Latest news with #A1c
Straits Times
4 days ago
- Health
- Straits Times
Singapore-developed device for diabetics measures long-term average blood sugar levels within 6 mins
Sign up now: Get ST's newsletters delivered to your inbox Users prick their fingers using a lancet and take a drop of blood using a sampler, a small implement similar to a floss pick. The blood is then placed on a test strip and fed into an analyser. SINGAPORE – A locally developed device for diabetic patients can measure their three-month average blood sugar levels within six minutes, instead of the few days it could take now. Unlike daily blood glucose monitoring, which only gives a snapshot of the person's blood sugar level at the time of testing, this provides a long-term view of average blood glucose levels. Such information is essential in managing diabetes, as it can help predict the risk of a patient developing complications in organs such as the eyes, kidneys and heart. NHG Polyclinics, the primary care arm of health cluster NHG Health, and local medical equipment firm SG Diagnostics have developed the Rapid HbA1c Point-Of-Care-Test for Improved Care. The blood test measures the amount of glucose (sugar) attached to haemoglobin A1c (HbA1c), a protein found in red blood cells. Users prick their fingers using a lancet and take a drop of blood using a sampler, a small implement similar to a floss pick. The blood is then placed on a test strip and fed into an analyser . Two buffer solutions are added to maintain the blood's acidity levels. Without the rapid test, blood samples typically have to be extracted from a vein and sent to a laboratory. Though polyclinics have such facilities, GPs, particularly those at smaller clinics, may not have the necessary equipment to test such samples and may have to send them out to a lab – a process that could take several days and require patients to make more than one visit to get their results. The Rapid HbA1c Point-Of-Care-Test for Improved Care will allow patients to receive their results almost instantaneously, said Kallang Polyclinic head Valerie Teo. The blood test measures the amount of glucose (sugar) attached to haemoglobin A1ca (HbA1c), a protein found in red blood cells. ST PHOTO: ARIFFIN JAMAR 'The patient will know their result on the spot before they go home,' said Dr Teo, who led the project to develop the test from 2022. Its accuracy is similar to those of lab-administered tests, she said. In July, the test won an Exemplary Innovation Award at the 2025 Public Sector Transformation Awards, one of 10 awards won by NHG Health . About 300 GP clinics islandwide have already adopted the device, Dr Teo said. Sold under the name PreciS-A HbA1c Analysis System, the test, which can be self-administered, is available on e-commerce sites such as Shopee and Lazada for $466, compared with around $25 for a lab test. A trial that saw 30 patients take the system home for use over six months was also conducted with the aim of testing the system's applicability for home use. The findings from that pilot are now being put together. The test can also potentially be used during home visits or at community screenings, allowing patients to get their results quickly, said Dr Teo. Such uses are in line with Singapore's Healthier SG preventive health initiative, she noted. 'We really want to reach our patients in the community to help ensure that patients get the gold standard way of monitoring,' she said. According to the 2022 National Population Health Survey, about one in 12 Singaporeans had diabetes in 2022. Separately, in July, NHG Polyclinics began a one-year trial of HealthVector Diabetes, a clinical analysis software that can estimate a patient's three-year risk of developing chronic kidney disease stage 3A – where there is a mild to moderate loss of kidney function – and beyond. The prevalence of the disease is about 42.3 per cent among diabetes patients here, four times higher than those without diabetes. Developed by Tan Tock Seng Hospital and Singapore General Hospital, the software uses clinical data to create a 'digital twin', or virtual model, of a patient's metabolism. This allows the risk of chronic kidney disease to be detected up to three years in advance, compared with the traditional method of using blood or urine tests, which often miss early or hidden risks. Other locally-made devices to tackle diabetes Core Smart Ring The smart ring is able to monitor a patient's blood glucose levels in a non-invasive manner via artificial intelligence-driven technology. ST PHOTO: GIN TAY Weighing about 3g, the titanium ring manufactured by Actxa uses the local deep tech firm's proprietary artificial intelligence-driven technology called BGEM (blood glucose evaluation and monitoring) to detect changes in blood volume and capture blood glucose levels. This facilitates the early detection of diabetic risk in a non-invasive manner. Using photoplethysmography (PPG) sensors, commonly found in wearables, the ring also provides sleep monitoring as well as continuous heart rate and blood oxygen monitoring, to provide users a deeper understanding of their cardiovascular and aerobic health. Customised 3D-printed insoles A podiatrist taking a foam box impression of a patient's foot to produce customised, 3D printed insoles for diabetic foot care. PHOTO: SENGKANG GENERAL HOSPITAL In July, Sengkang General Hospital announced an innovative approach to diabetic foot care by producing 3D-printed insoles in-house. Digital scans of a patient's foot impressions allow for each insole to be customised for individuals, including varying densities for different parts of the foot. Up to 25 per cent of diabetic patients develop foot ulcers, with more than 80 per cent of lower limb amputations originating from these ulcers. Diabetic patients can experience nerve damage and changes in foot structure, causing peak plantar pressure – or the maximum force exerted at a particular point on the sole – which leads to foot ulcers. Initial results show that these custom 3D-printed insoles can reduce peak plantar pressure by up to 28.5 per cent and improve pressure distribution by 52.7 per cent, compared with 23 per cent reduction and 40 per cent improved distribution with traditional insoles.
Medscape
08-08-2025
- Health
- Medscape
Fotagliptin Plus Metformin Enhances Glycemic Control in T2D
TOPLINE: Addition of fotagliptin to metformin significantly reduced A1c levels in patients with type 2 diabetes (T2D) compared with placebo plus metformin without increasing the incidence of hypoglycemic events. METHODOLOGY: Previous research indicated that fotagliptin, a dipeptidyl peptidase 4 inhibitor, provided superior glycemic control than placebo in patients with T2D. Researchers conducted a randomized controlled trial across 53 outpatient clinics in China to evaluate the efficacy and safety of fotagliptin as an add-on to metformin in patients with T2D. They included 402 patients with T2D (mean age, 55.1 years; mean A1c level, 8.09%; 59% men) who underwent dietary and exercise interventions and received a stable dose of ≥ 1500 mg/d metformin for at least 8 weeks before screening. Patients were randomly assigned in a 2:1 ratio to receive either fotagliptin 12 mg once daily or placebo in addition to a stable dose of metformin for 24 weeks during the double-blind treatment. Afterward, all patients received fotagliptin 12 mg once daily as part of the open-label fotagliptin treatment until the end of 52 weeks. The primary endpoint was a change in the A1c level from baseline to week 24. TAKEAWAY: At week 24, patients on metformin plus fotagliptin had least square mean change in the A1c level of -0.81% compared with -0.28% in those on metformin plus placebo, with an estimated treatment difference of -0.53% (P < .001). The A1c target of < 7.0% was achieved by 38.7% of patients on metformin plus fotagliptin compared with 16.9% of patients on metformin plus placebo (P < .0001), with similar results observed for the A1c target of ≤ 6.5% (P < .0001). In either group, the incidence of treatment-emergent adverse events leading to drug discontinuation was low. Hypoglycemic events were relatively less frequent in both groups and were considered mild to moderate. IN PRACTICE: 'In patients with T2D, who were treated with metformin, add-on with fotagliptin 12 mg once daily achieved a superior and clinically meaningful decrease in HbA1c compared with placebo,' the authors concluded. SOURCE: This study was led by Nan Yu, MD, Peking University First Hospital, Beijing, China. It was published online in Diabetes, Obesity and Metabolism. LIMITATIONS: This study included only Chinese patients with T2D, which may suggest selective bias. The duration of this study was not long enough to assess cardiovascular outcomes or benefits. DISCLOSURES: This study was supported by Shenzhen Salubris Pharmaceuticals Co., Ltd, with partial funding from the Shenzhen Science and Technology Program for Undertaking the National Science and Technology Major Project. One author reported being an employee of Shenzhen Salubris Pharmaceuticals Co., Ltd. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
05-08-2025
- Health
- Medscape
Dapagliflozin Delivers Post-MI, Regardless of BMI and A1c
TOPLINE: Dapagliflozin, an SGLT2 inhibitor, reduced the incidence of new-onset type 2 diabetes (T2D) following myocardial infarction (MI), regardless of baseline BMI or A1c levels, with a substantial reduction in heart failure symptoms seen in those with prediabetes and obesity. METHODOLOGY: Researchers performed a subanalysis of the DAPA-MI trial to assess whether cardiometabolic benefits of dapagliflozin after MI varied by baseline glycaemic status or BMI. They included patients who experienced acute MI within the last 7-10 days with impaired left ventricular systolic function and had no prior history of T2D or chronic heart failure. Patients were randomly assigned to receive either dapagliflozin (n = 1725; mean age, 62.9 years; 19% women) or placebo (n = 1700; mean age, 62.8 years; 20% women). In this subanalysis, patients were categorised as those having normal glycaemic levels (A1c levels < 5.7%) or having prediabetes (A1c levels, 5.7% to < 6.5%); BMI categories were < 25, 25 to < 30, and ≥ 30. Key outcomes included new-onset T2D and the occurrence of heart failure symptoms classified on the basis of the New York Heart Association (NYHA) class, assessed over a median follow-up duration of 11.6 months. TAKEAWAY: Patients who received dapagliflozin had a lower risk for new-onset T2D, irrespective of their baseline glycaemic status or BMI, than those who received placebo. Patients on dapagliflozin vs placebo showed a reduction in NYHA class III-IV symptoms, with a more pronounced effect seen in those with prediabetes than in those with normal A1c levels (P interaction = .009). Patients with both prediabetes and BMI ≥ 30 showed a 71% reduction in the occurrence of NYHA class III-IV symptoms with dapagliflozin (P = .005), corresponding to a 1-year absolute risk reduction of 10%. Dapagliflozin was similarly effective in achieving 5% or more weight loss across all A1c levels and BMI categories; rates of cardiovascular events were comparable between dapagliflozin and placebo groups. IN PRACTICE: "The findings of the present subanalyses support having a low threshold for commencing SGLT2 inhibition following acute MI in those with evidence of dysglycemia and/or obesity," the researchers wrote. SOURCE: This study was led by Robert F. Storey, MD, DM, University of Sheffield, Sheffield, England. It was published online on July 29, 2025, in the Journal of the American Heart Association. LIMITATIONS: The definition of the subgroups in a post hoc manner may have introduced bias. All assessments were performed only during active treatment; thus, glycometabolic effects after stopping medication remained uncertain. The follow-up period was relatively short, event rates were low, and CIs for hazard ratios were wide. DISCLOSURES: The DAPA-MI trial received funding from AstraZeneca. Several authors reported receiving research grants, personal fees, and consulting honoraria and having other financial ties with various institutes and pharmaceutical and healthcare companies including AstraZeneca. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
22-05-2025
- Health
- Medscape
Seniors With Diabetes Benefit From Intermittent Scanning CGM
The use of intermittent scanning continuous glucose monitoring (is-CGM) led to significant reductions in A1c levels among patients aged 60 years or older with type 1 or type 2 diabetes, with improvements visible after 3 months and persisting up to 24 months. The technology showed high acceptance among users, with only 2.8% discontinuing it due to device-related issues. METHODOLOGY: Although real-time CGM has shown effectiveness in improving glycaemic control and preventing hypoglycaemia in older adult patients, the efficacy of is-CGM remains understudied in this population. Researchers in the Netherlands conducted a retrospective case-control study to compare reductions in A1c levels between patients aged 60 years or older with type 1 or insulin-dependent type 2 diabetes who used is-CGM and those who did not. They selected 353 patients (median age, 67 years; 59.8% men) from an outpatient clinic in Groningen; those who used is-CGM (n = 142) were matched with control individuals (n = 211) who did not use is-CGM on the basis of age, sex, type of diabetes, and insulin treatment modality. Data were collected at baseline and 3, 6, 9, 12, and 24 months following the initiation of is-CGM, focusing on A1c levels and sensor usage. The primary endpoint was the difference in A1c levels over time between is-CGM users and control individuals relative to their baseline values. TAKEAWAY: Median baseline A1c levels were 7.9% and 7.8% among is-CGM users and control individuals, respectively. After 3 months of initiating is-CGM, a significant reduction in A1c levels was observed among users compared with control individuals (unadjusted estimates, −0.5% vs −0.01%; P = .013), with reductions persisting throughout the study. = .013), with reductions persisting throughout the study. After accounting for potential confounders, initiating is-CGM led to persistent statistically significant reductions in A1c levels at 6 months (−0.46%; P = .006) and 24 months (−0.39%; P = .033). = .006) and 24 months (−0.39%; = .033). Device acceptance was notably high, with only 2.8% of users discontinuing is-CGM due to device-related reasons. No cases of diabetes-related complications were seen in both the groups. IN PRACTICE: "Together with the minimal number of discontinuations due to device-related reasons, our findings argue for the use of this technology in the elderly (60+) population with DM [diabetes mellitus]," the authors wrote. SOURCE: This study was led by Riemer A. Been, MD, University Medical Center Groningen, Groningen, the Netherlands. It was published online on May 13, 2025, in Diabetes, Obesity and Metabolism . LIMITATIONS: The distribution of patients with type 1 diabetes was not evenly balanced between control and is-CGM groups. The study defined older adults as those aged 60 years or older, which may not have adequately reflected the diversity within this population, especially since those aged 80 years or older were underrepresented. The single-centre design at an academic hospital in the Netherlands may have limited the generalisability of the results to other regions. DISCLOSURES: This study was funded by the European Foundation for the Study of Diabetes. One author reported receiving an unrestricted educational grant from the European Foundation for the Study of Diabetes mentorship programme supported by AstraZeneca. The remaining authors reported having no conflicts of interest.
Medscape
09-05-2025
- Health
- Medscape
Cataract Surgery May Be Safe Beyond A1c Cutoffs
Cataract surgery was not associated with an increased risk for postoperative endophthalmitis or serious systemic adverse events in patients with diabetes, even when preoperative A1c levels were poorly controlled and exceeded 11.3%. METHODOLOGY: Researchers conducted a retrospective, longitudinal cohort study to explore the relationship between cataract surgery and the risk for postoperative endophthalmitis and serious systemic adverse events in patients with diabetes. They examined medical records of 94,952 men and women, aged 18 years or older, with type 1 or type 2 diabetes who underwent phacoemulsification cataract surgery and were stratified by A1c levels: Good (< 7%), moderate (7%-8.4%), poor (8.5%-11.3%), and very poor (> 11.3%) control. Patients in each group of A1c levels were matched by propensity score analysis with individuals without diabetes who underwent cataract surgery. To analyze the risk for serious systemic adverse events — mortality, stroke, transient ischemic attack, major cardiovascular events, and a composite of these events — the researchers compared 12,835 patients with diabetes who underwent cataract surgery with those who had similar A1c levels and a record of a routine eye examination but did not undergo the procedure. In both analyses, A1c documentation was required to have occurred within 3 months prior to cataract surgery. TAKEAWAY: The 30-day risk for postoperative endophthalmitis did not differ across A1c levels between patients with diabetes and people without the condition (good control: hazard ratio [HR], 0.62; 95% CI, 0.30-1.27; moderate control: HR, 1.08; 95% CI, 0.44-2.66; poor control: HR, 1.36; 95% CI, 0.43-4.28; and very poor control: HR, 2.85; 95% CI, 0.29-27.44). Similarly, the risk for serious systemic adverse events within 30 or 90 days after cataract surgery showed no difference across A1c levels in patients with diabetes who did or did not undergo cataract surgery. IN PRACTICE: 'Our findings suggest that preoperative A1c alone should not be a reason to cancel cataract surgery,' the authors wrote. 'A1c should be utilized as measure to inform wider control of hyperglycemia- and diabetes-related systemic comorbidities and that delaying cataract surgery on the numerical basis of elevated A1c is not necessary,' they added. SOURCE: This study was led by Zain S. Hussain, MD, and Ahmed F. Shakarchi, MD, MPH, from the Harvey and Bernice Jones Eye Institute at the University of Arkansas for Medical Sciences in Little Rock, Arkansas. It was published online on May 3, 2025, in American Journal of Ophthalmology . LIMITATIONS: The retrospective design limited the ability of this study to infer causality. Small sample sizes in certain subgroups of A1c resulted in wide CIs for some outcomes, potentially limiting the precision of findings. The control group of patients with diabetes who did not have a diagnosis of cataract may have been healthier, introducing selection bias. DISCLOSURES: No funding was reported by this study. The authors reported having no relevant conflicts of interest.
