الفهرس 
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Abstract
The association between poor glycaemic control and microvascular complications was confirmed in the prospective diabetes control and complications trial and (DCCT), which demonstrated that intensive therapy aimed at lower levels of glycaemia results in decreased rates of retinopathy, nephropathy and neuropathy in diabetic patients.
Diabetes is the most common cause of new patients requiring renal replacement therapy, accounting for 45% of cases in the United States.
Hyperglycemia is an important risk factor for the development of microvascular disease in patients with type 2 diabetes, as it is in patients with type 1 diabetes. This has been shown in several observational studies.
HbA1c is a form of haemoglobin that is formed in a non-enzymatic glycation pathway by haemoglobin exposure to plasma glucose. Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way.
HbA1c reflects average plasma glucose over the previous 8 to 12 weeks, it can be performed at any time of the day and does not require any special preparation such as fasting. These properties have made it the preferred test for assessing glycaemic control in people with diabetes.
The HbA1c levels are also theoretically suppressed by the resulting anemia associated with the shorter life span of erythrocytes. This factor establishes the argument that HbA1c underestimates glycaemic control in haemodialysis patients and that HbA1c is not a reliable test. Therefore, one should not use HbA1c as a guideline in patients with diabetes and renal disease who are on dialysis.