Comparison of blood or urine testing by patients with newly diagnosed non-insulin dependent diabetes: patient survey after randomised crossover trial

Abstract

Objective: To assess the role of polymerase chain reaction in defining infectiousness among people infected with hepatitis C virus. Design: Published studies of hepatitis C transmission were examined. Twenty nine studies with identified sources of hepatitis C infection who were tested for presence of hepatitis C RNA by polymerase chain reaction were reviewed, including studies of vertical transmission (n = 21), transmission after transplantation (n = 3), transfusion of blood components (n = 3), and needlestick exposure (n = 2). Subjects: All patients identified in studies. Results: A total of 2022 people who had been exposed to sources positive for antibody to hepatitis C were identified. Among 1148 people exposed to sources positive by polymerase chain reaction 148 cases of transmission occurred compared with no definite case among 874 people exposed to negative sources. Rates of transmission from positive sources were 6.2% for perinatal exposure, 6.1% after needlestick exposure, 78% after solid organ or bone marrow transplantation, and 83% after transfusion of blood components. Other factors influencing risk of vertical transmission were coinfection with HIV and level of hepatitis C viraemia. Conclusions: Negative results by polymerase chain reaction indicate an extremely low probability of transmission of hepatitis C from a person with antibody to hepatitis C.

Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: an epidemiological cohort study

“…ever, other studies do not [12][13][14][15][16]. A position statement from the American Diabetes Association recommends daily blood glucose self-measurement for pharmacologically (insulin or oral hypoglycaemic drugs) treated patients with type 2 diabetes [17].…”

Randomized Studies are Needed to Assess the True Role of Self-Monitoring of Blood Glucose in Noninsulin-Treated Type 2 Diabetes

“…[5][6][7]19 For example, the study by Fontbonne and colleagues, 6 which is included in all four of the meta-analyses presented here, showed SMBG to have a neutral effect when compared to SMUG and NSM. A likely reason for this, however, is that the study protocol provided no instructions to the patients for adjusting behavior based on SMBG data.…”

“…8,20,21 A not her issue t hat must be con sidered is t he appropriateness of the therapeutic intervention. An example of this is the randomized crossover study by Miles and colleagues, 19 which has become a key element in the reimbursement debate regarding the value of SMBG versus SMUG. One must question why better glucose control was not achieved.…”

“…• SMBG in noninsulin-treated patients has a positive effect on A1C levels; however, no significant difference was seen been SMBG and SMUG • Results should be interpreted cautiously because of the limited methodological quality of the studies analyzed Jansen (2006) 10 Allen et al 7 Brown et al 38 Davidson et al 5 Estey et al 20 Fontbonne et al 6 Guerci et al 36 Jaber et al 37 Kwon et al 21 Miles et al 19 Muchmore et al 34 Schwedes et al An analysis by Welschen and colleagues, 14 which included many of the same studies used by Sarol, also showed a beneficial effect of SMBG. However, the authors cautioned that their findings may have been influenced by the limited methodological quality of the studies analyzed.…”

Self-monitoring of blood glucose in type 2 diabetes: a new look at published trials

“…We analysed 18 relevant RCTs [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], some of which had not been included in previous meta-analyses [20][21][22][23][24][25]. Why do these trials not provide a reliable answer?…”