GLYCOSYLATED HEMOGLOBIN AS A PREDICTOR FOR THE OCCURRENCE OF MACROANGIOPATHIC COMPLICATIONS IN DIABETIC PATIENTS FROM BIHOR COUNTY
Abstract
Background and Aims: Prospective studies showed that long-term hemoglobin A1c (HbA1c) levels correlate directly with the risk of developing and progression of diabetic complications. The aim of the study was to evaluate the correlation between metabolic control and HbA1c variability with macrovascular complications and assess the role of HbA1c as an independent predictive factor for the occurrence of macrovascular complications in diabetic patients from Bihor County, Romania. Material and method: The study was conducted for a 5 years period (2007-2011) and included 321 diabetic patients with no evidence of macroangipathic complications. During the follow-up all the major vascular events were recorded. Results: At the end of the study a total of 85 chronic macrovascular complications were reported. Distribution plots show significantly higher incidence of vascular complications in patients in the group with poor glycemic control. Multivariate analysis showed that HbA1c can be considered an independent predictor of atherosclerotic complications as well as atherosclerotic complications risk score. The variability of HbA1C was not an independent predictor for macroangiopathic complications (p=0.78). Conclusions: Overall glycemic control was the most important factor in the progression of atherosclerosis but we could not rule out that glycemic variability might play a role in the development of complications in type 2 diabetes mellitus (T2DM) patients.