STATUS OF HbA1c;

Iron deficient diabetic and non diabetic patients.

Abstract

Background: Glycated hemoglobin [HbA1c] is a marker to identify the average plasma glucose level over past three
months but it is also influenced by the iron deficiency status of an individual. Objective: Research is designed to assess the relationship
between HbA1c concentration and iron status among diabetic and non diabetic subjects. Design: Cross sectional comparative study.
Setting: Tertiary Care Unit of Karachi, Pakistan. Period: Dec 2010 till June 2011. Material and methods: A total of 75 subjects of both
sexes were taken and divided into three groups. Fasting and random glucose levels, serum iron and TIBC were performed by enzymatic
method while HbA1c was estimated by fast iron resin separation method and Complete blood count (CBC ) was done by Coulter.
Statistical analysis: The data feeding and analysis was on computer package SPSS (Statistical Packages of Social Sciences) version
16.0. the results were given in the mean and Standard Deviation (SD) and correlation ( r ) for quantitative data i.e. age, FBS, RBS, HbA1c,
Serum Iron , Hb HCT, and TIBC. Using Analysis of Variance (ANOVA) with tukey test for comparison (Controls, Iron deficiency anemia with
and without diabetes mellitus). In all statistical analysis only p < 0.01 will be considered significant. Results: HbA1c is a non-specific
marker of Diabetes mellitus in iron deficieny anemia patients. Thus it is reccomended that iron status of diabetic patients must be
considered while interpreting results. This study showed significantly raised levels of Fasting blood glucose (FBS), random blood glucose
(RBS) and HbA1c in diabetic anemic patients when compared to control and nondiabetic anemic subjects (p < 0.01) while total iron
binding capacity (TIBC) and HbA1c in nondiabetic anemic subjects were also significantly raised when compared to control (p < 0.01).
Hemoglobin (Hb) , Hematocrit (HCT) and Serum Iron levels were significantly decreased in diabetic and nondiabetic anemic subjects
when compared to control (p < 0.01). Conclusions: Our study depicted that while diagnosing Diabetes mellitus in iron deficient patients
one should be carefull as HbA1c is not a very reliable parameter to assess glycemic control in iron deficiency anemia patients.