Abstract
BACKGROUND : Glycated hemoglobin (HbA 1 C) is used as a gold standard for monitoring glycemic control. American Diabetes Association (ADA) has certified HbA 1 C ≥ 6.5% as a diagnostic criterion for diabetes mellitus (DM). Recent studies suggest that conditions affecting erythrocyte turnover like Iron deficiency anemia (IDA) alters HbA 1 C levels but their results are conflicting. However the effect of IDA on HbA 1 C is rarely reported. To determine the impact of IDA on HbA 1 C levels among controlled diabetics [Fasting plasma glucose (FPG) <126mg/dl since last 6 months] independent of blood glucose concentration and its variation according to the degree of anemia. METHODS: This cross-sectional study carried out in SRM Medical College Hospital and Research Centre, Chennai includes totally 300 controlled diabetic patients –Type 2 DM (150 with IDA and 150 without IDA). Medical history recorded. HbA 1 C, complete hemogram and FPG were tested. RESULT: The mean HbA 1 C among controlled diabetics with IDA (7.86 ± 0.11%) was significantly higher than those without IDA (5.45 ± 0.038%) (P<0.05). HbA 1 C results were higher with the reduction of total hemoglobin (p< 0.05) CONCLUSION: IDA spuriously elevates HbA1C levels independent of blood glucose concentration in controlled-diabetics.HbA 1 C increases significantly as severity of anemia worsens. Thereby this study insists on the utter importance to exclude IDA and to correct it before any diagnostic or therapeutic decision is made based solely on HbA 1 C level.
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