In treating diabetes, what is important? - Glucose levels or outcome measures

9^th International Conference on Nephrology: Kidney & Therapeutics

September 29-30, 2016 Orlando, USA

Anil K Mandal

Mandal Diabetes Research Foundation, USA

Keynote: J Nephrol Ther

Abstract :

Gaps in knowledge prevail in recognizing which glycemic parameters to order and in determining glycemic control. However glycosylated hemoglobin (HbA1c) is most commonly ordered to determine glycemic control. HbA1c provides information of overtime glycemic control but does not inform post meal glycemic excusions. The latter may be significant in outcome measure such as cardiovascular disorder (CVD), renal failure or amputation in diabetes. In order to obviate the dilemma in importance between fasting blood glucose (FBG) and 2-h post prandial glucose (2hPPG), we have innovated delta (d) which is the difference between 2hPPG minus FBG. There is much information available relating 2hPPG or postprandial hyperglycemia to CVD and some information relating 2hPPG to renal failure or amputation. Thus much emphasis is laid upon glycemic control with little or no emphasis on the complications of diabetes or the outcome measures. The focus of the editorial is to draw attention to outcome measures by ordering fasting and 2-h postprandial (2hPPG) basic metabolic panel (BMP) which provides glucose levels, renal function test and electrolytes. HbA1c significantly relates to 2hPPG, thus by ordering F and 2hPP BMP instead of HbA1c alone will serve both purposes: Glycemic control and outcome measure. Delta (d) glucose (dhPPG-FBG) is a stronger predictor than 2hPPG of renal function deterioration.

Biography :

Anil K Mandal is board certified in Internal Medicine and Nephrology (not yet recertified in Nephrology). Diabetes Mellitus is the most common cause of kidney failure in the USA and worldwide and this strong association between diabetes and kidney failure has inspired him to develop the framework of Mandal Diabetes Research Foundation to assist diabetic patients in living a good life with medical treatment, and to avoid dialysis. He is a published author/editor of 12 books and more than 100 articles on research in diabetes and kidney disease. He is a two-time Fulbright Scholar and a Visiting Professor of 23 countries which permitted lectures on diabetes, high blood pressure and kidney diseases on five continents of the world. His astute knowledge and total dedication helped patients get better and to live a good life.

Email: amandal@med-spec.com