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Just as with the diagnosis of diabetes, being told you have celiac disease can hit you like a punch. If you have celiac disease, you are intolerant of the gluten [...]

Signs and Symptoms Diabetes mellitus is the most common endocrine disorder and is defined as a group of disorders that exhibit a defective or deficient insulin secretory process, glucose underutilization [...]

OBJECTIVE--Since 1997, the American Diabetes Association has recommended that nondiabetic individuals ≥ 45 years of age be screened for diabetes at least every 3 years. We sought to characterize the [...]

Objectives. Health care organizations often measure processes of care using only administrative data. We assessed whether measuring processes of diabetes care using administrative data without medical record data is likely to underdetect compliance with accepted standards for certain groups of patients. Data Sources/Study Setting. Assessment of quality indicators during 1998 using administrative and medical records data for a cohort of 1,335 diabetic patients enrolled in three Minnesota health plans. Study Design. Cross-sectional retrospective study assessing hemoglobin A1c testing, LDL cholesterol testing, and retinopathy screening from the two data sources. Analyses examined whether patient or clinic characteristics were associated with underdetection of quality indicators when administrative data were not supplemented with medical record data. Data Collection/Extraction Methods. The health plans provided administrative data, and trained abstractors collected medical records data. Principal Findings. Quality indicators that would be identified if administrative data were supplemented with medical records data are often not identified using administrative data alone. In adjusted analyses, older patients were more likely to have hemoglobin A1c testing underdetected in administrative data (compared to patients Conclusions. Diabetes quality indicators may be underdetected more frequently for elderly and black patients and the physicians, clinics, and plans who care for such patients when quality measurement is based on administrative data alone. This suggests that providers who care for such patients may be disproportionately affected by public release of such data or by its use in determining the magnitude of financial incentives. Key words. Quality measurement, quality indicators, diabetes care, In recent years, efforts to measure and improve the quality of care have expanded to include care for chronic medical conditions, such as diabetes mellitus, that are primarily treated in [...]

In 1997, an International Expert Committee was convened to reexamine the classification and diagnostic criteria of diabetes, which were based on the 1979 publication of the National Diabetes Data Group [...]

OBJECTIVE--We evaluated various strategies to identify individuals aged 45-74 years with pre-diabetes (either impaired glucose tolerance or impaired fasting glucose). RESEARCH DESIGN AND METHODS--We conducted a cost analysis to evaluate [...]

OBJECTIVE--To determine the age- and sex-specific prevalence of impaired fasting glycemia, impaired glucose tolerance, screen-detected diabetes, and known diabetes in a Danish population aged 30-60 years and to examine the [...]

Snapshots can reveal only a small, often indistinct, portion of a landscape. Any brief consideration of a topic as far-reaching and complex as diabetes is bound to suffer from the [...]

OBJECTIVE -- To validate and apply a method for independent assessment of insulin secretion and insulin sensitivity ([S.sub.1]) during the same test; that is, an intravenous glucose tolerance test followed [...]

OBJECTIVE -- To evaluate screening strategies based on fasting plasma glucose (FPG), clinical information, and the oral glucose tolerance test (OGTT) for detection of diabetes or other hyperglycemic states--impaired fasting [...]

OBJECTIVE -- The American Diabetes Association recommended substituting 2hBS (glycemia at the second hour of an oral glucose tolerance test [OGTT]) for fasting blood glucose (FBS) in screening for glucose [...]

As primary-care doctors, we have an ever growing role in managing our patients' overall health. This is especially apparent in our patients with diabetes mellitus. This disease affects not just [...]

Current methods for measuring long-term glycemia in patients with diabetes are Hb[A.sub.1c] and advanced glycation end products (AGEs), which are estimated by phenyl boronate affinity chromatography and competitive enzyme-linked immunosorbent assay, respectively. In this study, we hypothesize that the intrinsic fluorescence property of hemoglobin-AGE (Hb-AGE) may be a simple, accurate, and therefore better index for long-term glycemic status due to its highly specific nature and longer half-life. To establish this contention, in vitro and in vivo experiments were carried out. The former was performed by incubating commercially available hemoglobin with 5 and 20 mmol/l glucose and the latter through experimentally induced (streptozotocin) diabetes in an animal model (male Wistar rats) to identify the new fluorophore formed due to the nonenzymatic glycosylation of hemoglobin. An adduct exhibiting fluorescence at 308/345 nm of excitation/emission wavelengths has been identified and its time-dependent formation established. Under in vitro conditions, the first appearance of the new fluorophore was noticed only after a period of 2 months, whereas under in vivo conditions, it increased significantly after 2 months of hyperglycemia. Consistent with the observations, studies on patients with type 2 diabetes demonstrated an elevated level of this new fluorescent adduct in patients with persisting high levels of plasma glucose for >2 months. Based on the results obtained, Hb-AGE appears to be an efficient fluorescence-based biosensing molecule for the long-term monitoring of glycemic control in diabetes., Conventional diagnosis of diabetes and determination of immediate glycemic status in such patients is based on fasting plasma glucose levels or oral glucose tolerance test (1). Glycation of total serum [...]

Lavender top tubes are having an identity crisis these days. If there's an order for hemoglobin Ale, does it belong in Chemistry or Hematology? The trend to integrate and automate [...]

OBJECTIVE -- To develop and validate an empirical equation to screen for diabetes. RESEARCH DESIGN AND METHODS -- A predictive equation was developed using multiple logistic regression analysis and data [...]

OBJECTIVE -- To determine the feasibility of using either fasting plasma glucose or [HbA.sub.1c] to identify individuals in the U.S. population who meet the Diabetes Prevention Program (DPP) criteria for [...]

OBJECTIVE -- Our objective was to compare the performance of oral glucose tolerance tests (OGTTs) and multivariate models incorporating commonly available clinical variables in their ability to predict future cardiovascular [...]

Diabetes should be diagnosed using the standards set by the World Health Organization, rather than the standards of the American Diabetes Association, which may miss a considerable number of diabetes cases. Early diagnosis and treatment are necessary to minimize the impact of complications on diabetics.

Some 2,200 new cases of diabetes are diagnosed every day, however it is possible to control the disease and to live a normal life. Specific details are discussed.

HISTORY A 53-year-old man seeking advice for redness and then swelling of his right foot that started 2 weeks ago. Has 20-year history of insulin-requiring type 2 diabetes mellitus. No [...]

Byline: Dwight J. Rouse, John Owen Keywords: Ultrasonography; macrosomia; cesarean delivery Abstract: Both our previously performed decision analysis and more recent clinical data considered in the context of our decision analytic framework support the claim that in the pregnancies of women without diabetes the level of intervention and the economic costs of prophylactic cesarean delivery for fetal macrosomia diagnosed by means of ultrasonography are predicted to be excessive. Under the most plausible assumptions, a prophylactic cesarean policy with either a 4000- or 4500-g macrosomia threshold would require more than 1000 cesarean deliveries and millions of dollars to avert a single permanent brachial plexus injury. In the pregnancies of diabetic women, although such policies would be expected to perform appreciably better, their use would nevertheless entail considerable intervention for any benefit achieved. Under most assumptions, hundreds of cesarean deliveries and hundreds of thousands of dollars would be required to avert a single permanent brachial plexus injury. In light of the available data, optimizing the management of shoulder dystocia seems at present to be the most immediate and tenable approach to the prevention of birth-related brachial plexus injury. (Am J Obstet Gynecol 1999;181:332-8.) Article Note: (footnote) [star] From the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham., [star][star] Reprints not available from the authors, a 0002-9378/99 $8.00 + 0 6/1/97405

Australian diabetologists have established criteria for the diagnosis and classification of diabetes. Patients with strong thirst, copious urination, and a random venous blood glucose level of greater than or equal to 11 millimoles per liter (mmol/L) are considered diabetic. A fasting blood glucose level at or below 7 mmol/L is also definitive. The Australian organizations adopted World Health Organization and American Diabetes Association guidelines for diagnosis and classification of the disease.

The American Diabetes Assn recently issued new criteria for diabetes classification, diagnostic cutpoints and testing strategies. Diabetes mellitus afflicts an estimated 16 million Americans and is the fourth leading cause of disease-related deaths in the US. For medical laboratories, the new diagnostic cutpoints and recommendations for screening and management of hyperglycemia are expected to increase requests for procedures evaluating glycemic control., For the first time in almost 20 years, new recommendations on diagnosis, classification, and testing strategies for diabetes have been issued. For clinical labs, combatting this old enemy under the [...]

Recent recommendations by a panel of experts could promote earlier diagnosis and thereby help minimize the damage caused by complications of diabetes. Strategies include screening at age 45 and a [...]

Diabetes is the leading cause of new blindness in Americans under age 74, the leading cause of end-stage renal disease and non-traumatic amputation, and the sixth leading cause of death [...]