[Glycosylated hemoglobin as a prognostic index of the appearance of vascular complications in diabetic patients].

One hundred and fourty seven diabetic patients of both sexes with ages between 40 and 65 (44% Type 1 and 56% Type II), were studied and followed for a period of five years in order to evaluate the possible association between blood glucose control and the appearance and progression of vascular complications. A clinical metabolic characterization was performed in all patients both at the beginning and at the end of the study. Process of the results after 5 years was carried out dividing the total study sample in two groups, A and B, according to the level of glycosylated hemoglobin (HbA1) at the beginning of the study (HbA1 less than 10% or greater than 10%). The most frequent vascular complications both at the beginning and at the end of the study were retinopathy, hypertension, and angina pectoris, outstanding the high incidence of retinopathy (83%) found at the end of the study in the group of patients who were considered poorly controlled given the initial HbA1 values. A subset of 111 patients who did not present retinopathy at the beginning of the study were particularly analyzed, demonstrating in these cases a significant association between HbA1 levels at the beginning of the study and the appearance of retinopathy five years later. Type II diabetics particularly showed a 3 fold risk of developing this complication if their initial HbA1 levels were equal to or higher than 10%. This finding gives HbA1 determination a predictive value for the development of retinopathy and highlights the influence of glycemic control on the appearance and progression of this complication in diabetic patients.