How to Increase Laboratory Accuracy with Direct HbA1c Testing !

HbA1c:

Diabetes is a global epidemic affecting in the region of 425 million people according to the International Diabetes Federation. Worryingly, this figure is on the rise with forecasts suggesting diabetes will affect up to 629 million people globally by 2045. Such a dramatic increase highlights the fundamental need for better disease management. When we look at the worldwide prevalence of diabetes, the United States is one of the most prominent countries affected.

HbA1c - an important biomarker for diabetes management and control !

HbA1c, also known as hemoglobin A1c or glycated hemoglobin, is an important blood test used to determine how well diabetes is being controlled. It develops when hemoglobin, a protein within the red blood cells that carries oxygen throughout the body, joins with glucose in the blood, becoming “glycated.” The concentration of HbA1c in the blood of diabetic patients increases with rising blood glucose levels and is representative of the mean blood glucose level over the preceding six to eight weeks. HbA1c can therefore be described as a long-term indicator of diabetic control, unlike blood glucose which is only a short-term indicator of diabetic control. It is recommended that HbA1c levels are monitored every three to four months.

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Parents can Influence New Genetic Mutations in Children !

A new study has investigated how mothers and fathers cause new genetic mutations in their children, and how some of these mutations may lead to negative outcomes.

Characteristics that we inherit from our parents - starting with very basic features such as eye color or hair texture - shape not just our identity, but also the state of our health, both earlier and later in life.

That being the case, the study of genetics has become central to understanding who and what we are, as well as how our bodies are likely to develop in time, and how we might respond to internal or external factors.

For instance, recent studies have revealed the importance of genetic factors to conditions including Alzheimer's disease, brain cancer, and diabetes.

Given the importance of understanding the role of genetic factors to our health profile, scientists are constantly striving to decipher the mysteries of the human genome.

Researchers are looking at how the parents' age and sex determine
new genetic mutations in the offspring.

Read more: How do parents influence new genetic mutations in children?

Genetic Mutations in Parents May Increase Risk of ALS in Children

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Source: MSN Health

Differences between Type 1 and Type 2 Diabetes.

Diabetes, or diabetes mellitus (DM), is a metabolic disorder in which the body cannot properly store and use sugar.

It affects the body's ability to use glucose, a type of sugar found in the blood, as fuel. This happens because the body does not produce enough insulin, or the cells do not correctly respond to insulin to use glucose as energy.

Insulin is a type of hormone produced by the pancreas to regulate how blood sugar becomes energy. An imbalance of insulin or resistance to insulin causes diabetes.

Diabetes is linked to a higher risk of cardiovascular disease, kidney disease, vision loss, neurological conditions, and damage to blood vessels and organs.

There is type 1, type 2, and gestational diabetes. They have different causes and risk factors, and different lines of treatment.

This article will compare the similarities and differences of types 1 and 2 diabetes.

People with type 1 diabetes will require supplemental insulin on an

ongoing basis. People with type 2 will likely only need this for the later

stages of the condition. A healthcare specialist will be able to test

a patient for diabetes, even if type 2 diabetes shows no symptoms.

Read more: Differences between Type 1 and Type 2 Diabetes.

Source: MedicalNewsToday

Cardiac Biomarkers and Clinical Decision Making

New video discusses the importance of cardiac biomarkers

Click to watch video

In this video, hear from a former operating engineer at the White House who, despite an active lifestyle and basic good health, experienced sudden heart failure. In the context of his healthcare journey, the video highlights the role of cardiac biomarkers in clinical decision making and the diagnosis of a heart attack.

Diagnosed with advanced coronary artery disease, the patient underwent cardiac bypass surgery and was enrolled in a biomarker study during his postoperative course of treatment. “There’s no doubt that biomarkers have completely transformed how we care for our patients in cardiovascular medicine,” says the patient’s cardiologist.

Evaluation of Diabetic Marker HbA1c and Anemia in the Context of Kidney Disease

Each year, more than 100,000 people in the United States are diagnosed with kidney failure, the final stage of kidney disease.1 The most common cause is diabetes, accounting for nearly 44 percent of new cases. Often, a consequence of kidney disease is anemia. This occurs when kidneys fail to generate enough erythropoietin hormone to trigger adequate red blood cell production. For decades, clinicians have successfully used the hemoglobin A1c (HbA1c or A1C) assay to monitor long-term blood glucose control for patients with chronic diabetes. More recently, researchers have studied the HbA1c assay’s use as a potential diagnostic marker for diabetes complications such as kidney disease.

The HbA1c test measures average plasma glucose—hemoglobin in a red blood cell that was combined with glucose over the previous eight to 12 weeks. The higher the HbA1c value, the greater the risk that the diabetes patient will develop kidney disease, and perhaps, anemia, a common consequence of renal disease. However, a chemically modified derivative of hemoglobin called carbamylated hemoglobin (CHb) can affect the accuracy of the HbA1c test results. Studies have shown that the formation of CHb due to abnormal urea concentration is linked to both the severity and the duration of renal failure. Research findings have inspired conflicting viewpoints on the efficacy of HbA1c test results in the presence of CHb and on the level of CHb it takes to affect results. This article explores the links between diabetes and renal failure. It discusses what research has discovered about the effect of CHb on HbA1c testing. Finally, it shows how testing technology has improved to ensure HbA1c testing accuracy.

Read more: Evaluation of Diabetic Marker HbA1c and Anemia in the Context of Kidney Disease

Source: MedicalLaboratoryObserver

How Does Alcohol Affect My Blood Sugar Levels?

It is not uncommon to enjoy a glass of wine with dinner or to have drinks after work with friends. Alcohol consumption is very prevalent in the United States.

According to the National Institute on Alcohol Abuse and Alcoholism, in 2014:

• 87.6 percent of people age 18 and older reported drinking alcohol at some point in their lifetime
• 71 percent reported drinking in the past year
• 56.9 percent reported drinking in the past month

For many people, a glass of alcohol here and there does not pose a problem. For those with certain health conditions such as diabetes, however, alcohol can affect blood sugar levels and pose a health risk. It is important for them to understand what alcohol is and how it affects blood sugar levels.

Read more: How Does Alcohol Affect My Blood Sugar Levels?

The way that alcohol affects the body differs from person to person. People with diabetes and other
blood sugar-related illnesses must be extremely careful when consuming alcohol. Cocktails and
mixed drinks are full of sugar, so should be avoided by people with blood sugar problems.

Source: MedicalNewsToday

Short-Chain Fatty Acids In Control Of Body Weight And Insulin Sensitivity

The connection between the gut microbiota and the etiology of obesity and cardiometabolic disorders is increasingly being recognized by clinicians. Our gut microbiota might affect the cardiometabolic phenotype by fermenting indigestible dietary components and thereby producing short-chain fatty acids (SCFA). These SCFA are not only of importance in gut health and as signaling molecules, but might also enter the systemic circulation and directly affect metabolism or the function of peripheral tissues.

In this Review, we discuss the effects of three SCFA (acetate, propionate and butyrate) on energy homeostasis and metabolism, as well as how these SCFA can beneficially modulate adipose tissue, skeletal muscle and liver tissue function.

Read more: Short-Chain Fatty Acids In Control Of Body Weight And Insulin Sensitivity

Short-Chain Fatty Acids (SCFA) and liver function.

Source: NatureReviewsEndocrinology

How Reliable Is The Glycemic Index?

Individual response to glycemic index values vary so much that it may not be useful in indicating blood sugar response, says research published in the American Journal of Clinical Nutrition.

The glycemic index (GI) of a food indicates the speed with which blood sugar can be expected to rise after a person eats it. Each food gets a score out of 100 on the index, for example, 40 for baked beans.

Glycemic load is a measure that applies the GI to a portion of food. The glycemic load for a 150-gram serving of baked beans would be 6.

GI is used to help people with diabetes to control their blood sugar. Some food labels carry GI measurements. More recently, a number of popular diets have been based on GI. Lists are available for people to check the GI and glycemic load of different foods.

Read more: How Reliable Is The Glycemic Index?

People use the glycemic index as a guide to suitable foods, but is it a valid measure?

Source: medicalnewstoday

Cesarean Delivery May Increase Risk of Childhood Obesity

Children born by cesarean delivery may have an increased risk of becoming obese, compared with their siblings born by vaginal delivery, says study. This finding may have significant implications for the almost 1.3 million cesarean births per year in the United States.

Cesarean delivery is the most common U.S. surgical procedure and accounts for one third of deliveries nationwide.

The most common risk to children born via cesarean delivery is respiratory problems, while increasing evidence suggests children may also have an increased risk of other adverse health outcomes as adults.

Read more: Cesarean Delivery May Increase Risk of Childhood Obesity

Cesarean delivery can increase a child's risk of obesity into adulthood, study finds.

Source: medicalnewstoday

Cracking the Enigma of Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) affects one out of four people in the world, making it the most prevalent of all liver diseases and a major public health problem. The disease is defined by abnormally increased fat deposition in liver cells, which can progress with the addition of inflammation and cell damage to nonalcoholic steatohepatitis (NASH), leading to progressive stages of fibrosis and, finally, cirrhosis. Early NASH is characterized by fat and inflammation associated with minimal amounts of fibrosis, and late NASH is associated with advanced fibrosis or cirrhosis. NAFLD is most closely associated with obesity and diabetes, although there are likely other genetic, nutritional, and environmental factors involved in the pathogenesis.

Although there are no approved pharmacologic treatments for NAFLD, NASH, or cirrhosis, there are over a dozen different companies researching possible treatments. However, the development of drug therapies for the NAFLD spectrum of disease is hampered by a number of challenges:

• the chronic nature of the disorder and ultimately low morbidity and mortality,
• the impact of weight loss on the disease,
• a complex and poorly defined pathophysiology,
• the lack of easily administered diagnostic testing, and
• the evolving status of regulatory endpoints.

Read more: Cracking the Enigma of Fatty Liver Disease

The results of multiple clinical trials over the next few years will clarify potential therapies and target
pathways.  © Sebastian Kaulitzki/Fotolia]

Source: genengnews

All You Need to Know About the Glucose Tolerance Test

Most of the food people eat is turned directly into glucose when digested, and the body uses it as energy. The pancreas is responsible for making the hormone insulin which helps to get glucose into the cells of the body.

Diabetes is a long-term disease that occurs due to the pancreas not producing enough insulin or the body being unable to use the insulin it produces effectively.

The body is unable to process food properly to use for energy. Glucose builds up in the blood, which can lead to severe health problems.

There are two main types of diabetes. Type 1 diabetes is usually diagnosed in children and young adults and is also known as juvenile diabetes. With type 1 diabetes the body does not produce insulin. 

Read more: All You Need to Know About the Glucose Tolerance Test

A glucose tolerance test can be used to screen for type 2 diabetes. Gestational diabetes can occur in
pregnant woman who have never had diabetes but have high blood glucose levels. During the
glucose test, some people may experience nausea, lightheadedness, shortness of breath, and sweating.

Source: medicalnewstoday

Diabetes-Related Vision Loss Growing Worldwide

The worldwide burden of diabetes-related vision loss is growing alarmingly. Over 2 decades from 1990-2010, the number of people worldwide with diabetes-related blindness or visual impairment rose by an alarming 27 percent and 64 percent, respectively. In 2010, 1 in every 52 people had vision loss and 1 in every 39 people were blind due to diabetic retinopathy - where the retina is damaged by diabetes.

These figures are the result of an analysis by a global consortium, who recently published their work online in the journal Diabetes Care.

As the number of people living with diabetes worldwide grows, so does the chance that more people will develop diabetic retinopathy and suffer subsequent vision loss, especially if they do not receive or adhere to the care they need.

Diabetic retinopathy is a disease of the retina that damages sight as a result of chronic high blood sugar in diabetes. The high sugar damages the delicate blood vessels in the retina - the light-sensitive layer of tissue that lines the back of the eye.

Read more: Diabetes-Related Vision Loss Growing Worldwide

The researchers suggest poor control of blood glucose and inadequate access to eye health services inmany parts of the world are contributing to the growing global burden of diabetes-related vision loss.

Source: medicalnewstoday

Gut Bacteria, Antibiotics, and the Rise of Type 1 Diabetes

Breaking research investigates antibiotic use in children and the later development of type 1 diabetes. Could antibiotics be altering the gut biome and impacting future health?

In America, more than 30 million people have a diabetes diagnosis.

Of these cases, around 5 percent are classed as type 1 diabetes.

Type 1 diabetes, usually diagnosed in young adults and children, is an autoimmune disorder; it is sometimes referred to as juvenile diabetes.

The individual's immune system attacks and destroys specific cells within the pancreas - islet cells - that create insulin.

With the following decrease in insulin, blood glucose builds up and damages nerves and blood vessels.

Read more: Gut Bacteria, Antibiotics, and the Rise of Type 1 Diabetes

The wide usage of antibiotics may be affecting children's microbiomes and future immune systems.

Source: medicalnewstoday

Gallstones Raise the Risk of Heart Disease by a Fifth

A new meta-analysis, using data from hundreds of thousands of individuals, finds that gallbladder disease and heart disease are more intertwined than previously thought. The reasons behind this connection are, as yet, unclear.

Gallstones are small, hard deposits that form in the gallbladder - an organ that sits below the liver.

In wealthier countries, they are a common occurrence, affecting 10-15 percent of all adults.

Gallstones are thought to be produced due to an imbalance in the makeup of bile - a digestive aid produced by the liver and concentrated in the gallbladder.

Although generally small and often symptomless, over the years, gallstones can grow to the size of pebbles.

Read more: Gallstones Raise the Risk of Heart Disease by a Fifth

Gallstones' links to heart disease run deeper than previously thought.

Source: medicalnewstoday

Blood Tests You Need After Age 50

 

Five Blood Tests You Need After Age 50

1. HCV for hepatitis C virus: The virus that kills more Americans than any other disease will probably surprise you: It's hepatitis C.
2. Blood glucose test for diabetes: If you're overweight and have high blood pressure and a history of diabetes in your family, you're a prime candidate for a screening test of the sugar in your blood.
3. Lipid panel for high cholesterol: If your cholesterol numbers are borderline or if you have another health condition like diabetes that would increase your risk of heart problems, you'll want to be tested.
4. Bloodwork for sexually transmitted infections: If you have a new sexual partner, multiple sexual partners, or don't typically use condoms, mention it to your doc.
5. TSH test for hypothyroidism: If your thyroid-stimulating hormone blood test reveals that you have high TSH, you have an underactive thyroid, or hypothyroidism.

Read more: Blood Tests You Need After Age 50

Source: prevention

The Continuing Case for Point-of-Care Testing for HbA1c

There is an ongoing conflict between traditional clinical laboratories and the relative new kid on the block, point-of-care testing (POCT). Of course, the laboratory system will likely always be king. But there is absolutely a place for POCT, especially as the way in which we approach healthcare, especially diagnostics, develops beyond the usual settings.

POCT ensures the rapid provision of diagnostic information, ideally during one consultation, to enable clinical decisions to be made at the earliest opportunity. Such rapid provision of information facilitates optimization of the care process. The potential for any application of POCT can, therefore, be judged in terms of its contribution to decision making and to the process of care.

In the case of the management of diabetes patients, POCT for glycated hemoglobin (HbA1c) may offer a number of advantages—as long as the performance characteristics of the analyzers used are equivalent to those employed in the central laboratory, and can be certified as such.

The use of HbA1c for management of diabetes

Glycated hemoglobin (HbA1c) is well-recognized as a reliable measure for glycemic control.

Read more: The Continuing Case for Point-of-Care Testing for HbA1c

Figure 1. Glycated hemoglobin (HbA1c) explained

Source: mlo-online

Overcoming the Fear of Injections for Diabetes

Do you have an objection to injections? If you have type 2 diabetes, you may be afraid you’ll eventually need to give yourself insulin injections, or maybe your doctor has mentioned non-insulin injections might be in your future.

Treating diabetes with injections does not mean you have failed or did not follow your doctor’s instructions. Many diabetics will need insulin shots over time, and non-insulin injections are just a newer form of diabetes medication. However, you do need to overcome your fear and resistance if you want to get your diabetes under control. In order to do this, it’s important to determine the root of your anxiety, and identifying the problem can help you find solutions.

Get the Facts

While there have been attempts at developing an inhaled insulin, injections are currently the most common form of delivery with the technology available today.

Read more: Overcoming the Fear of Injections for Diabetes

Source: msn/health/medical

The Pathophysiology of Defective Proteostasis in the Hypothalamus — From Obesity to Ageing

Hypothalamic dysfunction has emerged as an important mechanism involved in the development of obesity and its comorbidities, as well as in the process of ageing and age-related diseases, such as type 2 diabetes mellitus, hypertension and Alzheimer disease. In both obesity and ageing, inflammatory signalling is thought to coordinate many of the cellular events that lead to hypothalamic neuronal dysfunction. This process is triggered by the activation of signalling via the toll-like receptor 4 pathway and endoplasmic reticulum stress, which in turn results in intracellular inflammatory signalling. However, the process that connects inflammation with neuronal dysfunction is complex and includes several regulatory mechanisms that ultimately control the homeostasis of intracellular proteins and organelles (also known as 'proteostasis'). This Review discusses the evidence for the key role of proteostasis in the control of hypothalamic neurons and the involvement of this process in regulating whole-body energy homeostasis and lifespan.

Key points

• Specialized neurons of the hypothalamus control caloric intake and energy expenditure in response to hormonal, nutritional and neural signals that reflect the energy stores in the body
• Malfunction of the hypothalamus occurs in obesity and ageing, which leads to an imbalance between caloric intake and energy expenditure resulting in positive energy balance and reduced lifespan
• The excessive consumption of certain nutrients and ageing affect different aspects of proteostasis in selected neurons of the hypothalamus, contributing to neuronal dysfunction in obesity and ageing
• Inflammation is one of the most important outcomes of disturbed proteostasis to occur in the hypothalamus during obesity and ageing
• Several genetic and pharmacological approaches used to correct the defects of proteostasis and reduce inflammation have proven effective in reducing obesity and increasing lifespan in experimental models

Read more: The Pathophysiology of Defective Proteostasis in the Hypothalamus — From Obesity to Ageing

Figure 1: Control of energy balance and lifespan by the hypothalamic network. Neurons of the
medium hypothalamus respond to systemic signals of whole-body energy status. Blood levels of
insulin fluctuate acutely in response to carbohydrates present in food and chronically in response
to increased adiposity.

Source: Nature Reviews Endocrinology

Eating Walnuts May Help Prevent Colon Cancer

A team of researchers from UConn Health and The Jackson Laboratory for Genomic Medicine found that eating walnuts can reduce one's risk of getting colon cancer.

In the study, mice that were fed walnuts (totaling seven percent to 10.5 percent of their total calories) developed fewer instances of colon cancer.

Seven to 10.5 percent of daily total calories coming from walnuts is equivalent to a human eating about an ounce of walnuts every day.

Walnut consumption

"Our results show for the first time that walnut consumption may reduce colon tumor development," said Daniel W. Rosenberg of UConn Health, principal investigator on the study.

Read more: Eating Walnuts May Help Prevent Colon Cancer

Could walnuts be the key to preventing colon cancer?

Source: medicalnewstoday

Borderline Diabetes: What You Need to Know

The term borderline diabetes refers to a condition called prediabetes. Prediabetes is a condition in which blood sugar levels are higher than normal but not high enough to be classed as type 2 diabetes.

Prediabetes is to be considered a risk factor for type 2 diabetes. It is estimated that 10 to 23 percent of people with prediabetes will go on to develop type 2 diabetes within 5 years.

Prediabetes can be accompanied by other risk factors. It is associated with conditions such as obesity, especially abdominal obesity, high blood pressure, high blood fat levels and low levels of "good" cholesterol.

When these risk factors "cluster" together in a person, there is a higher risk of not just type 2 diabetes but heart disease and stroke as well.

Read more: Borderline Diabetes: What You Need to Know

Source: medicalnewstoday