EFFECT OF IRON DEFICIENCY ANEMIA ON HbA1c IN DIABETIC, PRE-DIABETIC AND NONDIABETIC PATIENTS- IS THERE A DIFFERENCE??

Abstract

Background and objectives: HbA1c is routinely used to follow up blood sugar levels and is a useful index of chronic hyperglycaemia. Besides blood sugar, several factors like hemoglobinopathies, nutritional deficiencies etc. affect HbA1c levels.Present study was conducted to study the effect of IDA on HbA1c levels in Indian diabetic,pre-diabetic and non-diabetic adults. Materials & Methods: This is a retrospective cross section study consisting of 1657 patients over a period of 3 months.The diabetic group,prediabetic and normal control groups comprised of 251 ,373 and 1023 patients respectively . Results: The mean HbA1c levels were significantly lower in IDA diabetic group as compared to non-IDA diabetic group.In the prediabetic group the HbA1c levels were higher in IDA group as compared to non-IDA group but the difference was not statistically significant. In the normal control group the mean HbA1c levels were significantly higher in IDA group as compared to non-IDA group.HbA1c did not show significant correlation with RBC indices or iron profile parameters. Interpretation & Conclusion: HbA1c levels are higher in IDA patients in pre diabetic and normal controls. On contrary HbA1c levels are lower when IDA coexists with diabetes.It is highly advisable to correct the IDA deficiency in all patients before diagnosing diabetes as well as correction of IDA once the diagnosis so that the HbA1c levels are actual depiction of glycaemic control.