Evaluation of HBA1C as an Objective Marker for Monitoring Blood Glucose Control for Diabetes Patients on Treatment at Dormaa Presbyterian Hospital

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The unavailability or the expensiveness of new technologies such as glycosylated haemoglobin test to monitor long term glycaemic control is a problem in the Dormaa municipality. This study was aimed at evaluating the relationship between glycosylated haemoglobin (HbA1c) concentration and levels of instant fasting plasma glucose (FPG) concentration and mean fasting plasma glucose (FPG) concentration over a three-month period of diabetes patients on treatment. Hundred and fifty whole and plasma samples were collected from systematic grouping of diabetics on treatment (100) attending diabetes clinic at Dormaa Presbyterian hospital as consistently hypoglycaemic <3,5mmol (20), consistently normal 3.5-5.9 mmol/l(20),consistently above normal 6-6.9mmol/l (30) and hyperglcaemic ≥ 7.0 mmol/l(30) and 50 non diabetics healthy people in Dormaa Ahenkro, in Ghana. All laboratory assays were performed according to reagent and equipment manufacturers’ standards. HbA1c assays were measured by DCA 2000 immunossay method, FPG were performed using glucose hexokinase method and haemogobin levels (Hb) were assayed using Cyanmethaemoglobin assay. Socio-demographic data of all eligible participants was captured using a structured questionnaire. On the average, the diabetics (49.28±1.42 yrs) and the non-diabetics (48.98±2.92 yrs) were age matched. The mean systolic blood pressure of the diabetes group and its systematic groupings were significantly higher (p < 0.001) as compared to the control group. However there were no significant differences between diastolic pressures for both diabetics and non-diabetics. Even though the mean fasting plasma glucose of the diabetic group (5.17±0.19) was comparable to that of the control group (5.17±0.079) p>0.05, the levels of HbA1c among the diabetics were significantly higher as compared to the control group. There was significant positive correlation between HbA1c and the various monthly instant fasting plasma parameters as well as the mean fasting plasma glucose. It was observed that the strongest positive linear correlation existed between the HbA1c concentration and the average FPG concentration for the three-month period. Mean glycaemia strongly correlates with HbA1c be reliably depended on as an index of prognosis of diabetes mellitus. During treatment, for good prognosis the goal must be to keep HbA1c less than 7%
A thesis submitted to the Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, in partial fulfillment of the requirements for the degree of Master of Philosophy in Chemical Pathology, December-2013