Incidence and Association of Glycated Hemoglobin Levels with Iron Deficiency Anemia in Patients with or without Diabetes – A Study in a Semi Urban Area

Abstract

Introduction: HbA1c and other hemoglobins constitute the HbA1 fraction of the adult HbA3. HbA1c is also affected by pregnancy5,6, uremia7, hemolytic anemia8, hemoglobinopathies9, acute and chronic blodd loss10,11, Vitamin B12, folate deficiencies. Iron deficiency anemia is also shown to have a considerable effect on HbA1c levels12. Studies have shown that reduced iron levels are correlated with increased levels of HbA1c leading to false high levels of HbA1c in individuals. Materials and Methods: 1000 patients each with and without diabetes were included into the study. Hemoglobin levels, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MHCH), mean corpuscular volume (MCV), hematocrit, platelet count, total blood picture, differential leucocyte count was done for all samples. Samples from patients with IDA were tested for all the above parameters at base line, after 1 week, 1 month and 2 months following iron treatment. Type of anemia was categorized and mild moderate and severe based on hemoglobin levels. Results: Preponderance of females were seen in the anemic cases over males. 11.1% of non-diabetic and 16.3% of the diabetic patietns were anemic. The prevalence of low hemoglobin and low iron content was seen in 2.8% of the cases among non-diabetics while low Hb and normal iron levels were seen among 4.6% of the cases. Normal Hb with iron deficiency were seen among 3.7% of the cases while among the diabetics it was 2.1%, 7.3% and 6.9% respectively. Mean hemoglobin levels of all the severe anemic patients at base line was 5.9 ± 1.2, 9.1 ± 0.9 after 1 month and 10.6 ± 1.5 after 2 months of treatment. Conclusion: There is a significant association of HbA1c levels and Iron Deficiency Anemia according to our study, though more studies need to be conducted to assess a proper clinical diagnosis. Keywords: Iron Deficiency anemia, HbA1c, glycated hemoglobin, diabetic patients, non-diabetic patients