Objectives: To study the effect of providing tertiary (specialized) health care for type 2 diabetic patients to meet the WHO and ADA standards and glycemic targets.
Method: Six months, Jan. – Jun. 2010, cohort study was conducted on 600 adult diabetics who registered in the National Diabetes Center (NDC) / Al-Mustansiriya University, Baghdad – Iraq. They were followed for 3- 6 months; each time patients were examined physically and their blood pressure, height, weight and BMI were measured. Fasting blood samples were taken from all patients to test the FPG, HbA1c, T.Chol, TG, HDL and LDL.
Results: Patients’ age was 52.85±15.56 year and the male/female ratio was 1.01, the median duration of disease was 7 years and their BMI was 28.80 ± 13.02 kg/m2. Patients’ achievement during study period, of glycemic and cardiovascular risk factors, meet the targets of ADA, NHANES and NCEP/ATP III Guidelines of FPG, PPG, HbA1c, T.Chol, TG, LDL, HDL, systolic and diastolic blood pressure by 26.74%, 29.09%, 32.78%, 61.0%, 60.86%, 76.19%, 74.35%, 52.54% and 62.50% respectively.
Conclusions: We concluded that tertiary health service can help to meet the international guidelines and recommended targets for type 2 diabetes. Improving quality and coverage of tertiary health services may help in achieve and sustain targets; and afterward close adhering to the WHO and ADA standards and glycemic targets.
Abbreviations: BMI=Body Mass Index, FPG= Fasting Plasma Glucose, PPG = post prandial plasma glucose, HbA1c =glycated hemoglobin, T.Chol. = total cholesterol, TG = Triglyceride, LDL = low-density lipoprotein, HDL = high-density lipoprotein, ADA= American Diabetes Association, NHANES = National Health and Nutrition Examination Survey, NCEP/ATP III = National Cholesterol Education Program/Adult Treatment Panel
Here, a high sensitive method for biomarker identification according to nanostructure, using enzyme-linked immunosorbent assays (ELISAs), called Nano-ELISA, was presented. Different shapes of gold nanostructures (star and sphere; GNSs and GNPs) with a particle size of 40 nm for sphere particles were altered with a monoclonal antibody (Ab) as a detector Ab. To amplify the optical signal, gold nanostructures were employed as carriers of the signaling specific antibody against insulin growth factor binding protein- 3 (IGFBP-3). The substrate was catalytically oxidized by the Horseradish Peroxidase (HRP) conjugated gold nanostructure, and HRP also enhanced the optical signals, reflecting the amount of the targeting IGFBP-3. In comparison to t
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Performance evaluation is of great importance in all countries of the world, because it has a prominent and effective role in determining the efficiency and effectiveness of the optimal use of available resources, which are rare and important in achieving the desired objectives. With the continued growth of public spending and the limited resources, the State seeks to achieve its objectives through its units with minimal expenditure or deficit, rationality and wastefulness in the spending. In many countries, particularly developing countries, reforms are made in the public sector to achieve that goal through the adoption of IPSAS, which is reflected in the developmen
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