HbA1c CONTROL

Background: Diabetes Mellitus (DM) is a serious worldwide health concern.Pakistan is among the top 10 countries with the highest prevalence of diabetes in the worldwith estimates reaching as high as 21.6% in adults aged 30–79 years. HbA1C is the most usefuldiagnostic tool to assess the control and progression of disease and related complications.However, the predictors of good and bad control are not well established in our population.Objective: 1). To assess the level of A1C control among type 2 diabetic patients. 2). To find outfactors which can predict uncontrolled A1C. Study Design: Retrospective observational study.Setting: Among type 2 diabetes mellitus patients attending the outpatient of Diabetes Endocrineand Metabolic Centre (DEMC) of Lahore General Hospital, Lahore. Period: June 2012 to Feb2014. Material and methods: Total of 809 patients were randomly selected to assess A1C inthis population. At the same time, we assessed other factors associated with uncontrolled A1C.Chart review of the included patients was done using a data collection sheet, structured for thispurpose. Patient demographic data was gathered. Specific information including complicationsand laboratory results (HbA1C, Triglycerides (TG), Dyslipidemias) was collected. Diabetescomplication data was obtained clinically and through laboratory workup. The outcome wascalculated. Patients with A1C of <7% were considered well controlled. Other lab findings werecategorized with results being controlled according to the accepted cut off points. Results: Atotal of 809 patients were enrolled. Only 32.9% attained A1C control. Analyses showed thatsome factors were significantly associated with uncontrolled A1C. They were diabetes-relatedcomplications like presence of neuropathy, longer duration of diabetes and Dyslipidemias.When multivariate analysis was carried out, the chances of having uncontrolled A1C weresignificantly higher among patients who developed neuropathy and longer duration of diabetes,while triglycerides and other dyslipidemias were not statistically significant. Conclusion: Thelevel of HbA1C is significantly uncontrolled in our population. Uncontrolled HbA1C is morelikely to exist in patients with neuropathy and longer duration of Diabetes. High triglycerides andother dyslipidemia are also present in our population, but not statistically significant.