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5. Glycated haemoglobin (HbA1c) as a stable indicator of type 2 diabetes

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Author(s): P. Pasupathi | P. Manivannan | M. Uma | M. Deepa

Journal: International Journal of Pharmaceutical and Biomedical Research (IJPBR)
ISSN 0976-0350

Volume: 01;
Issue: 02;
Start page: 53;
Date: 2010;
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Keywords: Glycated haemoglobin | Mean blood glucose | Type 2 diabetes | Glycation

ABSTRACT
HbA1c expressed, as the percentage of adult haemoglobin that is glycated, is the most widely used measure of chronic glycaemia. Achieving near normal HbA1c levels have been shown to reduce long term complications and the HbA1c assay is recommended to determine whether treatment is adequate and to guide adjustments. However, daily adjustments of therapy are guided by glucose levels. We determined the relationship between an accurate measure of mean glucose levels over time and the HbA1c level, and whether HbA1c can be expressed in the same units as self monitoring results. The aim of the study was to assess whether HbA1c levels reflected mean blood glucose (MBG) levels in Type 2 diabetes. Despite the good correlation between HbA1c and MBG, the use of HbA1c alone for glycemic control monitoring in these patients could be insufficient to clearly trace their risk of complications. The study population consisted of 100 subjects divided into two groups viz. participants with diabetes (n=50) and non-diabetic (n=50). Changes in the levels of MBG and HbA1c were determined in diabetic and non-diabetic subjects. The level of blood glucose, HbA1c, MBG, microalbuminurea, urea and creatnine was significantly increased in diabetics than non diabetic subjects. There was a statistically significant relationship between MBG and HbA1c. The mathematical relationship established between HbA1c and MBG in this study should allow the expression of HbA1c as an equivalent for mean glucose level. This is likely to be beneficial to patients and care providers alike as the assay of chronic glucose control would be in the same units as the patient’s self-monitoring. However, before this transformation can take place, the mathematical relationship between HbA1c and MBG levels should be confirmed in a larger study with a more diverse population to ensure that the relationship applies for all diabetes patients.
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