Evaluation of HbA1c Level in Pre-Diabetics in Prognosis of Diabetes Involvement and Retinopathy

Pre-diabetes is a level before diabetes involvement. Pre-diabetes is prevalent, and if the blood glucose parameters of pre-diabetic patients do not reduce, patients will be involved with type 2 diabetes. In this study, we aimed to investigate the value of hemoglobin A1c (HbA1c) level for predicting diabetes and retinopathy involvement in pre-diabetics.

This prospective study was performed on pre-diabetics referred to the endocrinology clinic of Loghman Hakim Hospital (Tehran-Iran) from 2020-20211. The patients were assessed on age, sex, familial history of diabetes, systolic and diastolic blood pressure, and laboratory studies, including fasting blood sugar (FBS), oral glucose tolerance test (OGTT), HbA1c, lipid profile, aspartate aminotransferase (AST), and alanine transaminase (ALT). All participants underwent ocular examination by an expert ophthalmologist for retinopathy assessment. After one year, all participants were again assessed for all mentioned factors.

Pre-diabetics are five-fold more likely to be involved with diabetes after one year than patients with normal HbA1c. We found that patients with pre-diabetes HbA1c are 7.94 fold more at risk of retinopathy involvement than pre-diabetic patients with normal HbA1c (all p-values<0.05).

A high level of HbA1c in pre-diabetics increases the risks of retinopathy and diabetes involvement.