การประเมินผลการควบคุมระดับน้ำตาลในเลือดของผู้ป่วยเบาหวานชนิดที่ 2 ที่มีภาวะโลหิตจางจาก ธาลัสซีเมียและฮีโมลโกลบินที่ผิดปกติ

Tassanee Sirithansakul

Authors

Tassanee Sirithansakul Medical Technology Department, Trang Hospital

Keywords:

blood glucose level, Hemoglobin A1c, Diabetes, blood glucose level Control

Abstract

Our study aimed to assess the effects of glycemic control among patients with type 2 diabetes mellitus and patients with type 2 diabetes mellitus as well as thalassemia anemia and abnormal hemoglobin using Fasting plasma glucose (FPG) and Hemoglobin A1c (HbA1c) levels. We compared HbA1c levels, analyzed by Ion Exchange HPLC and Boronate Affinity Chromatography, in diabetic patients with thalassemia anemia and abnormal hemoglobin. We utilized retrospective data among patients with type 2 diabetes mellitus. We detected whether participants had abnormal levels of FPG or HbA1c, as well as hemoglobin abnormality (Hb) type. Data were analyzed using descriptive statistics. We also analyzed our data using Pearson correlation, linear regression, curve estimation, and t-test statistics.

Analyzing the data of 12,638 patients with type 2 diabetes, we found that most of them were in the non-glycemic control group (FPG> 130 mg /dL and HbA1c ≥7%) with a full day blood test (74.8%) and during the past few months (62.2%). We found the association between FPG level with sex, age, and HbA1c levels was moderate. The linear regression equation between FPG and HbA1c was: Y = 4.771 + 0.020X, p <0.000 (R2 = 0.429). HbA1c was significantly related to FPG. The equation was able to predict the accuracy of the HbA1c value of 42.9%.

In our analysis of 65 patients with type 2 diabetes mellitus with thalassemia anemia and abnormal hemoglobin, we found that most of them (64.6%) were in the non-glycemic control group according to their blood tests for the past few months (FPG> 130 mg / dL and HbA1c <7%). We found that the associations between FPG level with sex, age, service unit and HbA1c level were in the same direction. The linear regression equation between FPG and HbA1c was: Y = 4.866 + 0.002X, p = 0.530 (R2 = 0.006). HbA1c had no significant association with FPG. We found that linear regression equations cannot predict HbA1c levels based on FPG values. We observed that HbA1c levels were significantly different from having the Hemoglobin H disease (HbH), b-thalassemia trait, Hb E trait, and homozygous for the hemoglobin E (homozygous Hb E) (p-value <0.05).

In summary, type 2 diabetes mellitus patients with thalassemia anemia and abnormal hemoglobin cannot use the HbA1c values to accurately assess their glycemic control. Having anemia from thalassemia and abnormal hemoglobin may affect the accuracy of the HbA1c measurement. Analysts for these patients must recognize this phenomenon and select the appropriate HbA1c method.

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