Assessing Glycemic Control: Fasting / Postprandial, which one is better?

Glycaemic control is an important aspect in managing diabetes in order to prevent its complications .The study objectives were to compare the glycaemic control in patients monitored by fasting plasma glucose (FPG) and 2 hours postprandial glucose (PPG),determine the correlation between FPG and PPG with HbA1c and fructosamine and the factors associated with the control. FPG,HbA1c and fructosamine was drawn at 0 hour and PPG was drawn after 2 hours taking a standard breakfast. After 6 months,out of 82 patients (41 PPgroup, 39 FGgroup), 58.5% subjects in PP and 43.6% in FG were having good control of HbA1c. There was significant difference in mean glycaemic control (HbA1c and Fructosamine) between both groups(p=0.029, p=0.034).Both PPG and FPG significantly correlated with HbA1c and fructosamine but PPG showed better correlation to HbA1c than FPG (r= 0.604 vs.0.575).The sensitivity, specificity and PPV of PPG were 75%, 80.6% and 82.5% whereas FPG were 81.8%, 58.3% and 70.6% respectively. Factors associated with glycaemic control include age, number of OHA and without nephropathy.Thus, PPG predicted overall glycaemic control better than FPG.
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