- MeSH
- Biomarkers blood metabolism MeSH
- Diabetes Mellitus, Type 2 diagnosis complications MeSH
- Diabetes Mellitus diagnosis blood metabolism MeSH
- Economics, Medical trends MeSH
- Glycated Hemoglobin isolation & purification metabolism MeSH
- Hemoglobinopathies MeSH
- Blood Glucose isolation & purification metabolism MeSH
- Humans MeSH
- Metabolic Syndrome diagnosis complications MeSH
- Liver Diseases MeSH
- Prediabetic State diagnosis MeSH
- Renal Insufficiency MeSH
- Check Tag
- Humans MeSH
Popisujeme dva případy léčených kompenzovaných diabetiků s prokázanou přítomností paraproteinů v krevním séru. U obou z nich byly nalezeny výsledky HbA1c, neodpovídající jejich klinickému stavu a hodnotám plazmatické glukózy. Výsledky HbA1c byly porovnány s použitím dvou metod (obou na principu HPLC) měřením ve dvou různých laboratořích. U prvního pacienta s přítomností IgA kappa paraproteinu (48 g/l) poskytlo měření na přístroji DC-5 výsledky odpovídající dekompenzovanému diabetikovi a pacientovi bez diabetu v případě přístroje Variant II Turbo. U druhého pacienta s přítomností IgM lambda paraproteinu (27 g/l) byly oběma metodami opakovaně zjištěny neadekvátně nízké hodnoty HbA1c. Protože byla popsána řada interferencí paraproteinů při stanovení několika analytů krevního séra, považujeme za vhodné na tyto případy upozornit a pokračovat v podrobnějším studiu v budoucnosti na větším souboru diabetiků s prokázanou přítomností některého paraproteinu.
We describe two causes of treated diabetic patients with paraproteinemia. In both cases the results of HbA1c show strong discrepancies with clinical statement and with plasma glucose concentrations. HbA1c results were controlled by repeated measurements by other method in other laboratory. Different results were obtained. In case of fi rst patient with IgA kappa paraprotein (48 g/l) show results of HbA1c obtained by method DC-5 picture of decompensated diabetes, results of Variant II Turbo picture of non-diabetes person, while glucose and clinical state indicated well compensation of diabetes. In case of the second patient with IgM lambda paraprotein (27 g/l) there were very low and improbable results in both HbA1c methods, while clinical statement and plasma glucose were in entire concordance with picture of well compensated diabetes. Interferences of paraproteins are very often observed in some biochemical analyses, but interference of paraprotein in HbA1c measurement is unusual. We wish to alert on this possibility, because in old diabetic patients increases number of persons with paraprotein.
- MeSH
- Diabetes Mellitus, Type 2 blood MeSH
- Financing, Organized MeSH
- Glycated Hemoglobin analysis MeSH
- Immunoglobulin kappa-Chains blood MeSH
- Immunoglobulin lambda-Chains blood MeSH
- Blood Glucose analysis MeSH
- Humans MeSH
- Monoclonal Gammopathy of Undetermined Significance blood MeSH
- Reproducibility of Results MeSH
- Aged MeSH
- Serum chemistry MeSH
- Chromatography, High Pressure Liquid instrumentation MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Microvascular complications in diabetes are associated with poor long-term diabetes control as measured by HbA1c levels. Glucose fluctuations are related to oxidative stress, endothelial dysfunction, and inflammation, factors traditionally associated with the pathogenesis of vascular damage. Glucose variability has been associated with macrovascular disease in some studies but any association with microvascular disease remains controversial. This overview summarizes recent findings in the field of glucose variability and its possible relationship with retinopathy, nephropathy and neuropathy. It is concluded that randomized prospective follow-up trials could possibly help estimate whether short-term glucose variability should be considered as an independent risk factor for microvascular complications in diabetes.
- MeSH
- Diabetic Angiopathies metabolism MeSH
- Glycated Hemoglobin metabolism MeSH
- Blood Glucose metabolism MeSH
- Humans MeSH
- Microvessels pathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- MeSH
- Diabetes Mellitus diagnosis therapy MeSH
- Glycated Hemoglobin analysis MeSH
- Continuous Glucose Monitoring MeSH
- Blood Glucose * analysis MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comment MeSH
- Overall MeSH
- MeSH
- Biomarkers MeSH
- Diabetes Mellitus diagnosis physiopathology therapy MeSH
- Glycated Hemoglobin diagnostic use physiology MeSH
- Hyperglycemia physiopathology MeSH
- Blood Glucose analysis metabolism MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Glycated Hemoglobin * isolation & purification metabolism MeSH
- Indicators and Reagents standards MeSH
- Clinical Laboratory Techniques methods utilization MeSH
- Blood Glucose isolation & purification metabolism drug effects MeSH
- Humans MeSH
- Blood Specimen Collection methods standards MeSH
- Physicians' Offices standards utilization MeSH
- General Practitioners * MeSH
- Reference Standards MeSH
- Quality Control * MeSH
- Check Tag
- Humans MeSH
