التفاصيل البيبلوغرافية
| العنوان: |
Correlation of Continuous Glucose Monitoring Sensor with Fructosamine and Glycosylated Hemoglobin in the Evaluation of the Glycemic Control in Diabetics with Liver Cirrhosis. |
| المؤلفون: |
Vora, Avni, Gilet, Felicia, Mehta, Darshal, Strong, Penelope, Hatipoglu, Betul, Anel, Raquel Marguerite |
| المصدر: |
Diabetes; Jun2007 Supplement 1, Vol. 56, pA529-A529, 1/4p |
| مصطلحات موضوعية: |
BIOSENSORS, FRUCTOSE, HEMOGLOBINS, BLOOD sugar monitoring, PEOPLE with diabetes, CIRRHOSIS of the liver |
| مستخلص: |
Glycosylated hemoglobin(HbA1C) has been accepted as the standard of care for measurement of glycemic control in diabetic patients. Patients with liver cirrhosis have been observed to have falsely depressed HbA1C levels. At the same time, there is a high risk of hypoglycemia in these patients. Consequently, HghA1c may not be a reliable marker to assess long-term glycemic control. Serum fructosamine has been proposed to be an alternative but this test is also affected from low albumin commonly seen in cirrhotic patients. We evaluated the use of CGMS in the setting of cirrhosis and compared its practical values with HgbA1C and fructosamine. Between September to December 2006, five diabetic patients with proven cirrhosis of the liver underwent our protocol. Subjects consisted of 1 female and 4 males, with average age of 55.8±8.7 years and the average duration of diabetes of 10±6.7 years. The etiology of the liver disease was hepatitis C for 3 patients, NASH for one patient, and alcohol for the 5th patient. Three patients were on oral agents and two were taking insulin. The baseline mean HbA1C was 6.64±0.6% and fructosamine 324µmol/L±80.51. CGMS monitoring was done for three days along with evaluation of baseline chemistry, coagulation factors, and liver function tests. Average blood glucose recordings were obtained from CGMS reports and compared to HghA1C and fructosamine values. Results of the first five patients who finished the study showed : Day 1 average sugar levels to be 159.5±39.8, day 2 average 190.54±46.24, and day 3 average 165.5±37.54. The ranges of the blood glucose values were 120.25±18.35, 198±49.84, and 157.5±69.35 for days 1,2 and 3 respectively. The LDL was 83.25±20.4 mg/dL, HDL 35.8 ± 11.23 mg/dL, and triglycerides 184.6 ± 167.88 mg/dL. The creatinine clearance averaged 64.9±28.3, systolic blood pressure 125.8±10.6 mm Hg, and diastolic pressure 68.6 ± 10 mmHg. Average albumin was 3.28±0.55, total protein 7.06±1.33, AST 110.6±78.2, ALT 116.8±85.6, Alkaline phosphatase 86±27.4, and total bilirubin 1.58±0.73. Coagulation factors demonstrated PT average of 14.42±1.89, 1NR 1.08±0.18, PTT 30.65±4.25. Hgb values were 13.24±3.32. CGMS readings and fructosamine levels averaged higher values then expected with HgbA1C. In the management of cirrhotic diabetics, discrepancy between HghA1C and fructosamine were bridged with CGMS examination. CGMS provided more information about wide daily fluctuations seen in these patients. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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