BACKGROUND: Multiple laboratory tests are used in the diagnosis and management of patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these assays varies substantially. APPROACH: An expert committee compiled evidencebased recommendations for the use of laboratory analysis in patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. A draft of the guidelines was posted on the Internet, and the document was modified in response to comments. The guidelines were reviewed by the joint Evidence-Based Laboratory Medicine Committee of the AACC and the National Academy of Clinical Biochemistry and were accepted after revisions by the Professional Practice Committee and subsequent approval by the Executive Committee of the American Diabetes Association. CONTENT: In addition to the long-standing criteria based on measurement of venous plasma glucose, diabetes can be diagnosed by demonstrating increased hemoglobin A1c (HbA1c) concentrations in the blood. Monitoring of glycemic control is performed by the patients measuring their own plasma or blood glucose with meters and by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY: The guidelines provide specific recommendations based on published data or derived from expert consensus. Several analytes are found to have minimal clinical value at the present time, and measurement of them is not recommended.
Autoantibodies ; Biochemistry ; Blood Glucose ; C-Peptide ; Consensus ; Diabetes Mellitus ; Genetic Testing ; Glucose ; Hemoglobin A, Glycosylated ; Hemoglobins ; Humans ; Insulin ; Internet ; Joints ; Plasma ; Professional Practice ; Proinsulin

OBJECTIVES

As the population ages, the likelihood of cancer increases. Aging-related deficits that eventually manifest as frailty may be associated with poor emotional health in older patients with advanced cancer. This study aimed to determine whether frailty was strongly associated with emotional distress, particularly anxiety and depression.

METHOD

This is a single center, cross-sectional, descriptive study using the Geriatric 8 (G8) Frailty Screening Scale and the Hospital Anxiety and Depression Scoring (HADS) Scale.

RESULTS

One hundred five patients (105) were included in the study. Over-all, 86 (81.9%) were frail. Majority of them were female (50, 47.6%), married (57, 54.3%), and were able to graduate college (62, 59.0%). Hypertension (70, 66.7%) and diabetes mellitus (33, 31.4%) were the most common co morbidities. There was significant association between the patients’ functional status (ECOG score) and frailty (p = 0.001). Our results showed that the likelihood of being frail increased by 30% per unit increase in the ECOG score (OR 3.685, CI 1.623 - 8.366). More so, our results showed strong association between frailty, depression & anxiety (p = 0.000 & 0.001, respectively). We also found that the likelihood of being anxious & depressed was 7-times as much for those patients who were frail (OR 7.000, CI 2.132 – 22.981; OR 7.150 (CI 2.406 – 21.246, respectively).

CONCLUSION

Frailty had a strong association with both anxiety and depression. Frailty, in addition, had a good predictive value for emotional distress. Those who were frail had a 7-time likelihood of being anxious and depressed. Frailty was also associated with functional status. The chances of being frail increased by 30% for every unit increase in the ECOG score.

Frailty ; Elderly ; Aged ; Depression ; Anxiety

Objectives. Polymorphisms in metabolic genes which alter rates of bioactivation and detoxification have been shown to modulate susceptibility to colorectal cancer. This study sought to evaluate the colorectal cancer risk from environmental factors and to do polymorphism studies on genes that code for Phase I and II xenobiotic metabolic enzymes among Filipino colorectal cancer patients and matched controls. Methods. A total of 224 colorectal cancer cases and 276 controls from the Filipino population were genotyped for selected polymorphisms in GSTM1, GSTP1, GSTT1, NAT1 and NAT2. Medical and diet histories, occupational exposure and demographic data were also collected for all subject participants.Results. Univariate logistic regression of non-genetic factors identified exposure to UV (sunlight) (OR 1.99, 95% CI: 1.16-3.39) and wood dust (OR 2.66, 95% CI: 1.21-5.83) and moldy food exposure (OR 1.61, 95% CI:1.11-2.35) as risk factors; while the NAT2*6B allele (recessive model OR 1.51, 95% CI :1.06-2.16; dominant model OR 1.87, 95% CI: 1.05-3.33) and homozygous genotype (OR 2.19, 95% CI: 1.19-4.03) were found to be significant among the genetic factors. After multivariate logistic regression of both environmental and genetic factors, only UV radiation exposure (OR 2.08, 95% CI: 1.21-3.58) and wood dust exposure (OR 2.08, 95% CI: 0.95-5.30) remained to be significantly associated with increasing colorectal cancer risk in the study population.Conclusion. This study demonstrated that UV sunlight and wood dust exposure play a greater role in influencing colorectal cancer susceptibility than genotype status from genetic polymorphisms of the GST and the NAT` genes.
Colorectal Neoplasms ; Polymorphism, Genetic