79 NHW patients were analyzed. There was no concordance between A1c and OGTT for Hispanic (p=0.002) or NHW individuals (p=0.003) with prediabetes.
Conclusions
A1c is discordant with OGTT among Hispanic and NHW subjects for the diagnosis of prediabetes. Sole use of A1c to designate glycemic status will result in a greater prevalence of prediabetes among Hispanic and NHW New Mexicans.
Key Clinical Message
Recombinant chromosome 8 syndrome is caused by duplication of 8q and deletion of 8p. A fetus with anomalies was misdiagnosed with this syndrome based on an amniocyte karyotype. Postnatal chromosomal microarray and other studies identified a de novo derivative chromosome 8. For fetal anomalies, detailed genetic studies may be required.
OBJECTIVE: The American College of Obstetricians and Gynecologists recommends a delay in umbilical cord clamping in term infants for at least 30-60 sec after birth, irrespective of mode of delivery. However, most literature supporting this practice is from low risk vaginal deliveries (VD). There are no published data specific to ajog.org FELLOWS PLENARY Oral Plenary 2
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