Utility of casual postprandial glucose levels in type 2 diabetes management.

Abstract:

OBJECTIVE:Because readily available glycemic indicators are needed to guide clinical decision-making for intensification of diabetes therapy, our goals were to define the relationship between casual postprandial plasma glucose (cPPG) levels and HbA(1c) in patients with type 2 diabetes and to determine the predictive characteristics of a convenient glucose cutoff. RESEARCH DESIGN AND METHODS:We examined the relationship between cPPG levels (1-4 h post meal) and HbA(1c) levels in 1,827 unique patients who had both determinations during a single office visit. RESULTS:The population studied was predominantly African American and middle-aged, with average cPPG of 201 mg/dl and HbA(1c) of 8.4%. The prevalence of HbA(1c) > or = 7.0% was 67% and HbA(1c) >6.5% was 77%. Overall, cPPG and HbA(1c) were linearly correlated (r = 0.63, P < 0.001). The correlation between cPPG and HbA(1c) was strongest in patients treated with diet alone (n = 348, r = 0.75, P < 0.001) and weaker but still highly significant for patients treated with oral agents (n = 610, r = 0.64, P < 0.001) or insulin (n = 869, r = 0.56, P < 0.001). A cutoff cPPG >150 mg/dl predicted an HbA(1c) level > or = 7.0% in the whole group, with a sensitivity of 78%, a specificity of 62%, and an 80% positive predictive value. The same cPPG cutoff of 150 mg/dl predicted an HbA(1c) level >6.5%, with a sensitivity of 74%, a specificity of 66%, and an 88% positive predictive value. CONCLUSIONS:When rapid-turnaround HbA(1c) determinations are not available, a single cPPG level >150 mg/dl may be used during a clinic visit to identify most inadequately controlled patients and allow timely intensification of therapy.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

El-Kebbi IM,Ziemer DC,Cook CB,Gallina DL,Barnes CS,Phillips LS

doi

10.2337/diacare.27.2.335

subject

Has Abstract

pub_date

2004-02-01 00:00:00

pages

335-9

issue

2

eissn

0149-5992

issn

1935-5548

journal_volume

27

pub_type

临床试验,杂志文章,随机对照试验
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    更新日期:2001-11-01 00:00:00

  • Atherosclerotic vascular disease and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects in Finland.

    abstract::A cross-sectional study on the prevalence of atherosclerotic vascular disease (ASVD) and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects was carried out from 1982 to 1984 in East Finland (Kuopio) and West Finland (Turku), two areas known to differ markedly in prevalence of ASVD in the nondi...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.11.6.449

    authors: Laakso M,Rönnemaa T,Pyörälä K,Kallio V,Puukka P,Penttilä I

    更新日期:1988-06-01 00:00:00

  • Low prevalence of islet autoantibodies in patients with gestational diabetes mellitus.

    abstract:OBJECTIVE:To determine the proportion of patients with gestational diabetes mellitus (GDM) who have serological characteristics typical of IDDM. RESEARCH DESIGN AND METHODS:Islet cell antibodies (ICAs), insulin autoantibodies (IAAs), GAD65, and IA-2 antibodies were measured in 145 pregnant women with GDM, 33 with impa...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.20.1.81

    authors: Dozio N,Beretta A,Belloni C,Castiglioni M,Rosa S,Bosi E,Bonifacio E

    更新日期:1997-01-01 00:00:00

  • Genetically Driven Hyperglycemia Increases Risk of Coronary Artery Disease Separately From Type 2 Diabetes.

    abstract:OBJECTIVE:This study tested the hypothesis that genetically raised hyperglycemia increases coronary artery disease (CAD) risk separately from the risk conferred by type 2 diabetes as a whole. RESEARCH DESIGN AND METHODS:We conducted a Mendelian randomization (MR) analysis using summary-level statistics from the larges...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc16-2625

    authors: Merino J,Leong A,Posner DC,Porneala B,Masana L,Dupuis J,Florez JC

    更新日期:2017-05-01 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

  • Glycemic control in early IDDM. The Wisconsin Diabetes Registry.

    abstract:OBJECTIVE:A cohort (n = 277) was followed from diabetes diagnosis to evaluate longitudinal glycemic control, urinary C-peptide levels, and certain features of diabetes self-management. RESEARCH DESIGN AND METHODS:Unselected cases with IDDM, who were less than 30 yr of age, were identified at diagnosis from a 28-county...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.15.8.980

    authors: Allen C,Zaccaro DJ,Palta M,Klein R,Duck SC,D'Alessio DJ

    更新日期:1992-08-01 00:00:00

  • Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes.

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    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/diacare.27.3.813

    authors: Pickup JC

    更新日期:2004-03-01 00:00:00

  • The association between cardiovascular autonomic neuropathy and mortality in individuals with diabetes: a meta-analysis.

    abstract:OBJECTIVE:To examine by meta-analysis the relationship between cardiovascular autonomic neuropathy (CAN) and risk of mortality in individuals with diabetes. RESEARCH DESIGN AND METHODS:We searched Medline for English-language articles published from 1966 to 2001. Fifteen studies having a baseline assessment of cardiov...

    journal_title:Diabetes care

    pub_type: 杂志文章,meta分析

    doi:10.2337/diacare.26.6.1895

    authors: Maser RE,Mitchell BD,Vinik AI,Freeman R

    更新日期:2003-06-01 00:00:00

  • Incremental value of the pancreas allograft to the survival of simultaneous pancreas-kidney transplant recipients.

    abstract:OBJECTIVE:To quantify the incremental survival benefit of the pancreas allograft in simultaneous pancreas-kidney (SPK) transplant recipients. RESEARCH DESIGN AND METHODS:Data from the national transplant database from 2000 to 2007 were analyzed. SPK recipients who had functioning allografts to 1-year post transplant (...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-1718

    authors: Salvalaggio PR,Dzebisashvili N,Pinsky B,Schnitzler MA,Burroughs TE,Graff R,Axelrod DA,Brennan DC,Lentine KL

    更新日期:2009-04-01 00:00:00

  • Impact of peripheral neuropathy on bone density in patients with type 1 diabetes.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.22.5.827

    authors: Rix M,Andreassen H,Eskildsen P

    更新日期:1999-05-01 00:00:00

  • Effect of protein ingestion on the glucose and insulin response to a standardized oral glucose load.

    abstract::Type II diabetic subjects were given 50 g protein, 50 g glucose, or 50 g glucose with 50 g protein as a single meal in random sequence. The plasma glucose and insulin response was determined over the subsequent 5 h. The plasma glucose area above the baseline following a glucose meal was reduced 34% when protein was gi...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.7.5.465

    authors: Nuttall FQ,Mooradian AD,Gannon MC,Billington C,Krezowski P

    更新日期:1984-09-01 00:00:00

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    abstract:OBJECTIVE:To determine whether increasing doses (amounts) of beta-glucan present in an extruded breakfast cereal affect the glycemic and insulinemic responses in eight NIDDM subjects, compared with the same responses after a continental breakfast (bread, milk, cheese, ham). RESEARCH DESIGN AND METHODS:Breakfast cereal...

    journal_title:Diabetes care

    pub_type: 杂志文章

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    authors: Tappy L,Gügolz E,Würsch P

    更新日期:1996-08-01 00:00:00

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    pub_type: 杂志文章

    doi:10.2337/dc11-1849

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-0549

    authors: Staník J,Lethby M,Flanagan SE,Gasperíková D,Milosovicová B,Lever M,Bullman H,Zubcevic L,Hattersley AT,Ellard S,Ashcroft FM,Klimes I

    更新日期:2008-09-01 00:00:00

  • Glycemic control, atherosclerosis, and risk factors for cardiovascular disease in individuals with diabetes: the atherosclerosis risk in communities study.

    abstract:OBJECTIVE:Glycemic control (HbA(1c) [A1C]) is strongly associated with microvascular disease in individuals with diabetes, but its relation to macrovascular disease and atherosclerosis is less clear. This study examines the relationship between A1C, carotid intima-media thickness (IMT), and traditional cardiovascular r...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究

    doi:10.2337/diacare.28.8.1965

    authors: Selvin E,Coresh J,Golden SH,Boland LL,Brancati FL,Steffes MW,Atherosclerosis risk in communities study.

    更新日期:2005-08-01 00:00:00

  • Head-to-head comparison of sirolimus- and paclitaxel-eluting stent in the same diabetic patient with multiple coronary artery lesions: a prospective, randomized, multicenter study.

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    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.2337/dc07-1377

    authors: Tomai F,Reimers B,De Luca L,Galassi AR,Gaspardone A,Ghini AS,Ferrero V,Favero L,Gioffrè G,Prati F,Tamburino C,Ribichini F

    更新日期:2008-01-01 00:00:00

  • Prevalence of isthmic lumbar spondylolisthesis in nondiabetic subjects and NIDDM patients.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.17.6.592

    authors: Virta L,Rönnemaa T,Laakso M

    更新日期:1994-06-01 00:00:00

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc07-2349

    authors: Buckloh LM,Lochrie AS,Antal H,Milkes A,Canas JA,Hutchinson S,Wysocki T

    更新日期:2008-08-01 00:00:00

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.2.3.275

    authors: Baldwin D Jr,Winston E,Hoshizaki RJ,Garland JT,Baldwin D Sr,Holcomb HH,Flier JS,Rubenstein A

    更新日期:1979-05-01 00:00:00

  • Survey of physician practice behaviors related to diabetes mellitus in the U.S. Physician adherence to consensus recommendations.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.16.11.1507

    authors: Kenny SJ,Smith PJ,Goldschmid MG,Newman JM,Herman WH

    更新日期:1993-11-01 00:00:00

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-1042

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    更新日期:2009-11-01 00:00:00

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    journal_title:Diabetes care

    pub_type: 杂志文章

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    authors: Poirier P,Bogaty P,Garneau C,Marois L,Dumesnil JG

    更新日期:2001-01-01 00:00:00

  • Hypertriglyceridemia enhances monocyte binding to endothelial cells in NIDDM.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.19.10.1122

    authors: Hoogerbrugge N,Verkerk A,Jacobs ML,Postema PT,Jongkind JF

    更新日期:1996-10-01 00:00:00

  • Troponin T and pro-B-type natriuretic Peptide in fetuses of type 1 diabetic mothers.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-0552

    authors: Russell NE,Higgins MF,Amaruso M,Foley M,McAuliffe FM

    更新日期:2009-11-01 00:00:00

  • Hypocalcemia, hypomagnesemia, and transient hypoparathyroidism during therapy with potassium phosphate in diabetic ketoacidosis.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.2.3.265

    authors: Zipf WB,Bacon GE,Spencer ML,Kelch RP,Hopwood NJ,Hawker CD

    更新日期:1979-05-01 00:00:00

  • Postural instability in patients with diabetic sensory neuropathy.

    abstract:OBJECTIVE:Recent survey evidence suggests that sensory ataxia due to diabetic neuropathy may be a more frequent and serious problem than is commonly recognized. This view is further supported by research that confirms the major contribution of the somatosensory system to the control of posture. We therefore sought to d...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.17.12.1411

    authors: Simoneau GG,Ulbrecht JS,Derr JA,Becker MB,Cavanagh PR

    更新日期:1994-12-01 00:00:00

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    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.28.5.1145

    authors: McMahon GT,Plutzky J,Daher E,Bhattacharyya T,Grunberger G,DiCarli MF

    更新日期:2005-05-01 00:00:00

  • Body fatness and fat distribution as predictors of metabolic abnormalities and early carotid atherosclerosis.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.24.7.1248

    authors: Takami R,Takeda N,Hayashi M,Sasaki A,Kawachi S,Yoshino K,Takami K,Nakashima K,Akai A,Yamakita N,Yasuda K

    更新日期:2001-07-01 00:00:00

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.23.4.490

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    更新日期:2000-04-01 00:00:00

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