Comparison between Fasting Plasma Glucose and HbA1c in Glycemic Control of Type-2 Diabetic Patients

Abstract

Glycosylated hemoglobin (HbA1c) in diabetic patients reflects the average blood glucose level, and will not be affected by variability in blood glucose in short time.The aim of the study is to compare between fasting plasma glucose and HbA1c in determining the glycemic control and estimate blood pressure, body mass index(BMI),serum cholesterol and triglyceride in type 2 diabetic patients . The study was carried out during the period from 1st July to 31st September 2014 in Kirkuk Azadi teaching Hospital . The study included 75 samples of type 2 diabetic patients their ages 21-71 years old were taken randomly and 40 samples of control subjects.The type 2 diabetes mellitus were diagnosed based on the family history and clinical examination of the patient . 4 ml of fasting venous blood samples were collected from each diabetic patients and control group. Serum glucose, cholesterol and triglyceride were determined by enzymatic method and HbA1C was determined by quantitative colorimetric of glycohaemoglobin in whole blood measured spectrophotometrically . The results showed the higher incidence of diabetic patients in female( 82.6%) than male (17.4% ) . The result illustrate the high occurrence of type 2 diabetes at age 61-70 and 51-60 years which recorded 22.6% and 21.3% in female group while in male group the higher incidence at age 51-60years followed by 41-50 years old with percentage 9.3%, 5.3% respectively . Statistical analysis showed significant increase in systolic pressure(p<0.05) in diabetic patients . 38.6% of diabetic patients have overweight followed 32%are obese class-1-while only 4.6% have normal weight . Also the result showed increase in mean value of serum cholesterol and triglyceride which recorded 210 mg/dl and 176.5 mg /dl respectively compared to control group(p 0.01) . 9.3% of diabetic patients have polycystic ovary and 17.3% of them have family history of diabetes .The present study revealed increase in fasting plasma sugar concentration (273.3mg/dl) and ( HbA1c 8.9%) in diabetic group compared to control group (p 0.001) .The sensitivity and specificity and positive predictive value of HbA1c was reported 82%, 54% and 89% respectively. According to WHO classification of HbA1C in diabetic patients , the results indicated 73.3% of diabetic patients were poor control ,17.3% fair control and 9.3% were good control Conclusion:. HbA1c is not recommended as a diagnostic or a screening test while it is considered a marker of evaluation of long-term glycemic control in diabetic