Validity of random blood glucose as a predictor of the quality of glycaemic control by glycated haemoglobin in out-patient diabetic patients at Kenyatta National Hospital

Otieno, Fredrick; Ng’ang’a, Lucy; Kariuki, Mimie

doi:10.4314/eamj.v79i9.9122

Cited by 10 publications

(16 citation statements)

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“…Otieno et al . () found that RBG<7.0 mmol/l had high sensitivity (92%) for HbA 1c <7.8% in a Kenyan study population that consisted of patients with both type 1 and type 2 DM. Gill et al .…”

Section: Discussionmentioning

confidence: 97%

“…More advanced laboratory tests such as HbA 1c are frequently not affordable or available in rural parts of SSA, but measurement of random blood glucose (RBG) is usually feasible (Otieno et al . ). HbA 1c and RBG have a well‐known good correlation among patients with DM but differ between Caucasians and people of African origin (Bleyer et al .…”

Section: Introductionmentioning

confidence: 97%

“…; Otieno et al . ). However, to the best of our knowledge, no studies have investigated the diagnostic accuracy of RBG on good glycaemic control (HbA 1c <7.0% [53 mmol/mol]).…”

Section: Introductionmentioning

confidence: 97%

“…In the Western world, longterm glycaemic control is monitored among patients with DM by measuring glycosylated haemoglobin (HbA 1c ) repeatedly (International Diabetes Federation Guideline Development Group 2014). More advanced laboratory tests such as HbA 1c are frequently not affordable or avail-able in rural parts of SSA, but measurement of random blood glucose (RBG) is usually feasible (Otieno et al 2002). HbA 1c and RBG have a well-known good correlation among patients with DM but differ between Caucasians and people of African origin (Bleyer et al 2009).…”

Section: Introductionmentioning

confidence: 99%

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Random blood glucose may be used to assess long‐term glycaemic control among patients with type 2 diabetes mellitus in a rural African clinical setting

Rasmussen

Nordin

Rasmussen

et al. 2014

Tropical Med Int Health

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Abstractobjectives To investigate the diagnostic accuracy of random blood glucose (RBG) on good glycaemic control among patients with diabetes mellitus (DM) in a rural African setting.methods Cross-sectional study at St. Francis' Hospital in eastern Zambia. RBG and HbA 1c were measured during one clinical review only. Other information obtained was age, sex, body mass index, waist circumference, blood pressure, urine albumin-creatinine ratio, duration since diagnosis and medication.results One hundred and one patients with DM (type 1 DM = 23, type 2 DM = 78) were included. Spearman's rank correlation coefficient revealed a significant correlation between RBG and HbA 1c among the patients with type 2 DM (r = 0.73, P < 0.001) but not patients with type 1 DM (r = 0.17, P = 0.44). Furthermore, in a multivariate linear regression model (R 2 = 0.71) RBG (per mmol/l increment) (B = 0.28, 95% CI:0.24-0.32, P < 0.001) was significantly associated with HbA 1c among the patients with type 2 DM. Based on ROC analysis (AUC = 0.80, SE = 0.05), RBG ≤7.5 mmol/l was determined as the optimal cut-off value for good glycaemic control (HbA 1c <7.0% [53 mmol/mol]) among patients with type 2 DM (sensitivity = 76.7%; specificity = 70.8%; positive predictive value = 62.2%; negative predictive value = 82.9%).conclusions Random blood glucose could possibly be used to assess glycaemic control among patients with type 2 DM in rural settings of sub-Saharan Africa.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

“…; Otieno et al . ). However, to the best of our knowledge, no studies have investigated the diagnostic accuracy of RBG on good glycaemic control (HbA 1c <7.0% [53 mmol/mol]).…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Random blood glucose may be used to assess long‐term glycaemic control among patients with type 2 diabetes mellitus in a rural African clinical setting

Rasmussen

Nordin

Rasmussen

et al. 2014

Tropical Med Int Health

View full text Add to dashboard Cite

show abstract

“…The random blood glucose would likely have a large withinperson variation owing to the different consumption of foods, energy expenditure, and missing medications, and does not adequately portray diabetes control, especially in poorly controlled individuals. 2,3 Although the glycosylated hemoglobin is more robust and reflects glycemic control over the past 2 to 3 months, 4 the measure was obtained in a nonstandardized way (from the hospital laboratory or patient's physician) as and when ever possible, and it is not clear how many participants were excluded because of missing values, which may again have biased the results. Also, the participants were divided into arbitrary groups based on HbA1c levels, and the choice of cutoffs was not justified.…”

Section: Commentary and Analysismentioning

confidence: 99%

Glycemic Control is not Related to Postextraction Healing in Patients with Diabetes

Joshipura

2011

Journal of Evidence Based Dental Practice

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HbA1c performs well in monitoring glucose control even in populations with high prevalence of medical conditions that may alter its reliability: the OPTIMAL observational multicenter study

Niwaha

Rodgers

Greiner

et al. 2021

BMJ Open Diab Res Care

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IntroductionThe utility of HbA1c (glycosylated hemoglobin) to estimate glycemic control in populations of African and other low-resource countries has been questioned because of high prevalence of other medical conditions that may affect its reliability. Using continuous glucose monitoring (CGM), we aimed to determine the comparative performance of HbA1c, fasting plasma glucose (FPG) (within 5 hours of a meal) and random non-fasting glucose (RPG) in assessing glycemic burden.Research design and methodsWe assessed the performance of HbA1c, FPG and RPG in comparison to CGM mean glucose in 192 Ugandan participants with type 2 diabetes. Analysis was undertaken in all participants, and in subgroups with and without medical conditions reported to affect HbA1c reliability. We then assessed the performance of FPG and RPG, and optimal thresholds, in comparison to HbA1c in participants without medical conditions thought to alter HbA1c reliability.Results32.8% (63/192) of participants had medical conditions that may affect HbA1c reliability: anemia 9.4% (18/192), sickle cell trait and/or hemoglobin C (HbC) 22.4% (43/192), or renal impairment 6.3% (12/192). Despite high prevalence of medical conditions thought to affect HbA1c reliability, HbA1c had the strongest correlation with CGM measured glucose in day-to-day living (0.88, 95% CI 0.84 to 0.91), followed by FPG (0.82, 95% CI 0.76 to 0.86) and RPG (0.76, 95% CI 0.69 to 0.81). Among participants without conditions thought to affect HbA1c reliability, FPG and RPG had a similar diagnostic performance in identifying poor glycemic control defined by a range of HbA1c thresholds. FPG of ≥7.1 mmol/L and RPG of ≥10.5 mmol/L correctly identified 78.2% and 78.8%, respectively, of patients with an HbA1c of ≥7.0%.ConclusionsHbA1c is the optimal test for monitoring glucose control even in low-income and middle-income countries where medical conditions that may alter its reliability are prevalent; FPG and RPG are valuable alternatives where HbA1c is not available.

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Validity of random blood glucose as a predictor of the quality of glycaemic control by glycated haemoglobin in out-patient diabetic patients at Kenyatta National Hospital

Cited by 10 publications

References 0 publications

Random blood glucose may be used to assess long‐term glycaemic control among patients with type 2 diabetes mellitus in a rural African clinical setting

Random blood glucose may be used to assess long‐term glycaemic control among patients with type 2 diabetes mellitus in a rural African clinical setting

Glycemic Control is not Related to Postextraction Healing in Patients with Diabetes

HbA1c performs well in monitoring glucose control even in populations with high prevalence of medical conditions that may alter its reliability: the OPTIMAL observational multicenter study

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