Abstract

Introduction

Diabetes mellitus is one of the most common diseases of current era which is characterized by hyperglycemia either due to insulin deficiency or insulin resistance. Type 2 DM is also leading cause of coronary artery disease, peripheral artery disease, end-stage renal disease (ESRD) and adult blindness. With an increasing incidence worldwide, DM will be a leading cause of mortality and morbidity^[1]. The explosive increase of Diabetic population worldwide is a major public health concern both in developing and developed countries. Metabolic syndrome is also on an increasing trend. The metabolic syndrome is closely linked to insulin resistance and numerous studies indicate a link to iron overload. Increased serum ferritin, reflecting body iron overload, is often associated with measures of insulin resistance, such as elevated blood glucose and insulin levels^[2].

Obesity is a state of excess adipose tissue mass.^[3] However, in the presence of nutritional abundance and a sedentary lifestyle, and influenced importantly by genetic endowment, this system increases adipose energy stores and produces adverse health consequences . According to WHO global obesity almost doubled between 1980 and 2008. There were >200 million obese men and almost 300 million obese women, 11% of adults worldwide, in 2008.^[3] In developing countries, such as India obesity prevalence is rising (5%) with a greater tendency to harmful intraabdominal obesity at lower BMI in the population, and the consequences for metabolic and cardiovascular health are disproportionate to obesity prevalence.^[3] Although not a direct measure of adiposity, the most widely used method to gauge obesity is the Body Mass Index (BMI), which is equal to weight/height (in kg/m2).

Glycated Hemoglobin (HbA1c) is a routinely used marker for long-term glycemic control

Hence our study was aimed to establish a correlation between Body Mass Index with glycated Hemoglobin level in patients with type 2 diabetes mellitus.

Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The various factors which can contribute to hyperglycemia include reduced insulin, decreased glucose utilization and increased glucose production. DM is one of the leading causes of morbidity and mortality in human population^[4].

Although the prevalence of both type 1 and type 2 DM is increasing worldwide, the prevalence of type 2 DM is rising rapidly because of increase in obesity and  reduced physical activity as countries are becoming more industrialized. Metabolic disturbances associated with DM includes impaired glucose tolerance, insulin resistance, gestational diabetes, malnutrition or over nutrition and other risk factors like hypertension, polycystic ovarian syndrome and dyslipidemia^[5].

Glycated hemoglobin concentration represents the integrated values of glucose over preceding 6 to 8 weeks since the rate of formation of HbA1c is directly proportional to the concentration of glucose in blood.

It is currently considered as the best index of metabolic control for diabetic patients in clinical setting. It is as well a measure of risk for the development of micro and macrovascular complications.^[6,7]

The most important factor governing the quantity of glycated hemoglobin formed is the prevailing plasma glucose concentration. As the plasma glucose concentration is increased in diabetic subjects, glycated hemoglobin also increased in diabetic subjects.^[8]

It represents the mean daily blood sugar concentration and degree of carbohydrate imbalance, better than fasting blood glucose concentrations or glucose tolerance test results. Hence it may provide a better index of control of diabetic patient without resorting to a glucose loading procedure.^[8]