Study of Relationship between HbA1c and Microalbuminuria of Diabetic Patients

ABSTRACT

Background: Globally, as of 2010, an estimated 285 million people had diabetes, with type 2 making up about 90% of the cases. Its incidence is estimated to almost double, by 2030. Diabetic nephropathy is a consequence of long standing diabetes. The prevalence of microalbuminuria predicts progression to diabetic nephropathy. Measurement of glycated hemoglobin (HbA1c) has become the preferred method of diagnosis as well as assessing long-term glycaemic control. The present study was conducted to determine the magnitude and prevalence of microalbuminuria in relation to HbA1c in a group of diabetic patients admitted in Comilla Medical College Hospital of Bangladesh. Objectives: The relationship between HbA1c and microalbuminuria of diabetic patients was assessed in a hospital-based cross-sectional study in a tertiary level hospital.Material & Methods:A hospital-based cross-sectional descriptive study was carried out in department of Medicine, Comilla Medical College Hospital from 1st July, 2011 to 30th June, 2012. One hundred known admitted diabetic patients with age 25� years were included in this study.Results:Microalbuminuria had a significant correlation with HbA1c (p<0.05) (r=0.24). Increasing HbA1c was associated with increasing microalbuminuria above optimal cut-off points of HbA1c 7%. The prevalence of microalbuminuria was 33.33 % at HbA1c(6.1-6.9)%, whereas it was 75% at HbA1c (7.1-7.9)%. Microalbuminuria was 38.74 � 9.76 mg/gm (p<0.05) at HbA1c <7%, whereas it was 65.86 � 21.29 mg/gm (p<0.05) at HbA1c ?7%.Conclusions:The present study found an early onset of microalbuminuria in the selected community which could be due to poor glycaemic control (high HbA1c ? 7%) after excluding other causes of microalbuminuria. Screening for microalbuminuria and HbA1c test should be done in both newly and already diagnosed diabetic patients as an early marker of renal dysfunction and glycaemic control.