Mehnaz Khattak, Sami Saeed, Jawwad Anis Khan, Sadaf Durrani, Hasan Ikram, Umme Farwa.
HbA1c Levels in Diabetic patients with Chronic Liver Disease.
J Islamic Int Med Coll Jan ;16(1):14-8.

Objective: To investigate the accuracy of HbA1c in diabetic patients with chronic liver disease (CLD). Study Design: Cross-sectional/ observational study. Place and Duration of Study: Fauji Foundation Hospital, Rawalpindi (FFH), from July 2019-July 2020. Materials and Methods: This study was carried out on 100 subjects divided in two groups i.e. Group A and Group B. Group A included diabetics with CLD (chronic hepatitis C) and Group B included diabetics without CLD. Each group consisted of 50 known type 2 diabetes mellitus (T2DM) participants, who were randomly selected from liver and medical OPD of FFH, Rawalpindi. Blood samples of the participants were analyzed for HCV, HbA1c and liver enzymes. Chemical analysis was carried out at the department of Pathology FFH, Rawalpindi. For statistical analysis version 21 of SPSS was used. Results: Our study showed that HbA1c levels were low in group A (6.6+-1.10% vs. 9.58+-2.09% p < 0.05) when compared to group B. Group A showed significantly higher levels of alanine aminotransferase (ALT) than group B (74.65+-21.84 U/L vs. 38.44+-23.79 U/L p<0.05). Serum albumin was also lower in group A in comparison to group B (29.52+-2.21g/L vs. 36.24+-3.99 g/L p<0.05). HbA1c levels showed significantly negative association with ALT in group A (r-0.418 p<0.05) while in group B the negative correlation was not significant statistically (r0.197 p=0.171). A significant negative association of HbA1c with Albumin was also seen in group A (r-0.391 p<0.05) Regression analyses showed a significant relationship between HbA1c and ALT in group A. Conclusion: Our study concludes that HbA1c levels are significantly decreased in diabetic patients with CLD (chronic hepatitis C) than diabetics without CLD. Therefore, HbA1c is not a reliable predictor for long-term glycemic monitoring in diabetic patients having CLD.

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