Correlation Between Hemoglobin A1C Level and Fasting Blood Glucose Level: a Summary on the Reports in the Setting with High Prevalence of Hemoglobin Disorder

Correlation Between Hemoglobin A1C Level and Fasting Blood Glucose Level: a Summary on the Reports in the Setting with High Prevalence of Hemoglobin Disorder The investigation of hemoglobin A1C is presently accepted as a tool for the evaluation of the glycemic control in the diabetic patients. However, due to the high cost, it is limitedly used in many developing countries. The old classical approach, fasting blood glucose determination, is still the standard method in those countries. There are many reports showing the correlation between hemoglobin A1C level and fasting blood glucose level. An interesting point is that there is a limited assessment on those reports, especially in the setting with possible problems of using hemoglobin A1C due to the interference from hemoglobin disorder. In this work, the author performed a meta-analysis by fixed effect model to summarize the reports on the correlation between hemoglobin A1C level and fasting blood glucose level in the setting with high prevalence of hemoglobin disorder, Thailand. The databases PUBMED (from 1910 to February 2012), Cochrane Library (from 1993 to February 2012) and Thai Index Medicus (from 1918 to February 2012) were used for searching the time span. Only four specific reports on the correlation between hemoglobin A1C level and fasting blood glucose have been found. All reports are homogeneous presenting a poor correlation between the two parameters. Of overall 1,207 diabetic cases, a pooled correlation coefficient is equal to 0.48. The result shows that the poor correlation might be due to the high prevalence of hemoglobin disorder in this setting. This might imply that fasting blood glucose might not be used to imply hemoglobin A1C in the areas with the background of endemic hemoglobin disorder. Korelacija između nivoa hemoglobina A1C i nivoa jutarnjeg nivoa šećera u krvi: rezime izveštaja u uslovima sa visokom prevalencom poremećaja hemoglobina Trenutno ispitivanje nivoa hemoglobina A1C se smatra sredstvom u proceni kontrole nivoa šećera u krvi kod dijabetičara. Međutim, zbog visoke cene ovakva ispitivanja su u manjoj meri zastupljena u zemljama u razvoju. Stari, klasičan pristup - određivanje nivoa šećera u krvi je još uvek standardna metoda u ovim zemljama. Postoje mnogi izveštaji koji pokazuju korelaciju između nivoa hemoglobina A1C i jutarnjeg nivoa šećera u krvi. Ono što je interesantno je da je procena tih izveštaja krajnje ograničena, naročito u sredinama sa mogućim problemima korišćenja hemoglobina A1C usled javljanja poremećaja hemoglobina. U radu je autor predstavio meta anlizu kako bi rezimirao izveštaje o korelaciji između nivoa hemoglobina A1C i i jutarnjeg nivoa šećera u krvi u uslovima prevalence poremećaja hemoglobina, Tajland. Za proučavanje vremenskog perioda korišćene su baze podataka PUBMED (u periodu od 1910 do 2012) i Kohran biblioteka (od 1993 do februara 2012) i Thai Index Medicus (od 1918 do februara 2012). Pronađena su samo četiri specifična izveštaja o korelaciji između nivoa hemoglobina A1C i jutarnjeg nivoa šećera u krvi. Svi izveštaji su ujednačeni i prikazuju slabu korelaciju između ova dva parametra. Od ukupno 1.207 slučajeva, koeficijent korelacije je iznosio 0.48. Rezultati ukazuju da je slaba korelacija možda uslovljena velikom prevalencom poremećaja hemoglobina u ovom okruženju. To bi dalje moglo da implicira da se nivo jutarnjeg šećera u krvi možda ne može koristiti za određivanje nivoa hemoglobina A1C u oblastima sa endemskim poremećajima hemoglobina.