Abstract
Background: Subclinical inflammation characterized by elevated inflammatory markers is found in diabetic patients. Inflammation, an important cardiovascular risk factor, is elevated in diabetics with poor glycemic control than those with good control.
 Aim: To study the effect between glycemic status on inflammatory markers in pre-diabetes and diabetes.
 Methods: This study included 300 subjects divided into 3 groups; Control: 100, Pre-diabetes: 100 patients and Diabetes: 100 patients. Basic details of all the participants like age and gender were recorded and laboratory investigations like fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), IL-6, CRP, fibrinogen, uric acid and adiponectin were conducted.
 Results: Compared to controls, the levels FBS, HbA1c, IL-6, CRP, fibrinogen and uric acid were elevated and adiponectin was decreased in pre-diabetes and diabetes. The inflammatory parameters (IL-6, CRP, fibrinogen, uric acid and adiponectin) were significantly correlated with glycemic parameters (FBS, HbA1c) in diabetes, i.e. r=0.28, r=0.55, r=0.2, r=0.48 and r=-0.4 respectively in case of FBS and r=-0.39, r=0.48, r=0.21, r=0.33 and r=-0.53 respectively for HbA1c. Similarly, in pre-diabetes, FBS correlated significantly with adiponectin (r=-0.19), fibrinogen (r=0.29) and uric acid (r=0.18) while that with HbA1c was significant with adiponectin (r=-0.31), IL-6 (r=0.25), CRP (r=0.21) and fibrinogen (r=0.3). 
 Conclusion: The strong correlations observed between glycemic control parameters and inflammation parameters in pre-diabetes and diabetes suggested the crucial involvement of inflammation in the diabetes development. So better control of glycemia can cause significant reduction in inflammation and arrest the health burden.
 Key words: Glycemic control, Pre-diabetes, Diabetes, Inflammation.
Highlights
Diabetes, a serious and devastating public health problem is increasing exponentially worldwide
Compared to controls, the levels fasting blood sugar (FBS), HbA1c, IL-6, CRP, fibrinogen and uric acid were elevated and adiponectin was decreased in pre-diabetes and diabetes
In pre-diabetes, FBS correlated significantly with adiponectin (r=-0.19), fibrinogen (r=0.29) and uric acid (r=0.18) while that with HbA1c was significant with adiponectin (r=-0.31), IL-6 (r=0.25), CRP (r=0.21) and fibrinogen (r=0.3)
Summary
A serious and devastating public health problem is increasing exponentially worldwide. Complications like retinopathy, nephropathy and neuropathy account for the microvascular complications [3] These complications have increased prodigious burden to diabetes since the risk of cardiovascular disease is increased by 2-4 folds in diabetic subjects [4]. Results: Compared to controls, the levels FBS, HbA1c, IL-6, CRP, fibrinogen and uric acid were elevated and adiponectin was decreased in pre-diabetes and diabetes. The inflammatory parameters (IL-6, CRP, fibrinogen, uric acid and adiponectin) were significantly correlated with glycemic parameters (FBS, HbA1c) in diabetes, i.e. r=0.28, r=0.55, r=0.2, r=0.48 and r=-0.4 respectively in case of FBS and r=-0.39, r=0.48, r=0.21, r=0.33 and r=-0.53 respectively for HbA1c. In pre-diabetes, FBS correlated significantly with adiponectin (r=-0.19), fibrinogen (r=0.29) and uric acid (r=0.18) while that with HbA1c was significant with adiponectin (r=-0.31), IL-6 (r=0.25), CRP (r=0.21) and fibrinogen (r=0.3).
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