Evaluation of Red Blood Cell Indices for Prediction of Glycemic Control in People Living with Type 2 Diabetes.

Abstract

Achieving target glycemic control in people living with diabetes lessens most of the diabetes-related complications and hemoglobin A1C is the gold standard test for assessing the long-term glycemic control. However, the expensive cost, and its limited access are problematic for routine use in developing countries, demanding an urgent alternative solution. Hence, this study aimed to assess the potential of red blood cell indices in predicting glycemic control among people living with type 2 diabetes at Dilla University Hospital. A cross-sectional study was conducted among 207 participants with type 2 diabetes. Red blood cell indices were compared between the poor and good glycemic control groups using the t-test. Performance of red cell indices in discriminating poor glycemic control was assessed using receiver operating characteristic analysis. The prevalence of poor glycemic control among the participants was 91.8%. Higher mean hemoglobin (p=0.002) and mean corpuscular hemoglobin (p=0.015) was found in the good glycemic control group. An inverse correlation was also observed between hemoglobin A1C and mean corpuscular hemoglobin (r=-0.158; P=0.023). The area under the curve to discriminate poor glycemic control from good was statistically significant for hemoglobin, hematocrit, and mean corpuscular hemoglobin. However, hemoglobin had the highest discrimination ability at a cutoff ≤14.8 g/dL; area under the curve was 0.738 (P=0.001), sensitivity, specificity, and positive predictive value were 68.95%, 82.35%, and 97.77%, respectively. This study revealed that hemoglobin can potentially be used to assess glycemic control among people with type 2 diabetes but the interpretation needs to be cautious.