Browsing by Person "Jahan, Nowrozy K."

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Poor glycaemic control and its metabolic and demographic risk factors in a Malaysian community-based study
(Springer, 2018-01-25) Reidpath, Daniel; Soyiri, Ireneous; Jahan, Nowrozy K.; Mohan, Devi; Ahmad, Badariah; Ahmad, Mohtar Pungut; Kassim, Zaid Bin; Allotey, Pascale
Objectives The lack of population-based evidence on the risk factors for poor glycaemic control in diabetics, particularly in resource-poor settings, is a challenge for the prevention of long-term complications. This study aimed to identify the metabolic and demographic risk factors for poor glycaemic control among diabetics in a rural community in Malaysia. Methods A total of 1844 (780 males and 1064 females) known diabetics aged ≥ 35 years were identified from the South East Asia Community Observatory (SEACO) health and demographic surveillance site database. Results 41.3% of the sample had poor glycaemic control. Poor glycaemic control was associated with age and ethnicity, with older participants (65+) better controlled than younger adults (45–54), and Malaysian Indians most poorly controlled, followed by Malay and then Chinese participants. Metabolic risk factors were also highly associated with poor glycaemic control. Conclusions There is a critical need for evidence for a better understanding of the mechanisms of the associations between risk factors and glycaemic control.
Single, community-based blood glucose readings may be a viable alternative for community surveillance of HbA1c and poor glycaemic control in people with known diabetes in resource-poor settings
(Taylor and Francis Group, 2016-08-09) Reidpath, Daniel; Jahan, Nowrozy K.; Mohan, Devi; Allotey, Pascale
Background The term HbA 1c (glycated haemoglobin) is commonly used in relation to diabetes mellitus. The measure gives an indication of the average blood sugar levels over a period of weeks or months prior to testing. For most low- and middle-income countries HbA1c measurement in community surveillance is prohibitively expensive. A question arises about the possibility of using a single blood glucose measure for estimating HbA1c and therefore identifying poor glycaemic control in resource-poor settings. Design Using data from the 2011–2012 US National Health and Nutrition Examination Surveys, we examined the relationship between HbA1c and a single fasting measure of blood glucose in a non-clinical population of people with known diabetes (n=333). A linear equation for estimating HbA1c from blood glucose was developed. Appropriate blood glucose cut-off values were set for poor glycaemic control (HbA1c≥69.4 mmol/mol). Results The HbA1c and blood glucose measures were well correlated (r=0.7). Three blood glucose cut-off values were considered for classifying poor glycaemic control: 8.0, 8.9, and 11.4 mmol/L. A blood glucose of 11.4 had a specificity of 1, but poor sensitivity (0.37); 8.9 had high specificity (0.94) and moderate sensitivity (0.7); 8.0 was associated with good specificity (0.81) and sensitivity (0.75). Conclusions Where HbA1c measurement is too expensive for community surveillance, a single blood glucose measure may be a reasonable alternative. Generalising the specific results from these US data to low resource settings may not be appropriate, but the general approach is worthy of further investigation.