CORRELATION OF GLYCOSYLATED HEMOGLOBIN LEVELS WITH FASTING AND POSTPRANDIAL GLUCOSE IN SOUTH INDIAN TYPE 2 DIABETIC PATIENTS
Keywords:
Glycosylated Hemoglobin, Fasting blood sugar, Postprandial blood sugar, CorrelationAbstract
Objective: To assess the correlation of glycosylated hemoglobin levels with fasting and postprandial glucose in South Indian type 2 diabetic patients.
Methods: This retrospective observational study was carried out as per the protocol approved by the institutional ethics committee (IEC) and case records of patients (≥ 40 y old) diagnosed with type 2 diabetes mellitus (T2DM) and complications, that fasting blood sugar (FBS), postprandial blood sugar (PPBS) and HbA1c measured during previous follow-ups were included in the study. Statistical analyses were carried out using SPSS Ver.20 and p ≤ 0.05 were considered statistically significant.
Results: Based on the study criteria, 633 case profiles were selected and enrolled in the study. Most of the patients were males 488 (77.1%) and the mean age of patients was 59.7 y (SD=9.6). The mean fasting glucose and postprandial glucose were 9.42 mmol/l (SD=4.2), 13.39 mmol/l (SD=5.2) respectively. Patients were suffering from different type of diabetes complications, and most of them had poor glycemic control as the mean HbA1c was found to be 8.7 % (SD=2.2). The FBS and PPBS were plotted against HbA1c values showed moderate correlation and the sensitivity, specificity, positive predictive value and negative predictive value of postprandial glucose level was better than the fasting blood glucose level.
Conclusion: This present study showed that there is the significant correlation between PPBS and HbA1c values. Since PPBS is performed routinely, its interpretation in terms of long term glycemic control will help clinicians to tailor their therapeutic strategies.
Downloads
References
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2013;36(Suppl 1):67-74.
Diabetes Control and Complications Trial Research Group. The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes 1995;44:968-83.
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Br Med J 2000;321:405-12.
Kramer CK, Araneta MR, Barrett-Connor E. A1C and diabetes diagnosis: the rancho bernardo study. Diabetes Care 2010;33:101-3.
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2014;37:14.
Monnier L, Colette C. Target for glycemic control concentrating on glucose. Diabetes Care 2009;32(Suppl 2):199–204.
Imran SA, Rabasa-Lhoret R, Ross S. Targets for glycemic control. Canadian J Diabetes 2013;37:31–4.
Monnier L, Colette C. Targeting prandial hyperglycemia: how important is it and how best to do this? Curr Diabetes Rep 2008;8:368-74.
Leiter LA, Ceriello A, Davidson JA, Hanefeld M, Monnier L, Owens DR, et al. Postprandial glucose regulation: New data and new implications. Clin Ther 2005;27:42-56.
Monnier L, Colette C. Postprandial and basal hyperglycaemia in type 2 diabetes: contributions to overall glucose exposure and diabetic complications. J Diabetes Metab 2015;41:9-15.
Monami M, Adalsteinsson JE, Desideri CM, Ragghianti B, Dicembrini I, Mannucci E. Fasting and post-prandial glucose and diabetic complication. A meta-analysis. Nutr Metab Cardiovasc Dis 2013;23:591-8.
Bennett CM, Guo M, Dharmage SC. HbA1c as a screening tool for detection of type 2 diabetes: a systematic review. Diabetic Med 2007;24:333-43.
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Br Med J 2000;321:405-12.
Nordwall M, Abrahamsson M, Dhir M, Fredrikson M, Ludvigsson J, Arnqvist HJ. Impact of HbA1c, followed from onset of type 1 diabetes, on the development of severe retinopathy and nephropathy: the VISS Study (Vascular Diabetic Complications in Southeast Sweden). Diabetes Care 2015;38:308-15.
Diabetes Control and Complications Trial Research Group. The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes 1995;44:968-83.
Bhaktha G, Nayak BS, Mayya S, Shantaram M. Is HbA1c a risk factor for type 2 diabetic subjects without macro and micro vascular complications? Arch Physiol Biochem 2012;118:69-71.
Nitin S. HbA1c and factors other than diabetes mellitus affecting it. Singapore Med J 2010;51:616-22.
Ketema EB, Kibret KT. Correlation of fasting and postprandial plasma glucose with HbA1c in assessing glycemic control; systematic review and meta-analysis. Arch Public Health 2015;73:1-9.
Rosediani M, Azidah AK, Mafauzy M. Correlation between fasting plasma glucose, post prandial glucose and glycated haemoglobin and fructosamine. Med J Malaysia 2006;61:67-71.
Bonora E. Postprandial peaks as a risk factor for cardiovascular disease: epidemiological perspectives. Int J Clin Pract Suppl 2002;129:5-11.
Woerle HJ, Neumann C, Zschau S, Tenner S, Irsigler A, Schirra J, et al. Impact of fasting and postprandial glycemia on overall glycemic control in type 2 diabetes: importance of postprandial glycemia to achieve target HbA1c levels. Int J Clin Pract 2007;77:280-5.
Haddadinezhad S, Ghazaleh N. Relation of fasting and postprandial and plasma glucose with hemoglobinA1c in diabetics. Int J Diabetes Dev Countries 2010;301:8-10.
Jacobson AM, Braffett BH, Cleary PA, Gubitosi-Klug RA, Larkin ME. DCCT/EDIC research group. The long-term effects of type 1 diabetes treatment and complications on health-related quality of life A 23-year follow-up of the diabetes control and complications/epidemiology of diabetes interventions and complications cohort. Diabetes Care 2013;36:3131-8.
Tunceli K, Bradley CJ, Nerenz D. The impact of diabetes on employment and work productivity. Diabetes Care 2005;28:2662-7.
American Diabetes Association. Standards of medical care in diabetes. Abridged for primary care providers. Clin Diabetes 2015;33:97-111.
Adham M, Froelicher ES, Batieha A, Ajlouni K. Glycaemic control and its associated factors in type 2 diabetic patients in Amman, Jordan. Eastern Mediterranean Health J 2010; 16:732-9.
Benoit SR, Fleming R, Philis-Tsimikas A, Ji M. Predictors of glycemic control among patients with type 2 diabetes: a longitudinal study. BMC Public Health 2005;5:36.
Harrabi I, Al Harbi F, Al Ghamdi S. Predictors of glycemic control among patients with type 2 diabetes in najran armed forces hospital: a pilot study. J Diabetes Mellitus 2014;4:141-7.
Ghazanfari Z, Haghdoost AA, Alizadeh SM, Atapour J, Zolala F. A comparison of HbA1c and fasting blood sugar tests in general population. Int J Prev Med 2010;1:187-94.
Swetha NK. Comparison of fasting blood glucose and post prandial blood glucose with HbA1c in assessing the glycemic control. Int J Healthcare Biomed Res 2014;2:134-9.
Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complications 2010;24:84-9.
Texas diabetes council: Treatment Algorithms, Protocols, Guidelines, and Recommendati-ons. Available from: http://www.tdctoolkit.org/wpcontent/themes/tdc/algorithms/ Algorithm%20Master.pdf. [Last accessed on 10 June 2016].
Sikaris K. The correlation of hemoglobin A1c to blood glucose. J Diabetes Sci Technol 2009;3:429-38.
Ketema EB, Kibret KT. Correlation of fasting and postprandial plasma glucose with HbA1c in assessing glycemic control; systematic review and meta-analysis. Arch Public Health 2015;73:1-9.
Abrahamson MJ. Optimal glycemic control in type 2 diabetes mellitus: fasting and postprandial glucose in context. Arch Intern Med 2004;164:486-91.
Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients variations with increasing levels of HbA1c. Diabetes Care 2003; 26:881-5.