Category: Diabetes/Prediabetes/Hypoglycemia

PERFORMANCE OF GLYCATED HEMOGLOBIN (HBA1C) FOR DETECTING NEWLY DIAGNOSED DIABETES AND PRE DIABETES IN DIFFERENT ETHNICITIES OF PAKISTAN

Monday, Apr 8
1:00 AM – 2:00 AM

Objective :

Primary objective was to calculate the mean HbA1c level in newly diagnosed diabetic patients of our population and to determine difference due to ethnicity. Additionally HbA1c would be compared with fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hr PG) value after OGTT in patients with newly diagnosed diabetes.


Methods : A cross sectional study was conducted from July 2014-November 2015 at the Section of Chemical Pathology, Department of Pathology & Laboratory Medicine, Aga Khan University, Karachi, Pakistan. . All consecutive subjects with suspected of DM above 18 to 65 years, coming for OGTT were included in the study after taking approval from institution’s ethical review committee (ERC). Fiev ml of blood was drawn for glucose and HbA1C in sodium fluoride and EDTA tubes respectively. Samples for FPG and 2-hr PG were analyzed immediately, while whole blood samples for HbA1c were stored at -80°C until analysis. Data was analyzed using SPSS version 19.0


Results : Total 146 subjects who underwent OGTT testing for diagnosis of type 2 DM were included in this study. Amongst them majority were females (52%) and mean age of study participants was 45.1±13.3 years. HbA1c levels were significantly different amongst the ethnicities (p-value <0.03*) showing highest mean HbA1c, FPG and 2-hr PG levels in Sindhis. Comparison gave the following correlation coefficient, HbA1c was positively correlated with FPG (r=0.69**, p value <0.001) and 2-hr PG (r=0.61**, p value <0.001). The overall concordance of HbA1c with the comparison method, 2-hr PG was 57%.


Discussion :

Ethno-racial difference was also observed in the present study with significantly high mean HbA1c levels in Sindhi population compared to other ethnicities. However the reason for this ethnic and racial differences are still unknown but in a study by Cohen et al revealed that difference in mean erythrocyte age, even in haematologically normal individuals, can considerably affect the time available for glycation and consequently the HbA1c concentration


Conclusion : The mean levels of HbA1c among Sindhi population are greater than that in other populations. Therefore, a single value of HbA1c ≥6.5% is not adequate to identify patients with impaired diabetes and early diabetes and we suggest that new cutoffs for HbA1c should be defined for our population.

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Sheharbano Imran

Demonstrator
Foundation university Islamabad
Rawalpindi, Punjab, Pakistan

Dr Shehrabano Imran is currently working in Foundation university Islamabad Pakistan as demonstrator in Department of Pathology. I have completed my residency training from Aga Khan University Karachi and now joined Foundation University.

Hafsa Majid

Assistant professor
Aga Khan University Hospital
karachi, Sindh, Pakistan

Dr Hafsa Majid is currently working in Aga Khan University (AKUH) Karachi Pakistan as Assistant Professor in Section of Chemical Pathology , Department of Pathology & Laboratory Medicine.

Lena Jafri

Associate profesoor
Aga Khan University Hospital
karachi, Sindh, Pakistan

Dr Lena Jafri is currently working in Aga Khan University (AKUH) Karachi Pakistan as Associate Professor in Section of Chemical Pathology , Department of Pathology & Laboratory Medicine.

Aysha Habib Khan

Associate profesoor
Aga Khan University Hospital
karachi, Sindh, Pakistan

Dr Aysha Habib is currently working in Aga Khan University (AKUH) Karachi Pakistan as Associate Professor in Section of Chemical Pathology , Department of Pathology & Laboratory Medicine.