Abstract
BACKGROUND: Diabetes Mellitus (DM) has become a major health problem worldwide. American Diabetes Association has considered HbA 1 C levels ≤ 6.5 % as the prime target for glycemic control and as a diagnostic criterion for DM. Anemia is common in DM (8-66%).Studies on alteration of HbA 1 C in IDA have conflicting results. OBJECTIVES: To identify and compare the effect of IDA on HbA 1 C levels among controlled diabetics (Fasting plasma glucose (FPG) <126mg/dl since last 6 months) and non-diabetics and its variation according to the degree of anemia. METHODS: This cross-sectional study done in SRM Medical College Hospital and Research Centre, Chennai includes 150 Controlled diabetics (75 with IDA and 75 without IDA) and 150 non diabetics (75 with IDA and 75 without IDA). HbA 1 C, complete hemogram, iron profile and FPG were tested. Medical history was recorded. RESULTS: The mean HbA 1 C in controlled diabetics with and without IDA were 8.81±0.13 & 5.79±0.01 respectively (P<0.05) and in non-diabetics with and without IDA were 6.84±0.07 & 5.12±0.04 respectively (P<0.05). The difference between no, mild, moderate and severe anemia in both diabetics and non-diabetics was statistically significant (p< 0.05). Mean HbA 1 C% was highest in groups with severe anemia. CONCLUSION: IDA falsely elevates HbA 1 C level independent of blood glucose concentration in both controlled diabetics and non-diabetics. Hence prior to alteration of treatment regimen based on HbA 1 C for diabetes, IDA should be diagnosed and corrected. Concurrent evaluation for anemia is critical to correctly interpret glycemic status in Indian population with prevalent IDA. DOI: 10.21276/APALM.1276
Highlights
Diabetes has become a major health problem worldwide with an estimated 300 million people to be diagnosed with the disease in the 10 years and 370 million by 2030. [1] In 2010, American Diabetes Association (ADA) has considered HbA1C levels as the prime target for glycemic control and as a diagnostic criterion for Diabetes Mellitus (DM)
Prior to alteration of treatment regimen based on HbA1C for diabetes, IDA should be diagnosed and corrected
HbA1C ≥ 6.5% has been established for the diagnosis of DM for its high specificity and certified by the World Health Organization (WHO) in 2011.[1,2,3] Anemia is common among DM and its incidence ranges from 8-66%.[4]
Summary
Diabetes has become a major health problem worldwide with an estimated 300 million people to be diagnosed with the disease in the 10 years and 370 million by 2030. [1] In 2010, American Diabetes Association (ADA) has considered HbA1C levels as the prime target for glycemic control and as a diagnostic criterion for Diabetes Mellitus (DM). Diabetes has become a major health problem worldwide with an estimated 300 million people to be diagnosed with the disease in the 10 years and 370 million by 2030. [1] In 2010, American Diabetes Association (ADA) has considered HbA1C levels as the prime target for glycemic control and as a diagnostic criterion for Diabetes Mellitus (DM). It was believed that HbA1C was affected only by blood glucose levels.[4,5] certain study results have proven that HbA1C levels are altered by various other co-existing factors, along with DM, especially that of IDA which is a major public health problem in developing countries like India. Diabetes Mellitus (DM) has become a major health problem worldwide. American Diabetes Association has considered HbA1C levels ≤ 6.5 % as the prime target for glycemic control and as a diagnostic criterion for DM. Studies on alteration of HbA1C in IDA have conflicting results
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