A study of influence of iron deficiency anemia on levels of hba1c among non-diabetic patients in a tertiary care hospital

Abstract

Aim and Objectives: Glycated haemoglobin, HbA1c is the “gold standard� for monitoring glycemic control. Worldwide, 50% of anemia is attributed to iron deficiency. Several studies have shown an association between iron deficiency anaemia and higher HbA1c levels, but the results are conflicting, and the matter is under debate. To shed additional light on this, in the present study we aimed to analyse the effect of iron deficiency anemia (IDA) on HbA1c levels in nondiabetic adults. Material and Methods: In this descriptive study conducted from 1st December 2018 to 30th November 2019, laboratory data of 30 cases with anemia, normal fasting and postprandial plasma glucose levels and normal HbA1c and 30 healthy controls were analysed. The results were statistically analysed. Results: Mean Hb among cases was 9.27 ± 2.32 (3.6 gm/dL to 11.7 gm/dL) and that among controls was 13.79 ±1.35 (12 gm/dL to 16.4 gm/dL). The total mean FBG and PPBG were 96.17 ± 3.19 and 10 ± 8.63 respectively. The mean HbA1c was 6.5 ± 0.6 g%. The mean HbA1c for cases with Iron Deficiency Anemia was more than that for healthy controls (5.63 ± 0.07 and 5.37 ± 0.07 respectively) with p-value 0.0001. The mean iron for cases and controls were 30 and 58 respectively with p-value 0.0001. The mean MCV, MCH and MCHC was 84.33 ± 0.97, 27.29 ± 0.97 and 32.2 ± 0.27 respectively (p-value-0.0030,0.0000, 0.0000). Conclusion: HbA1c is not affected by the blood sugar levels alone. There are certain confounding factors when HbA1c is measured, especially that of iron deficiency. Our study concludes that iron deficiency was associated with higher proportions of HbA1c, which could cause problems in the diagnostic and therapeutic interpretation of the HbA1c concentrations. Hence, the iron status must be considered during the interpretation of the HbA1c.