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. 2014;18(2):88-93.
doi: 10.6091/ibj.1257.2014.

Influence of iron deficiency anemia on hemoglobin A1c levels in diabetic individuals with controlled plasma glucose levels

Alap L Christy  1 , Poornima A Manjrekar  1 , Ruby P Babu  1 , Anupama Hegde  1 , M S Rukmini  1
Affiliations

Influence of iron deficiency anemia on hemoglobin A1c levels in diabetic individuals with controlled plasma glucose levels

Alap L Christy et al. Iran Biomed J. 2014.

Abstract

Introduction: Hemoglobin A1C (HbA1c) reflects patient's glycemic status over the previous 3 months. Previous studies have reported that iron deficiency may elevate A1C concentrations, independent of glycemia. This study is aimed to analyze the effect of iron deficiency anemia on HbA1c levels in diabetic population having plasma glucose levels in control.

Methods: Totally, 120 diabetic, iron-deficient anemic individuals (70 females and 50 males) having controlled plasma glucose levels with same number of iron-sufficient non-anemic individuals were streamlined for the study. Their data of HbA1c (Bio-Rad D-10 HPLC analyzer), ferritin (cobas e411 ECLIA hormone analyzer), fasting plasma glucose (FPG, Roche Hitachi P800/917 chemistry analyzer), hemoglobin (Beckman Coulter LH780), peripheral smear examination, red cell indices, and medical history were recorded. Statistical analysis was carried out by student's t-test, Chi-square test, and Pearson's coefficient of regression.

Results: We found elevated HbA1c (6.8 ± 1.4%) in iron-deficient individuals as compared to controls, and elevation was more in women (7.02 ± 1.58%). On further classification on the basis of FPG levels, A1C was elevated more in group having fasting glucose levels between 100-126 mg/dl (7.33 ± 1.55%) compared to the those with normal plasma glucose levels (<100 mg/dl). No significant correlation was found between HbA1c and ferritin and hemoglobin.

Conclusion: This study found a positive correlation between iron deficiency anemia and increased A1C levels, especially in the controlled diabetic women and individuals having FPG between 100-126 mg/dl. Hence, before altering the treatment regimen for diabetic patient, presence of iron deficiency anemia should be considered.

Keywords: Iron deficiency anemia; Hemoglobin A1C; Diabetes.

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Figures

Fig. 1
Fig. 1
Selection of cases and controls
Fig. 2
Fig. 2
Distribution of HbA1c (%) genderwise in subjects with iron deficiency anemia and no anemia
Fig. 3
Fig. 3
HbA1c levels in patients having fasting plasma glucose (FPG) below 100 and between 100-126
See this image and copyright information in PMC

References

    1. John A. Iron Deficiency and Other Hypoproliferative Anemias. In: Longo D, Fauci A, Kasper D, Hauser S, Jameson J, Loscalzo J, editors , editors. Principles of Internal Medicine by Harrisons. 17th ed. United States of America: McGraw-Hill; 2008. pp. 628–35.
    1. Brooks AP, Metcalfe J, Day JL, Edwards MS. Iron deficiency and glycosylated haemoglobin A1. Lancet. 1980 Jul;316(8186) - PubMed
    1. Kim C, Bullard KM, Herman WH, Beckles GL. Association between iron deficiency and A1C levels among adults without diabetes in the National Health and Nutrition Examination Survey, 1999–2006. Diabetes Care. 2010 Apr;33 - PMC - PubMed
    1. Standards of Medical Care in Diabetes—2011. Diabetes Care. 2011;34(1):S13. - PMC - PubMed
    1. Sinha N, Mishra TK, Sinha T, Gupta N. Effect of iron deficiency anemia on hemoglobin A1c levels. Ann Lab Med. 2012 Jan;32(1):17–22. - PMC - PubMed

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