A Study of Consistencies between HbA1c and the Incidence of Eye and Kidney Complication in Diabetic Patients from Promkiri Hospital Nakhon Si Thammarat Province
Keywords:
HbA1c, diabetic retinopathy, diabetic nephropathy, Diabetic mellitusAbstract
Thailand’s Diabetes Care Guidelines recommend HbA1c testing at least once a year in type 2 diabetic patients (T2DM); however, this may not be sufficient to prevent microvascular complications especially diabetic retinopathy (DR) and diabetic nephropathy (DN). This research aimed to study consistence between the average estimated HbA1c (calculated by converting from blood glucose monitoring) and laboratory measured HbA1c, the cumulative incidence of DR and DN in good and poor glycemic control groups, and the incidence density of DR and DN with consistencies and non-consistencies HbA1c values in poor glycemic control group. The medical records of 131 patients of Promkiri’s Chronic Disease Clinic registered to T2DM in 2010-2011 were analyzed. The results found consistencies of HbA1c in 1st and 2nd years after registration and decreased in the following years. The cumulative incidence of DR in patients with good and poor glycemic control were 0.188 and 0.365, DN 1.475 and 1.023, and DR+DN 0.142 and 0.342 respectively. The calculated HbA1c was associated with both DR and DR+DN (p < 0.05), the incidence density of consistencies and non-consistencies HbA1c of DR were 2.03 and 4.71 per 100 person-year, and of DR+DN were 1.47 and 4.52 per 100 person-year. In conclusion, HbA1c testing once a year may not be sufficient to prevent microvascular complications.
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