Abstract
Background: Glycated hemoglobin (HbA1c) is a pivotal marker in the diagnosis, prognosis, and therapeutic monitoring of diabetes mellitus. Given the involvement of hemoglobin in non-enzymatic glycation reactions, it is hypothesized that total hemoglobin concentration might impact HbA1c levels alongside blood glucose concentrations. Objectives: This study aimed to estimate and compare plasma fasting glucose level and total hemoglobin level in type 2 diabetes mellitus (T2DM) patients with and without anemia. The study also aimed to estimate HbA1C and compare with calculated HbA1C using formula in T2DM patients with and without anemia and to correlate between total hemoglobin levels with directly measured HbA1c in T2DM patients with and without anemia. Methodology: This cross-sectional study, employing purposive sampling, investigated 30 anemic and 30 non-anemic Type 2 Diabetes Mellitus (T2DM) patients at the Central Diagnostic Laboratory. Total Hemoglobin, HbA1C, and Fasting Plasma Glucose were measured for the patients and the data was analyzed. Results: Independent 't' tests revealed significant differences (p < 0.0001) in estimated HbA1c, fasting blood sugar, calculated HbA1c, and Hb levels between the two groups. Subgroup analyses exhibited significant differences in estimated HbA1c for both groups individually (p = 0.003 for T2DM without anemia and p<0.0001 for T2DM with anemia). Pearson's correlation analysis indicated no significant correlation between HbA1c and hemoglobin in either subgroup. Similarly linear regression analysis treating HbA1c as the dependent variable yielded a non-significant p-value, suggesting that hemoglobin levels do not significantly influence HbA1c. Conclusion: In conclusion, regardless of anemia status, our findings suggest that hemoglobin is not a significant predictor of HbA1c levels in T2DM patients, offering valuable insights into factors influencing HbA1c variability in diabetic populations.
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