Infectious diseases including Dengue illness remains the commonest cause of hospitalization in Indian settings. It is a significant global public health problem, with 2.5 billion world's population at risk and an estimated 50 to 390 million annual infections. Clinically, dengue illness manifestation varies from asymptomatic state to severe symptomatic disease. Symptomatic disease events in turn range from self-limiting dengue fever (DF) to severe dengue. Severe dengue, manifests as; dengue hemorrhagic fever (DHF), hypovolemic shock-dengue shock syndrome (DSS) or severe organ impairment. Thrombocytopenia is a common element to both dengue fever and severe dengue; and clinicians, unfortunately, tend to 'react' to thrombocytopenia with platelet transfusions at predetermined platelet thresholds. Readily available lab parameters to guide the clinician of impending platelet recovery is needed, one such parameter gaining recent interest is Platelet Indices (PIs): mean platelet volume (MPV) and platelet distribution width (PDW). Serially observing mean platelet volume along with Platelets might be valuable, with a rising trend in MPV suggesting platelet and patient recovery.
Background: Iron deficiency anemia remains a common condition in India and Hemoglobin A1c (HbA1c) is commonly being used in diabetic individuals both as a parameter of glycemic control over previous three months and as a diagnostic tool. HbA1c levels have been reported to be altered by the presence of nutritional anemias, hemolytic anemia and variant hemoglobin (Hb) among others. Interestingly, iron deficiency anemia effect on HbA1c levels were not found in many studies. Hence a study is conducted to observe the effects if any in routine clinical practice scenario of mild to moderate anemia on HbA1c.
Methods: sixty Type 2 Diabetic (T2D) patients HbA1c was analyzed with their Fasting Blood Sugar (FBS), Post Lunch Blood Sugar (PLBS), along with Hemoglobin levels. T2D patients coming for routine follow-up were studied after their consent, with ethical committee clearance. All the parameters were found to have a normal distribution, i.e., they had an acceptable level of skewness — 0.5 to -0.5 -- were then analyzed further with statistical tools viz., Pearson’s correlate and linear regression.
Results: The mean HbA1c was found to be 8.9. Further, the mean Hemoglobin (Hb), FBS and PLBS were: 12.29, 157.9 and 229 respectively. The Pearson’s correlate and linear regression analysis was done. HbA1c correlated well with FBS and PLBS, one tailed significance p value being <0.01 for both FBS and PLBS; but was not found to correlate with Hb: p value 0.146 (not significant).
Conclusions : In the present study representing field scenario, the HbA1c was not correlated with mild anemia but was significantly correlated with FBS and PLBS. Hence in a routine clinical practice scenario the presence of mild anemia didn’t appear to interfere with the HbA1c levels.
Keywords: Diabetes mellitus, HbA1c, Fasting Blood Sugar, Hemoglobin, Nutritional Anemia, Regression analysis
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