Effect of Iron Deficiency Anemia on HbA1c Levels Among Diabetic and Nondiabetic Patients

Abstract

Background and Aims: Hemoglobin A1c (HbA1c) is widely used for assessment of glycemic status and diagnosis of diabetes. HbA1c levels are influenced by age, ethnicity, and conditions that alter the red cell turnover or survival. We aimed to assess the effect of iron deficiency anemia (IDA) on HbA1c levels among adult diabetic and nondiabetic patients and correlate HbA1c with iron profile. Materials and Methods: A cross-sectional study was carried out among 150 patients, of whom 50 were diagnosed diabetics with IDA, 50 were nondiabetics with IDA, and 50 were controls. They were investigated for hemogram, renal function test, HbA1c, and iron profile. Results: Mean HbA1c value among controls was 5.03 ± 0.34%, among diabetics with IDA was 8.69 ± 0.92%, and among nondiabetics with IDA was 5.87 ± 0.76% and this difference was statistically significant. Total iron binding capacity (TIBC) was 332.54 ± 58.32 µg/dL among controls, 420.63 ± 119.03 µg/dL among nondiabetics with IDA, and 495.88 ± 126.79 µg/dL among diabetics with IDA. Pearson’s correlation coefficient of HbA1c with serum ferritin was -0.444, with serum iron was -0.357, and with TIBC was 0.476. Conclusion: HbA1c levels are elevated in diabetes with IDA. HBA1c is negatively correlated with serum iron and ferritin and positively correlated with TIBC.