Glycated Haemoglobin Determination in the Biological Follow-Up of Diabetic Subjects Admitted to the Endocrinology Department of the CNHU-HKM of Cotonou
Introduction: One of the biological markers for monitoring glycaemic control in diabetic patients is glycated protein. The definition of a reference method to improve the accuracy of measurement tools is necessary. The aim of our study was to assess the glycemic control of diabetic patients based on glycated hemoglobin. Patients and Method: This is a descriptive cross-sectional study conducted in April 2021 at the national university hospital center (CNHU-HKM) of Cotonou. All patients who consulted during the period and who gave their consent were included. After collecting the blood samples according to the classical standards of the pre-analytical phase, we measured the blood glucose level and the HbA1c. Results: The mean blood glucose level of the patients was 1.52 ± 0.16 g/L with extremes of 0.80 g/L and 3.5 g/L. The mean HbA1c proportion was 8.39% ± 0.60% with a minimum and maximum value of 5.40% and 16% respectively. We also noted that the mean body mass index (BMI) of the patients was 28.61 ± 1.46 Kg/m2 with extremes of 17.50 Kg/m2 and 46.02 Kg/m2. Oral anti diabetic and hygienic-dietary measures were used by 44 patients (80%) and hygienic-dietary measures (HDM) only used by 9.09%. A frequency of 87.53% of patients had at least one degenerative complication. Retinopathy was the most observed degenerative disease (36.36%) followed by cardiovascular disease (25.45%). Conclusion: This study showed that there is a poor correlation between fasting blood glucose and glycated haemoglobin levels, which could be due to several biological and clinical reasons. It also showed that despite the respect of hygienic dietary measures and a well conducted treatment, it is difficult to obtain a satisfactory glycemic balance in obese patients.
References
[1]
Organisation Mondiale de la Santé (OMS) (2016) Rapport Mondial sur le Diabète. Organisation Mondiale de la Santé, Genève. https://www.who.int/diabetes/global-report/fr/
[2]
American Diabetes Association (2010) Standards of Medical Care in Diabetes—2010. Diabetes Care, 33, S11-S61. https://doi.org/10.2337/dc10-S011
[3]
Nathan, D.M., Turgeon, H. and Regan, S. (2007) Relationship between Glycated Haemoglobin Levels and Mean Blood Glucose over Time. Diabétologia, 50, 2239-2244. https://doi.org/10.1007/s00125-007-0803-0
[4]
Ohde, S., Deshpande, G.A., Yokomichi, H., Takahashi, O., Fukui, T. and Yamagata, Z. (2018) HbA1c Monitoring Interval in Patients on Treatment for Stable Type Diabetes. A Ten Year Retrospective, Open Cohort Study. Diabetes Research and Clinical Practice, 135, 166-171. https://doi.org/10.1016/j.diabres.2017.11.013
[5]
Djrolo, F., Amoussou Guenou, K., Zannou, D., Houinato, D., Ahouandogbo, F. and Houngbe, F. (2003) Prévalence du diabète sucre au Benin. Louvain Médical, 122, S258-S262.
[6]
Makulo, J.R., Nseka, N.M., Lepira, F.B., Bieleli, E. and Nge, O.A. (2010) [Correlation between Capillary Fasting Glucose and HbA1c: Study on 181 Type 2 Diabetics Patients in Democratic Republic of the Congo]. Medecine Tropicale, 70, 513-516. (In French)
[7]
Kaké, A.., Sylla, D., Camara, M.Y., Diaby, M., Oyana, P., Camara, I., Samaké, M., Andeme, N., Ondo, M. and Ondo, C. (2019) Overweight and Obesity: A Public Health Problem of Growing Concern in Malabo (Equatorial Guinea). RAFMI, 6, 34-41.
[8]
Oniankitan, O., Fianyo, E. and Mijiyawa, M. (2009) Gonarthrosis in Rheumatology Consultation in Lomé (Togo). Mali Médical, 24, 4-6.
[9]
Keita, C. (2008) Retinopathy in Type 2 Diabetics in the Internal Medicine Department of the Chu du Point G. Ph.D. Thesis, Bamako.
[10]
Cisse, S. (2002) Etude de la rétinopathie diabétique dans le service de médecine interne de l’hôpital du point G. Thesis, Bamako.
[11]
Touré, A. (1998) Suivi des diabétiques Epidémiologie, Traitement, Evolution. Thesis, Bamako.
[12]
Diakité, S. (1979) Contribution à l’étude du diabète au Mali. Thesis, Bamako.
[13]
Taleb, N., Salti, H., Al-Mokaddam, M. and Merheb, M. (2008) Prevalence and Determinants of Albuminuria in a Cohort of Diabetes Patients in Lebanon. Annals of Saudi Medicine, 28, 420-425. https://doi.org/10.5144/0256-4947.2008.420
[14]
Yameogo, N., Mbayé, A., Ndour, M., et al. (2012) Etude de la micro-albuminurie et les autres facteurs de risques cardio-vasculaires dans la population des diabétiques de type 2 sénégalais. Médecine d’Afrique, 59, 303-308.
[15]
Ketema, E.B. and Kibret, K.T. (2015) Correlation of Fasting and Postprandial Plasma Glucose with HbA1c in Assessing Glycemic Control; Systematic Review and Meta-Analysis. Archives of Public Health, 73, Article No. 43. https://doi.org/10.1186/s13690-015-0088-6
[16]
Assavedo, C.R.A., Codjo, L., Alassani, A., et al. (2016) Risks Factors of Retinopathy among Diabetic’s Patients in Benin in 2014. Journal of Ophthalmology & Clinical Research, 3, Article No. 025. https://doi.org/10.24966/OCR-8887/100025
[17]
Misra, A. and Bloomgarden, Z.T. (2018) Discordance between HbA1c and SMBG. Journal of Diabetes, 10, 908-910. https://doi.org/10.1111/1753-0407.12843
[18]
Procopiou, M. (2006) Glycated Haemoglobin: Update and Novelty. Revue Médicale Suisse, 2, Article ID: 31392.
[19]
Lotfi, Z., Aboussaleh, Y., Sbaibi, R., Achouri, I. and Benguedour, R. (2017) [The Overweight, the Obesity and the Glycemic Control among Diabetics of the Provincial Reference Center of Diabetes (CRD), Kenitra, Morocco]. Pan African Medical Journal, 27, 189. (In French)
[20]
Antuna-Puente, B., et al. (2008) Obesity, Inflammation and Insulin Resistance: What Role for Adipokines. Diabetes & Metabolism, 34, 2-11.