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Understanding Blood Glucose Levels and Diabetes Management
Glycosylated Hemoglobins and Long-Term Blood Glucose Control
Glycosylated Hemoglobin (HbA1c) as a Marker
Glycosylated hemoglobin components, particularly HbA1c, are crucial markers for long-term blood glucose control in diabetic patients. Elevated levels of HbA1c are indicative of poor blood glucose regulation. In insulin-dependent juvenile diabetic patients, HbA1c levels are significantly higher compared to non-diabetic individuals, with values of 10.0±1.9% versus 4.9±0.7% respectively1. This elevation correlates with the degree of blood glucose regulation, as measured by antecedent 24-hour urinary glucose excretion1.
Correlation with Plasma Cholesterol Levels
The study also found a correlation between total glycosylated hemoglobin components (Hb A1a+b+c) and plasma cholesterol levels. This suggests that long-term hyperglycemia is associated with hypercholesterolemia, highlighting the importance of maintaining controlled blood glucose levels to prevent additional metabolic complications1.
Fasting Blood Glucose Measurements in Non-Insulin-Dependent Diabetes
Targeting Fasting Blood Glucose Levels
In non-insulin-dependent diabetes, managing fasting blood glucose levels is a practical approach. Aiming for a fasting blood glucose concentration of less than 108 mg/dl (6 mmol/l) has shown promising results in general practice settings. Over a one-year follow-up, the number of patients achieving this target increased significantly from 26% to 59%2.
Effectiveness and Practicality
The mean fasting blood glucose concentration of 112 patients decreased significantly from 148 mg/dl to 113 mg/dl within three months, and although it slightly increased to 126 mg/dl after one year, it remained significantly lower than the initial levels2. This method proved to be cost-effective and practical, with some practices achieving good results through specialized clinics or nurse-administered tests under general practitioner supervision2.
Conclusion
Monitoring and managing blood glucose levels are essential for effective diabetes control. Glycosylated hemoglobin (HbA1c) serves as a reliable marker for long-term glucose regulation and is associated with other metabolic parameters like plasma cholesterol levels. For non-insulin-dependent diabetes, targeting fasting blood glucose levels below 108 mg/dl has been shown to improve overall glucose control effectively. These strategies underscore the importance of regular monitoring and tailored management plans in diabetes care.
Sources and full results
Most relevant research papers on this topic
Glycosylated hemoglobins and long-term blood glucose control in diabetes mellitus.
Glycosylated hemoglobin measurement is a good index of long-term blood glucose levels in diabetic patients, and long-term hyperglycemia is associated with hypercholesterolemia.
Observational Study
Highly CitedGeneral practice care of non-insulin-dependent diabetes with fasting blood glucose measurements.
Fasting blood glucose measurements in general practices can improve blood glucose control in non-insulin-dependent diabetes patients, with less expensive results than regular urine tests.
Observational StudyToward universal criteria for gestational diabetes: relationships between seventy-five and one hundred gram glucose loads and between capillary and venous glucose concentrations.
In metabolically healthy women, both 75 and 100 gm glucose loads lead to different blood glucose levels at 1 and 2 hours, but in gestational diabetes mellitus, 1-hour glucose levels do not differ between the two loads or blood fractions.
RCTHighly CitedPrevalence of impaired glucose tolerance among children and adolescents with marked obesity.
Impaired glucose tolerance is highly prevalent in children and adolescents with severe obesity, irrespective of ethnic group, and is associated with insulin resistance, while beta-cell function remains relatively preserved.
Observational StudyHighly CitedTranslating the A1C Assay Into Estimated Average Glucose Values
A1C levels can be expressed as estimated average glucose (eAG) for most patients with type 1 and type 2 diabetes, allowing for more accurate diabetes treatment adjustments.
Observational Study
Rigorous JournalHighly CitedThe relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years.
The progressive relationship between glucose levels and cardiovascular risk extends below the diabetic threshold.
Meta-AnalysisHighly CitedNormal fasting plasma glucose levels and type 2 diabetes in young men.
Higher fasting plasma glucose levels within the normal range are an independent risk factor for type 2 diabetes in young men, and may help identify seemingly healthy men at increased risk for diabetes.
Observational StudyHighly CitedGlucose levels and risk of dementia.
Higher glucose levels may be a risk factor for dementia, even in individuals without diabetes.
Observational StudyHighly CitedGlucose Concentrations of Less Than 3.0 mmol/L (54 mg/dL) Should Be Reported in Clinical Trials: A Joint Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes
The International Hypoglycaemia Study Group recommends reporting glucose levels below 3.0 mmol/L (54 mg/dL) in clinical trials to compare the effectiveness of interventions in reducing hypoglycemia in diabetes treatment.
Very Rigorous JournalHighly CitedHaplotype combinations of calpain 10 gene polymorphisms associate with increased risk of impaired glucose tolerance and type 2 diabetes in South Indians.
Specific haplotype combinations of calpain 10 variants increase the risk of impaired glucose tolerance and type 2 diabetes in South Indians, but calpain 10 is not a common determinant of susceptibility to type 2 diabetes.
Observational StudyHighly Cited