Day-to-day variability of fasting plasma glucose in newly diagnosed type 2 diabetic subjects.

Ollerton, Richard L.; Playle, Rebecca; Ahmed, Kazi Rumana; Dunstan, Frank David John; Luzio, Stephen; Owens, David R.

doi:10.2337/diacare.22.3.394

Cited by 86 publications

(52 citation statements)

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“…The currently recommended "confirmatory" test after the discovery of a single elevated FPG value (Ն7.0 mmol/l) is a repeat FPG measurement or OGTT; however, most physicians repeat the FPG (1). Our data and those from other studies (16,28,29) suggest that requiring two FPG measurements Ն7.0 mmol/l for the diagnosis of diabetes only compounds the insensitivity of a single FPG test. A recent study of newly diagnosed subjects with type 2 diabetes found that 95% of FPG measurements varied by Ϯ15% on a daily basis (29).…”

Section: Conclusion -Previous Reportssupporting

confidence: 69%

“…Our data and those from other studies (16,28,29) suggest that requiring two FPG measurements Ն7.0 mmol/l for the diagnosis of diabetes only compounds the insensitivity of a single FPG test. A recent study of newly diagnosed subjects with type 2 diabetes found that 95% of FPG measurements varied by Ϯ15% on a daily basis (29). Manucci et al (28) reported that concordant FPG values Ͼ7.0 mmol/l occur in merely 55% of obese diabetic subjects.…”

Section: Conclusion -Previous Reportssupporting

confidence: 69%

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HbA1c Measurement Improves the Detection of Type 2 Diabetes in High-Risk Individuals With Nondiagnostic Levels of Fasting Plasma Glucose

Perry¹,

et al. 2001

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OBJECTIVE -Whereas new diagnostic criteria based on a fasting plasma glucose (FPG) of Ͼ126 mg/dl (7.8 mmol/l) have improved the detection of diabetes, multiple reports indicate that many people with diabetes diagnosed by 2-h oral glucose tolerance test (OGTT) glucose measurements of Ն11.1 mmol/l (200 mg/dl) would remain undiagnosed based on this FPG criteria. Thus, improved methods to detect diabetes are particularly needed for high-risk individuals. We evaluated whether the combination of FPG and HbA 1c measurements enhanced detection of diabetes in those individuals at risk for diabetes with nondiagnostic or minimally elevated FPG. RESEARCH DESIGN AND METHODS -We analyzed FPG, OGTT, and HbA 1c data from 244 subjects screened for participation in the Early Diabetes Intervention Program (EDIP).RESULTS -Of 244 high-risk subjects studied by FPG measurements and OGTT, 24% of the individuals with FPG levels of 5.5-6.0 mmol/l (100 -109 mg/dl) had OGTT-diagnosed diabetes, and nearly 50% of the individuals with FPG levels of 6.1-6.9 mmol/l (110 -125 mg/dl) had OGTT-diagnosed diabetes. In the subjects with OGTT-diagnosed diabetes and FPG levels between 5.5 and 8.0 mmol/l, detection of an elevated HbA 1c (Ͼ6.1% or mean ϩ 2 SDs) led to a substantial improvement in diagnostic sensitivity over the FPG threshold of 7.0 mmol/l (61 vs. 45%, respectively, P ϭ 0.002). Concordant FPG levels Ն7.0 mmol/l (currently recommended for diagnosis) occurred in only 19% of our cohort with type 2 diabetes. CONCLUSIONS -Diagnostic criteria based on FPG criteria are relatively insensitive in the detection of early type 2 diabetes in at-risk subjects. HbA 1c measurement improves the sensitivity of screening in high-risk individuals. Diabetes Care 24:465-471, 2001

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Section: Conclusion -Previous Reportssupporting

confidence: 69%

Section: Conclusion -Previous Reportssupporting

confidence: 69%

HbA1c Measurement Improves the Detection of Type 2 Diabetes in High-Risk Individuals With Nondiagnostic Levels of Fasting Plasma Glucose

Perry¹,

et al. 2001

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“…42 The problems with traditional blood glucose estimations include high intraindividual biological variability (4%-14%), preanalytical variability like the method of collection, storage (rate of fall of glucose in samples at room temperature 3-8 mg/dL/hour) and lifestyle measures like exercise and calorie restriction and difficulty in ensuring fasting state before blood glucose measurement. 62,63 HbA1c overcomes many of these difficulties as it does not need a fasting state for sample collection or a glucose load and can be measured in a single sample collected at any time of the day. Additional advantages include analytical variability of less than 2% and information on glycaemic status over the past 2-3 months.…”

Section: Hba1c As a Diagnostic Test For Diabetes Mellitusmentioning

confidence: 99%

Clinical applications of glycosylated haemoglobin

SA¹,

Sachan²,

PVLN³

2013

JCSR

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“…A study investigating the day-to-day variability of FPG in 193 newly diagnosed patients with T2DM 74 exhibited FPG variations of ±15% on a daily basis. Subjects with higher FPG were more likely to experience larger changes in FPG values measured from day to day.…”

Section: Day-to-day Blood Glucose Variabilitymentioning

confidence: 99%

Common Standards of Basal Insulin Titration in T2DM

Arnolds

Heise

Flacke

et al. 2013

J Diabetes Sci Technol

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Type 2 diabetes mellitus has become a worldwide major health problem, and the number of people affected is steadily increasing. Thus, not all patients suffering from the disease can be treated by specialized diabetes centers or outpatient clinics, but by primary care physicians. The latter, however, might have time constraints and have to deal with many kinds of diseases or with multimorbid patients, so their focus is not so much on lowering high blood glucose values. Thus, the physicians, as well as the patients themselves, are often reluctant to initiate and adjust insulin therapy, although basal insulin therapy is considered the appropriate strategy after oral antidiabetic drug failure, according to the latest international guidelines. A substantial number of clinical studies have shown that insulin initiation and optimization can be managed successfully by using titration algorithms-even in cases where patients themselves are the drivers of insulin titration. Nevertheless, tools and strategies are needed to facilitate this process in the daily life of both primary health care professionals and patients with diabetes.

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Day-to-day variability of fasting plasma glucose in newly diagnosed type 2 diabetic subjects.

Cited by 86 publications

References 0 publications

HbA1c Measurement Improves the Detection of Type 2 Diabetes in High-Risk Individuals With Nondiagnostic Levels of Fasting Plasma Glucose

HbA1c Measurement Improves the Detection of Type 2 Diabetes in High-Risk Individuals With Nondiagnostic Levels of Fasting Plasma Glucose

Clinical applications of glycosylated haemoglobin

Common Standards of Basal Insulin Titration in T2DM

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