Family history of diabetes is a significant risk factor for developing type 2 diabetes. There is the need for a convenient screening tool for Diabetes Mellitus among populations at risk. The aim of this study was to determine the prevalence of Diabetes mellitus among the asymptomatic first degree relatives of Type 2 DM patients and to compare the Glycosylated haemoglobin (HbA1c) and Oral Glucose Tolerance Tests (OGTT) as screening tool.
One hundred and eighty asymptomatic first degree relatives of Type 2 DM subjects were evaluated over a period of one year. The blood pressure and anthropometric indices of all the subjects including weight, height, waist and hip circumferences were measured . The HbA1cwas determined using the NGSP certified HPLC method. The two hour post glucose load of the OGTT was measured and the plasma glucose levels were estimated using the glucose oxidase method. The fasting plasma Lipid levels were also measured. Data was analyzed using SPSS software . Statistical significance was determined as a p value of < 0.05.
The prevalence of Diabetes among the first degree relatives of Type 2 DM using the HbA1c and OGTT was 18.8% and 16.6% respectively. Prevalance of Pre diabetes using HBA1c and OGTT was 11.6% and 10%. There was significant correlation between the HbA1c and the Systolic Blood Pressure (p=0.001), Body Mass Index (p=0.001), Waist circumference(p=0.001), Total Cholesterol (p=0.001) and High Density Lipoprotein Cholesterol (HDLc) levels (p=0.001).
The role of HbA1c as a screening tool for the diagnosis of Diabetes has been proposed for quite some time. Unlike the OGTT, HbA1c does not require any special patient preparation. In this study, the prevalance of diabetes and pre diabetes among the asymptomatic first degree relatives of Type 2 DM was found to be quite high.The similar number of indviduals were diagnosed to be having diabetes and pre diabetes by both HbA1c and the OGTT.In addition HbA1c had significant correlations with some cardiovascular risk factors. As Undiagnosed Abnormalities of glucose metabolism are quite common in first degree relatives of type 2 DM patients and hyperglycemia is a confirmed significant risk factor for cardiovascular disease, a simple and convinient parameter like HbA1c can be recommended for diagnosis of diabetes , as diabetic patients diagnosed by any method have more cardiovascular morbidity and mortality than non diabetics.
The results suggest that the HbA1c can serve as a screening test for Diabetes among populations at risk. It can also be used as a predictor of cardiovascular risk as it has significant levels of correlation to some cardiovascular risk factors.
Name Dr. Vipan Talwar
MBBS ,MD,(Medicine) ,DM, (Endocrinology)
Director & Sr. Consultant - Endocrinology and Diabetes at Golden Hospital, Jalandhar
Teaching Experience :Five Years of experience of teaching post graduate students at Safdurjung Hospital, New Delhi and PGIMER Chandigarh
Awards : *Rotary award for Excellence in field of Medicine, * J S A Award for Outstanding Services in Medical Field
Publications :Number of publications as Orignal articles, review articles, case reports in International and national indexed journals.
Areas of interest
• Diabetes,,CGMS,AGMS ,Insulin Pumps
• Obesity, Thyroid disorders,
• Growth disorders, Adrenals disorder
• Reproductive Endocrinology.
Golden Hospital, Jalandhar
GOURAV TALWAR , MBBS- SUBHARTI MEDICAL COLLEGE ,MEERUT. KEEN INTREST IN FIELD OF DIABETES AND ENDOCRINOLOGY
MBBS student with keen interest in field of diabetes and endocrinology