Non-Glucose Metabolism Determinants in HgbA1c

Cardiovascular Disease, Neuropathy, and Retinopathy — Diabetes Care

In a study of 648 apparently healthy individuals, 12% had an elevated total A 1 level (measured in that study) not explained by measurement error or glucose intolerance and remaining in the same range over 3.5 years in 90% of those initially with high and in 68% of those initially with low baseline levels (1). There was no correlation with glucose tolerance, with caloric intake, or with physical activity, but A 1 level was associated with cigarette use and with clinically overt atherosclerosis, leading Dekker to conclude that “factors unrelated to glucose metabolism are the main determinants of A 1” in nondiabetic individuals, perhaps with bearing on risk of what are considered complications of diabetes.

Economic Burden of Diabetes Worsening

My oldest son is pre-Med.  I keep gently reminding him endocrinology is an exciting field.

Costs, Complexity of Treating Diabetes Increasing Steadily, Says Study — AAFP News Now — American Academy of Family Physicians

A recent study from the CDC and NIH shows that nearly 13 percent of adults in the United States have diabetes, but 40 percent of those individuals haven’t been diagnosed yet.

AF + DM = 61% Greater Risk of All-Cause Mortality

Medical News: Atrial Fibrillation Predicts Poor Outcome in Diabetes – in Cardiovascular, Diabetes from MedPage Today

Among the findings:

  • Over 4.3 years of follow-up, 879 patients died and 53% of those deaths were from cardiovascular causes
  • 15% of the deaths occurred in patients with atrial fibrillation
  • Atrial fibrillation was associated with a 77% risk of cardiovascular death (P<0.0001) and a 68% increase in risk of death from heart failure (P=0.0002) over the course of the study
  • Atrial fibrillation was associated with an increased risk of ischemic stroke (P=0.0006)
  • 26% of patients with atrial fibrillation at baseline were on anticoagulant therapy
  • Among patients taking oral anticoagulant therapy at baseline, the “adjusted HRs associated with [atrial fibrillation] were 2.16 (95% CI 1.15 to 4.07; P=0.02) and 2.32 (95% CI 1.06 to 5.12, P=0.04) for all-cause mortality and cardiovascular death, respectively.”