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Article
Evidence Based Updating of HbA1c Targets: Global Guidelines forGlycemic Control in Type 2 Diabetes Mellitus

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Abstract

Background:Measurement of hemoglobin A1c (A1C) is a renowned tactic for gauging long-term glycemic control, and exemplifies an outstanding influence to the quality of care in diabetic patients.The concept of targets is open to criticism; they may be unattainable, or limit what could be attained, and in addition they may be economically difficult to attain. However, without some form of targeted control of an asymptomatic condition it becomes difficult to promote care at allObjectives: The present article aims to address the most recent evidence-based global guidelines of A1C targets intended for glycemic control in Type 2 Diabetes Mellitus (T2D).Key messages:Rationale for Treatment Targets of A1C includesevidence for microvascular and macrovascular protectionand changes in quality of life. More or less stringent A1C goals may be appropriate for individual patients, andgoals should be individualized based on:duration of diabetes, age/life expectancy, comorbid conditions, CVD or advanced microvascular complications,hypoglycemia unawareness, and individual patient considerations


Article
The Effect of Age and Gender on Fetuin-A and Some Biochemical parameters in Blood Sera of Iraqi patients with T2DM: A comparative study
تاثير العمر والجنس على مستوى البروتين الكبدي الجنيني – A وبعض المؤشرات البيوكيميائيه في مصول المرضى العراقيين المصابين بداء السكري من النمط الثاني .:دراسة مقارنه

Authors: Amal R. Farahan امال رشيد فرحان --- Walla E. Jassem ولاء اسماعيل جاسم
Journal: Baghdad Science Journal مجلة بغداد للعلوم ISSN: 20788665 24117986 Year: 2015 Volume: 12 Issue: 1 Pages: 197-203
Publisher: Baghdad University جامعة بغداد

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Abstract

The serum protein test includes measurement of the level of total protein(albumin, globulin). Fetuin-A is a blood protein made in liver. It can inhibit insulin receptor, enhance insulin sensitivity and make the individuals more likely to develop type 2 diabetes, then disorder in lipid profile (Total cholesterol(TC), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), Triglyceride(TG) and very low density lipoprotein cholesterol (VLDL-c) . To evaluate Fetuin-A, total protein, albumin, globulin, HbAlc and lipid profile in 200 adult and elderly Iraqi patients with type 2 Diabetes Mellitus were taken and compare them with 200 subjects as a healthy control. The laboratory analysis(for patients and control ) were performed to determine these parameters .The results show that FBG. HbA1c, Lipid profile for (patients and control) (except HDL-c) were increase with age with a significant difference (p<0.01) between patients and control in each age and with no significant difference (p>0.05) between male and female. Serum total protein, globulin, Fetuin-A, increase with age while albumin decrease with age(in patients and control).

يتضمن اختبار البروتين الكلي قياس مستوى(الألبومين , الكلوبيولين) .الفتيون –A هو بروتين ينتج بالكبد ويطرح الى مجرى الدم ويستطيع تثبيط عمل مستلمات الأنسولين ويزيد من تحسس الأنسولين ويجعل الشخص البالغ اكثر قابليه على الاصابه بداء السكري من النمط الثاني ,اضطراب بالدهون (الكولسترول الكلي ,البروتين ألدهني عالي الكثافة ,البروتين ألدهني واطئ الكثافة ,الدهون الثلاثية ,البروتين ألدهني واطئ الكثافة جدا) .و لتقدير كمية, البروتين الكبدي الجنيني- A والبروتين الكلي ,الألبومين , الكلوبيولين ,الدهون والهيمكلوبين السكري (التراكمي)تم اخذ 200 شخص بالغ ,من الكبار في السن مصابين بداء السكري من النمط الثاني (100 نساء, 100 رجال) ومقارنه النتائج بـ 200 شخص (100 نساء ,100 رجل)أصحاء كمجموعه مقارنه. تم اجراء التحاليل ألمختبريه (للمرضى والأصحاء) لتقدير هذه المؤشرات.أظهرت النتائج ان نسبه الكلوكوز عند الصيام ,الهيمكلوبين السكري (تراكمي) والدهون كلها عدا (الدهون البروتينيه عاليه الكثافة )تزداد بتقدم العمر بوجود فرق معنوي عالي (P<0.01) بين المرضى والأصحاء ولا يوجد فرق معنوي (P>0.05)بين الرجال والنساء .كما لوحظ ان البروتين الكلي والكلوبيولين والبروتين الجنيني يزداد بتقدم العمر والألبومين يقل بتقدم العمر (عند المرضى والأصحاء) .

Keywords

Fetuin-A --- HbA1c --- Lipid profile --- Protein --- Albumin --- Globulin.


Article
The Relationship between Oxidative Stress and Osteopontin Levelsin Diabetic Patient with Acute Coronary Syndrome

Authors: Bushra Arebie Al-Hussieny --- Tariq Hovthy Al-Khayat --- Monem Makki Al-Shouk
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 4 Pages: 956 -968
Publisher: Babylon University جامعة بابل

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Abstract

This study was performed to determine osteopontin levels in sera of diabetic patients having acute coronary syndrome and finding the relationship betweenosteopontin and oxidative stress in the corresponding patients .A case –controlled study for 60Iraqi diabetic patients (33male and 27 female)with acute coronary syndrome (STEMI and NSTEMI) and 20 diabetic patients without myocardial infraction were selectedforthisstudy. Besides,Forty healthy subjects served as control group.The serum levels of Osteopontin (OPN),HbA1c,SOD,CAT and Malondialdehyde (MDA) were determined for the corresponding patients.The result obtained were compared with those 40 subject(20male and 20 female) who are apparently healthy (control group).All the selected patients were non -smokers,non –hypertensive and have no inflammatory disease which may affected the results of the measured parameters. Osteopontin levels were significantly increasedin patientswith DM,STEMI and NSTEMIcompared to the controls. The levels of MDA and HbA1Cin the patients were significantlyhigher compared to the controls whileSOD ,CATwere significantly lower compared to the controls, and a significant positive was found between osteopontin,HbA1C and MDA and negative correlation was found with SOD and CAT levels.The increase Osteopentin levels inrelevance to oxidative stress and HbA1C level may indicate the role of hyperglycemia in the induction of this acute inflammatory marker which can be considered as a prognostic indicator of diabetic complications especially diabetic patients with MI.

Keywords

OPN --- MDA --- DM --- STEMI --- NSTEMI --- SOD --- CAT and HbA1C --- MI.

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