Abstract

Background: Evidence suggests a potential relationship between high or variable HbA1C 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 Explore potential association between microalbuminuria and high HbA1C levels in Melanesian adults with diabetes mellitus, and • Assess predictive value of a high HbA1C level as an indicator for 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 was conducted at a provincial hospital in Papua New Guinea in 2017. Result: A significant correlation between UACR and HbA1C (p-value = 0.056, 95% CI 0.02 - 1.98), and UACR and duration of diabetes (p-value = 0.010, 95% CI 0.19 - 1.40) was observed in a multivariate regression model. Conclusion: A significant correlation between UACR and HbA1C level was observed, which supports usefulness of HbA1C as a clinical indicator for onset or progression of microalbuminuria and subclinical diabetic kidney disease. In settings without microalbuminuria testing, high HbA1C levels can serve as a proxy to presence or progression of microalbuminuria, prompting timely interventions to prevent progression of diabetic nephropathy.