STUDY ON THE ROLE OF HBA1C AS A PROGNOSTIC FACTOR IN TYPE 2 DIABETES PATIENTS WITH SEPSIS

Abstract

Background: Diabetes mellitus, particularly type 2, is associated with increased susceptibility to infections and poor outcomes in septic states due to impaired immune responses and organ dysfunction. HbA1c, reflecting long-term glycemic control, may offer prognostic insights in such patients. This study evaluates the utility of HbA1c as a predictor of mortality and hospital outcomes in type 2 diabetic patients admitted with sepsis.

Methods: This observational study was conducted at Madras Medical College and Rajiv Gandhi Government General Hospital over six months, including 100 type 2 diabetes mellitus patients with sepsis. Patients were evaluated using clinical examination and laboratory parameters, including HbA1c, CRP, blood glucose, APACHE II, and SOFA scores. Exclusion criteria included chronic kidney disease, type 1 diabetes, anemia, pregnancy, and immunosuppressive states. The primary outcome was 30-day mortality. Data analysis was performed using SPSS and Epi Info.

Results: The 30-day mortality rate was 29%. Mean HbA1c in non-survivors (10.55%) was significantly higher than in survivors (7.64%) (p < 0.001). Mortality was 93% in patients with HbA1c >9%. APACHE II, SOFA scores, CRP, leukocyte count, and vital parameters (heart rate, respiratory rate, temperature, and blood pressure) significantly correlated with mortality. Admission blood glucose, serum sodium, potassium, bicarbonate, bilirubin, and platelet count did not show significant correlation with mortality.

Conclusion: HbA1c is a significant independent predictor of mortality in type 2 diabetes patients with sepsis, comparable in efficacy to APACHE II and SOFA scores. Chronic glycemic control plays a critical role in sepsis outcomes. HbA1c can aid in early identification of high-risk patients, allowing for prompt intervention and improved prognostication.