Comparison of HbA1c levels and body mass index for prevention of diabetic kidney disease: A retrospective longitudinal study using outpatient clinical data in Japanese patients with type 2 diabetes mellitus

Nakanishi, Shuhei; Hirukawa, Hidenori; Shimoda, Masashi; Tatsumi, Fuminori; Kohara, Kenji; Obata, Atsushi; Okauchi, Seizo; Katakura, Yukino; Sanada, Junpei; Fushimi, Yoshiro; Kan, Yuki; Tomita, Akiko; Isobe, Hayato; Iwamoto, Hiroki; Takahashi, Kaio; Mune, Tomoatsu; Kaku, Kohei; Kaneto, Hideaki

doi:10.1016/j.diabres.2019.107807

Cited by 17 publications

(23 citation statements)

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“…Insulin resistance as a clinical characteristic of T2DM is closely related to obesity. Improving insulin resistance is one of the major targets in diabetes treatment [32][33][34] . However, studies focusing on the role of KD in the improvement of insulin resistance in patients with diabetes are very limited; most of the studies focused on the effect in obese subjects 35,36 .…”

Section: Discussionmentioning

confidence: 99%

Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

et al. 2020

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Background At present, the beneficial effect of the ketogenic diet (KD) on weight loss in obese patients is generally recognized. However, a systematic research on the role of KD in the improvement of glycemic and lipid metabolism of patients with diabetes is still found scarce. Methods This meta-study employed the meta-analysis model of random effects or of fixed effects to analyze the average difference before and after KD and the corresponding 95% CI, thereby evaluating the effect of KD on T2DM. Results After KD intervention, in terms of glycemic control, the level of fasting blood glucose decreased by 1.29 mmol/L (95% CI: −1.78 to −0.79) on average, and glycated hemoglobin A1c by 1.07 (95% CI: −1.37 to −0.78). As for lipid metabolism, triglyceride was decreased by 0.72 (95% CI: −1.01 to −0.43) on average, total cholesterol by 0.33 (95% CI: −0.66 to −0.01), and low-density lipoprotein by 0.05 (95% CI: −0.25 to −0.15); yet, high-density lipoprotein increased by 0.14 (95% CI: 0.03−0.25). In addition, patients’ weight decreased by 8.66 (95% CI: −11.40 to −5.92), waist circumference by 9.17 (95% CI: −10.67 to −7.66), and BMI by 3.13 (95% CI: −3.31 to −2.95). Conclusion KD not only has a therapeutic effect on glycemic and lipid control among patients with T2DM but also significantly contributes to their weight loss.

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Section: Discussionmentioning

confidence: 99%

Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

et al. 2020

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“…In addition, dyslipidaemia and renal disease work together to worsen the clinical situation of diabetics and increase the risk of renal or cardiovascular consequences ( 4 ). Body composition indicators, such as body mass index (BMI), can predict the prognosis and complications of patients with T2DM, such as diabetic nephropathy (DKD); the predictor effect being similar to that of glycated haemoglobin (HbA1c) ( 5 ). Therefore, such indicators are of importance in monitoring disease progress and evaluating the prognosis and quality of life of patients with T2DM.…”

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confidence: 99%

Effect of tai chi on glycaemic control, lipid metabolism and body composition in adults with type 2 diabetes: A meta-analysis and systematic review

Guo¹,

Xü²,

Qin³

et al. 2021

J Rehabil Med

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Objective The aim of this systematic review was to evaluate the effects of tai chi on metabolic control and body composition indicators in patients with type 2 diabetes mellitus. Design Systematic review and meta-analysis of existing literature. Methods Electronic resource databases were searched to collect eligible studies. Two reviewers selected studies and independently evaluated methodological quality. Results Twenty-three studies were included in this meta-analysis. The pooled results showed that tai chi had significant effects in improving metabolic indices, such as fasting blood glucose (mean difference (MD) = –1.04; 95% confidence interval (95% CI) –1.42 to 0.66; p < 0.01) and total cholesterol (MD = –0.50; 95% CI –0.86 to –0.13; p < 0.01) compared with conventional clinical therapy. Most indices did not support the use of tai chi over aerobic exercise, except for glycated haemoglobin (HbA1c) (MD = –0.24; 95% CI –0.49 to 0.00; p < 0.01) and high-density lipoprotein (MD = 0.07; 95% CI 0.01 to 0.12; p < 0.01). Conclusion Tai chi had better effects on metabolic control and body composition indicators than clinical conventional therapy, but only on HbA1c and HDL were superior than that of aerobic exercise. The best time-window for tai chi intervention may differ with different metabolic indices. LAY ABSTRACT Exercise therapy is a possible alternative and effective strategy for blood glucose control in patients with type 2 diabetes, since drug therapy is associated with side-effects, long-term loss of efficacy, and poor adherence to lifelong treatment. A review of evidence was performed regarding the effects of tai chi on glycaemic control and other indicators in patients with type 2 diabetes mellitus. The results indicate that tai chi not only improves metabolic control, e.g. fasting blood glucose and total cholesterol, but also improves body composition indicators, e.g. body mass index. However, benefits of tai chi over aerobic exercise were seen in only a few outcome measures. The type and methodology of studies varied widely, with discrepancies in intensity, frequency, and duration of tai chi; therefore, further high-quality research is needed in order to draw specific and accurate conclusions.

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“…Nakanishi’s study also suggested an association between renal function and HbA1c, suggesting that HbA1c>7.0% increases the risk of diabetic microangiopathy, which increases the risk of diabetic nephropathy. 13 In our results, HbA1c was most closely related to blood glucose, so we focused on analyzing the influence of HbA1c on trauma patients. There are some studies on the relationship between blood sugar and trauma prognosis, but the results are not consistent.…”

Section: Discussionmentioning

confidence: 98%

Glycosylated Hemoglobin as a Predictor of Sepsis and All-Cause Mortality in Trauma Patients

Guo¹,

Shen²

2021

IDR

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Background and Purpose Infection is a common comorbidity and cause of death in emergency trauma patients, especially in diabetic patients. Once the patients are admitted, they are more susceptible to further complications like sepsis and resultant increase in in-hospital mortality. Therefore, it is necessary to evaluate risk factors associated with sepsis after trauma and death in trauma patients. Methods A total of 397 trauma patients were divided into 2 groups according to HbA1c level, HbA1c: <6.5% (n = 259), HbA1c: >6.5% (n = 138), and baseline clinical characteristics were collected. The independent risk factors of sepsis associated with trauma were screened using univariate and multivariate logistic regression analysis. Cox proportional hazards regression analysis was used to investigate risk factors for 30-day all-cause mortality. Results The sepsis incidence (76.1% vs 35.9%, P<0.001) and mortality rate (29.7% vs 7.3%, P<0.001) were significantly higher in HbA1c>6.5% group. Multivariate logistic regression analysis revealed that the independent risk factors of sepsis after trauma were diabetes (OR: 3.1, 95% CI: 1.41–6.79), hypertension (OR: 2.55, 95% CI: 1.35–4.82), coagulation disorder (OR: 3.45, 95% CI: 1.23–9.67), creatinine (OR: 3.71, 95% CI: 1.66–8.31), urea nitrogen (OR: 0.96, 95% CI: 0.92–0.99), HbA1c%>6.5 (OR: 2.05, 95% CI: 1.65–2.54), increase in body mass index (OR: 1.08, 95% CI: 1.03–1.13) and lower initial GCS score (OR: 0.93, 95% CI: 0.88–0.99). Multivariable Cox proportional hazard analysis revealed that male (HR: 1.94, 95% CI: 1.21–3.12), HbA1c >6.5% (HR: 1.45, 95% CI: 1.32–1.6), albumin (HR: 0.54, 95% CI: 0.34–0.86), creatinine (HR: 1.02, 95% CI: 1.01–1.03), APTT (HR: 1.02, 95% CI: 1.01–1.03), SOFA score (HR: 1.2, 95% CI: 1.1–1.31), age >65 years (HR: 3.21, 95% CI: 1.95–5.3) were independent risk factor for trauma patients’ mortality. Conclusion The prevalence of sepsis and mortality was higher in trauma patients with HbA1c >6.5%. HbA1c was independent risk factor for sepsis and all cases of mortality in trauma patients.

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Comparison of HbA1c levels and body mass index for prevention of diabetic kidney disease: A retrospective longitudinal study using outpatient clinical data in Japanese patients with type 2 diabetes mellitus

Cited by 17 publications

References 18 publications

Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

Effect of tai chi on glycaemic control, lipid metabolism and body composition in adults with type 2 diabetes: A meta-analysis and systematic review

Glycosylated Hemoglobin as a Predictor of Sepsis and All-Cause Mortality in Trauma Patients

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