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Significance of HbA1c levels in diabetic retinopathy extremes in South Africa

M Mjwara, M Khan, C-H Kruse, W Sibanda, C Connolly

Abstract


Background. Diabetic retinopathy (DR) is one of the leading causes of blindness in sub-Saharan Africa and globally, placing a huge disease burden on patients and the public health system. DR varies in severity from non-proliferative to proliferative DR (PDR).

Objectives. Using a monitor of medium- to long-term blood glucose control, to determine the association between glycated haemoglobin (HbA1c) levels in patients with PDR and those with no DR.

Methods. A prospective, cross-sectional study was conducted at McCord Provincial Eye Hospital in Durban, South Africa. We studied only patients diagnosed with diabetes mellitus (DM) for >1 year who had either PDR or no DR, and compared their HbA1c levels. Patients with non-proliferative DR were not included.

Results. Patients with PDR had significantly higher HbA1c levels than those with no DR. Patients with type 1 DM had higher HbA1c levels than patients with type 2 DM in both the PDR and no-DR groups. Older patients (>70 years) had lower HbA1c levels than younger patients. Gender, race and duration of diabetes had no influence on HbA1c levels.

Conclusions. PDR was associated with higher HbA1c in type 2 DM in all races and age groups and was independent of duration of disease. The trend was the same for type 1 DM, but significance could not be reached, probably because of small numbers in this subset of patients.


Authors' affiliations

M Mjwara, Department of Ophthalmology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

M Khan, Department of Ophthalmology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

C-H Kruse, Department of Ophthalmology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

W Sibanda, Biostatistics Department, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa

C Connolly, Biostatistics Department, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa

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Keywords

Hba1c; Glycated haemoglobin; Proliferative diabetic retinopathy; No retinopathy; Burden of disease; Duration of illness; Type 1 diabetes mellitus; Type 2 diabetes mellitus

Cite this article

South African Medical Journal 2021;111(9):886-890.

Article History

Date submitted: 2021-09-02
Date published: 2021-09-02

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