Cardiovascular disease (CVD) is the leading cause of death globally, and diabetes mellitus (DM) is a well-established risk factor. Among the risk factors for CVD, DM is a major modifiable factor. In the fatal CVD outcomes, acute myocardial infarction (AMI) is the most common cause of death.

To develop a long-term quality-of-care score for predicting the occurrence of AMI among patients with type 2 DM on the basis of the hypothesis that good quality of care can reduce the risk of AMI in patients with DM.

Using Taiwan's Longitudinal Cohort of Diabetes Patient Database and the medical charts of a medical center, we identified incident patients diagnosed with type 2 DM from 1999 to 2003 and followed them until 2011. We constructed a summary quality-of-care score (with values ranging from 0 to 8) with process indicators (frequencies of HbA1c and lipid profile testing and urine, foot and retinal examinations), intermediate outcome indicators (low-density lipoprotein, blood pressure and HbA1c), and co-morbidity of hypertension. The associations between the score and the incidence of AMI were evaluated using Cox regression models.

A total of 7351 patients who had sufficient information to calculate the score were enrolled. In comparison with participants who had scores ≤ 1, those with scores between 2 and 4 had a lower risk of developing AMI [adjusted hazard ratio (AHR) = 0.71; 95% confidence interval (95%CI): 0.55-0.90], and those with scores ≥ 5 had an even lower risk (AHR = 0.37; 95%CI: 0.21-0.66).

Good quality of care can reduce the risk of AMI in patients with type 2 DM. The quality-of-care score developed in this study had a significant association with the risk of AMI and thus can be applied to guiding the care for these patients.

To assess the extent to which people with diabetes in low- and middle-income countries (LMIC) of Asia and the Middle East met evidence-based care recommendations through a systematic review of published literature.

Electronic searches of Medline and Embase were carried out for studies assessing quality of care among people with diabetes in Asia and the Middle East between 1993 and 2012. Benchmarking against American Diabetes Association guidelines, we reported level and proportions meeting recommended risk factor control (glycated hemoglobin [HbA1c], blood pressure, and low density lipoprotein-cholesterol [LDL]) and preventive care processes across different settings.

One hundred and fifteen publications met eligibility for inclusion (91 reported risk factor control, 7 reported preventive processes, and 17 reported both). Only China, Thailand, Malaysia and Philippines had nationally representative data. Mean HbA1c (6.5-11% or 48-97 mmol/mol), SBP (120-152 mm Hg), and LDL (2.4-3.8 mmol/l) varied greatly. Despite variation in availability of data, studies consistently showed that recommended care goals were not being achieved.

The practice of auditing and benchmarking against evidence-based guidelines appears to be uncommon in Asia and the Middle East and there was heterogeneity of reporting across studies, populations, and methods used. The available data showed inadequate care.

Control of plasma glucose could prevent the progression of most of the complications of diabetes and hemoglobinA1c (HbA1c) is the most important criterion controlling these long-term complications.

This study was performed to assess the effect of fasting plasma glucose (FPG) and two- hour postprandial plasma glucose (2hpp) levels on HbA1c.

In this descriptive, cross-sectional study; 300 patients were enrolled, assessed, and followed up at the clinic of the Diabetic Center of the University of Medical Science, Hamadan, Iran. All studied patients were diagnosed type 1 or 2 diabetes mellitus. Sampling was performed; we assessed FPG and 2hpp plasma glucose at baseline and at every two weeks to one month-as needed. HbA1c was assessed at the end of study. Results were analyzed by Pierson Covariance and Multiple Regression methods.

The mean plasma glucose in three groups of HbA1c (good to fair) were 148.5 +/- 56.80 mg/dl at fasting, and 199.70 +/- 53.01 mg/dl at two hours after breakfast (2hpp) and mean concentration of HbA1c were 8.41 +/- 1.1 %. The plasma glucose level and HbA1c were 0.312 for fasting and, 0.416 for 2hpp at covariant value.

The postprandial (after breakfast) plasma glucose has closer association to glycosylated hemoglobin than fasting plasma glucose, therefore evaluating postprandial plasma glucose should be our focus.