Glycated albumin (GA) compares well with glycated hemoglobin (HbA1c) as a marker of diabetes control, and direct is more accurate than calculated low-density lipoprotein (LDL) cholesterol, in Type 2 diabetes patients with hypertriglyceridemia, new research shows.

HbA1c is the gold standard for measurement of diabetes control, but is a labor-intensive assay that requires the use of whole blood rather than frozen serum or plasma.

LDL cholesterol is usually calculated from fasting values of total cholesterol, triglyceride, and high-density lipoprotein (HDL) cholesterol, but is affected by hypertriglyceridemia, which is common in patients with diabetes.

For these reasons, Ernst Schaefer (Tufts University, Boston, Massachusetts, USA) and colleagues have evaluated the use of two novel assays, GA and direct LDL cholesterol, as compared with HbA1c and calculated LDL cholesterol, for evaluating diabetes control and lipid levels in patients with Type 2 diabetes.

HbA1c, GA, and direct LDL cholesterol were measured from fasting blood samples of 616 male and female patients with Type 2 diabetes and 895 non-diabetic controls.

The results, reported in the journal Clinica Chimica Acta, show HbA1c and GA had a correlation of 0.70 in both patients with diabetes and in controls.

Mean values of HbA1c and GA were 38.7% and 43.4% higher, respectively, than controls in men, and 41.1% and 40.1% higher, respectively, than controls in women.

While GA assessment is easier and more cost-effective than HbA1c, the authors note that the shorter half-life of albumin compared with red blood cells means that GA reflects mean glycemia over approximately 2-3 weeks, compared with 2-3 months for HbA1c. Therefore, “GA would need to be measured every 2-4 weeks to capture information regarding chronic glycemia,” they write.

Calculated and direct LDL-C values correlated very highly (r=0.96), but in 8.5% of the male and 3.8% of the female diabetic population in this study calculated LDL cholesterol values could not be determined because of fasting triglyceride levels greater than 4.5 mmol/l.

Importantly, the correlations between HbA1c and GA, and between calculated and direct LDL cholesterol did not differ by gender, race, or age.

The authors conclude, “Calculated LDL cholesterol provides an accurate assessment of fasting LDL cholesterol compared with a direct measurement in most subjects, except for those with hypertriglyceridemia, and GA correlates with HbA1c in diabetic and non-diabetic subjects and may serve as a reasonable marker of short term diabetic control.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

The number of individuals being diagnosed with Type 2 Diabetes is on the rise in America . You may be in your early twenties or thirties with no cares in the world, so you think. Don’t be caught off guard. Type 2 Diabetes is not just for old people!

The American diet is notoriously bad. Fast food junkies are everywhere. Young adults think they have no time to prepare decent meals so they stop in the nearest fast food place and pick up something to eat really quick and think their problem of what to eat is solved for the time being. Little do they know they are setting a fuse for the time bomb of diabetes to be set off in the not too distant future.

Diet is important no matter what age you are. Dieting to loose weight is the norm among the young for vanity’s sake. I mean, everyone want to take pride in how their body looks and what kind of impression of having it all together they give people. However, eating a diet that is full of natural nutrition is needed for your health’s sake. Don’t be fooled, you may be the next victim of this dreadful disease called diabetes.

A survey conducted by the American Diabetes Association shows that early onset Type 2 diabetes is around 35 years of age. If you are a young middle aged adult that has type 2 diabetes, there are natural lifestyle changes as well as better eating habits that can incorporated into your daily life to stave off some other bad health conditions that can be the result of having this disease. You can find a lot of important and extremely helpful information in various ebooks that are online that have been written by people who have actually conquered diabetes. Much of this information you will not find in the medical field. Doctors may not tell you how to conquer diabetes. But you do not have to depend on them. Strong minded people do not submit to doctors opinions only. Changing the way that you eat and paying special attention to your daily diet can help you keep your blood sugar levels stable. You may not even need medication if you incorporate some healthy choices into your daily life. Exercising is another key ingredient to conquering this dreadful disease.

If you do not educate yourself about diabetes and make some small changes to your diet and lifestyle, you run the risk of contracting co-existing diseases like heart failure, risk of having your limbs amputated later on in life or the danger of going blind.

Before it is too late for you, stop the fast food madness and learn how to cook healthy whole foods. Cut out your addiction to sugar and cut way down on your alcohol consumption. Remember to make time for exercise and drop the killer addiction to nicotine. Why put your life at risk? Protect who you are and how you want to live your life. There is no need to fall prey to diabetes like so many Americans are doing these days, just to satisfy some temporary fixes to stressful lives. You may be one who thinks diabetes will never happen to you. You can make sure of it by taking control of bad choices now.

Diabetes and Exercise

Several years ago, Tommy Johnson, at age of 28, looked at his mirror image in his home in Phoenix and wondered what was happening to his body, as he watched.

Hospitalized in Phoenix for several days of testing, Johnson was found to have Type 1, or insulin-dependent diabetes. He didn’t even have the time to go through denial, depression or any of the other classic emotional symptoms, says Johnson.

He had training camp coming up, and like hundreds of professional football players, his job was on the line, linked exactly to his performance in training camp. Johnson relates that he just listened to what the doctor had to say about ways in which to keep his blood sugar levels, as close to normal as possible.

Taking Self-Responsibility

There are two major types of diabetes. Type II or non-insulin-dependent diabetes represents about 90% o f all cases of diabetes. However Type I diabetes is the more severe form of the disease. This is a genetically-based chronic endocrine disorder of unknown cause, that affects the body’s ability to manufacture and utilize insulin, the hormone needed to break down sugars and starches into blood sugar (glucose), the body’s major energy source.

As a result, sugar levels in the blood become too high. The cells of the pancreas (the small insulin-producing organ located behind the stomach) don’t function properly, making it difficult to metabolize food. Since the glucose can’t be utilized, the levels raise dangerously; daily insulin injections are needed in order to live. This differs from Type Ii diabetes, where insulin is produced but the amount is insufficient or else the cells can’t utilize it properly.

There are risks associated with exercise for the Type I, insulin-dependent diabetic - such as low blood sugar (hypoglycemia) - but if an athlete learns to control changing glucose levels by adjusting insulin levels and snacking on sugary, or slowly - absorbed carbohydrates when needed, and then it’s possible to exercise quite vigorously. Other than insulin or diet, exercise is the most important factor in helping diabetics maintains proper blood sugar levels.

Workout Tips

Athletes with Type I diabetes can compete in any sport - as long as they closely monitor their blood sugar levels.

1. Exercise regularly, preferably at the same time each day to help you determine and stabilize your insulin and food requirements.

2. Exercise with someone else. This person should know that you have diabetes, be aware of the signs of hypoglycemia (confusion, weakness, unconsciousness, convulsions), and know how to respond in an emergency.

3. Don’t inject insulin into the muscle you will be exercising, or the insulin will be mobilized faster, and you will become hypoglycemic.

4. Most often, sports-active diabetics should keep their insulin dosage the same, and eat more food. If you repeatedly become hypoglycemic during or after exercise (despite increased food intake) talk to your physician about reducing your insulin.

5. To best determine our food/ insulin needs, you should monitor your blood glucose during training (for example, between laps of swimming or running). Also, you may have to re-check these needs when the weather changes from hot to cold.

6. Always exercise after eating, when your blood sugar is on the rise. Don’t start to exercise with low blood sugar; eat a snack first.

7. Always carry sugar, in some form, with you. Always have coins with you for food from a vending machine or an emergency phone call.

8. During long-term exercise, plan to constantly replace glucose supplies, at regular intervals.

9. On an extra-long hike or bike ride, eat six small meals containing both carbohydrate and protein (the protein is for sustained energy). Be over-prepared with extra food in case you are unexpectedly delayed.

10. Since exercise has a lingering effect, you should eat more than usual after you finish exercising. Other wise, you may become hypoglycemic that night, or even the next day.