An Algorithm for the Care of Type 2 Diabetes

Cole, Andrew; Nathan, David M.; Savaria-Porter, Elizabeth; Copeland, Paul M.; Turchin, Alexander; Brunt, Melanie; Zusman, Randall M.; Barrett, J; Wexler, Deborah J.; Case, Emily; McMahon, Graham T.; Mort, Elizabeth

doi:10.1097/hpc.0b013e3181c017e2

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…The Middle East region has not been spared from this scourge and currently is among those worst-hit [1]. This global epidemic, shared by both industrialized and developing countries, has stimulated increased public awareness of the disease, the identification of risk factors and the knowledge that DMT2 can be delayed and, even better, prevented [3-5]. Recognition of the importance of glycemic control in the prevention of the complications and morbidity of DMT2 has led to worldwide campaigns for modifications in lifestyle and an intensive search for better antidiabetes medications [6-8].…”

Section: Introductionmentioning

confidence: 99%

Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (riyadh cohort 2): a decade of an epidemic

Al-Daghri

Al‐Attas

Alokail

et al. 2011

BMC Med

214

193

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BackgroundFollow-up epidemiologic studies are needed to assess trends and patterns of disease spread. No follow-up epidemiologic study has been done in the Kingdom of Saudi Arabia to assess the current prevalence of major chronic, noncommunicable diseases, specifically in the urban region, where modifiable risk factors remain rampant. This study aims to fill this gap.MethodsA total of 9,149 adult Saudis ages seven to eighty years (5,357 males (58.6%) and 3,792 females (41.4%)) were randomly selected from the Riyadh Cohort Study for inclusion. Diagnosis of type 2 diabetes mellitus (DMT2) and obesity were based on the World Health Organization definitions. Diagnoses of hypertension and coronary artery disease (CAD) were based on the Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and American Heart Association criteria, respectively.ResultsThe overall crude prevalence of DMT2 was 23.1% (95% confidence interval (95% CI) 20.47 to 22.15). The age-adjusted prevalence of DMT2 was 31.6%. DMT2 prevalence was significantly higher in males, with an overall age-adjusted prevalence of 34.7% (95% CI 32.6 to 35.4), than in females, who had an overall age-adjusted prevalence of 28.6% (95% CI 26.7 to 29.3) (P < 0.001). The overall crude prevalence of obesity was 31.1% (95% CI 30.1 to 32.0). The age-adjusted prevalence of obesity was 40.0%. The prevalence of obesity was higher in females, with an overall prevalence of 36.5% (95% CI 35.1 to 37.83), than in males (25.1% (95% CI 23.7 to 26.3)) (P < 0.001). The age-adjusted prevalence of hypertension and CAD were 32.6% (95% CI 31.7 to 33.6) and 6.9% (95% CI 6.4 to 7.4), respectively.ConclusionComparisons of our findings with earlier data show that the prevalence of DMT2, hypertension and CAD in Riyadh, Saudi Arabia, has alarmingly worsened. Aggressive promotion of public awareness, continued screening and early intervention are pivotal to boosting a positive response.

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Section: Introductionmentioning

confidence: 99%

Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (riyadh cohort 2): a decade of an epidemic

Al-Daghri

Al‐Attas

Alokail

et al. 2011

BMC Med

214

193

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

A 6-month “self-monitoring” lifestyle modification with increased sunlight exposure modestly improves vitamin D status, lipid profile and glycemic status in overweight and obese Saudi adults with varying glycemic levels

et al. 2014

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BackgroundThe over-all age-adjusted prevalence of diabetes mellitus type 2 (DMT2) in Saudi Arabia is unprecedented at 31%. Aggressive measures should be done to curb down increasing incidence. In this prospective 6-month study we aim to determine whether a self-monitoring, life-style modification program that includes increased sunlight exposure confer improvement in vitamin D status and health benefits among adult Saudi overweight and obese patients with varying glycemic status.MethodsA total of 150 overweight and obese Saudi adults with varying glycemic status aged 30–60 years were included in this study. They were divided into 3 groups (Non-DMT2, Pre-diabetes and DMT2). Baseline anthropometrics and blood glucose were taken at baseline and after 6 months. Fasting blood sugar, lipid profile, calcium, albumin and phosphate were measured routinely. Serum 25(OH) vitamin D was measured using standard assays. Within the time period they were instructed to reduce total intake of fat, increased fiber intake and increase sun exposure.ResultsIn all groups there was a significant improvement in vitamin D levels as well as serum triglycerides, LDL- and total cholesterol. However, a significant increase in serum glucose levels was noted in the non-DMT2 group, and a significant decrease in HDL-cholesterol in both non-DMT2 and pre-diabetes group. In the pre-diabetes group, 53.2% were able to normalize their fasting blood levels after 6 months, with 8.5% reaching the DMT2 stage and 38.3% remaining pre-diabetic. In all groups there was a significant increase in the prevalence of hypertension.ConclusionImproving vitamin D status with modest lifestyle modifications over a short-period translates to improvement in lipid profile except HDL-cholesterol among overweight and obese Saudi adults, but not BMI and blood pressure. Findings of the present study merit further investigation as to whether full vitamin D status correction can delay or prevent onset of DMT2.

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“…In reality, clinicians may be hesitant to treat patients aggressively, due to fear of hypoglycemic complications or uneasiness associated with adapting to a new therapy. The rule of "ABC" (A1C, Blood Pressure, Cholesterol) outlines the treatment goals for A1c (b7%, submit to modification based on individuals' adverse effects during glycemic management), blood pressure (≤ 129/79 mm Hg), and cholesterol (LDL b100 mg/dL in patients with ≥40 years of vascular disease) [75].…”

Section: Glycated Hemoglobin In the Treatment And Long-term Managemenmentioning

confidence: 99%

Current aspects in hemoglobin A1c detection: A review

Ang

Thevarajah

Alias

et al. 2015

Clinica Chimica Acta

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Type 2 diabetes mellitus (T2DM) is a pressing health issue that threatens global health and the productivity of populations worldwide. Despite its long-recognized role in diabetes management, glycated hemoglobin (HbA1c) only received WHO endorsement as a T2DM diagnostic tool in 2011. Although conventional plasma-specific tests have long been utilized to diagnose T2DM, the public should be informed that plasma-specific tests are not markedly better than HbA1c tests, particularly in terms of variability and convenience for diagnosing diabetes. In the midst of the debates associated with establishing HbA1c as the preeminent diabetes diagnostic tool, unceasing efforts to standardize HbA1c tests have played an integral part in achieving more efficient communication from laboratory to clinical practice and thus better diabetes care. This review discusses the current status of HbA1c tests in the diagnosis, prevention, treatment and management of T2DM across the globe, focusing on increasing the recognition of glycated hemoglobin variants with effective utilization of different HbA1c methods, updating the current status of HbA1c standardization programs, tapping into the potential of POC analyzers to establish a cost-effective HbA1c test for diabetes care, and inspiring the advancement of HbA1c biosensors for future clinical usage.

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An Algorithm for the Care of Type 2 Diabetes

Cited by 4 publications

References 17 publications

Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (riyadh cohort 2): a decade of an epidemic

Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (riyadh cohort 2): a decade of an epidemic

A 6-month “self-monitoring” lifestyle modification with increased sunlight exposure modestly improves vitamin D status, lipid profile and glycemic status in overweight and obese Saudi adults with varying glycemic levels

Current aspects in hemoglobin A1c detection: A review

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