ASSOCIATION BETWEEN HbA1c AND RENAL FUNCTION IMPAIRMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A CROSS-SECTIONAL STUDY

Abstract

Introduction: Type 2 Diabetes Mellitus (T2DM) represents a profound global public health crisis, with a disproportionately high burden in South Asia, including Pakistan. Glycated hemoglobin (HbA1c) is the cornerstone for assessing long-term glycemic control, while renal function tests (RFTs), including serum creatinine and urea, are fundamental for detecting kidney impairment. This study aimed to evaluate the correlation between HbA1c and RFT in a cohort of T2DM patients in Peshawar, Pakistan.

Methodology: A hospital-based, descriptive cross-sectional study was conducted from June to November 2024 at the Endocrinology Ward of Hayatabad Medical Complex, Peshawar. A total of 290 participants (145 T2DM patients and 145 age-matched non-diabetic controls) were enrolled via non-probability convenience sampling. Fasting venous blood samples were analyzed for HbA1c, serum creatinine, and serum urea using a Cobas c503 automated chemistry analyzer. Statistical analysis was performed using SPSS, employing independent samples t-tests and descriptive statistics.

Results: The study population had a mean age of 49.73 ± 10.12 years. Gender distribution was comparable. The mean HbA1c level was significantly elevated in the diabetic group (9.44% ± 2.43) compared to controls (4.43% ± 0.54), with a p-value of <0.001. Renal function markers were also significantly higher in diabetics: serum creatinine (0.91 ± 0.32 mg/dL vs. 0.73 ± 0.19 mg/dL, p=0.001) and serum urea (32.07 ± 18.82 mg/dL vs. 26.44 ± 8.09 mg/dL, p<0.001). The standard deviations for urea were notably larger in the diabetic group, indicating greater variability.

Conclusion: This study confirms a strong and significant association between poor glycemic control, as indicated by elevated HbA1c, and impaired renal function in T2DM patients in Peshawar. The findings underscore the critical need for stringent glycemic management and regular, integrated monitoring of both metabolic and renal parameters to prevent or delay the onset of diabetic nephropathy in this high-risk population.