Association of Microalbuminuria with High HbA1C levels in Melanesian Adults with Diabetes of at-least 1 Year Duration.

BackgroundEvidence suggest a potential relationship between high or variable HbA1C levels and presence or rate of change of microalbuminuria. Disruption of the vascular endothelial glycocalyx has been linked to chronic hyperglycemia and microalbuminuria, suggesting a possible shared pathophysiological mechanism. AimTo 1) explore potential association between microalbuminuria and high HbA1C levels in Melanesian adults with diabetes mellitus, and 2) asses predictive value of a high HbA1C reading as an indicator of the presence or progression of microalbuminuria. MethodA cross-sectional study on 190 patients with either type 1 or 2 diabetes of at least 1-year duration done at a provincial hospital in Papua New Guinea in 2017. ResultA significant [P=0.0221], though weak [R2=0.028 <0.70], correlation between UACR and HbA1C [95% statistical confidence] was observed in univariate regression, which was marginally significant [P=0.056] after controlling for weight, systolic hypertension, duration of diabetes, gender and age in multivariate regression. ConclusionA significant [p=0.022], though weak, correlation between UACR and HbA1C levels was observed, which may support usefulness of HbA1C as a predictor for microalbuminuria and diabetic kidney disease. In settings without microalbuminuria testing, high HbA1c levels can be used as a proxy to indicate presence or progression of microalbuminuria, thus prompting timely interventions to prevent further progression of diabetic nephropathy.