Abstract
ObjectiveTo determine the correlation of glycated hemoglobin (HbA1c) with red cell width (RDW) and other analytic parameters of red blood cells (RBCs) in type II diabetic patients.DesignCross-sectional analytical study.Place and duration of the studyAl-Tibri Medical College and Hospital Karachi; from July 2017 to January 2018.Patients and methodsThis cross-sectional study was conducted on diagnosed type II diabetic patients visiting the outpatient department of medicine at Al-Tibri Medical College Hospital from July 2017 to January 2018. Diabetes mellitus was diagnosed according to American Diabetes Association (ADA) guidelines. After taking consent and conducting a clinical assessment (include history and physical examination), laboratory tests, such as fasting blood glucose, random blood glucose, complete blood count (CBC), and HbA1c, were collected on proforma.ResultsA total of 119 patients were eligible for the study with a mean age of 48.63±12.462 (range 24-76) years; among those, males were 74 (62.2%) and females were 45 (37.8%). The mean duration of diabetes mellitus (DM) was 6.735±3.759 (range 1-20) years. The mean hemoglobin of patients was 11.59±1.315 gm/dl. The mean corpuscular volume (MCV) was 76.65±11.121 fl and the mean RDW was found to be 18.287±4.352, with the highest value of 30.20. The mean MCH was 30.223±23.873 pg, with the highest value of 38.4 pg. The mean cell hemoglobin concentration (MCHC) was 28.214±4.7498 mg/dl.The HbA1c of the study population was found to be moderately uncontrolled and the mean HbA1c was 8.278±5.015%, with the highest value of 16.2%. The mean fasting blood sugar was 158±39.50 mg/dl while the mean random blood sugar was 236±57.390 mg/dl.The correlation of HbA1c with RDW turned out to be significant statistically (p-0.035) while other RBCs and/or hematological parameters, such as MCV, hemoglobin, and platelets, revealed no significant correlation.ConclusionThe study highlighted that RDW has a significant correlation with HbA1c and is an inexpensive and freely available test so it may be used as a marker of glycemic status.
Highlights
It is estimated that there are 382-million people living with diabetes, and the International Diabetes Federation has projected that 592-million people will have diabetes by 2035 [1]
The study highlighted that red cell width (RDW) has a significant correlation with HbA1c and is an inexpensive and freely available test so it may be used as a marker of glycemic status
Diabetes mellitus was diagnosed according to American Diabetic Association (ADA) guidelines: HbA1c ≥ 6.5% or fasting blood glucose (FBG) ≥ 126 mg/dl or two-hour plasma glucose ≥ 200 mg/dl during an oral glucose tolerance test (OGTT)
Summary
It is estimated that there are 382-million people living with diabetes, and the International Diabetes Federation has projected that 592-million people will have diabetes by 2035 [1]. Following a diagnosis of diabetes, management, regular follow-up with an assessment for complications, and blood sugar monitoring always remain a big challenge for any health care provider, especially in low socioeconomic countries. The cost-effectiveness of those measures or tools for the assessment of complications status and blood sugar monitoring is highly desirable and encouraged. In this regard, recently, glycated hemoglobin (HbA1c) was used as a tool for glycemic control but since 2010, it is accepted for the diagnosis of diabetes too [2]. HbA1c concentration is measured as an index of glycemic control for a period over eight to 12 weeks
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