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International Journal of Endocrinology
Volume 2016, Article ID 8390210, 7 pages
http://dx.doi.org/10.1155/2016/8390210
Research Article

Glycated Hemoglobin Levels in Patients with Decompensated Cirrhosis

1Division of Gastroenterology and Hepatology, University of Tennessee Health Sciences Center, Memphis, TN, USA
2Methodist Transplant Institute, Division of Surgery, University of Tennessee Health Sciences Center, Memphis, TN, USA

Received 20 April 2016; Revised 27 July 2016; Accepted 18 September 2016

Academic Editor: Dario Iafusco

Copyright © 2016 Jeffrey Nadelson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Aim of this study is to determine if HbA1c levels are a reliable predictor of glycemic control in patients with decompensated cirrhosis. Methods. 200 unique patients referred for liver transplantation at University of Tennessee/Methodist University Transplant Institute with a HbA1c result were included. Three glucose levels prior to the “measured” A1c (MA1c) were input into an HbA1c calculator from the American Diabetes Association website to determine the “calculated” A1c (CA1c). The differences between MA1c and CA1c levels were computed. Patients were divided into three groups: group A, difference of <0.5; group B, 0.51–1.5; and group C, >1.5. Results. 97 (49%) patients had hemoglobin A1c of less than 5%. Discordance between calculated and measured HbA1c of >0.5% was seen in 47% (). Higher level of discordance of greater than >1.5 was in 12% of patients (). Hemoglobin was an independent predictor for higher discordance (odds ratio 0.77 95%, CI 0.60–0.99, and value 0.04). HbA1c was an independent predictor of occurrence of HCC (OR 2.69 955, CI 1.38–5.43, and value 0.008). Conclusion. HbA1c is not a reliable predictor of glycemic control in patients with decompensated cirrhosis, especially in those with severe anemia.