Study to Determine the Incidence of High HbA1c in Patients with Ischemic Stroke at Bilawal Medical College, Kotri, Sindh, Pakistan

Ahmed, Atif; Poorani, K.; Kalhoro, Mohammad Amjad; Khokar, Nisar Ahmed; Dars, Abdul Ghaffar

doi:10.9734/jpri/2021/v33i30a31610

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Only 22% of patients had optimum diabetic control (HbA1c ≤7%). In other local studies, as many as 35-75% of diabetic patients have poor control based on their HbA1c [13][14].…”

Section: Discussionmentioning

confidence: 95%

Assessment of Factors Associated With Non-Compliance to Self-Management Practices in People With Type 2 Diabetes

Rahmatullah¹,

Qutubuddin²,

Rahman³

et al. 2021

Cureus

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Aim and objectiveDiabetes mellitus is a chronic metabolic disorder that requires continuous self-management practices. The aim of our study is to assess the factors resulting in non-compliance with self-management practices in people with type 2 diabetes mellitus (T2DM). MethodsThis cross-sectional study was conducted at Baqai Institute of Diabetology and Endocrinology (BIDE), a tertiary care center in Karachi, Pakistan, from March 2019 to May 2019. People with T2DM diagnosed for at least six months were included. A predesigned questionnaire was used to assess various components of selfmanagement such as the use of oral hypoglycemic agents (OHAs) and insulin, self-monitoring of blood glucose (SMBG), physical activity, and daily foot care. Certified diabetes educators conducted interviews on a one-to-one basis. Data were entered and analyzed by using SPSS (version 20; IBM Corp., Armonk, NY). ResultsBetter glycated hemoglobin (HbA1c) levels were observed in compliant persons and a statistically significant difference was noted in those who were compliant with insulin use. Good compliance with self-management was observed in people who were given diabetes education previously.A total of 205 people with T2DM were included in the study, with a mean age of 52.66 ± 11.2 years and a mean duration of diabetes of 8.9 ± 7.5 years. There were 62.9% males and 37.1% females. Oral hypoglycemic agents (OHAs) were prescribed to 62.9% while 33.9 % were on both OHAs and insulin. Non-compliance with the intake of OHAs was 33.3%, insulin injection 21%, SMBG 25.7%, physical activity 69.5%, and foot care practice 34.3%. Various reasons identified for non-compliance included forgetfulness (negligence) (88%), fear of hypoglycemia (10.6%), time constraints (48%), and lack of foot care knowledge (84.8%). ConclusionNon-compliance with T2DM self-management is multifactorial and needs continuous reinforcement of structured diabetes education sessions. The study showed that the provision of diabetes education is directly proportional to self-management compliance levels.

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“…Only 22% of patients had optimum diabetic control (HbA1c ≤7%). In other local studies, as many as 35-75% of diabetic patients have poor control based on their HbA1c [13][14].…”

Section: Discussionmentioning

confidence: 95%

Assessment of Factors Associated With Non-Compliance to Self-Management Practices in People With Type 2 Diabetes

Rahmatullah¹,

Qutubuddin²,

Rahman³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Nomani et al concluded that an elevated risk of ischemic stroke was indicated by an HbA1c higher than 5.6% [ 16 ]. Studies by Oh et al, Ahmed et al, and Raj et al reported that increased HbA1c showed a markedly significant increase in ischemic stroke after adjusting for confounding variables [ 17 - 19 ]. These results align with this present study in which a continuous correlation between the HbA1c values and the risk of ischemic stroke was observed.…”

Section: Discussionmentioning

confidence: 99%

Association of Glycated Hemoglobin With Acute Ischemic Stroke in a Tertiary Care Center in a Tribal Region of Jharkhand

Priya,

Mardi,

Kapoor

et al. 2024

Cureus

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Background: Increased glycated hemoglobin (HbA1c) levels have shown an association with an increased risk of stroke in patients admitted to a tertiary care center in Jharkhand. Objectives: To find out and estimate the risk of acute ischemic stroke in patients with increased HbA1c levels compared with controls. Methods: This observational case-control study was conducted on patients admitted to the department of general medicine at a tertiary care center in Ranchi from June 2021 to November 2022. The patients included in this study were those aged 18 years or older and who were clinically and radiologically diagnosed with acute ischemic stroke. Only patients with a first episode of stroke were included, and patients with hemorrhagic stroke or transient ischemic attack were excluded from this study. An equal number of control participants were also included. Ion exchange high-performance liquid chromatography was used to perform the HbA1c tests. The same method was used to measure HbA1c levels in the controls. All findings were recorded in a Microsoft Excel sheet (Microsoft Corporation, Redmond, WA), and the data were analyzed using SPSS version 22.0 software (IBM Corp., Armonk, NY). After performing a descriptive statistical analysis, the findings were classified over a range of values and described accordingly. For each variable, an independent t-test was performed to compare the cases with the controls. A multivariable logistic regression analysis was used to choose the appropriate potential factors to determine the association in the multivariable analysis. Results: A total of 185 cases and 185 controls were included. The mean age of the cases with ischemic stroke was 63.77 ± 10.312, and that of the controls was 53.18 ± 11.35 (p < 0.01). The mean HbA1c level in the patients of acute ischemic stroke was 6.97 ± 1.84, and that of the controls was 5.99 ± 1.69 (p < 0.01). The mean random blood sugar (RBS) value in the ischemic stroke cases was 170.21 ± 84.16, and that of the controls was 150.03 ± 82.25 (p = 0.02). To compare the factors that were determined to be statistically significant between ischemic stroke cases and controls, a multivariable logistic regression analysis was performed. The HbA1c p-value was 0.01, the odds ratio (OR) was 1.280, and the 95% CI was 1.11-1.48. The other variables apart from HbA1c that were statistically significant between the ischemic stroke cases and the controls were age (p < 0.01, OR: 1.280, 95% CI: 1.06-1.11), hypertension (p = 0.618, OR: 1.130, 95% CI: 0.70-1.83), and high-density lipoprotein (p = 0.055, OR: 0.975, 95% CI: 0.95-1.00). When other cofounders were considered, it was concluded that with a 1% increase in HbA1c, the risk of stroke increases by 28% (OR: 1.28, 95% CI: 1.11-1.48). To compare the variables that were determined to be statistically significant between the control and ischemic stroke case groups, a multivariable logistic regression was used. The area under the receiver operating characteristic curve for HbA1c was 0.7...

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Study to Determine the Incidence of High HbA1c in Patients with Ischemic Stroke at Bilawal Medical College, Kotri, Sindh, Pakistan

Cited by 2 publications

References 12 publications

Assessment of Factors Associated With Non-Compliance to Self-Management Practices in People With Type 2 Diabetes

Assessment of Factors Associated With Non-Compliance to Self-Management Practices in People With Type 2 Diabetes

Association of Glycated Hemoglobin With Acute Ischemic Stroke in a Tertiary Care Center in a Tribal Region of Jharkhand

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