Diabetic Profile- Screening of HBA1C - A Random Community Assessment

Abstract

IntrOductIOnDiabetes Mellitus (DM), often referred to as diabetes-is a condition in which the body either does not produce enough insulin, or does not properly respond to insulin. This leads on to hyperglycaemia, which is the basic cause of systemic complications associated with the disease. Strict control of blood sugar remains the pivot in the decreased incidence of complications [1]. Glycated haemoglobin or A1C should be measured in all individuals with DM during their initial evaluation and as part of their comprehensive diabetes care [2]. It is the primary predictor of long-term complications of DM [3]. In the normal 120 day life span of the RBCs, glucose molecules react with Hb, forming glycated Hb. Measuring HbA1c can reveal as to how high the blood glucose has been on an average, over the past 8-12 weeks. A normal non-diabetic HbA1c value is 3.5-5.5%. In diabetics, range of 6.5% to 7% is good. In individuals with poorly controlled diabetes, the quantity of this glycated Hb is much higher than in healthy people. A build up of glycated Hb within the red blood cells, therefore, reflects the average level of glucose to which the cells have been exposed during their life cycle. The glycaemic goal is to achieve an A1C as close to normal as possible, without developing significant hypoglycaemia. In general, the target A1C should be <7.0% with a more stringent target (<6%) for many patients. A higher A1C goal may be appropriate for the very young or old or in individuals with limited life spans or comorbid conditions [4]. The major consideration is the frequency and severity of hypoglycaemia, since this becomes more common with a more stringent A1C goal. The advantages of doing HbA1C assessment are non-requirement of fasting, with fewer perturbations with stress, diet and exercise. It captures the chronic hyperglycaemia better than fasting glucose levels. The analytical variability is similar with estimation of blood glucose community Section levels [5]. With this background, we made a random assessment of HbA1C in a sample diabetic population, using clinical questionnaire on complications. Such simple data collections with their analysis for the South Indian population are not available much. aim 1. To find out the control of diabetes in randomly selected patients of a community in a given time.2. To find out the clinical incidence of target organ damage in terms of a vascular event.3. To find out the incidences of hypoglycaemic episodes and their correlations with HbA1C levels.4. To estimate the prevalence of risk factors like smoking and obesity. MAterIAl And MethOdsA simple observational study was conducted on diabetic patients at the diabetic centre in Kumbakonam, Southern India. The first 100 semi-urban diabetic patients who came to two nearby private clinics with similar treatment concepts in one day were taken up for the study. They were subjected to a simple questionnaire and a random HbA1c level was estimated after getting their consents. No ethical issues were involved, as the study was basically abou...

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