European Journal of Biomedical and Pharmaceutical Sciences

PREPONDERANCE OF INCREASED GLYCOSYLATED HEMOGLOBIN (HBA1c) AND CHRONIC COMPLICATIONS IN DIABETES MELLITUS PATIENTS RECEIVING MEDICARE IN A TERTIARY INSTITUTION IN NIGERIA; WHAT NEED TO BE DONE

B. K. Myke-Mbata*, C.O. Dioka, S.C. Meludu, S.A. Adebisi, E.K. Oghagbon

ABSTRACT

Background: HBA1c serves as a marker for average blood glucose levels over the previous months prior to the measurement.In diabetes mellitus, higher amounts of glycated hemoglobin, indicates poor glycemic control which have been associated with cardiovascular diseases. Objectives: We, therefore compared HbA1c and fasting blood glucose among subjects of varying degree of complications with controls to evaluate the effect of glycemic control on chronic complications of diabetes mellitus in developing country in order to emphasize the need for tight glycemic control as a means of prevention of chronic complications among diabetic patients. Methods: 109 type 2 DM subjects (47 males and 62 females) and 100 non-DM controls of the same age range (40-80 yrs) were recruited for this study. The chronic complications found were: nephropathy, retinopathy, coronary artery disease, cerebrovascular disease, peripheral vascular disease and diabetic foot. These were further classified into micro vascular complications (nephropathy and retinopathy) and macrovascular complications (Coronary Artery Disease, Cerebrovascular Disease, Peripheral Vascular Disease and diabetic foot).Of these 109 DM subjects, 36 were without chronic complications, 37 have microvascular complications only and 36 have a combination of microvascular and macrovascular complications. HbA1c and fasting blood glucose were analysed using standard methods. RESULT: The mean levels of HbA1c, fasting blood glucose and diastolic blood pressure were significantly higher in DM subjects when compared to the control (p<0.05). HbA1c, fasting blood glucose and diastolic blood pressure were significantly higher in DM subjects with chronic complications than those without complications (p<0.05).In this study among the 109 diabetic subjects 36,37and36 had no complications, microvascular complications only and a combination of microvascular and macrovascular complications respectively. The prevalence of chronic complications among the diabetic subjects studied were 66.9%.Moreso 73.4 % of the diabetic subjects had elevated glycosylated hemoglobin. Education, Age, exercise, employment status, alcohol consumption and medical checkup are significant variables associated with complications in the subjects. Conclusion: Poor glycemic control is an important variable that determined the emergence of chronic complication among diabetes mellitus subject studied.Other variables such as Age, exercise, employment status, alcohol consumption and medical checkup are significant variables associated with complications in the subjects.

Keywords: microvascular and macrovascular complications.