Biomedical subjects

Ru-Lin Chen

Publications and source records attributed to Ru-Lin Chen.

3 recordsLinked to original sources

PubMed2006

Decrease heart rate variability but preserve postural blood pressure change in type 2 diabetes with microalbuminuria.

BACKGROUND: This study compares the cardiovascular autonomic function in type 2 diabetes with and without microalbuminuria, in order to identify the possible links between early nephropathy and diabetic autonomic neuropathy (DAN). METHODS: Cardiovascular reflex tests were performed to determine the cardiovascular autonomic function. Thirty cases of type 2 diabetes with microalbuminuria were studied for evidence of DAN to compare with a normoalbuminuric group of 56 diabetic patients. RESULTS: There was an increased prevalence of autonomic dysfunction in patients with microalbuminuria (63.3% in the microalbuminuria group vs. 40.0% in the normoalbuminuric controls, p = 0.001). These patients had lower heart rate variability during single breathing tests (6.9 +/- 4.3 vs. 9.6 +/- 3.6 beats/minute, p = 0.005), during 6 consecutive breathings (5.8 +/- 3.6 vs. 8.2 +/- 3.3 beats/minute, p = 0.005), after standing up (12.2 +/- 4.6 vs. 15.0 +/- 5.2 beats/ minute, p = 0.012), and during the Valsalva maneuver (11.3 +/- 3.5 vs. 13.2 +/- 3.6 beats/minute, p = 0.022). The heart rate variability with these stresses was revealed to be less favorable in subjects with microalbuminuria. However, blood pressure (BP) changes from the sitting to standing position were not significantly different for systolic BP (11.5 +/- 10.7 vs. 10.7 +/- 7.8 mmHg, p = 0.741) and diastolic BP (5.2 +/- 4.4 vs. 5.9 +/- 4.0 mmHg, p = 0.451) between the 2 groups. CONCLUSION: Type 2 diabetic patients with microalbuminuria have diminished heart rate variability in response to deep breathing, change of position and the Valsalva maneuver, but they preserve BP response to postural change. Therefore, microalbuminuria seems to be associated with early DAN, but not with advanced DAN.

Aged↗

PubMed2004

A prospective study of glycemic control during holiday time in type 2 diabetic patients.

OBJECTIVE: In the U.K. Prospective Diabetes Study, A1C increased from 1.2 to 1.7% and fasting plasma glucose from 1.0 to 2.8 mmol/l over 10 years in type 2 diabetic patients. It is not known whether the blood glucose increase observed in long-term studies of type 2 diabetes results from small, steady increases throughout the year or from increases during discrete periods. RESEARCH DESIGN AND METHODS: To estimate the variation of actual glycemic control and its relation to holiday times, we measured A1C and fructosamine in 110 patients with type 2 diabetes. These measurements were performed four times at intervals of 4-6 weeks; therefore, glycemic change was determined for three periods: preholiday period (from between November 13 and December 20 to between December 20 and January 20), holiday period (from between December 20 and January 20 to between January 28 and February 28), and postholiday period (from between January 28 and February 28 to between March 1 and April 10). A final measurement of A1C was obtained from 90 subjects in the following December or January. RESULTS: The mean A1C increased, but not significantly, during the preholiday (increase 0.135 +/- 0.723%, P = 0.055) and holiday (increase 0.094 +/- 0.828%, P = 0.239) periods. The mean A1C decreased, but not significantly, during the postholiday period (decrease 0.022 +/- 0.588%, P = 0.695). Altogether, the A1C change during these three periods increased significantly (increase 0.207 +/- 0.943%, P = 0.024). The mean fructosamine increased significantly during the preholiday period (increase 0.151 +/- 0.460 mmol/l, P = 0.001), but there was no significant change during the holiday period (increase 0.057 +/- 0.593 mmol/l, P = 0.321). However, fructosamine decreased significantly during the postholiday period (decrease 0.178 +/- 0.448 mmol/l, P < 0.001). Altogether, the fructosamine changes during the study periods showed no significant difference (increase 0.030 +/- 0.566 mmol/l, P = 0.579). Between March or early April and the following December or January, there was no additional change in A1C (decrease 0.009 +/- 1.039%, P = 0.935) for the 90 participants who returned for follow-up treatment. CONCLUSIONS: The present study demonstrates an influence of winter holidays on the glycemic control of patients who have type 2 diabetes, and this poor glycemic control might not be reversed during the summer and autumn months. Therefore, the cumulative effects of the yearly A1C gain during the winter holidays are likely to contribute to the substantial increase in A1C that occurs every year among type 2 diabetic individuals.

Adult↗

PubMed2002

A comparison of fructosamine and HbA1c for home self-monitoring blood glucose levels in type 2 diabetes.

BACKGROUND: Optimal glycemic control is believed to be essential in patients with diabetes to minimize any long-term complications. Measurement of the levels of glycated protein, such as fructosamine and glycated hemoglobin (HbA1c), is the most reliable method for assessing a period of glycemic control. This prospective study was performed to investigate whether fructosamine or HbA1c could provide a reliable index of glycemic control in type 2 diabetes. METHODS: Twenty-five patients with type 2 diabetes were studied at four-week intervals. Their fasting, preprandial and postprandial blood glucose levels were checked by glucometer twice a week for 16 weeks. Serum fructosamine and HbA1c were measured on every visit. The correlation of fructosamine and HbA1c with self-monitoring of blood glucose (SMBG) values in the previous 1 to 16 weeks prior to their measurements were calculated. RESULTS: Both fructosamine and HbA1c were significantly correlated with SMBG values from one week to 16 weeks prior to measurements. The correlation between fructosamine and SMBG was stronger in the prior 3 to 6 weeks. The correlation between HbA1c and SMBG was higher in the previous 4 to 12 weeks with the peak falling in the previous 8-10 weeks. Except for the previous one week, all the correlations were significantly stronger between HbA1c and SMBG than between fructosamine and SMBG. CONCLUSIONS: In type 2 diabetes, serum fructosamine assay can better reflect average blood glucose concentration over the previous 3 to 6 weeks and HbA1c is better reflective over the previous 8 to 10 weeks. HbA1c measurement correlates more significantly with home capillary blood glucose levels than the fructosamine assay, even over the previous 2 to 3 weeks.

Adult↗