Hemoglobin A1C Level and Complications or Comorbidities in Type 2 Diabetes Patients at Lumduan Distric, Surin Province.
Article Sidebar
Main Article Content
Abstract
Background: Type 2 diabetes is an important health problem in Thailand. The Ministry of Public Health has issued policies for disease screening for early detection as well as for prevention of complications. Hemoglobin A1C (HbAlC) better reflects the long-term patient’s glycemic control than does fasting plasma glucose. Patients with HbAlC values of greater than 7 % correlates with increased complications compared with those with values below 7 %. The risk of complications further increases if HbAlC level exceeds 9 %The Surin Provincial Health Office in 2012 reported that 38.4% of patients in Surin province have HbAlC levels of less than 7 %, among which 3.7% have diabetic retinopathy and 7.7% have diabetic nephropathy. This study aims to determine the glycemic control as defined by HbAlC levels of type 2 diabetic patients in Lamduan district as well as its relation with diabetic complications.
Methods: Data was retrospectively collected from our diabetes register from September 2011
to August 2014. Only patients with complete data including age, gender, HbAlC level, presence of diabetic complications as diagnosed by a physician were included in the study. Patients that died during the period were excluded. Descriptive statistics were used to represent the results. Logistic regression was used to examine the correlation between HbAlC level and diabetic complications and comorbidities.
Results: During the study period, there were 1,156 diabetic patients, among which 742 had complete data. Thirty-three percent of the cohort were male, the average age was 60.9 ± 11.3, the mean HbAlC was 7.61 ±1.89 % and 50.1% of patients had HbAlC level exceeding 7 % and 20.6% exceeding 9 % A large proportion of 82.5% had complications or comorbidities with hyperlipidemia being the most prevalent at 60.3%. There was no significant difference in the prevalence of renal, cardiovascular or retinal complications between those with HbAlC less than or exceeding 7 %
Conclusion: Diabetic patients in Lamduan district had a mean HbAlC level of 7.61 ±1.89 % with 50.1% having HbAlC level exceeding 7%. However, there was no significant difference in the prevalence of renal, cardiovascular or retinal complications between those with HbAlC less than or exceeding 7%
Article Details
References
2. สำนักวิจัยและประเมินเทคโนโลยีทางการแพทย์ กรมการแพทย์ กระทรวงสาธารณสุข พ.ศ. 2556. เอกสารข้อมูล สถาณการณ์โรคเบาหวาน/ ความดันโลหิตสูงในประเทศไทย [Internet], [cited 2015 May 11]. Available from: https://www.dms.moph.go.th/imrta/ images/data/doc_dm_ht.pdf
3. Zoungas S, Chalmers J, Ninomiya T, Li Q, Cooper ME, Colagiuri S, et al. Association of HbAlc levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds. Diabetologia 2011;55:3:636-43.
4. Molyneaux LM, Constantino Ml, McGill M, Zilkens R, Yue DK. Better glycaemic control and risk reduction of diabetic complications in Type 2 diabetes: comparison with the DCCT. Diabetes Res Clin Pract 1998;42:2:77-83.
5. Rohlfing CL, Wiedmeyer H-M, Little RR, England JD, Tennill A, Goldstein DE. Defining the Relationship Between Plasma Glucose and HbAlc Analysis of glucose profiles and HbAlc in the Diabetes ControlandComplicationsTrial. Diabetes Care 2002;25:2:275-8.
6. Repas T. Managing Loss of Glycemic Control in Middle-Aged Patients With Diabetes: The Role of GLP-1 Receptor Agonists in Combination-Therapy Regimens. J Am Osteopath Assoc 2014;114:5 suppl2:S14-21.
7. Nicholas J, Charlton J, Dregan A, Gulliford MC. Recent HbAlc Values and Mortality Risk in Type 2 Diabetes. Population-Based Case-Control Study. PLoS ONE 2013;8:7:e68008.
8. Group TDC and CTR. The Relationship of Glycemic Exposure (HbAlc) to the Risk of Development and Progression of Retinopathy in the Diabetes Control and Complications Trial. Diabetes 1995;44:8:968-83
9. สมาคมโรคเบาหวานแห่งประเทศไทย. แนวทางเวชปฏิบัติสำหรับโรคเบาหวาน 2557 [Internet], [cited 2015 May 11]. Available from: https://wvwv.chiangmaihealth.com/ cmpho_web53/attachments/3475_
10. Type 2 Diabetes Screening and Treatment Guideline - diabetes2.pdf [Internet], [cited 2015 May 11]. Available from: https://vvvvw.ghc.org/all-sites/guidelines/ diabetes2.pdf
11.Ghazanfari Z, Haghdoost AA, Alizadeh SM, Atapour J, Zolala F. A Comparison of HbAlc and Fasting Blood Sugar Tests in General Population. Int J Prev Med [Internet], 2010 Oct 31 [cited 2014 Oct ll];l(3).Availablefrom: https://ijpm.mui. ac.ir/index.php/ ijpm/article/view/10
12. Juarez DT, Sentell T,Tokumaru S, Goo R, Davis JW, Mau MM. Factors Associated With Poor Glycemic Control or Wide Glycemic Variability Among Diabetes Patients in Hawaii, 2006-2009. Prev Chronic Dis [Internet], 2012 Sep 27 [cited 2015 May 11];9. Available from: https:// www.cdc.gov/pcd/issues/2012/ 12_0065.htm
13.Nalysnyk L, Hernandez-Medina M, Krishnarajah G. Glycaemic variability and complications in patients with diabetes mellitus: evidence from a systematic review of the literature. Diabetes ObesMetab 2010;12:4:288-98.
14. Group TDC and CTR. The Relationship of Glycemic Exposure (HbAlc) to the Risk of Development and Progression of Retinopathy in the Diabetes Control and Complications Trial. Diabetes 1995;44:8:968-83.
15. Srisurin W. Prevalence and effect of hemoglobin E disorders on Hbalc and lipid profile of diabetic patients at Surin Hospital. J Med Assoc Thail Chotmaihet Thangphaet 2011;94:l:36-42.
16. เสถียร สุขพณิชนันท์. beta-thalassemiahb e [Internet], [cited 2015 May 14]. Available from: https://www.thalassemia.or.th/thaiversion/diag-carrier-th.htm