Rapid A1c availability improves clinical decision-making in an urban primary care clinic.

Abstract:

OBJECTIVE:Failure to meet goals for glycemic control in primary care settings may be due in part to lack of information critical to guide intensification of therapy. Our objective is to determine whether rapid-turnaround A1c availability would improve intensification of diabetes therapy and reduce A1c levels in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS:In this prospective controlled trial, A1c was determined on capillary glucose samples and made available to providers, either during ("rapid") or after ("routine") the patient visit. Frequency of intensification of pharmacological diabetes therapy in inadequately controlled patients and A1c levels were assessed at baseline and after follow-up. RESULTS:We recruited 597 subjects. Patients were 79% female and 96% African American, with average age of 61 years, duration of diabetes 10 years, BMI 33 kg/m(2), and A1c 8.5%. The rapid and routine groups had similar clinical demographics. Rapid A1c availability resulted in more frequent intensification of therapy when A1c was >/=7.0% at the baseline visit (51 vs. 32% of patients, P = 0.01), particularly when A1c was >8.0% and/or random glucose was in the 8.4-14.4 mmol/l range (151-250 mg/dl). In 275 patients with two follow-up visits, A1c fell significantly in the rapid group (from 8.4 to 8.1%, P = 0.04) but not in the routine group (from 8.1 to 8.0%, P = 0.31). CONCLUSIONS:Availability of rapid A1c measurements increased the frequency of intensification of therapy and lowered A1c levels in patients with type 2 diabetes in an urban neighborhood health center.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Miller CD,Barnes CS,Phillips LS,Ziemer DC,Gallina DL,Cook CB,Maryman SD,El-Kebbi IM

doi

10.2337/diacare.26.4.1158

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

1158-63

issue

4

eissn

0149-5992

issn

1935-5548

journal_volume

26

pub_type

临床试验,杂志文章
  • Impact of Lowering BMI Cut Points as Recommended in the Revised American Diabetes Association's Standards of Medical Care in Diabetes-2015 on Diabetes Screening in Asian Americans.

    abstract:OBJECTIVE:This study estimated the screening prevalence of prediabetes and diabetes using a lower BMI cutoff of 23 kg/m(2) in Asians in the U.S. using the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2012. RESEARCH DESIGN AND METHODS:A cross-sectional analysis was conducted of non-Hispanic As...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc15-0299

    authors: Hsia DS,Larrivee S,Cefalu WT,Johnson WD

    更新日期:2015-11-01 00:00:00

  • Hemoglobin A1c versus oral glucose tolerance test in postpartum diabetes screening.

    abstract:OBJECTIVE:To determine the usefulness of measuring hemoglobin A(1c) (A1C), alone or combined with the fasting glucose test, compared with the oral glucose tolerance test (OGTT) for the reassessment of the carbohydrate metabolism status in postpartum women with a history of gestational diabetes mellitus (GDM). RESEARCH...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc11-2111

    authors: Picón MJ,Murri M,Muñoz A,Fernández-García JC,Gomez-Huelgas R,Tinahones FJ

    更新日期:2012-08-01 00:00:00

  • Assessing the impact of visual acuity on quality of life in individuals with type 2 diabetes using the short form-36.

    abstract:OBJECTIVE:We sought to ascertain quality-of-life measures and utility values associated with visual acuity in type 2 diabetes. RESEARCH DESIGN AND METHODS:The Medical Outcome Study Short Form with 36 items (SF-36) was administered to 4,051 individuals with type 2 diabetes who were enrolled in the Lipids in Diabetes St...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc05-2150

    authors: Clarke PM,Simon J,Cull CA,Holman RR

    更新日期:2006-07-01 00:00:00

  • Impact of BMI and the metabolic syndrome on the risk of diabetes in middle-aged men.

    abstract:OBJECTIVE:The existence of an obese subgroup with a healthy metabolic profile and low diabetes risk has been proposed; yet long-term data are lacking. We aimed to investigate associations between combinations of BMI categories and metabolic syndrome and risk of type 2 diabetes in middle-aged men. RESEARCH DESIGN AND M...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc10-0955

    authors: Arnlöv J,Sundström J,Ingelsson E,Lind L

    更新日期:2011-01-01 00:00:00

  • Altered hierarchy of protective responses against severe hypoglycemia in normal aging in healthy men.

    abstract:OBJECTIVE:To investigate the effect of normal aging on the protective responses against hypoglycemia, in view of the fact that type II diabetes is primarily a disease of aging, and its treatment is associated with risk of hypoglycemia with cognitive impairment. RESEARCH DESIGN AND METHODS:Plasma glucose was lowered st...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.20.2.135

    authors: Matyka K,Evans M,Lomas J,Cranston I,Macdonald I,Amiel SA

    更新日期:1997-02-01 00:00:00

  • Biologic and quality-of-life outcomes from the Mediterranean Lifestyle Program: a randomized clinical trial.

    abstract:OBJECTIVE:Few multiple lifestyle behavior change programs have been designed to reduce the risk of coronary heart disease in postmenopausal women with type 2 diabetes. This study tested the effectiveness of the Mediterranean Lifestyle Program (MLP), a comprehensive lifestyle self-management program (Mediterranean low-s...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.26.8.2288

    authors: Toobert DJ,Glasgow RE,Strycker LA,Barrera M Jr,Radcliffe JL,Wander RC,Bagdade JD

    更新日期:2003-08-01 00:00:00

  • Smoking and mortality among women with type 2 diabetes: The Nurses' Health Study cohort.

    abstract:OBJECTIVE:To assess the relationship between cigarette smoking and mortality among women with type 2 diabetes in the Nurses' Health Study cohort. RESEARCH DESIGN AND METHODS:The Nurses' Health Study, a prospective cohort of U.S. female registered nurses, included 7,401 women with type 2 diabetes diagnosed at baseline ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.24.12.2043

    authors: Al-Delaimy WK,Willett WC,Manson JE,Speizer FE,Hu FB

    更新日期:2001-12-01 00:00:00

  • Diabetes and oral tumors in Hungary: epidemiological correlations.

    abstract:OBJECTIVE:Numerous publications have already demonstrated that diabetes is a risk factor for the development of periodontal diseases and various inflammatory lesions in the oral mucosa. A possible correlation between diabetes and oral premalignancies and tumors was examined in this study, as no literature data are avai...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.27.3.770

    authors: Ujpál M,Matos O,Bíbok G,Somogyi A,Szabó G,Suba Z

    更新日期:2004-03-01 00:00:00

  • A highly successful and novel model for treatment of chronic painful diabetic peripheral neuropathy.

    abstract:OBJECTIVE:To investigate why, in spite of a vast variety of treatment agents, the alleviation of pain in patients with diabetic neuropathy is difficult. Previous studies have not used a treatment algorithm based on anatomic site and neuropathophysiological source of the neuropathic pain. RESEARCH DESIGN AND METHODS:A ...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章

    doi:10.2337/diacare.16.8.1103

    authors: Pfeifer MA,Ross DR,Schrage JP,Gelber DA,Schumer MP,Crain GM,Markwell SJ,Jung S

    更新日期:1993-08-01 00:00:00

  • Diabeloop DBLG1 Closed-Loop System Enables Patients With Type 1 Diabetes to Significantly Improve Their Glycemic Control in Real-Life Situations Without Serious Adverse Events: 6-Month Follow-up.

    abstract:OBJECTIVE:To analyze safety and efficacy of the Diabeloop Generation 1 (DBLG1) hybrid closed-loop artificial pancreas system in patients with type 1 diabetes in real-world conditions. RESEARCH DESIGN AND METHODS:After a 1-week run-in period with their usual pump, 25 patients were provided the commercial DBLG1 system. ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc20-1809

    authors: Amadou C,Franc S,Benhamou PY,Lablanche S,Huneker E,Charpentier G,Penfornis A,Diabeloop Consortium.

    更新日期:2021-01-11 00:00:00

  • Increasing expenditure on health care incurred by diabetic subjects in a developing country: a study from India.

    abstract:OBJECTIVE:This study aimed to assess the direct cost incurred by diabetic subjects who were in different income groups in urban and rural India, as well as to examine the changing trends of costs in the urban setting from 1998 to 2005. RESEARCH DESIGN AND METHODS:A total of 556 diabetic subjects from various urban and...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc06-0144

    authors: Ramachandran A,Ramachandran S,Snehalatha C,Augustine C,Murugesan N,Viswanathan V,Kapur A,Williams R

    更新日期:2007-02-01 00:00:00

  • Postprandial exercise in type I diabetic patients on multiple daily insulin injection regimen.

    abstract::This study shows the influence on plasma glucose concentrations of 45 min of mild exercise (48 +/- 4% of maximum aerobic capacity) performed 180 min after breakfast and 195 min after a subcutaneous injection of regular insulin by six type I (insulin-dependent) diabetic patients on a three-daily insulin injection regim...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.11.2.107

    authors: Trovati M,Anfossi G,Vitali S,Mularoni E,Massucco P,De Facis R,Carta Q,Lucchina PG,Emanuelli G

    更新日期:1988-02-01 00:00:00

  • Skeletal muscle deoxygenation after the onset of moderate exercise suggests slowed microvascular blood flow kinetics in type 2 diabetes.

    abstract:OBJECTIVE:People with type 2 diabetes have impaired exercise responses even in the absence of cardiovascular complications. One key factor associated with the exercise intolerance is abnormally slowed oxygen uptake (VO2) kinetics during submaximal exercise. The mechanisms of this delayed adaptation during exercise are ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc07-0843

    authors: Bauer TA,Reusch JE,Levi M,Regensteiner JG

    更新日期:2007-11-01 00:00:00

  • Carotid atherosclerosis and serum lipoprotein(a) concentrations in patients with NIDDM.

    abstract:OBJECTIVE:To investigate the association of carotid atherosclerosis and serum lipoprotein(a) [Lp(a)] concentrations in subjects with NIDDM. RESEARCH DESIGN AND METHODS:We measured carotid intima-media thickness (IMT) and Lp(a) concentrations in 117 NIDDM subjects. Subjects were divided into tertiles according to IMT v...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.20.5.829

    authors: Yamamoto M,Egusa G,Yamakido M

    更新日期:1997-05-01 00:00:00

  • Sex disparities in treatment of cardiac risk factors in patients with type 2 diabetes.

    abstract:OBJECTIVE:Diabetes eliminates the protective effect of female sex on the risk of coronary heart disease (CHD). We assessed sex differences in the treatment of CHD risk factors among patients with diabetes. RESEARCH DESIGN AND METHODS:A cross-sectional analysis included 3,849 patients with diabetes treated in five acad...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究

    doi:10.2337/diacare.28.3.514

    authors: Wexler DJ,Grant RW,Meigs JB,Nathan DM,Cagliero E

    更新日期:2005-03-01 00:00:00

  • Transient neonatal diabetes, ZFP57, and hypomethylation of multiple imprinted loci: a detailed follow-up.

    abstract:OBJECTIVE:Transient neonatal diabetes mellitus 1 (TNDM1) is the most common cause of diabetes presenting at birth. Approximately 5% of the cases are due to recessive ZFP57 mutations, causing hypomethylation at the TNDM locus and other imprinted loci (HIL). This has consequences for patient care because it has impact on...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-0700

    authors: Boonen SE,Mackay DJ,Hahnemann JM,Docherty L,Grønskov K,Lehmann A,Larsen LG,Haemers AP,Kockaerts Y,Dooms L,Vu DC,Ngoc CT,Nguyen PB,Kordonouri O,Sundberg F,Dayanikli P,Puthi V,Acerini C,Massoud AF,Tümer Z,Temple IK

    更新日期:2013-03-01 00:00:00

  • Hyperinsulinemia or increased sympathetic drive as links for obesity and hypertension.

    abstract::The association of obesity with hypertension has been amply demonstrated in cross-sectional, longitudinal, and dietary-intervention studies, but the mechanisms remain enigmatic. Both conditions are independently characterized by similar metabolic alterations, i.e., glucose intolerance, dyslipoproteinemia, elevated ser...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/diacare.14.6.470

    authors: Modan M,Halkin H

    更新日期:1991-06-01 00:00:00

  • Microalbuminuria, preeclampsia, and preterm delivery in pregnant women with type 1 diabetes: results from a nationwide Danish study.

    abstract:OBJECTIVE:To study the association between microalbuminuria and development of preeclampsia and preterm delivery in pregnant women with type 1 diabetes. RESEARCH DESIGN AND METHODS:This was a population-based prospective study in 846 normoalbuminuric or microalbuminuric women with type 1 diabetes without antihypertens...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-1219

    authors: Jensen DM,Damm P,Ovesen P,Mølsted-Pedersen L,Beck-Nielsen H,Westergaard JG,Moeller M,Mathiesen ER

    更新日期:2010-01-01 00:00:00

  • Self-monitored blood glucose: the essential biofeedback signal in the diabetic patient's effort to achieve normoglycemia.

    abstract::Seventeen pregnant diabetic women participated in a special outpatient program during which they learned to self-monitor blood glucose (BG) and to vary insulin dosage on the basis of the results. The Ames Eyetone reflectance meter and the Boehringer Reflomat were used for BG analysis. BG was self-monitored at least tw...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.3.1.163

    authors: Irsigler K,Bali-Taubald C

    更新日期:1980-01-01 00:00:00

  • Reconciliation of Type 2 Diabetes Remission Rates in Studies of Roux-en-Y Gastric Bypass.

    abstract:OBJECTIVE:Bariatric surgery may induce remission of type 2 diabetes in obese patients. However, estimates of remission rates reported in the literature range from 25 to 81%, contributing to the uncertainty patients and physicians both face as they assess treatment options. This analysis attempts to reconcile the seemin...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc16-0954

    authors: Isaman DJ,Rothberg AE,Herman WH

    更新日期:2016-12-01 00:00:00

  • Predicting future cardiovascular disease: do we need the oral glucose tolerance test?

    abstract:OBJECTIVE:Our objective was to compare the performance of oral glucose tolerance tests (OGTTs) and multivariate models incorporating commonly available clinical variables in their ability to predict future cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS:We randomly selected 2,662 Mexican-Americans and 1,595 ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.25.10.1851

    authors: Stern MP,Fatehi P,Williams K,Haffner SM

    更新日期:2002-10-01 00:00:00

  • Glycemic control and complications in type II diabetes. Design of a feasibility trial. VA CS Group (CSDM)

    abstract:OBJECTIVE:To determine, after 1 yr of follow-up in type II diabetes patients, whether a statistically and clinically significant difference can be achieved in HbA1c between a standard therapy group and an intensively treated group, while maintaining HbA1c levels in both groups within ranges acceptable in regular commun...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.15.11.1560

    authors: Abraira C,Emanuele N,Colwell J,Henderson W,Comstock J,Levin S,Nuttall F,Sawin C

    更新日期:1992-11-01 00:00:00

  • Racial disparities in quality-adjusted life-years associated with diabetes and visual impairment.

    abstract:OBJECTIVE:Compare differences in health-related quality of life among blacks and whites to examine if race, diabetes, and visual impairment (VI) present a triple disadvantage in terms of quality-adjusted life expectancy. RESEARCH DESIGN AND METHODS:Data were analyzed from the 2000-2003 Medical Expenditure Panel Survey...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc11-2433

    authors: McCollister KE,Zheng DD,Fernandez CA,Lee DJ,Lam BL,Arheart KL,Galor A,Ocasio M,Muennig P

    更新日期:2012-08-01 00:00:00

  • Proinsulin Secretion Is a Persistent Feature of Type 1 Diabetes.

    abstract:OBJECTIVE:Abnormally elevated proinsulin secretion has been reported in type 2 and early type 1 diabetes when significant C-peptide is present. We questioned whether individuals with long-standing type 1 diabetes and low or absent C-peptide secretory capacity retained the ability to make proinsulin. RESEARCH DESIGN AN...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc17-2625

    authors: Sims EK,Bahnson HT,Nyalwidhe J,Haataja L,Davis AK,Speake C,DiMeglio LA,Blum J,Morris MA,Mirmira RG,Nadler J,Mastracci TL,Marcovina S,Qian WJ,Yi L,Swensen AC,Yip-Schneider M,Schmidt CM,Considine RV,Arvan P,Greenbau

    更新日期:2019-02-01 00:00:00

  • Costs and consequences associated with newer medications for glycemic control in type 2 diabetes.

    abstract:OBJECTIVE:Newer medications offer more options for glycemic control in type 2 diabetes. However, they come at considerable costs. We undertook a health economic analysis to better understand the value of adding two newer medications (exenatide and sitagliptin) as second-line therapy to glycemic control strategies for p...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-1488

    authors: Sinha A,Rajan M,Hoerger T,Pogach L

    更新日期:2010-04-01 00:00:00

  • Rapid progression of albumin excretion is an independent predictor of cardiovascular mortality in patients with type 2 diabetes and microalbuminuria.

    abstract:OBJECTIVE:In patients with type 2 diabetes, microalbuminuria is associated with an increase in predominantly cardiovascular mortality. Considerable interindividual variability in the rate of progression of microalbuminuria exists. The prognostic significance of rate of progression of microalbuminuria with regard to car...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.24.12.2097

    authors: Spoelstra-de Man AM,Brouwer CB,Stehouwer CD,Smulders YM

    更新日期:2001-12-01 00:00:00

  • Using the BRAVO Risk Engine to Predict Cardiovascular Outcomes in Clinical Trials With Sodium-Glucose Transporter 2 Inhibitors.

    abstract:OBJECTIVE:This study evaluated the ability of the Building, Relating, Assessing, and Validating Outcomes (BRAVO) risk engine to accurately project cardiovascular outcomes in three major clinical trials-BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), C...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc20-0227

    authors: Shao H,Shi L,Fonseca VA

    更新日期:2020-07-01 00:00:00

  • Evidence of reduced β-cell function in Asian Indians with mild dysglycemia.

    abstract:OBJECTIVE:To examine β-cell function across a spectrum of glycemia among Asian Indians, a population experiencing type 2 diabetes development at young ages despite low BMI. RESEARCH DESIGN AND METHODS:One-thousand two-hundred sixty-four individuals without known diabetes in the Diabetes Community Lifestyle Improvement...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-2290

    authors: Staimez LR,Weber MB,Ranjani H,Ali MK,Echouffo-Tcheugui JB,Phillips LS,Mohan V,Narayan KM

    更新日期:2013-09-01 00:00:00

  • The development and utility of a novel scale that quantifies the glycemic progression toward type 1 diabetes over 6 months.

    abstract:OBJECTIVE:We developed a scale to serve as a potential end point for 6-month glycemic progression (PS6M) toward type 1 diabetes (T1D) in autoantibody-positive relatives of individuals with T1D. RESEARCH DESIGN AND METHODS:The PS6M was developed from Diabetes Prevention Trial-Type 1 (DPT-1) data and tested in the Trial...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc14-2787

    authors: Sosenko JM,Skyler JS,Beam CA,Boulware D,Mahon JL,Krischer JP,Greenbaum CJ,Rafkin LE,Matheson D,Herold KC,Palmer JP,Type 1 Diabetes TrialNet and Diabetes Prevention Trial–Type 1 Study Groups.

    更新日期:2015-05-01 00:00:00

  • Lipid, glycemic, and insulin responses to meals rich in saturated, cis-monounsaturated, and polyunsaturated (n-3 and n-6) fatty acids in subjects with type 2 diabetes.

    abstract:OBJECTIVE:The recommendations for dietary fats in patients with type 2 diabetes are based largely on the impact of fatty acids on fasting serum lipid and glucose concentrations. How fatty acids affect postprandial insulin, glucose, and triglyceride concentrations, however, remains unclear. The objective of this study w...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc07-1026

    authors: Shah M,Adams-Huet B,Brinkley L,Grundy SM,Garg A

    更新日期:2007-12-01 00:00:00