Correlation between HbA1c and Diabetic Complications

Diabetes mellitus is a syndrome of faulty insulin secretion, action or both with multiple complications. Those that affect the eyes, kidneys and peripheral nervous system are collectively called the microvascular complications in contrast to the less diabetes-specific macrovascular complications. Multiple studies in different countries confirm that a higher HbA1c level is an independent risk factor for the development of diabetic complications. Therefore, a descriptive cross sectional study was performed using data from 194 patients in the medical ward in Ayub Teaching Hospital Abbottabad. This study included 105 females and 89 males with documented diabetes. The values of HbA1c were recorded and any macro vascular or micro vascular complication was noted. Most of the patients were using insulin and the oral drug used in most cases was from the class of drugs called sulfonylureas. The majority of the patients had HbA1c values between 7-9 % with CVA as the complication documented in most cases. The micro vascular complication in most cases was neuropathy. Both these types of complications were statistically significantly associated with the levels of HbA1c. Out of all, 122 had hypertension as well with the majority not taking any drug therapy. The macro vascular complications of diabetes were also found to have statistically significant association with hypertension. In conclusion, although most studies negate the impact of strict glycemic control on the macro vascular complications but this effect in turn is indirectly influenced by micro complications, thus, good glycemic control is imperative to prevent the chronic complications of diabetes. The use of HbA1c as a single value may have limited benefit but can be enhanced by keeping an eye on the variability pattern over months or years.