Interest and limits of HbA1c in Management of Diabetes Mellitus

Abstract

Correct glycemic control, assessed by the glycated hemoglobin level, is necessary to prevent chronic complications of diabetes mellitus, the progression of which is alarming throughout the world.
Aim: The aim of this work is to evaluate the glycemic control of Gabonese diabetic patients followed externally at the university hospital of Libreville and discuss about the value of HbA1c in our context.
Patients and methods: we performed a cross-sectional prospective study based on data brought back by outpatients during their periodic controls between October and November 2016.
Results: 200 patients had been registered and 160 (80%) had done their HbA1c test, among which 63 % of women and 37 % of men. Average HbA1c was 7.74 ± 2.24%. 46.25% had an HbA1c rate ≤ 7%, 18.75% between 7.1% and 8%, and 35% over 8%. Oral antidiabetic drugs were prescribed in 68.12% of patients, insulin alone in 14.37%, and the combination of insulin and oral antidiabetic drugs in 11.87% of patients.
Conclusion: These results are encouraging in African context but their interpretation must be qualified because of the high prevalence of hemoglobinopathies, anemia and G6PD deficiency, which distort the glycated haemoglobin assay.