Results from a prospective cohort study carried out at a hospital in the Bronx area of New York in the USA suggest that many patients without diagnosed diabetes have abnormally high glycated hemoglobin (HbA1c) levels and are at increased risk for Type 2 diabetes.

“Hospital-based HbA1c testing might identify patients for whom further testing is indicated to make the diagnosis of diabetes,” suggest the researchers.

Charles Nordin (Jacobi Medical Center, Bronx, New York, USA) and colleagues tested HbA1c levels of 971 patients admitted to the general medicine service of a Bronx hospital over a 4-month period.

The team checked records for prior diagnosis of diabetes and other relevant data and followed-up patients who had repeat testing of HbA1c or glucose within 1 year of admission.

The Bronx area has a diabetes prevalence that is one of the highest in the USA and in line with this 342 (35.2%) patients tested had diabetes.

A normal HbA1c is generally considered to be below 6%. The mean HbA1c of the remaining cohort (n=629) was 6.05%. Of these patients, 152 (24%) had an admission HbA1c of at least 6.5% and 62 (9.9%) had an HbA1c of at least 7.0%.

In total, 55 of the patients with an admission HbA1c of at least 6.5% had a follow-up HbA1c test within 1 year, at which point 44 (88%) patients met the criteria for diabetes proposed by The International Expert Committee using repeated HbA1c testing.

“Our study supports the hypothesis that HbA1c testing on the inpatient service of a public hospital in a high-risk community can help to identify patients at risk for diabetes,” conclude the authors in the Journal of Clinical Endocrinology and Metabolism.

The researchers caution that use of single HbA1c measurements for diagnosing diabetes is unwise as factors such as hospital admission can significantly influence HbA1c levels.

They add: “Further studies will be needed to determine the role of inpatient HbA1c testing for diagnosis and treatment of diabetes.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Free abstract

Are you or someone in your family affected with diabetes? Chances are either you or someone you know is dealing with diabetes, or may be considered pre-diabetic. If you have diabetes, more than likely you are very aware how significant your diet is in the management and treatment of your diabetes. Perhaps your diabetes requires you to receive insulin injections to help control the level of your blood sugar.

If you have to deal with insulin you know the importance of the proper dosage and receiving it at the right times.

Perhaps you don’t require receiving insulin however you do require diabetic medication to help you control your diabetes. One way or another you’ve got it under control with diet, diabetic medication, and/or insulin.

Let’s take the treatment of your diabetes a step further. Have you considered exercise as part of the treatment of your diabetes? Once you become aware of how exercise benefits the treatment of diabetes, your approach in dealing with your diabetes may change your life. Exercising with diabetes needs to become a lifetime commitment, one that will all around improve your quality of life.

Exercise benefits in managing diabetes in a number of ways. In fact, exercise combined with controlling your diet, and diabetic medication will not only help you control and maintain a healthy weight, but also control your blood sugar level. Exercising with diabetes improves the use of insulin in your body. It also burns body fat which helps to improve the effectiveness of the body’s insulin.

The reduction of blood sugar is most significant in the treatment of diabetes. When exercising, the muscles need extra energy in the form of glucose. With continued exercise the muscles use up to twenty times the amount of glucose compared to the normal rate. Often times, exercise has such a positive effect in lowering glucose that in some cases where one is taking diabetic medication the need for the medication can be reduced or discontinued completely.

In addition to exercise directly affecting one’s insulin and decreasing blood sugar, there are benefits to your overall health which indirectly improves your diabetic condition. For example, exercising with diabetes reduces stress, improves muscle strength, and lowers blood pressure. It also improves blood circulation and energy level while decreasing risks for heart disease and stroke.

Strength training has shown to be beneficial in the treatment and management of diabetes. Strength training not only makes the muscles stronger, but the muscles increase in size. With strengthening and enlarging the muscle also increases the need for more energy. The larger muscles then increase the ability to absorb and utilize additional blood glucose in order to provide fuel. The more glucose absorbed into the muscles and used as fuel, the lower the blood sugar in the blood.

Incorporating exercise with management of diabetes not only improves one’s health and well being, but it also helps to prevent other conditions and diseases which are the result of excessive glucose in the blood.

Yes, 2 out of 3 people that suffer with diabetes die because of heart disease or stroke. Once someone has diabetes, he/she is at much higher risk of developing problems with other parts of their body, including the heart. This means that it is crucial for people to be diagnosed early in order to receive the proper treatment of diabetes.

People with diabetes are more prone to developing coronary artery disease. This can result in a blocking or narrowing of your blood vessels leading to the heart. This kind of heart disease is quite common. The blood vessels carry your blood, which contains oxygen among other things to your heart. When these vessels get blocked, it can cause a heart attack or a stroke.

Therefore, people need to watch for the onset of diabetes so they can receive the correct treatment early on. With early treatment of diabetes, the risk for developing the coronary artery disease can be lowered. This will in turn lower the chances of a stroke or heart attack from occurring.

You need to have an A1C test to measure your blood glucose levels. This test is usually recommended being done about every 2 or 3 months. The ADA (American Diabetes Association) suggests that people should have a blood glucose level under 7.0 on this test.

You need to also watch your blood pressure when you have diabetes, in order to prevent other problems from occurring. High blood pressure can also bring on heart attacks and strokes. A safe blood pressure is 130/80 or below as recommended by the ADA.

A person needs to watch their cholesterol levels for maximum health. The quantity of fat contained in your blood is what cholesterol levels are all about. The good cholesterol or HDL actually provides protection for your heart. The bad cholesterol or LDL can lead to your blood vessels becoming clogged, which can then cause heart attacks to happen as we mentioned earlier. Also, triglycerides are a different form of fat in the blood, which can make the chances for heart attack higher.

LDL cholesterol should be lower than 100 mg/dl, while HDL cholesterol should be above 40mg/dl for men and 50mg/dl for women. Triglycerides need to be under 150 mg/dl for both sexes.

You need to watch what you eat normally for your health; this becomes even more important if you have diabetes. Sometimes just by changing one’s diet a person can control a mild form of diabetes and the other problems we have discussed here. This usually includes eating a low-fat diet and watching salt intake. You also need to be sure you are at your recommended weight, which eating in this way will help you do. Being overweight can cause diabetes along with heart problems. So you should shed those extra pounds if needed.

Have a daily exercise routine to help lower blood pressure, strengthen your heart, and control or prevent diabetes. Exercise is good for everyone, make sure to do some cardio and weight bearing exercise to have a full workout.