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

Abstract Background Evidence suggest a potential relationship between high or variable HbA 1 C 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. Aim To 1) explore potential association between microalbuminuria and high HbA 1 C levels in Melanesian adults with diabetes mellitus, and 2) asses predictive value of a high HbA 1 C reading as an indicator of the presence or progression of microalbuminuria. Method A 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. Result A significant [P=0.0221], though weak [R 2 =0.028 <0.70], correlation between UACR and HbA 1 C [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. Conclusion A significant [p=0.022], though weak, correlation between UACR and HbA 1 C levels was observed, which may support usefulness of HbA 1 C 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.