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6. Safety of the use of gold nanoparticles conjugated with proinsulin peptide and administered by hollow microneedles as an immunotherapy in type 1 diabetes

Author

Tatovic, D, primary, McAteer, M A, additional, Barry, J, additional, Barrientos, A, additional, Rodríguez Terradillos, K, additional, Perera, I, additional, Kochba, E, additional, Levin, Y, additional, Dul, M, additional, Coulman, S A, additional, Birchall, J C, additional, von Ruhland, C, additional, Howell, A, additional, Stenson, R, additional, Alhadj Ali, M, additional, Luzio, S D, additional, Dunseath, G, additional, Cheung, W Y, additional, Holland, G, additional, May, K, additional, Ingram, J R, additional, Chowdhury, M M U, additional, Wong, F S, additional, Casas, R, additional, Dayan, C, additional, and Ludvigsson, J, additional

Published
2022
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10. Utility of HbA1c assessment in people with diabetes awaiting liver transplantation

Author

Bhattacharjee, D., Vracar, S., Round, R. A., Nightingale, P. G., Williams, J. A., Gkoutos, G. V., Stratton, I. M., Parker, R., Luzio, S. D., Webber, J., Manley, S. E., Roberts, G. A., and Ghosh, S.

Subjects
Blood Glucose, Glycated Hemoglobin, Liver Cirrhosis, Male, Disease Management, Erythrocytes, Abnormal, Middle Aged, Liver Transplantation, Research: Care Delivery, Predictive Value of Tests, Erythrocyte Count, Humans, Diabetic Nephropathies, Female, Care Delivery, Research Articles, Aged
Abstract

Aims To investigate the relationship between HbA1c and glucose in people with co‐existing liver disease and diabetes awaiting transplant, and in those with diabetes but no liver disease. Methods HbA1c and random plasma glucose data were collected for 125 people with diabetes without liver disease and for 29 people awaiting liver transplant with diabetes and cirrhosis. Cirrhosis was caused by non‐alcoholic fatty liver disease, hepatitis C, alcoholic liver disease, hereditary haemochromatosis, polycystic liver/kidneys, cryptogenic/non‐cirrhotic portal hypertension and α‐1‐antitrypsin‐related disease. Results The median (interquartile range) age of the diabetes with cirrhosis group was 55 (49–63) years compared to 60 (50–71) years (P=0.13) in the group without cirrhosis. In the diabetes with cirrhosis group there were 21 men (72%) compared with 86 men (69%) in the group with diabetes and no cirrhosis (P=0.82). Of the group with diabetes and cirrhosis, 27 people (93%) were of white European ethnicity, two (7%) were South Asian and none was of Afro‐Caribbean/other ethnicity compared with 94 (75%), 16 (13%), 10 (8%)/5 (4%), respectively, in the group with diabetes and no cirrhosis (P=0.20). Median (interquartile range) HbA1c was 41 (32–56) mmol/mol [5.9 (5.1–7.3)%] vs 61 (52–70) mmol/mol [7.7 (6.9–8.6)%] (P, What's new? HbA1c may not be an accurate reflection of blood glucose for the diagnosis/monitoring of diabetes in people with other illnesses or on certain drugs; people with diabetes and liver disease awaiting transplantation are one such group.HbA1c was found to be depressed relative to random plasma glucose by 20 mmol/mol in people with diabetes and cirrhosis (n = 28) compared to people with diabetes but no liver disease (n = 125); however, HbA1c was elevated in one person with cirrhosis attributable to α‐1‐antitrypsin disorder.Compromised HbA1c may be related to haematological differences associated with liver disease involving erythrocyte half‐life, with shorter/longer times giving less/more opportunity for glycation of haemoglobin.

Published
2019

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