Correlation Between HbA1C and Four Hours After Lunch and Before Dinner Blood Sugar Levels in Patients with Type 2 Diabetes Mellitus Treated with Oral Antidiabetic Drugs
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Published:
Feb 1, 2019
Keywords:
HbA1C ิblood sugar levels diabetes
Main Article Content
Abstract
Objective: To determine the relationship between HbA1C and blood sugar levels measured at 8 hours of fasting, 4-hours post lunch and before dinner (pre-dinner) in type 2 diabetes mellitus and derive linear regression equation between HbA1C and these 3 blood sugar levels. Methods: The study was prospective research in outpatients receiving cares from the diabetes clinic at Panatnikhom Hospital. Those who met the inclusion criteria were trained to do self-monitoring of blood glucose (SMBG) using Accu-Chek® Performa and recorded sugar levels measured at 8 hours of fasting, 4-hours post lunch and pre-dinner. HbA1C levels were measured two months after the start of SMBG. Results: There were 88 participants in the study. The correlations between HbA1C and blood glucose levels measured at 8 hours of fasting, 4-hours post lunch and pre-dinner were statistically significant with r=0.607, 0.518 and 0.595, respectively (P < 0.001). Equations to predict HbA1C levels from blood sugar levels were 1) HbA1C = 3.849 + 0.029(fasting blood glucose) 2) HbA1C = 5.296 + 0.017(blood glucose at 4-hr post lunch) and 3) HbA1C = 5.310 + 0.018(blood glucose at pre-dinner). Conclusion: In addition to fasting blood glucose, blood sugar levels before dinner could be an alternative for evaluating blood glucose control in patients with type 2 diabetes mellitus and for making decision on the provision of treatment and pharmaceutical are to patients with type 2 diabetes attending an after-hours clinic.
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Research Articles
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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2. American Association of Clinical Endocrinologists and American College of Endocrinology. Clinical practice guidelines for developing a diabetes mellitus comprehensive care plan. Endocr Pract. 2015;21(Suppl 1):S1-87.
3. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. Diabetes Control and Complications Trial Research Group. New Engl J Med. 1993; 329: 977-86.
4. Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. J Pediatr. 1994;125:177-88.
5. Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ, et al. Translating the A1C assay into estimated average glucose values. Diabetes Care. 2008;31:1473-8.
6. Liang CC, Tsan KW, Ma SM, Chow SF, Wu CC. The relationship between fasting glucose and HbA1c among customers of health examination services. Formos J Endocrin Metab. 2010;1:1-5.
7. Bouma M, Dekker JH, de Sonnaville JJ, van der Does FE, de Vries H, Kriegsman DM, et al. How valid is fasting plasma glucose as a parameter of glycemic control in non-insulin-using patients with type 2 diabetes?. Diabetes Care. 1999;22:904-7.
8. Mekvanich N. The relationship between fasting plasma glucose and hemoglobin A1c for creating average plasme glucose chart in diabetes patients of Pranangklao Hospital. J Med Tech Assoc Thailand. 2557;42:4975-89.
9. Soonthornpun S, Rattarasarn C, Leelawattana R, Setasuban W. Postprandial plasma glucose: a good index of glycemic control in type 2 diabetic patients having near-normal fasting glucose levels. Diabetes Res Clin Pr. 1999; 46: 23-7.
10. Bastyr EJ, 3rd, Stuart CA, Brodows RG, Schwartz S, Graf CJ, Zagar A, et al. Therapy focused on lowering postprandial glucose, not fasting glucose, may be superior for lowering HbA1c. IOEZ Study Group. Diabetes Care. 2000;23:1236-41.
11. Rosediani M, Azidah AK, Mafauzy M. Correlation between fasting plasma glucose, post prandial glucose and glycated haemoglobin and fructose- mine. Med J Malaysia. 2006;61:67-71.
12. van 't Riet E, Alssema M, Rijkelijkhuizen JM, Kostense PJ, Nijpels G, Dekker JM. Relationship between A1C and glucose levels in the general Dutch population: the new Hoorn study. Diabetes Care. 2010;33:61-6.
13. Saiedullah M, Begum S, Shermin S, Rahman MR, Khan M. Relationship of glycosylated hemoglobin with fasting and postprandial plasma glucose in nondiabetic, pre-diabetic and newly diagnosed diabetic subjects. Bangladesh Med J. 2011; 40: 37-8.
14. Shrestha L, Jha B, Yadav B, Sharma S. Correlation between fasting blood glucose, postprandial blood glucose and glycated hemoglobin in non-insulin treated type 2 diabetic subjects. STCJ. 2012;1:18-21.
15. Vaneet K, Minni V, Brinder C, Amandeep K, Kamaljit S. To study the correlation between glycated hemoglobin and Fasting or random blood sugar levels for the screening of DM. JARBS. 2014;6:21-5.
16. Swetha NK. Comparison of fasting blood glucose & post prandial blood glucose with HbA1c in assessing the glycemic control. IJHBR. 2014;2:134-9.
17. Avignon A, Radauceanu A, Monnier L. Nonfasting plasma glucose is a better marker of diabetic control than fasting plasma glucose in type 2 diabetes.
Diabetes Care. 1997;20:1822-6.
18. Kikuchi K, Nezu U, Shirakawa J, Sato K, Togashi Y, Kikuchi T, et al. Correlations of fasting and postprandial blood glucose increments to the overall diurnal hyperglycemic status in type 2 diabetic patients: variations with levels of HbA1c. Endocr J. 2010;57:259-66.
19. Pichayapaiboon S. Area under the curve of glucose: an accurate indicator of glucose control in type 2 diabetic patients [dissertation]. Bangkok: Chulalongkorn University; 2011.
20. Rohlfing CL, Wiedmeyer HM, Little RR, England JD, Tennill A, Goldstein DE. Defining the relationship between plasma glucose and HbA(1c): analysis of glucose profiles and HbA(1c) in the Diabetes Control and Complications Trial. Diabetes Care. 2002;25:275-8.
21. Howell DC. Statistical methods for psychology. 8th ed. CA: Wadsworth Cengage Learning; 2013.
22. Bureau of Epidemiology, Department of Disease Control. Annual epidemiology surveillance report 2014 [online]. 2014 [cited May 25, 2016]. Available from: http://www.boe.moph.go.th/Annual/AESR201 4/aesr2557/Part%201/ncd/diabetes.pdf.
23. Diabetes Association of Thailand under The Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn. The epidemic of diabetes and its impact on Thailand [online]. 2013 [cited June 6, 2015]. Available from: http://www.diabassocthai. org/sites/default/files/briefingbook_38.pdf.
24. Mongkolchaipak T. Factors affecting medication adherence of diabetes patients at Police General Hospital [dissertation]. Bangkok: Chulalongkorn University; 2015.
25. Warakornpipat S. Glycemic management using self-monitoring of blood glucose in insulin-treated type 2 diabetes patients with uncontrollable blood glucose level [dissertation]. Bangkok: Chulalong- korn University; 2008.
26. Lekphet J. Medication therapy management for type 2 diabetes outpatients by the pharmacist at Nongbua Hospital [dissertation]. Bangkok: Chulalongkorn University; 2011.
27. Diabetes Association of Thailand under The Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn, The Endocrine Society of Thailand, Department of Medical Services, Nation Health Security Office. Clinical Practice Guideline for Diabetes. Bangkok: Aroonkarnpim; 2014.
28. Bays HE, Chapman RH, Grandy S, Group SI. The relationship of body mass index to diabetes mellitus, hypertension and dyslipidaemia: compari son of data from two national surveys. Int J Clin Pract. 2007;61:737-47.
29. Chavier-Roper RG, Alick-Ortiz S, Davila-Plaza G, Morales-Quinones AG. The Relationship between diabetes mellitus and body mass index: primary care facility in Puerto Rico. Bol Asoc Med P R. 2014;106:17-21.
30. Abdullah A, Peeters A, de Courten M, Stoelwinder J. The magnitude of association between overweight and obesity and the risk of diabetes: A meta-analysis of prospective cohort studies. Diabetes Res Clin Pr. 2010;89:309-19.
31. Poldongnauk S, Rattanachaiwong S, Wichai J, Thonrach T. Metabolic syndrome. Khonkaen: Klungnanawittaya; 2015.
32. Bonora E, Calcaterra F, Lombardi S, Bonfante N, Formentini G, Bonadonna RC, et al. Plasma glucose levels throughout the day and HbA1C interrelationships in type 2 diabetes: implications for treatment and monitoring of metabolic control. Diabetes Care. 2001;24:2023-9.
33. Fonseca V. Clinical significance of targeting postprandial and fasting hyperglycemia in managing type 2 diabetes mellitus. Curr Med Res Opin. 2003;19:635-41.
