CONVERSE CONTRIBUTIONS OF FASTING AND POSTPRANDIAL GLUCOSE TO HBA1C AND GLYCATED ALBUMIN.

Background: Diabetes mellitus (DM) comprises a group of common metabolic disorders that share phenotype of hyperglycemia, and is often accompanied by presence of glucose in urine, from which the name of condition is derived. The aim: was to evaluate the relative contribution of fasting and postprandial plasma glucose to both glycated heamoglobin (HbA1C) and glycated albumin(GA) in type 2 diabetic patients. Subjects and Methods: This cross-sectional study was conducted on 50 non acarbose non insulin receiving type 2 diabetic subjects attending the out patient endocrinology clinc at Benha University Hospitals during the period from July 2014 to July 2015 after approval of Benha University ethical committee. All the patients were subjected to full history taking Complete physical examination ,fasting , postprandial and prelaunch blood glucose measurement ,serum GA and HbA1C measurement. Serum GA concentration was quantitatively measured using an Enzyme–Linked Immuno-Sorbant Assay (ELISA) kit the study . Results: Among the 50 studied patients 12 were males (24%) and 38 were females (76%)with their age ranged from 43-75 year with the mean age being 57.4±8.6. The study revealed that the relative contribution of the postprandial plasma glucose to HbA1C (rho =0.710 and p<0.001) was higher than that of fasting plasma glucose (rho=.574 and p=0.021) in group 1 patients,the relative contribution of the postprandial plasma glucose to HbA1C (rho=0.707 and p= 0.02 2) was equal to that of fasting plasma glucose (rho=0.707 and p=0.022) in group 2 patients and the relative contribution of the fasting plasma glucose to HbA1C (rho=0.679 and p=.001) was higher than that of the postprandial plasma glucose (rho =0.659 and p= 0.002) in group 3 patients. The study also revealed that the relative contribution of the postprandial plasma glucose to glycated albumin(rho =0.515 and p< 0.001) was higher than that of fasting plasma glucose (rho=0.338 and p=0.016 Conclusion: both fasting blood glucose and postprandial blood glucose correlated significantly with HbA1c and GA. The relative contribution of postprandial plasma glucose was high in patients with fairly good control of diabetes (HbA1C>7.3%) and decreased progressively with worsening diabetes (HbA1c <8%). IN contrast the contribution of fasting plasma glucose showed a gradual increase with increasing level of HbA1c. For patients with A1c between 7.4 percent and 8 percent, post prandial &fasting make equal contributions to overall hyperglycemia. Keywords:Fasting blood glucose,postprandial blood glucose,HbA1Cand GA