Journal of Diabetology (Jan 2015)
Role of HbA1C level as a diagnostic tool of diabetes and pre-diabetes in middle-aged Bangladeshi population
Abstract
Diabetes Mellitus is one of the leading non -communicable diseases all over the w orld including Bangladesh. Diabetes is often preceded by a prodromal condition termed pre -diabetes. Oral glucose tolerance test (OGTT) still is regarded as gold standard in diagnosis of blood glucose abnormality. Although less number of bodies are considering measurement of HbA1C as an alternate tool to identify risk group. The present study w as undertaken to evaluate the role of measurement of HbA1C in t he diagnosis of diabetes and pre-diabetes in middle-aged Bangladeshi subjects. A total 177 subjects of age w ithin the range of 30-45 years w ere selected for the purpose and classified into healthy control (n=62) pre-diabetes (n= 69) and diabetes (n=46) groups based on the values of OGTT. Middle aged Bangladeshi subjects attending Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) hospital, the HbA1C values w ere 5.0 -5.6% in control group, 5.6-6.2% in pre-diabetes and 8.1-9.7% in diabetes group (95% CI). The optimal cut -off value of HbA1C related to pre-diabetes diagnosed by OGTT w as 5.6%, w hich show ed the sensitivity 47.8%, specificity 74.2%, positive predictive value 67.3% and negative predictive value 58.5%. Variants of hemoglobin especially Hemoglobin E (HbE) is prevalent in South East Asia including Bangladesh. The presence of genetic variants of hemoglobin can profoundly affect the accuracy of HbA1C measurements. So measurement of HbA1C may not correlate adequately w ith actual blood glucose level.
