2002, Number 1
Hemoglobina glucosilada: prueba de laboratorio necesaria para el control metabolico de pacientes mexicanos con Diabetes mellitus tipo 2.
Cerda-Flores RM, Rojas-Alvarado MA, Dávila-Rodríguez MI, González QG, Cortés-Gutiérrez EI, Leal-Garza CH
Full text
Language: Spanish
References: 11
Page:
PDF size: 86.88 Kb.
ABSTRACT
Glycosylated hemoglobin (HbA1c) is a blood test that gives an estimate of the average blood sugar (glucose) for the previous three months. The fasting blood glucose (FBG) and HbA1c determinations give a well idea about the metabolic control of the diabetics. Both tests are determined routinely in many countries but into the Mexican Institutes of Health only the FBG test is carried out for this purpose. The aim of this study was to know if non-insulin-dependent diabetic mellitus (NIDDM) outpatients attending in a clinical hospital of the IMSS after the physician evaluation based only on the FBG test were under a good or bad metabolic control. At the same time, we carried out the HbA1c test independently of the physician evaluation in order to know if the NIDDM patients were well evaluated. A serial case study was undertaken in which concentrations of FBG and HbA1c were measured in 93 diabetics (under treatment) at the outpatient clinic of the IMSS in Monterrey, Mexico. A structured, self-administrated question naire was used to obtain data on age, gender, duration of diabetes, a recent history of polydipsia, polyuria and polyphagia, height, weight, blood pressure, treatment kind, and BMI. The American Diabetic Association (ADA) (currently recommends that the HbA1c be maintained under 7.0%) and the European criteria (currently recommends that the HbA1c be maintained under 7.6%) were used to evaluate the level of metabolic control. The 93 patients had HbA1C levels higher than 8.0% and FBG levels between 63 and 300 mg/dl. According to ADA criteria and European criteria all the patients were out of good metabolic control. These points towards the HbA1c and FBG confirm the doubts about the usefulness of FBG values as a tool for assessing metabolic control. These results suggest a low level in the practice of monitoring indicators in NIDDM. We suggest that the HbA1c test must be taken in account by the Mexican Institutes of Health to improve a better metabolic control in their diabetic patients.REFERENCES
Revilla-Monsalve MC, F Arreola, G Castro-Martinez, J Escobedo-de la Peña, S Fiorelli, C Gutierrez, S Islas- Andrade, E Junco-Lorenzana, A Lifshitz-Guinzberg, JD Mendez, G Partida-Hernandez, B Salazar-Schettino, y F Vazquez-Estupiñan 1995. Pruebas de laboratorio útiles para el control de la diabetes mellitus. Hemoglobina glucosilada. Rev Med IMSS (Mex) 33:501-504.