Glycosylated Haemoglobin: Determinants and Metabolic Correlates in T2DM in a Semi-Urban Nigeria Setting. A Prospective Study.

Background: The reliability of the glycosylated hemoglobin (HbA1c), documented to be the gold standard in the diagnosis and monitoring of diabetes mellitus, could be related to some medical conditions. The study determined the associates of the HbA1c in the diagnosis and monitoring of diabetes mellitus. Methods: Data from 213 participants were analyzed in this prospective study to assess the determinants and correlates of HbA1c in a type 2 diabetic mellitus (T2DM) population. Independent associates of HbA1c were determined using regression analysis. Results: The mean age of the 213 (50.23% females) participants was 66.9 ± 8.7 years. Majority were middle aged (60.10%), 158 (74.18%) were taking metformin. The mean HbA1c) was 5.89 ± 1.56%, it was higher in females, reduced with aging (p=0.08) but was positively related to the educational status, body mass index, waist hip ratio, waist circumference, and the blood pressure. Poor diabetes control was found in 25.82% of the participants, it was less common in men (p=0.09), elderly (p=0.001) and kidney dysfunction (p<0.001). The HbA1c was positively associated with the left ventricular hypertrophy (LVH), p=0.001, fasting insulin (p=0.003), insulin resistance (p=0.004).and was independently associated with LVH, hyperhomocysteinemia, insulin resistance and kidney function. Conclusion: The control of diabetes mellitus was poor in women, in non-elderly, obesity, subclinical atherosclerosis and LVH. Using the HbA1c, early screening for at-risk population, and effective monitoring of diabetes patients is imperative to avert or minimize the deleterious effect of T2DM on the population, particularly the productive age group.