Michael.Massing + comorbidities + risk + normal   15

Early adverse effect of abnormal glucose metabolism on arterial stiffness in drug naïve hypertensive patients
Among hypertensive subjects with [normal glucose regulation] there was an increase in [estimated arterial stiffness] from low normal to high normal values of glucose (p<0.01). [Arterial stiffness] was independently related to all glucose metabolic parameters (p<0.001 for all). In the present study, we demonstrated an association between arterial stiffness and glucose tolerance in hypertensive subjects. Given the prognostic significance of arterial stiffness, aims should be towards closer monitoring and intensive care of hypertensive patients with abnormal glucose metabolism.
glucose  metabolism  tolerance  impaired  dysglycemia  risk  heart  vascular  arterial  stiffness  normal  morbidity  comorbidities  hypertension  high  blood  pressure  correlation 
january 2012 by Michael.Massing
“Normal” Blood Sugar Levels May Still Mean You Have Prediabetes « Diabetes Dialectics
[Under 1% of those starting with fasting blood sugar levels between 51 and 82 mg/dl wound up diabetic;] more than 3% did so if they had values between 91 and 99. After controlling for other [risk factors], that corresponded to a two-fold difference in risk of developing the disease.
[With prediabetes, the long-term damage of diabetes—especially to the] heart and circulatory system—may already be starting. If your blood sugar tests over 100 mg/dl fasting more than once, your fasting blood sugar is likely to go over the 125 mg/dl level used to diagnose full diabetes within 3 years.
More importantly, if your blood sugar is at 100 mg/dl fasting, it is very likely that your post-meal blood sugar is heading towards the diabetic range, which is over 200 mg/dl which is why your fasting blood sugar is deteriorating. High post-meal blood sugars kill beta cells. If you can bring down those post-meal highs, you may be able to prevent the beta cell death that is destroying your fasting control!
diabetes  prediabetes  criteria  risk  progression  prevention  normal  blood  sugar  glucose  standards  threshold  number  to  harm  intervention  medical  research  fasting  beta  cell  death  point  comorbidities  symptoms  late-stage  complications  morbidity  postprandial  tipping  self  care  management  correlation  peer-reviewed  late  end-stage  diagnosis  from delicious
june 2011 by Michael.Massing
Diabetes-related symptom distress in association w... [Diabetes Care. 2008] - PubMed result
[This study assessed] associations between diabetes-related symptom distress, glucose metabolism status, and comorbidities of type 2 diabetes [via] a cross-sectional sample of 281 individuals with normal glucose metabolism (NGM), 181 individuals with impaired glucose metabolism (IGM), and 107 subjects with type 2 diabetes. We used the revised type 2 Diabetes Symptom Checklist (DSC-R) to assess diabetes-related symptom distress.

The total symptom distress score (range 0-100) was relatively low for diabetic subjects (mean +/- SD 8.4 +/- 9.4), although...significantly different from that for subjects with IGM (6.5 +/- 7.1) and NGM (6.1 +/- 7.9)...Ischemic heart disease was associated with elevated DSC-R scores on three subscales, whereas depression showed higher symptom distress levels across all DSC-R domains.

Worsening glucose metabolism [correlates with increasing diabetes-related symptom distress, a relationship] attenuated by ischemic heart disease and particularly by depression.
diabetes  depression  comorbidities  medical  research  peer-reviewed  blood  glucose  metabolism  sugar  prediabetes  normal  comparison  morbidity  affective  mood  disorders  risk  correlation  stress  distress  factor  etiology  from delicious
april 2011 by Michael.Massing
Normal Fasting Plasma Glucose and Risk of Type 2 Diabetes Diagnosis
Subjects developed diabetes at a rate of less than 1% per year during a mean follow-up of 81.0 months. Each mg/dL of fasting plasma glucose increased diabetes risk by 6% (hazard ratio [HR] 1.06, 95% confidence interval [CI], 1.05-1.07...) after controlling for other risk factors. Compared with those with fasting plasma glucose levels less than 85 mg/dL, subjects with glucose levels of 95 to 99 mg/dL were 2.33 times more likely to develop diabetes (HR 2.33; 95% CI, 1.95-2.79...). Subjects in the 90 to 94 mg/dL group were 49% more likely to progress to diabetes (HR 1.49; 95% CI, 1.23-1.79...). [P <.0001 in all caes] All other risk factors except sex were significantly associated with a diabetes diagnosis.
The strong independent association between the level of normal fasting plasma glucose and the incidence of diabetes after controlling for other risk factors suggests that diabetes risk increases as fasting plasma glucose levels increase, even within the currently accepted normal range.
normal  FPG  blood  glucose  standards  risk  high  threshold  cutoff  diabetes  medical  research  comorbidities  symptoms  late-stage  complications  morbidity  prediabetes  self  care  management  correlation  late  end-stage  diagnosis  from delicious
april 2011 by Michael.Massing
Diabetes Risk Extends Into "Normal" FPG Range - American Diabetes Association
Although the overall risk of developing diabetes was low in people with normal FPG levels, the risk increased as FPG increased, after taking other factors into account. For every 1 milligram per deciliter increase in FPG, the risk of developing diabetes increased by 6 percent. Patients with an FPG of 95 to 99 were more than twice as likely to develop diabetes as those with an FPG less than 85, and patients with an FPG of 90 to 94 were 49 percent more likely to develop diabetes than those with an FPG less than 85. Other risk factors for diabetes, such as obesity, high blood pressure, cholesterol problems, and smoking, made development of the disease more likely.
FPG  normal  risk  blood  glucose  research  medical  peer-reviewed  diabetes  comorbidities  symptoms  late-stage  complications  standards  morbidity  prediabetes  self  care  management  threshold  late  end-stage  diagnosis  from delicious
april 2011 by Michael.Massing
New Guidelines Issued on Optimal Hemoglobin A1C Targets for Type 2 Diabetes
Below 7%, below 6.5% OR NORMAL?
When do we [tell the public the honest truth]? To reduce your risks as if you did not have diabetes, then you need an A1c that represents a healthy individual without diabetes. [A] normal A1c for a healthy person without diabetes should be 4.3 to 4.6%. In the Epic-Norfolk study they showed that an A1c of 5% compared to an individual with an A1c of 6% had an increased risk of cardiovascular death of 28% higher.
In all of the recommendations they say that the A1c should be as low as possible without hypoglycemia. The ADA sticks with 7% or below, AACE stays with 6.5% or below, what does below mean? When we say it should be 7 or below then that is usually where most medical professionals stop being aggressive. We hear 7% we hear 6.5 % we even sometimes hear 6%.
If your child had diabetes, would you be satisfied at 6.5% or would you want it Normal, as if they did not have diabetes? Or would you like to wait 15 years and see what the studies tell us?
blood  glucose  target  management  normal  Richard  Bernstein  remission  diabetes  tight  control  A1c  medical  research  risk  comorbidities  symptoms  late-stage  complications  standards  morbidity  prediabetes  self  care  benefit  threshold  self-monitored  monitoring  SMBG  late  end-stage  diagnosis  from delicious
march 2011 by Michael.Massing
Blood Test May Predict Risk of Diabetes - DiabetesPro - American Diabetes Association | Nature Medicine
[Higher levels] of five amino acids may predict diabetes years before symptoms begin to develop...[Blood tests for these amino acids predicted] risk of type 2 diabetes in otherwise healthy adults as well as in those with traditional diabetes risk factors. Certain metabolic abnormalities, which may lead to type 2 diabetes, can be present years before, such as insulin resistance. This [study] followed 2,422 healthy adults with normal blood sugars for 12 years[; 201 developed type 2 diabetes. Elevated levels of] amino acids isoleucine, leucine, valine, tyrosine, and phenylalanine were all associated with type 2 diabetes. Measuring combinations of these amino acids rather than one amino acid was a more accurate predictor of future [risk. I]n people closely matched for traditional risk factors such as obesity or insulin resistance, those with the highest levels of isoleucine, phenylalanine, and tyrosine had a 5 to 7 times higher risk of type 2 diabetes than those with the lowest levels.
research  amino  acids  diabetes  risk  prognostic  indicators  via:diabetes.org  factor  correlation  insulin  resistance  T2D  type  2  peer-reviewed  in  vivo  human  longitudinal  isoleucine  leucine  valine  tyrosine  phenylalanine  etiology  obesity  late-stage  symptoms  complications  comorbidities  standards  normal  late  end-stage  diagnosis  clinical  trial  from delicious
march 2011 by Michael.Massing
What's the Best Test to Diagnose Diabetes in Children? | Lee J. Journal of Pediatrics, Feb. 2011
The HbA1c test is less sensitive in diagnosing diabetes and prediabetes in children than in adults...."The HbA1c test just doesn't perform as well in kids as it does in adults." [The] test can be useful as an adjunct to other diabetes tests.... <br />
"If a child is overweight and obese and has two of four risk factors for diabetes, they should be screened in some other way beside HbA1c."
Risk factors include family history of diabetes, maternal history of gestational diabetes, belonging to certain ethnic groups (Native Americans, African-Americans, or Asians/South Pacific Islanders), or any signs of insulin resistance such as polycystic ovary syndrome, high blood pressure, or high cholesterol levels....
Diabetes is diagnosed when an HbA1c level is 6.5% or more; prediabetes is diagnosed when an HbA1c level is between 6% and 6.4% on two separate tests. Prediabetes is marked by higher than normal glucose levels that place a person at risk for developing Type 2 diabetes.
diabetes  prognostic  A1c  OGTT  fasting  blood  plasma  glucose  youth  via:DiabetesInControl  insulin  resistance  T2D  type  2  research  peer-reviewed  children  standards  factor  clinical  in  vivo  human  correlation  obesity  hypertension  high  pressure  waist  size  ethnicity  gestational  cholesterol  fats  lipids  statistical  comorbidities  risk  normal  diagnosis  trial  etiology  from delicious
march 2011 by Michael.Massing
Glycemic Levels Predict Risk of Retinopathy | Massin M, et al Archives of Ophthalmology, 2011: 129(2): 188-195
Higher fasting plasma glucose and HbA1c increased the risk of retinopathy when follow-up digital retina imaging was performed 10 years later.
[T]he investigators recommend using thresholds of 108 mg/dL for fasting plasma glucose and 6.0% for HbA1c to predict those at higher risk for later developing retinopathy.
diabetes  management  goals  threshold  blood  glucose  prognostic  via:DiabetesInControl  eyes  risk  retinopathy  morbidity  comorbidities  peer-reviewed  research  normal  standards  diagnosis  from delicious
february 2011 by Michael.Massing
"White-coat" Hypertension In Diabetics Increases Risk of Complications
White-coat hypertension[--the tendency for some patients who normally don't have high blood pressure to have a temporary increase while in the doctor's office--]is considered harmless in most people, but it appears to increase the risk of microvascular complications in patients with type 2 diabetes, Brazilian researchers report in Diabetes Care.
Dr. Caroline B. Kramer, lead investigator stated that, "We believe that blood pressure levels are a strong predictor of chronic complications"....[W]hite-coat hypertensives had a higher average systolic blood pressure...during daytime monitoring (126.6 versus 123.2 mm Hg) and during 24-hour ambulatory monitoring (124.7 versus 121.0 mm Hg)...[W]hite-coat hypertension was associated with...protein in the urine, which is a risk factor for nephropathy, and a nearly three-fold increased risk of developing diabetic retinopathy.
"[W]hite-coat hypertension should not be considered a harmless condition and treatment should be considered."
blood  pressure  risk  diabetes  symptoms  comorbidities  normal  hypertension  high  correlation  peer-reviewed  research 
january 2009 by Michael.Massing
Dieting May Cut Risk For Gum Disease, Mostly In Males
"Chronic inflammation appears to be an important factor underlying...many age-related disorders, and dietary restriction has been shown to reduce the risk for chronic disease and promote longevity in multiple animal models," says [Mark Reynolds, DDS, whose study of rhesus monkeys] showed that males fed a diet of 30% fewer calories...had significantly lower levels of...periodontal pocketing, less immune response to invading bacteria, and higher inflammatory molecules than males fed a normal diet....
Also, for the monkeys not fed the reduced-calorie diet, males showed "significantly greater periodontal breakdown" than females. Consistent with previous studies of humans, the monkeys in the study showed an increasing degree of gum problems as they aged.
Aging and obesity are associated with increased biological signs of overall inflammation and periodontal disease in humans, says Reynolds. [A]bout one-third of adults aged 30 to 90 have periodontitis...
diet  dental  inflammation  comorbidities  risk  normal 
january 2009 by Michael.Massing
HbA1c variability Predicts Nephropathy, Retinopathy in Type 1 Diabetes
Nephropathy and retinopathy can be...predicted based on long-term fluctuations in HbA1c variability, according to researchers from the Hull Royal Infirmary, University of Hull and Hull York Medical School [who] analyzed data from the DCCT - a 9-year follow-up study that compared the effect of intensive vs. conventional blood glucose control on the development of microvascular complications....Patients assigned to conventional...control experienced [pronounced] greater HbA1c variability than patients assigned to intensive [control] "presumably because the event rate, range of variability and spread of variability at any given mean HbA1c was much larger than [among intensive-treatment patients]" These findings are in contrast to a previously published DCCT analysis that concluded HbA1c variability did not strongly affect risk for diabetes complications....[F]luctuations in HbA1c [presumably also represent] periods of poor glycemic control which would increase the risk for retinopathy.
diabetes  kidneys  symptoms  microvascular  standards  management  goals  threshold  blood  glucose  prognostic  risk  morbidity  comorbidities  peer-reviewed  research  normal  late  complications  kidney  disease  nephropathy  end-stage  diagnosis 
november 2008 by Michael.Massing
It's Not Just Blood Sugars: Family Ties Raise Risk of Diabetes Complications
'Our research indicates that susceptibility to certain complications of type 1 diabetes, especially retinal damage, has a strong familial and probably genetic component, and women may be more susceptible to these complications than are men.'
diabetes  blood  glucose  prognostic  familial  gendered  women  eyes  risk  morbidity  comorbidities  peer-reviewed  research  normal  late  symptoms  complications  correlation  T1D  kidneys  neuropathy  genetics  medical  epigenetics  late-stage  eye  damage  retinopathy  type  1  kidney  disease  nephropathy  standards  end-stage  diagnosis 
november 2007 by Michael.Massing

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