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IntroductionThis project describes the management of diabetes, according to certain demographic factors via the monitoring of HbA1c results over a three-year period (2012-2014). The impact of these factors including age, gender, diagnosis, and referral location on glycemia was established. Patient history records were analyzed to determine factors associated with the lower glycemia levels throughout the two-year period.Aims• To characterize glycemia in individual patients attending Kuwaiti Inpatient and Outpatient facilities over a two-year period• To establish associations of glycemia with demographic factors (age, sex), clinical diagnosis (diabetes and other medical conditions), and referral locationMethodsA retrospective observational study of glycemia was performed in a population of patients attending Kuwaiti hospital and outpatient facilities between 2012 and 2014. Information collected included age, sex, clinical diagnosis, and referral location. Glycemia was assessed by measurement of non-fasting glycated hemoglobin (HbA1c). Associations of glycemia with demographic and other factors were established-tests and other statistical processes were performed.ResultsHbA1c measurements were made in 854 patients between January 2012 and September 2014. Patients were omitted depending on the information available for the various categories. The calculated mean and standard deviation (SD) HbA1c of all patients was 7.81%±1.98.In total, 305 male patients were analyzed ranging from 13 years old to 89 years old. Their mean HbA1c was 8.06% with an SD of ±0.11.Overall, 297 female patients were analyzed with ages ranging from 10 years old to 90 years old. Their mean HbA1c was 7.89% with an SD of ±0.33.Although females experienced more fluctuations in their glycemic control from 2012-2014, they had lower glycemic levels overall compared to the male patients.The lower HbA1c levels with a decreasing glycemic level trend belonged to the twenty-one to thirty-year-old patients; twelve patients were analyzed and found to have an average HbA1c of 7.96% with an SD of ±0.86. They achieved one of the lowest glycemic values compared to the other age ranges. In the data collected for three years, their HbA1c level continuously decreased to a stable range.Because the inpatient and polyclinic patients experienced many fluctuations with their results increasing and decreasing in glycemic values, the outpatient patients maintained lower glycemic levels. The outpatient location started with poor HbA1c values of 9.2% and 10.4%respectively, but then decreased thelevels and maintained a rather stable level of glycemia with an average HbA1c value of 7.5% in 2014. The overall average for this group was 8.04% with a standard deviation of ±0.99.Patients categorized as diabetics under the diagnosis portion of their request forms managed their glycemic levels over a three-year period (2012-2014). The patients in this group decreased their glycemic levels gradually over the period of this study. The average HbA1c value from 2012-2013 was 8.37% with an SD of ±0.24 for the diabetic patients, while from 2013-2014 the average HbA1c for diabetic patients was 8.11% with an SD of ±0.11 with a P-value of 0.96 which concludes an insignificant difference.ConclusionFemale patients (n=297) had lower glycemia than male patients (n=305). This might be because of more hormonal changes in females than males and the lifestyle changes more females tend to make such as dieting. Lower Glycemia was observed in 21-30-year-old patients than any other age group. Glycemia was higher in inpatients than in outpatients because inpatients are more reliant on medications that may alter their glucose levels or be used to maintain a healthy glucose level. HbA1c gradually decreased in glycemic levels for diabetic patients than it did for any other diagnosis. Therefore, as study portrayed the HbA1c levels in various broad categories, future studies ought to focus on one of the groups and analyze it with detail in order to help maintain healthy glycemic levels.CHAPTER ONEAbstractIntroductionThis project describes the management of diabetes, according to certain demographic factors via the monitoring of HbA1c results over a three-year period (2012-2014). The impact of these factors including age, gender, diagnosis, and referral location on glycemia was established. Patient history records were analyzed to determine factors associated with the lower glycemia levels throughout the two-year period.Aims• To characterize glycemia in individual patients attending Kuwaiti Inpatient and Outpatient facilities over a two-year period• To establish associations of glycemia with demographic factors (age, sex), clinical diagnosis (diabetes and other medical conditions), and referral locationMethodsA retrospective observational study of glycemia was performed in a population of patients attending Kuwaiti hospital and outpatient facilities between 2012 and 2014. Information collected included age, sex, clinical diagnosis, and referral location. Glycemia was assessed by measurement of non-fasting glycated hemoglobin (HbA1c). Associations of glycemia with demographic and other factors were established-tests and other statistical processes were performed.ResultsHbA1c measurements were made in 854 patients between January 2012 and September 2014. Patients were omitted depending on the information available for the various categories. The calculated mean and standard deviation (SD) HbA1c of all patients was 7.81%±1.98.In total, 305 male patients were analyzed ranging from 13 years old to 89 years old. Their mean HbA1c was 8.06% with an SD of ±0.11.Overall, 297 female patients were analyzed with ages ranging from 10 years old to 90 years old. Their mean HbA1c was 7.89% with an SD of ±0.33.Although females experienced more fluctuations in their glycemic control from 2012-2014, they had lower glycemic levels overall compared to the male patients.The lower HbA1c levels with a decreasing glycemic level trend belonged to the twenty-one to thirty-year-old patients; twelve patients were analyzed and found to have an average HbA1c of 7.96% with an SD of ±0.86. They achieved one of the lowest glycemic values compared to the other age ranges. In the data collected for three years, their HbA1c level continuously decreased to a stable range.Because the inpatient and polyclinic patients experienced many fluctuations with their results increasing and decreasing in glycemic values, the outpatient patients maintained lower glycemic levels. The outpatient location started with poor HbA1c values of 9.2% and 10.4%respectively, but then decreased thelevels and maintained a rather stable level of glycemia with an average HbA1c value of 7.5% in 2014. The overall average for this group was 8.04% with a standard deviation of ±0.99.Patients categorized as diabetics under the diagnosis portion of their request forms managed their glycemic levels over a three-year period (2012-2014). The patients in this group decreased their glycemic levels gradually over the period of this study. The average HbA1c value from 2012-2013 was 8.37% with an SD of ±0.24 for the diabetic patients, while from 2013-2014 the average HbA1c for diabetic patients was 8.11% with an SD of ±0.11 with a P-value of 0.96 which concludes an insignificant difference.ConclusionFemale patients (n=297) had lower glycemia than male patients (n=305). This might be because of more hormonal changes in females than males and the lifestyle changes more females tend to make such as dieting. Lower Glycemia was observed in 21-30-year-old patients than any other age group. Glycemia was higher in inpatients than in outpatients because inpatients are more reliant on medications that may alter their glucose levels or be used to maintain a healthy glucose level. HbA1c gradually decreased in glycemic levels for diabetic patients than it did for any other diagnosis. Therefore, as study portrayed the HbA1c levels in various broad categories, future studies ought to focus on one of the groups and analyze it with detail in order to help maintain healthy glycemic levels.
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