Title: Evaluation of Levels of Glycosylated Hemoglobin (HbA1c) in Patients with Type – 2 Diabetes Mellitus and in Healthy People, Attending P.M.C.H, Patna
Authors: Dr Dilip Kumar, Dr S. Raza, Dr Satyendu Sagar
DOI: https://dx.doi.org/10.18535/jmscr/v6i10.44
Abstract
Objective: The aim of present study was observing the incidence and magnitude of abnormal concentrations of glycosylated hemoglobin (HbA1C) in Type – 2 Diabetes Mellitus (NIDDM) and assessing the adequacy of control of the diabetic patients.
Materials and Methods: A total of 106 diabetic patients were selected in both sexes in different age groups, 20 healthy people were selected for control group, Glycosylated hemoglobin was measured by D-10, Column Chromatography methods(HPLC) supplied by Biorad. Blood sugar was measured by Hexokinase methods (Fully automated Roche Integra machine). Urine Sugar is measured by automated urine analyzer and also by rapid strip, supplied by Dirui Industries.
Results: Maximum incidence of DM occurred in the 5th decade, there was male preponderance with male and female ratio of 4:1. The level of HbA1c in untreated and treated diabetics was 8.30% + 0.37 (range 6.83% - 10.40%) and 7.72% + 0.44 range (5.52% -12.41%). The corresponding FBS levels were 181 + 17 mg/dl (range 130 – 282 mg/dl) and 151 + 17 mg/dl (range 78 – 310 mg/dl) respectively. The mean of glycosylated Hemoglobin in normal individuals was found to be 5.30% + .24 (range 4.50% - 6.5%) and mean FBS level was 79 +2mg/dl (range 68 – 88 mg/dl).The value of HbA1c was approximately 1.5 times higher in untreated diabetics then in the control group. This was statistically significant. The HbA1c level correlated closely with the FBS level in diabetics.
Conclusion: It is concluded that in assessing glycemic control in diabetics with high glycosylated hemoglobin levels, concurrent FBS levels estimations are essential. However, estimation of HbA1c should be viewed as an adjunct to and not a replacement for FBS estimation in the assessment of glycemic control in treated diabetics.
Keywords: Diabetes mellitus, Glycosylated Hemoglobin, fasting blood glucose level.
References
- Principals of Internal medicine by Harrison’s – 18th
- CMDT- 2016
- Text book of Illustrative Biochemistry- Harper’s 30th. Edition.
- Text book of Biochemistry –Lippincort’s
- Glycated hemoglobin analysis Annuals of clinical biochemistry. 34 (pt 1): 17-31, Jan 2007.
- Diabetic Peripheral neuropathy invariably accompany nephropathy in type I diabetes mellitus; diabetes research and clinical practice, 39 (2009) 55-61.
- Raheja et al (1981), Cerami et al (1978), Scobie et al (1981), Svendsen et al (1979), Srivastava et al (1984), Triveli et al (1971), Gonen et al (1977), Gabby et al (1977)
- Winckers and Jacotes, 1971, Practical chemical Biochemistry by Harold Varley, Gowenlock and Bell, M. Vol, 1. 5th Edition, 395-96, 2012.
- Tottersall, R.B., Dyke, D.A. Ranny H.M. Bruckhaimer, S.M; Haemoglobin In diabetes mellitus : Studies in identical twins. N. Engl J. Med. 293, 1171-73, 1975. (Quoted by Watkine, P.J. Laslia, R.D.G. The medical Annual, 5-7, 2013/14.)
- Bourcher B.I. et al :Diabetologic 21:34, (2011).
- Trivially, L.A. Raney, H.N., Lai ; H.T. : Haemoglobin Components in patients with diabetes mellitus, N. Engl. J. Med. 284, 353-57, 1971. (Quoted by Gonen et al, Diabetologic, 15, 1-8, 2008).
- Dunn PS, Cole KA, Soeldner JS. Further development and automation of a high pressure liquid chromatography method for the determination of glycosylated haemoglobins. Metabolism 2007; 28 777-9.
- Gabbay K.H., Glycosylated haemoglobin and diabetic control, N. Engl. J. Med., 295, 443-44, 2006.
- Fraser D.M., Smith A.F., Gray, R.S. BorseyD.q. Sinclair M.E., Clarke, during treatment Br. Med. Our., 1979-81, 2009.
- Elkeler R.S., Wn. J. Humbly J: Haemoglobin A, Blood glucose and high density lipoprotein in cholesterol in insulin-requiring diabetes Lancet 9547-49, 2008.
- Graf et al 1978, Paulson and Koury (1976), Chandlia et al (1980), Bunn et al (1976)