UTILIZATION OF GLYCOSYLATED HAEMOGLOBINAND MICROALBUMIN IN THE MANAGEMENT OF UNCONTROLLED DIABETES MELLITUS PATIENTS ATTENDING KIBAGABAGA DISTRICT HOSPITAL, RWANDA
Valens Karenzi - Masters Student, Jomo Kenyatta University of Agriculture and Technology, Kenya
Amos Mbugua - Department of Medical Laboratory Sciences, Jomo Kenyatta University of Agriculture and Technology, Kenya
Stanley Waithaka - Department of Medical Laboratory Sciences, Mount Kenya University, Kenya
Jean Bosco Gahutu - Direction of Research and Innovation, College of Medicine and Health Sciences, University of Rwanda, Rwanda
ABSTRACT
Background: Diabetes Mellitus is a clinical syndrome described by hyperglycemia because of the total or relative lack of insulin. One of chronic complication of poorly controlled diabetes is diabetic nephropathy which may prompt end-stage renal disease. Objective: To establish a correlation between glycosylated haemoglobin and microalbumin in the management of uncontrolled diabetes mellitus patients attending Kibagabaga District Hospital. Materials and Methods: Hospital-based cross-sectional design was used. Data was collected from 246 participants that attended the diabetic outpatient diabetic clinic at Kibagabaga District Hospital from March to June 2019. Spot urine was collected to measure microalbumin. Microalbumin was used as urinary albumin-to-creatinine ratio (ACR) > 3 mg/mmol. The Whole blood samples were collected in Ethylenediamine tetraacetic acid (EDTA) tube for glycosylated haemoglobin (HBA1c) measurement. A cut-off value of HBA1c > 6.5 % was used as uncontrolled diabetes mellitus. Data ware analyzed by statistical software” SPSS” version 21. Results: Out of 246 patients, 178 (72.36%) were female and 68 (27.64%) were male. The youngest and oldest had 31 and 81 years old respectively and the average age was 57.9 years. The duration of diabetes varies from 1 to 19 years with an average of 6.5 years. 113 (31.5%) patients with (HBA1c <6.5%) were excluded from the study during screening and 246 (68.5%) patients with uncontrolled diabetes (HBA1c > 6.5%) were included in the study. 80 (32.9%) of study subjects had microalbumin (ACR>3mg/dl) and 166 (67.1%) had normoalbuminuria (ACR<3mg/dl) and no case of macroalbuminuria (ACR>100 mg/dl) recorded. ACR was significantly positively correlated with HbA1C and duration of diabetes. Conclusions: Our study revealed that around 68.5% of the diabetic patients were uncontrolled and 32.9% of them had microalbumin. The significant positive correlation between ACR and HBA1c results among uncontrolled diabetes patients helped us to propose the access to glycosylated haemoglobin and microalbumin testing at the district hospital level. This will also assist to predict the kidney complication among uncontrolled diabetes patients.
