Data on the internal consistency of fasting blood glucose (FBG) and 2 hrs-oral glucose tolerance test (OGTT) are scarce despite of its importance both for research and treatment purposes.
FBG and OGTT were performed on two consecutive days among the 218 (107 men and 111 women) newly diagnosed type 2 diabetes patients at BIRDEM (a diabetic hospital), Dhaka Bangladesh.
Further studies are needed to investigate the observed difference in FBG measures with specific attention to BMI and the fasting state. Different diagnostic criteria have been established to reduce the risks for the development of complications among the diabetic patients [1,4]. The ADA published revised criteria for the diagnosis of diabetes that includes a FPG value, with a confirmatory test on a subsequent day [6]. All people with type 2 diabetes who were diagnosed within 4 weeks prior to the scrutiny attending FBG test at outdoor facility of Bangladesh Institute of Research on Diabetes, Endocrinology and Metabolism (BIRDEM) hospital, Dhaka, Bangladesh were requested to participate in the study during the month of November, 2003. 1st day data collection- (FBG1 and OGTT1) – Screening subjects attending BIRDEM hospital for confirmatory test were informed about the procedures of the test previously at the time of collection screening test result.
2nd day data collection- (FBG2 and OGTT2) - FBG and OGTT tests were repeated on all the subjects on the next day by ensuing the same procedure.
Consistency of the diagnostic procedures FBG or OGTT for the diagnosis of diabetes mellitus appeared to be reasonably reliable on two consecutive days. Relatively stronger consistency over the repeated tests was observed among lower level of FBG values, while this was true for higher OGTT values.
More investigations are needed to reduce the ambiguity of the test results by including some control subjects, preferably in the hospital and rather than fasting time to reduce the confusion, and to observe the creditability of the fasting state as assessed by interviews.
We sincerely thank the team at BIRDEM hospital for their cooperation and the subjects for their participation. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus Diabetes Care 20 (1997), pp. The DECODE Study Group on behalf of the European Diabetes Epidemiology Group: Is fasting glucose sufficient to define diabetes?
A1c test: medlineplus medical encyclopedia, A1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. Shown below is a Blood Sugar Level Chart, simply designed for basic glucose and blood sugar testing.
For more nutritional information, charts, health stats, worksheets, and other free printable items, visit any of the links shown on this page. Click this link to exit the Blood Sugar Level Chart page, and visit the Main Health Info Page.Hit this link for a collection of Great American Recipes. Fasting is in a state of non-eating, where the stomach is empty and as much glucose as possible has been moved from the blood stream. Copyright © 2016 A Normal Blood Sugar Level This site offers general advice for staying healthy. The normal a1c level – mendosa, You want to control your diabetes as much as possible. Hemoglobin a1c test: get information about the results, Hemoglobin a1c test is used as a standard tool to determine blood sugar control for patients with diabetes.


Hemoglobin a1c (hba1c): learn about the test and levels, Learn about the hemoglobin a1c (hba1c) blood test for diabetes. Further, an interview with each subject was conducted and HbA1c, bio-physical and anthropometric examinations were performed. The observed variation for FBG and OGTT should be considered during diagnosis of diabetes or control of the condition. The most widely used diagnostic criteria for glucose intolerance was recommended by the World Health Organization (WHO) based on fasting plasma glucose (FPG) value and glucose value measured 2 hrs after a standard 75-g glucose load (OGTT) [5]. In contrast to the recommendation of ADA, World Health Organization (WHO) recommends using the OGTT in clinical practice [5]. At that time participants were asked to undertake 12 hrs fast for confirmatory test, avoid any treatment for diabetes and physical activities during this one month. A fasting sample of venous blood was also collected for HbA1c measurement on the second day by HPLC (ion exchange high-performance liquid chromatography) using a Modular Diabetes Monitoring System (BioRad, Variant, USA) method. However, it was observed that PD was normally distributed and that a total of 95% of the FBG and OGTT values varied respectively within approximately ± 25 % and ± 24% on a day to day basis. We extend our thanks to Medical Statistician Geir Aamodt at the Department of Medical Statistics, University of Oslo for his assistance in analyzing the data. Comparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods for diabetes. Comparison of fasting And 2-hour glucose and HBA1c levels for Diagnosing diabetes: diagnostic criteria and Performance revisited.
Repeatability of the oral glucose tolerance test for the diagnosis impaired glucose tolerance and diabetes? Report of a WHO Consultation, Part 1: Diagnosis and classification of Diabetes Mellitus, Geneva 1999, Worl Health Organization.
Comparing methods of mesurment: why plotting difference against standard method is misleading. Day-to-day variability of fasting plasma in newly diagnosed type 2 diabetic subjects, Diabetes Care 22 (1999), pp. Comparison of the fasting and the 2-hour glucose criteria for diabetes in different Asian cohorts.
A 17-gauge Luer-lock venflon was inserted in to both anticubital fossa and sample was taken for HbA1c.
Statistical comparisons among sex, BMI, SBP and DBP were made by one sample t- test for continuous variables and chi-square tests for group comparisons. The inconsistency of the test results was largely influenced by female subjects following FBG procedure. HbA1c appeared to have improved associations with FBG measures contrasting against OGTT values. The upper limit of blood glucose measurement by HemoCue Blood-glucose analyzer and sample size may also be a concern for further investigation. If blood test results are coming back in the upper ranges on the is chart further medical treatment by a doctor is probably indicated.


Moreover, the DECODE study found that almost 30% of all patients with diabetes (based on fasting or 2hrs - PG following OGTT or both) would remain undetected [7].
At the end of 2hrs blood glucose test, all subjects were interviewed to collect information regarding socio-economic, family history, treatment history and smoking habit etc. Anthropometrical data and blood pressure were measured in the same examination room to avoid any influence of physical activity between 2 hrs time of glucose drink and OGTT2. Moreover, both FBG and OGTT values appeared to have no significant deviation from normality as assessed by the PD. Either setting will likely have implications in the epidemiology, treatment and control of the state of diabetes. As you can see the blood sugar amount increases after a meal when the food is digested and glucose is absorbed into the blood.
This low agreement may raise concern for identification and treatment of people with diabetes. Moreover, the increased variability was also stratified by hypertension, which may raise attention for diagnosis of hypertensive subjects.
The blood sugar level falls as insulin does its work of moving the glucose from the blood in to tissues needing it for food. It was also recommended by ADA that the internal stability of the diagnostic procedures should be carefully considered when monitoring glycemic control for people with diabetes [10,13].
Liner regression analysis was carried out to describe the relation between FBG, OGTT and HbA1c with PDs and averaged values of them. Therefore, elevated variability of the test results among women and hypertensive subjects by FBG procedure deserves attention for future studies with a focus on obese status. This may have been true for the newly diagnosed cases as was observed in other studies [18]. This pattern is a normal occurrence as glucose is needed in the body for proper brain functioning as well as for fuel for muscles and other cells. Data on the internal consistency of these two procedures is scarce especially from ethnic groups representing the highest increase of incidence in type 2 diabetes. Scattered diagrams are also presented to indicate the correlation and inter-relationship of those values.
Keep your glucose levels functioning like the chart above and everything should be just fine. Therefore the purpose of the study was to assess the day to day variability of FBG and OGTT in people with newly diagnosed type 2 diabetes in Bangladesh. In addition, both the diagnostic procedures were examined against glycosylated hemoglobin A1c in order to observe the strength of FBG and OGTT procedures.



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Comments

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