Evaluation of HbA1c in The Diagnosis of Diabetes
Keywords:
Diabetes mellitus, HbA1c, Plasma Glucose measurement
Abstract
Background: Diabetes has become a major health problem in India with the largest number of diabetic patient burden in the world. It is estimated that, this disease will assume epidemic proportions during the first quarter of the 21st century and by the year 2025, >75% of people with diabetes will reside in developing countries, as compared with 62% in 1995. We evaluated the clinical utility of HbA1c as the base line investigation along with plasma glucose estimation in hospitalized patients for diagnosis of diabetes mellitus. Methods: A total of 400 patients of more than 25 yrs were tested. All the patients were evaluated by a random plasma glucose estimation, plasma glucose fasting and 2h after 75 g of glucose and HbA1c. Result: Fasting plasma levels varied from 82mg/dl to 216 mg/dl A total of 11 patients had plasma glucose values in the diabetic range (>126mg/dl) Plasma glucose in these patients ranged from 129 to 216 mg/dl. Patients with diabetes had higher HbA1c levels than subjects without diabetes. We found that an HbA1c value =>6.5% was 100% (11/11) specific for the diagnosis of diabetes. Conclusion: HbA1c correlated well with fasting plasma glucose values. In clinical settings, this test would be preferred as a first line test for diagnosis of diabetes in our country as it is convenient for the patient.References
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2. Ramachandran, C. Snehalatha And Vijay Viswanathan. Burden Of Type 2 Diabetes And Its Complications –The Indian Scenario. Current Science, Vol. 83, No. 12, 25 Dec 2002.
3. World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Report of a WHO Consultation. Geneva: World Health Organization, 1999.
4. International Expert Committee. Report on the Role of the A1C Assay in the Diagnosis of Diabetes. Diabetes Care July 2009 Vol. 32 No. 7 1327-1334.
5. Zhong X. Lu, Karen Z. Walker, Kerin O'Dea, Ken A. Sikaris, Jonathan E. Shaw. A1C for Screening and Diagnosis of Type 2 Diabetes in Routine Clinical Practice. Diabetes Care April 2010 vol. 33 no. 4 817-819.
6. Ko GT, Chan JC, Tsang LW, Cockram CS.Combined use of fasting plasma glucose and HbA1c predicts the progression to diabetes in Chinese subjects. Diabetes Care 2000 Dec; 23(12):1770-3.
7. Tapp RJ, Tikellis G, Wong TY,Harper C, Zimmet PZ, Shaw JE. Longitudinal association of glucose metabolism with retinopathy. Diabetes Care 2008; 31: 1349– 1354.
8. Relationship between glycated hemoglobin and microvascular complications: is there a natural cut-off point for the diagnosis of diabetes. Diabetologia. 22 4 2009.
9. Murphy JM, Browne RW, Hill L, Bolelli GF, Abagnato C, Berrino F, Freudenheim J, Trevisan M, Muti P. Effects of transportation and delay in processing on the stability of nutritional and metabolic biomarkers. Nutr Cancer 2000; 37: 155– 160
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2018-06-08
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