Abstract
Diabetes mellitus is a global health problem in 21st century. The incidence of diabetes mellitus is in rise and is estimated to be more prevalent in coming years. It is becoming one of the most common non-infectious and non-neoplastic causes of morbidity and mortality. Various complications are associated with diabetes mellitus. With control of blood glucose level, complications of diabetes mellitus can be minimized. In different time frame, different parameters and level have been used to diagnose diabetes. Glycosylated hemoglobin A1c is one of the reliable indicator of chronic hyperglycemia. In 2011, World Health Organization has included HbA1c in the diagnostic criteria. Various methods are used to detect the level of HbA1c. Glycosylated hemoglobin is being used in the management of diabetes mellitus. Various studies have shown its prognostic implication in micro and macrovascular complications. Here we discuss various methods of estimation of HbA1c, various role of HbA1c in the management of Diabetes Mellitus and limitation of the test.
Highlights
Diabetes mellitus, a chronic metabolic syndrome, is characterized by persistent hyperglycemia resulting from either insulin deficiency or increased insulin resistant
In a study done by Mostafa SA et al[15], out of total 8696 study population, 3.3% were diagnosed as diabetes mellitus using oral glucose tolerance test (OGTT) and 5.8% using HbA1c test (≥6.5%)
HbA1c had been shown to decrease as glycemic control improved, and periodical measurement of HbA1c level has become a commonly used tool to monitor the effectiveness of hyperglycemia management.[20]
Summary
A chronic metabolic syndrome, is characterized by persistent hyperglycemia resulting from either insulin deficiency or increased insulin resistant. The main reasons behind were inadequate standardization and its insensitiveness.[14] HbA1c ≥ 6.5% (48 mmol/mol) is considered equivalent to fasting blood glucose level 126mg/dl (7mmol/L).[3] It is quite clear that, increased HbA1c level indicates chronic hyperglycemia. In a study done by Mostafa SA et al[15], out of total 8696 study population, 3.3% were diagnosed as diabetes mellitus using oral glucose tolerance test (OGTT) and 5.8% using HbA1c test (≥6.5%). Combination of HbA1c and glucose tests is needed to reduce the missed diagnosis rate.[17]
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