The Glycaemic Sixer [Glycaemic Hexad]. | [Journal of Pakistan Medical Association • 2018]

Author(s):

1. Sanjay Kalra: Department of Endocrinology, Bharti Hospital, Karnal, India

Abstract:

This opinion piece describes a cricket-based analogy, the Glycaemic Sixer, for diabetes care. The hexad lists six glycaemic parameters which must be targeted to achieve optimal cardiovascular outcomes. All six parameters, i.e., fasting glucose, post prandial glucose, glycosylated haemoglobin, avoidance of hypoglycaemia, avoidance of nocturnal hypoglycaemia, and minimization of glycaemic variability, are associated with cardiovascular outcomes. Hence, equal attention must be paid to all these while planning strategies and choosing drugs for diabetes management. The Glycaemic Sixer promotes safety along with efficacy, and supports institution of individualized, patient centred care, using evidence-based therapeutic agents.

Page(s): 1541-1542

DOI: DOI not available

Published: Journal: Journal of Pakistan Medical Association, Volume: 68, Issue: 10, Year: 2018

Keywords:

Type 2 diabetes , Safety , patient centred care , Glycaemic pentad , Glycaemic triad

References:

[1] 1978.Effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes: VII. Mortality and selected nonfatal events with insulin treatment,JAMA 240 37 -42

[2] Temelkova-KurktschievTS,KoehlerC,HenkelE,LeonhardtW,FueckerKA,HanefeldM., 2000.Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose or HbA1c level,Diabetes Care 23 1830 -4

[3] RayKK,SeshasaiSR,WijesuriyaS,SivakumaranR,NethercottS,PreissD,ErqouS,SattarN., 2009.Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials,The Lancet 373 1765 -72

[4] CusiK,CunninghamGR,ComstockJP, 1995.Safety and efficacy of normalizing fasting glucose with bedtime NPH insulin alone in NIDDM,Diabetes Care 18 843 -51

[5] BajwaSJ,BaruahM,SehgalV., 2013.Hypoglycaemia in anesthesiology practice: Diagnostic, preventive, and management strategies,Saudi J Anaesth 7 447 -52

[6] 2009.,Diabetes Metab Res Rev 25 199 -207

[7] KrishnaSV,KotaSK,ModiKD, 2013.Glycemic variability: clinical implications,Indian J Endocrinol Metab 17 611 -

[8] FrierBM,SchernthanerG,HellerSR, 2011.Hypoglycemia and cardiovascular risks,Diabetes Care 34 S132 -7

[9] StahnA,PistroschF,GanzX,TeigeM,KoehlerC,BornsteinS,HanefeldM., 2014.Relationship between hypoglycemic episodes and ventricular arrhythmias in patients with type 2 diabetes and cardiovascular diseases: silent hypoglycemias and silent arrhythmias,Diabetes Care 37 516 -20

[10] KalraS,MukherjeeJJ,VenkataramanS,BantwalG,ShaikhS,SabooB,DasAK,RamachandranA, 2013.Hypoglycemia: The neglected complication,Indian J Endocrinol Metab 17 819 -

Citations

Downloads

Views