PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

HbA1C test for glucose monitoring poorly predictive in dialysis patients

2011-06-01
(Press-News.org) WINSTON-SALEM, N.C. – May 31, 2011 – The gold standard long-term glucose monitoring test for patients with diabetes proved to be of limited value in dialysis patients, according to a new study at Wake Forest Baptist Medical Center.

The study appears online in the Clinical Journal of the American Society of Nephrology and is scheduled for the July print issue.

Blood sugar monitoring is a vital part of diabetes management. Patients and physicians rely on the hemoglobin A1c (HbA1c) test to measure an individual's average blood sugar level over the prior three months. It is the most commonly used long-term blood sugar test, and is widely trusted in the medical community.

While the American Diabetes Association has deemed the HbA1c test an effective tool for diagnosing diabetes, kidney doctors recently determined that the HbA1c is not as useful for managing patients with diabetes and advanced kidney failure. Another test, the glycated albumin or GA assay, appears to be far more effective in this setting.

"Many organs don't function properly in severe kidney failure," explained Barry I. Freedman, M.D., John H. Felts III Professor and lead investigator. "For example, most dialysis patients have anemia with fewer red blood cells than they should, which has a dramatic impact on the accuracy of the HbA1c reading."

Hemoglobin inside red blood cells carries oxygen in the body. Blood sugar chemically interacts with the hemoglobin to identify a value for HbA1c. But HbA1c results are only accurate when red cells have a normal lifespan. Dialysis patients have shorter red cell survival, reducing the time that sugar in the bloodstream has to interact with hemoglobin, and causing lower HbA1c values.

"Doctors long thought the HbA1c predicted outcomes in diabetes," Freedman said. "This test is not predictive of outcomes in diabetes patients with kidney disease on dialysis. Dialysis patients and physicians get a false sense of security because their lower HbA1c actually relates to shorter red cell survival, yet suggests diabetes control is better than it really is."

Nearly 500,000 people are on dialysis in the Unites States and diabetes is the cause of kidney failure in nearly 50 percent of them. Diabetes is the most common cause of kidney failure worldwide and is associated with high mortality rates – more than 20 percent of dialysis patients die each year. As such, there is an urgent need for accurate blood sugar testing in diabetic dialysis patients.

Freedman and colleagues evaluated 444 patients with diabetes undergoing dialysis. Patients continued their normal treatment and HbA1c monitoring, but also agreed to have a GA test every three months for an average of more than 2.3 years.

The GA test, developed by Tokyo-based Asahi Kasei Pharma Corporation, measures blood sugars over the past 17 days, as opposed to the longer time frame for HbA1c. In situations where rapid changes occur in blood sugar, the GA gives a more accurate picture of diabetes control. The GA test used in this study is available in Japan, China and South Korea, but is not yet FDA approved in the United States.

Wake Forest Baptist researchers compared the patients' HbA1c and GA test results, assessing their ability to predict hospitalizations and survival. They found that the HbA1c failed to predict these important medical outcomes. In contrast, the GA was a strong predictor of patient survival and hospitalizations.

"This is the first study showing that a blood sugar test predicts risk of death in diabetic dialysis patients, as well as risk of hospitalization," Freedman said. "This test provides the missing link that will allow dialysis patients and physicians to accurately gauge risk. The association is clear: high GA readings predict higher risk."

Freedman suggests physicians not rely on the HbA1c in dialysis patients, instead suggesting that blood glucose levels be directly monitored with multiple daily readings until the GA test is available in the states.

###

Wake Forest Baptist is the largest academic provider of outpatient dialysis services in the country, with 17 freestanding facilities treating more than 1,550 patients. Co-authors on the study, sponsored by Asahi Kasei Pharma Corporation, are: Lilian Andries, M.D., Zak K. Shihabi, Ph.D., Michael V. Rocco, M.D., Gregory B. Russell, M.S., Cesar Y. Cardona, M.D., and Anthony J. Bleyer, M.D., all of Wake Forest Baptist. Additional support and testing was provided by Meridian Laboratories in Charlotte, NC, as well as the outpatient dialysis services of Wake Forest Baptist.

Media Relations Contacts: Jessica Guenzel, jguenzel@wakehealth.edu, (336) 716-3487; or Bonnie Davis, bdavis@wakehealth.edu, (336) 716-4977.

Wake Forest Baptist Medical Center (www.wakehealth.edu) is a fully integrated academic medical center located in Winston-Salem, N.C. Wake Forest School of Medicine directs the education and research components, with the medical school ranked among the nation's best and recognized as a leading research center in regenerative medicine, cancer, the neurosciences, aging, addiction and public health sciences. Piedmont Triad Research Park, a division of Wake Forest Baptist, fosters biotechnology innovation in an urban park community. Wake Forest Baptist Health, the clinical enterprise, includes a flagship tertiary care hospital for adults, Brenner Children's Hospital, a network of affiliated community-based hospitals, physician practices and outpatient services. The institution's clinical programs and the medical school are consistently recognized as among the best in the country by U.S.News & World Report.

END



ELSE PRESS RELEASES FROM THIS DATE:

Harvard scientists 'see' the early cellular cause of dry eye disease for the first time

2011-06-01
Bethesda, MD—If you are one of the millions of people around the world who struggle with dry eye disease, good news is on the way. A new research discovery published in the Journal of Leukocyte Biology (https://www.jleukbio.org) offers hope for new drugs that treat the cellular cause of the disease rather than its symptoms. That's because the research is the first to identify natural killer (NK) cells, a type of cell that provides innate immunity to the eyes, as promoting the inflammation that plays a critical role in the development of dry eye disease. "Dry eye disease ...

Long-term study data supports association between childhood ADHD and substance abuse risk

2011-06-01
Analysis of data from two long-term studies of the impact of attention-deficit hyperactivity disorder (ADHD) on the development of psychiatric disorders in young adults confirms that ADHD alone significantly increases the risk of cigarette smoking and substance abuse in both boys and girls. The report from a team of Massachusetts General Hospital (MGH) investigators will appear in the Journal of the American Academy of Child & Adolescent Psychiatry and has been released online. "Our study, which is one of the largest set of longitudinal studies of this issue to date, ...

Origins of XMRV deciphered, undermining claims for a role in human disease

Origins of XMRV deciphered, undermining claims for a role in human disease
2011-06-01
Delineation of the origin of the retrovirus known as XMRV from the genomes of laboratory mice indicates that the virus is unlikely to be responsible for either prostate cancer or chronic fatigue syndrome in humans, as has been widely published. The virus arose because of genetic recombination of two mouse viruses. Subsequent infection of lab experiments with XMRV formed the basis of the original association. Reporting in Science, Vinay Pathak, Ph.D., and his research team from the National Cancer Institute (NCI), part of the National Institutes of Health, in collaboration ...

Extra weight equals better health-related quality of life for blacks, not so for women

2011-06-01
A survey of nearly 4,000 Americans finds that obese women reported significantly worse health than obese men. Blacks who were overweight also reported better health than blacks in the normal or obese weight categories. Respondents were divided into three categories: normal, overweight, or obese, according to their height and weight. The survey results are published online in the June issue of Springer's journal Quality of Life Research and they come from a study funded by the National Institute on Aging. During the survey, researchers conducted comprehensive telephone ...

Support for local community programs key to climate change response in Arctic

2011-06-01
"When we talk about supporting adaptation to climate change, what we mean is supporting resilience at the community level," says Noorjehan Johnson, Vanier Canada Graduate Scholar in Cultural Anthropology at McGill University. "In the Arctic, much of the resilience is fostered through community institutions, which are playing an increasingly important role in crafting a local-level response to climate change." Johnson's research has taken her to Kanngiqtugaapik (Clyde River) on Baffin Island, Nunavut. There, she has been finding out how Inuit communities are adapting to ...

Study finds dangerous bacteria on cell phones of hospital patients

2011-06-01
Washington, DC, May 31, 2011 -- Cell phones used by patients and their visitors were twice as likely to contain potentially dangerous bacteria as those of healthcare workers (HCW), according to a study published in the June issue of the American Journal of Infection Control, the official publication of APIC - the Association for Professionals in Infection Control and Epidemiology. A team of researchers from the Department of Medical Microbiology at Inonu University in Malatya, Turkey collected swab samples from three parts of cell phones—the keypad, microphone and ear ...

Medical ethicists working in hospitals need to have standards

2011-06-01
A Queen's University professor is helping standardize practices for healthcare ethicists who consult and give guidance on medical ethics issues to doctors, nurses and patients across the country. "It's time for healthcare ethicists to have some formal practice guidelines, a governing code of ethics, and uniform education and certification standards," says Cheryl Cline, Director of the Office of Bioethics in the Faculty of Health Sciences and Clinical Ethicist at Kingston General Hospital. "Our job is to provide Canadian patients and their families with high quality ethics ...

Bilingualism no big deal for brain, Kansas researcher finds

2011-06-01
How do people who speak more than one language keep from mixing them up? How do they find the right word in the right language when being fluent in just one language means knowing about 30,000 words? That's what science has wondered about for decades, offering complicated theories on how the brain processes more than one language and sometimes theorizing that bilingualism degrades cognitive performance. But University of Kansas psycholinguist Mike Vitevitch thinks that complicated explanations of how the brain processes two or more languages overlook a straightforward ...

EARTH: D-Day's legacy sands

2011-06-01
Alexandria, VA –Next week marks the 67th anniversary of D-Day, when the Allies stormed the beaches at Normandy, France, and changed the face of World War II. Not much evidence of the war remains in Normandy: a few dilapidated relics, a cemetery, a war memorial. But something else was left behind that cannot be seen by the naked eye: shrapnel and iron and glass beads left over from the D-Day invasions in 1944. Two geologists visited Omaha Beach in 1988 and collected samples of the sand. Upon returning to their labs, they examined the sand under microscopes and discovered ...

Key goals for building on 30 years of HIV/AIDS research

2011-06-01
In the 30 years since the first reported cases of a mysterious illness now known as AIDS, researchers have made extraordinary advances in understanding, treating and preventing the disease. Now the challenge, according to experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is to build on those successes to control and, ultimately, end the HIV/AIDS pandemic. In an article published online today by the Annals of Internal Medicine, Anthony S. Fauci, M.D., NIAID Director, and Carl W. Dieffenbach, Ph.D., ...

LAST 30 PRESS RELEASES:

Understanding survival disparities in cancer care: A population-based study on mobility patterns

Common sleep aid may leave behind a dirty brain

Plant cells gain immune capabilities when it’s time to fight disease

Study sheds light on depression in community-dwelling older adults

Discovery of new class of particles could take quantum mechanics one step further

Cost-effectiveness of a polypill for cardiovascular disease prevention in an underserved population

Development and validation of a tool to predict onset of mild cognitive impairment and Alzheimer dementia

New AI predicts inner workings of cells

Scientists uncover key step in how diazotrophs “fix” nitrogen

The hidden mechanics of earthquake ignition

Scientists leverage artificial intelligence to fast-track methane mitigation strategies in animal agriculture

Researchers unravel a novel mechanism regulating gene expression in the brain that could guide solutions to circadian and other disorders

Discovery of 'Punk' and 'Emo' fossils challenges our understanding of ancient molluscs

Exposure to aircraft noise linked to worse heart function

Deans of the University of Nottingham visited Korea University's College of Medicine

New study assesses wildfire risk from standing dead trees in Yellowstone National Park

A new approach for improving hot corrosion resistance and anti-oxidation performance in silicide coating on niobium alloys

UC San Diego to lead data hub of CDC-funded pandemic preparedness network

Biomimetic teakwood structured environmental barrier coating

Low-cost system will improve communications among industrial machines

Elderberry juice shows benefits for weight management, metabolic health

A new era in genetic engineering

Study identifies coastal black pine trees resistant to tsunamis and strong winds

From gender dysphoria to special skills: decoding the link

Study advances possible blood test for early-stage Alzheimer’s disease

New international research collaboration to develop and test an improved dietary supplement for pregnant women

Presenting a path forward for future genetically-modified pig heart transplants: lessons learned from second patient

When the past meets the future: Innovative drone mapping unlocks secrets of Bronze Age ‘mega fortress’ in the Caucasus

AI could improve the success of IVF treatment

Moving in sync, slowly, in glassy liquids

[Press-News.org] HbA1C test for glucose monitoring poorly predictive in dialysis patients