[Glycosylated hemoglobin as a prognostic index of the appearance of vascular complications in diabetic patients]. / La hemoglobina glucosilada como índice predictor de la aparición de complicaciones vasculares en pacientes diabéticos.

One hundred and fourty seven diabetic patients of both sexes with ages between 40 and 65 (44% Type 1 and 56% Type II), were studied and followed for a period of five years in order to evaluate the possible association between blood glucose control and the appearance and progression of vascular complications. A clinical metabolic characterization was performed in all patients both at the beginning and at the end of the study. Process of the results after 5 years was carried out dividing the total study sample in two groups, A and B, according to the level of glycosylated hemoglobin (HbA1) at the beginning of the study (HbA1 less than 10% or greater than 10%). The most frequent vascular complications both at the beginning and at the end of the study were retinopathy, hypertension, and angina pectoris, outstanding the high incidence of retinopathy (83%) found at the end of the study in the group of patients who were considered poorly controlled given the initial HbA1 values. A subset of 111 patients who did not present retinopathy at the beginning of the study were particularly analyzed, demonstrating in these cases a significant association between HbA1 levels at the beginning of the study and the appearance of retinopathy five years later. Type II diabetics particularly showed a 3 fold risk of developing this complication if their initial HbA1 levels were equal to or higher than 10%. This finding gives HbA1 determination a predictive value for the development of retinopathy and highlights the influence of glycemic control on the appearance and progression of this complication in diabetic patients.

[Correlation of the levels of glycosylated hemoglobin and total cholesterol, total triglycerides and HDL cholesterol in a sample of insulin-dependent diabetics]. / Correlación entre niveles de hemoglobina glicosilada y de colesterol total, triglicéridos totales y HDL-colesterol en una muestra de diabéticos insulinodependientes.

In 132 insulin-dependent diabetics (type I), between 15 and 45 years old (73 women and 59 men) glycosylated hemoglobin (HbA1), total cholesterol (TC), HDL-cholesterol (HDL-C) and total triglycerides (TG) have been determined. We observed that sex did not significantly influence the parameters studied. In the younger group of patients (aged between 15 and 30 years) HbA1, TC, TG were significantly greater than in the older group of patients (p less than 0.05 and p less than 0.01, respectively). In this series, an elevated correlation among HbA1 and TG levels was found. This was also found, although to a lesser extent, when considering TC levels (r = 0.45, p less than 0.05). However, no correlation between HbA1 and HDL-C was found in the total sample or regarding age. These results allow us to point out the usefulness and the application of HbA1 determination in evaluating the relationship between carbohydrate and lipid metabolism in type 1 diabetics.