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Articoli con TAG: diabete mellito

Pazienti diabetici di tipo 2, non in terapia insulinica e albumina glicata: una valutazione multidimensionale
Insuline-Naive type 2 diabetic patients: a multidimensional evaluation on the role of glycated albumin
<p>Insuline-Naa&iuml;ve type 2 diabetic patients: a multidimensional evaluation on the role of glycated albumin Introduction: glycated Albumin (GA) is an innovative glycemic marker, that could be used in the clinical practice, as an add-on strategy, to the traditional glycemic monitoring systems, such as glycated haemoglobin (Hb1Ac) and fasting plasma glucose (FPG). The study aims at presenting the results of a multidimensional analysis conducted in Italy, exploring the main clinical, economic, ethical, social and organizational implications, related to the introduction of GA. Methods: an Health Technology Assessment (HTA) approach was implemented. The analysis considered the Italian National Healthcare Service (NHS) perspective, and assumed a 12-month time horizon, focusing on type 2 diabetes patients insulin-na&iuml;ve, assuming oral therapy. The 9 HTA dimensions (derived from the Core Model developed by the European Network of HTA &ndash; EUnetHTA) were deployed, considering scientific evidence, health economics tools and qualitative approaches, through the administration of specific questionnaires to 15 diabetes experts. Results: literature reported better GA safety and efficacy profiles, thus being a predictor of the relative risk for diabetes complications development, and increasing the therapeutic success after 3 months of therapy (97.0% versus71.6%). From an economic point of view, GA introduction resulted in an economic advantage of 1.06% and in a better trade-off between costs sustained and efficacy gained. Considering a 7-item Likert Scale (ranging from -3 to +3), negative perceptions emerged with regard to equity aspects (0.13 versus0.72) due to GA limited accessibility, whereas it would improve both patients (2.17 versus1.33) and care givers (1.50 versus0.83) quality of life. In the short term, GA required training courses and equipment update, whereas, in the long term, it could be considered the preferable solution from an organizational perspective (0.30 versus0.01). Conclusions: the results of this study demonstrated GA strategic relevance, its economic sustainability and feasibility, as well as the potential clinical pathway improvement.</p>
Biochimica Clinica ; 44(1) 052-060
Contributi Scientifici - Scientific Papers
 
Raccomandazioni 2015 per l’esecuzione dell’esame da carico orale di glucosio
2015 recommendations for oral glucose tolerance testing (OGTT)
M. Carta, A. Mosca, A. Lapolla, R. Testa per il Gruppo di Studio SIBioC-Medicina di Laboratorio/SIPMeL Diabete mellito
<p>Despite its large use and importance, OGTT is&nbsp;still plagued by poor reproducibility and sometimes is not appropriately performed. In 2006 the joint Study Group on&nbsp;Diabetes mellitus made recommendations concerning OGTT in order to harmonize the test procedure according to&nbsp;WHO and American Diabetes Association guidelines. This document should be regarded as an updated version of the&nbsp;original 2006 recommendations, including some improvements and changes, particularly regarding the use of OGTT for&nbsp;the diagnosis of gestational diabetes in agreement with the 2010 guidelines of the Italian Ministry of Health. The list of&nbsp;drugs having effect on the glucose tolerance has been updated too.</p>
Biochimica Clinica ; 39(2) 135-140
Documenti SIBioC - SIBioC Documents
 
L’interferenza dell’emolisi sulla misura dell’insulina
Analytical interference of hemolysis on serum insulin measurement
<p>Insulin is a polypeptide hormone, secretedfrom pancreatic &beta;-cell, involved in the regulation of glucose and lipid metabolism. Insulin measurement is a useful toolto identify some clinical conditions, such as fasting hypoglycemia, some types of diabetes, the presence of insulinresistance. An important pre-analytical aspect that influences the determination of insulin serum concentration is thepresence of hemolysis. In fact, it is well known that insulin is degraded by a protease released by red blood cells afterhemolysis. The aim of this study is to evaluate the interference of hemolysis on insulin measurements performed bya chemiluminescence method. To study the effect of hemolysis on insulin degradation, we added increasingconcentrations of red blood cell hemolysate to a serum pool with known insulin concentration. The reduction of insulinlevels was affected by the degree of hemolysis, by the time elapsed before the assay and by the temperature ofsamples storage. Our results show that insulin values do not decrease significantly (&lt;10%) when hemolysis is &lt;2.0g/L of free hemoglobin (corresponding to H-index=200) if samples are maintained at low temperatures (i.e. in an ice-water slurry) until the assay is performed.</p>
Biochimica Clinica ; 43(3) 273-277
Contributi Scientifici - Scientific Papers