Relationship of Glycosylated Hemoglobin with Fasting Plasma Glucose and 2 Hours After Breakfast Plasma Glucose in Type 2 Diabetes
American Journal of Internal Medicine
Volume 3, Issue 4, July 2015, Pages: 160-164
Received: May 31, 2015;
Accepted: Jun. 9, 2015;
Published: Jun. 25, 2015
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Sheikh Salahuddin Ahmed, Faculty of Medicine, Universiti Kuala Lumpur, Royal College of Medicine Perak, No. 3, Jalan Greentown, Ipoh, Perak, Malaysia
Tarafdar Runa Laila, Faculty of Medicine, Universiti Kuala Lumpur, Royal College of Medicine Perak, No. 3, Jalan Greentown, Ipoh, Perak, Malaysia
Fazle Nur, Department of Endocrinology, Bangladesh Institute of Health Sciences and Hospital, Mirpur, Bangladesh
Mamun Ul Islam Khan, Department of Endocrinology, Bangladesh Institute of Health Sciences and Hospital, Mirpur, Bangladesh
Umme Sadia Mili, Department of Endocrinology, Bangladesh Institute of Health Sciences and Hospital, Mirpur, Bangladesh
Md. Abdul Mahid Khan, Department of Internal Medicine (Cardiology), Gastro Liver Hospital & Research Institute Ltd, Dhaka, Bangladesh
Mohammad Rafiqul Hoque, Department of Biochemistry, Shahid Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
Background: Glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG) and 2 hours (2-hr) after breakfast (ABF) plasma glucose, are often used to monitor and manage glycemia in stable diabetic patients. Data regarding the relationship and relative contribution of FPG and 2-hr ABF plasma glucose to HbA1c level in Type 2 diabetes mellitus (T2DM) are insufficient. Objective: To examine the correlation of FPG, and 2-hr ABF with HbA1c in known patients having T2DM; and to find out which one of FPG and ABF is the dominant contributor to overall glycemia in monitoring diabetes. Study Design and Methods: The study was carried on 664 known T2DM patients under treatment and routine follow-up at a tertiary care hospital in Bangladesh. FPG & 2-hr ABF plasma glucose concentrations were measured by hexokinase method. HbA1c was measured by high performance liquid chromatography based hemoglobin assay system. The Pearson correlation coefficient was used to investigate the relationship of FPG and ABF with HbA1c and their significance. Results: Both FPG and ABF levels were correlated with HbA1c but higher correlation was seen between FPG and HbA1c. The correlation coefficients between FPG and HbA1c and between ABF and HbA1c were 0.722 and 0.664 respectively. Both the correlations were found statistically significant (p<0.001). Conclusion: In patients with T2DM, FPG and ABF both were significantly correlated with HbA1c; and in our study we found that overall correlation of HbA1c with FPG was higher than ABF plasma glucose level.
Sheikh Salahuddin Ahmed,
Tarafdar Runa Laila,
Mamun Ul Islam Khan,
Umme Sadia Mili,
Md. Abdul Mahid Khan,
Mohammad Rafiqul Hoque,
Relationship of Glycosylated Hemoglobin with Fasting Plasma Glucose and 2 Hours After Breakfast Plasma Glucose in Type 2 Diabetes, American Journal of Internal Medicine.
Vol. 3, No. 4,
2015, pp. 160-164.
Whiting DR, Guariguata L, Weil C, Shaw J. IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011 (Dec);94(3):311-21.
Service FJ, O’Brien PC. The relation of glycaemia to the risk of development and progression of retinopathy in the Diabetic Control and Complications Trial. Diabetologia 2001;44(10):1215-20.
Sorkin JD, Muller DC, Fleg JL, Andres R. The relation of fasting and 2-h postchallenge plasma glucose to mortality: data from the Baltimore Longitudinal Study of Aging with a critical review of the literature. Diabetes Care 2005;28:2626-32.
Cavalot F, Pagliarino A, Valle M, Martino LD, Bonomo K, Massucco P, et al. Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study. Diabetes Care 2011;34:2237-43.
Albers JW, Herman WH, Pop-Busui R, Feldman EL, Martin CL, Cleary PA, et al. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Effect of prior intensive insulin treatment during the Diabetes Control and Complications Trial (DCCT) on peripheral neuropathy in type 1 diabetes during the Epidemiology of Diabetes Interventions and Complications (EDIC) study. Diabetes Care 2010;33:1090–96.
Stratton IM, Adler AI, Neil HAW, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405–12.
Handelsman Y, Mechanick JI, Blonde L, Grunberger G, Bloomgarden ZT, Bray GA,, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for Developing a Diabetes Mellitus Comprehensive Care Plan. Endocr Pract 2011;17(Suppl 2):1-53
Diabetes Control and Complications Trial Research Group, ‘The effect of intensive treatment of diabetes on development and progression of long term complications in insulin dependent diabetes mellitus’, N Engl J Med 1993;329:977-86.
UK Prospective Diabetes Study Group, Intensive blood glucose with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet 1998;352:837-53.
Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS et al. National Academy of Clinical Biochemistry. Position statement executive summary: guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care 2011;34:1419–23.
Bonora E, Calcaterra F, Lombardi S, Bonfante N, Formentini G, Bonadonna RC, et al. Plasma glucose levels throughout the day and HbA1C interrelationships control in type 2 diabetes: implications for treatment and monitoring of metabolic control. Diabetes Care 2001 Dec;24(12):2023-29.
Saiedullah M, Begum S, Shermin S, Rahman MR, Khan MAH. Relationship of glycosylated hemoglobin with fasting and postprandial plasma glucose in nondiabetic, pre-diabetic and newly diagnosed diabetic subjects. Bangladesh Med J 2011;40:37-38.
Hossain T, Latif ZA, Sarkar AA. Relationship of HbA1c with Fasting and Plasma Glucose 2 Hours after Oral Glucose Load in Non Diabetic and Newly Diagnosed Pre Diabetic and Diabetic Patients. Birdem Med J 2012;2(2):81-83.
Gupta S, Puppalwar PV, Chalak A. Correlation of fasting and post meal plasma glucose level to increased HbA1c levels in type-2 diabetes mellitus. Int J Adv Med 2014;1:127-31.
Carroll M, Izard A, Riboni K, Burge M, Schade D: Fasting hyperglycemia predicts the magnitude of postprandial hyperglycemia. Diabetes Care 2002;25:1247–48.
Masram SW, Bimanpalli MV. Assessment of contribution of fasting and post meal plasma glucose to increased HbA1C in diabetes mellitus-comparative study. Int J Biol Med Res 2012;3(3):2020-24.
Azim W, Mushtaq GM, Azim S, Farooq W. Assessment of fasting and two-hour post-prandial glucose as an economical test for monitoring of glycemic control, compared to glycated haemoglobin. Med Channel 2011;17(2):5-7.
Shahram H, Ghazaleh N. Relation of fasting and postprandial plasma glucose with hemoglobinA1c in diabetics. Int J Diabetes Dev Ctries 2010 Jan-Mar;30(1):8–10.
Rosediani M, Azidah AK, Mafauzy M. Correlation between fasting plasma glucose, post prandial glucose and glycated haemoglobin and fructosamine. Med J Malaysia 2006 Mar;61(1):67-71.
Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: variations with increasing levels of HbA1c. Diabetes Care 2003;26:881–85.
Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, McDonald JM, Parrott M. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem 2002;48(3):436-72.
American Diabetes Association: Postprandial blood glucose (Consensus Statement). Diabetes Care 2001;24:775-78.