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Assessment of the differences of hematological variables and their correlation with glycemic control among type 2 diabetes mellitus patients in Iraq: Comparative cross-sectional study

Year 2024, Volume: 11 Issue: 3, 435 - 444, 29.08.2024
https://doi.org/10.21448/ijsm.1332875

Abstract

This research aimed to assess the hematological traits of male adults diagnosed with diabetes and investigate the relationship between blood sugar levels with hematological factors among patients. A cross-sectional comparison study was conducted at Fallujah Teaching Hospital from April 1 to July 30, 2023. The research comprised 185 volunteers, including 125 individuals with type 2 diabetes mellitus (65 with well blood sugar levels and 60 with poorly-regulated blood sugar levels) and 60 healthy individuals serving as controls. The evaluation of hematological parameters was conducted using Swelab-Alfa. An independent T-test was used for assessment. The patients exhibited substantially decreased mean absolute lymphocyte count, Hct, MCHC, and PLT values compared to the control group. The diabetic group had significantly higher mean values for total neutrophil count, absolute basophil counts, RDWSD, RDWCV, PDW, PLCR, and MPV than the control group. Patients with poor glycemic control had substantially elevated levels of Mon, Eos, Bas, MCHC, PLT, MPV, PLCR, and PCT. In contrast, individuals with poor glycemic control had substantially lower levels of Neu, RBC count, and PDW. The findings demonstrated a statistically significant positive connection between neutrophil count, MCV, MCH, MCHC, PDW, MPV, PLCR, and PCT with FBG. Lym, RBC count, and Hct exhibited a statistically significant inverse connection with FBG in individuals with type 2 diabetes mellitus (T2DM). This research demonstrated a notable impact of diabetes mellitus, poor glycemic control, and fasting blood glucose levels on some hematological markers.

References

  • Adane, T., Asrie, F., Getaneh, Z., & Getawa, S. (2021). White blood cells and platelet profiles of diabetic patients at University of Gondar specialized referral hospital: A comparative cross‐sectional study. Journal of clinical laboratory Analysis, 35(6), e23808. https://doi.org/10.1002/jcla.23808
  • Agu, K.C. (2018). Diabetes mellitus: A review of some of the prognostic markers of response to treatment and management. Journal of Insulin Resistance, 3(1), 1 10. https://doi.org/10.4102/jir.v3i1.36
  • Alam, J., Mallik, S.K., Hasan, M.J., Choudhury, S., & Sikder, H. (2015). A Comparative Analysis of Biochemical and Hematological Parameters in Diabetic and Non-Diabetic Adults. Advanced Medical Sciences: An International Journal, 2(1), 1–9.
  • Alhadas, K.R., Santos, S.N., Freitas, M.M.S., Viana, S.M.S., Ribeiro, L.C., & Costa, M.B. (2016). Are platelet indices useful in the evaluation of type 2 diabetic patients?. Jornal Brasileiro de Patologia e Medicina Laboratorial, 52, 96-102. https://doi.org/10.5935/1676-2444.20160017
  • American Diabetes Association (2019). 6. Glycemic targets: standards of medical care in diabetes-2019. Diabetes Care, 42(suppl.1), 61–70.
  • American Diabetes Association (2014). Diagnosis and classification of diabetes mellitus. Diabetes care, 37(Supplement_1), S81-S90. https://doi.org/10.2337/dc19-S006
  • Antwi-Baffour, S., Kyeremeh, R., Boateng, S.O., Annison, L., & Seidu, M.A. (2018). Haematological parameters and lipid profile abnormalities among patients with Type-2 diabetes mellitus in Ghana. Lipids in Health and Disease, 17(1), 1 9. https://doi.org/10.1186/s12944-018-0926-y
  • Arkew, M., Asmerom, H., Tesfa, T., Tsegaye, S., Gemechu, K., Bete, T., & Haile, K. (2022). Red blood cell parameters and their correlation with glycemic control among type 2 diabetic adult patients in Eastern Ethiopia: a comparative cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 15, 3499 3507. https://doi.org/10.2147/DMSO.S386093
  • Arkew, M., Yemane, T., Mengistu, Y., Gemechu, K., & Tesfaye, G. (2021). Hematological parameters of type 2 diabetic adult patients at Debre Berhan Referral Hospital, Northeast Ethiopia: A comparative cross sectional study. PloS one, 16(6), 0253286. https://doi.org/10.1371/journal.pone.0253286
  • Asmah, R.H., Yeboah, G., Asare-Anane, H., Antwi-Baffour, S., Archampong, T.N., Brown, C.A., & Ayeh-Kumi, P.F. (2015). Relationship between oxidative stress and haematological indices in patients with diabetes in the Ghanaian population. Clinical diabetes and endocrinology, 1(1), 1-5. https://doi.org/10.1186/s40842-015-0008-2
  • Asmamaw, M., Sime, T., Kene, K., Fekadie Baye, M., Teshome, M., & Zawdie, B. (2021). Evaluation of red blood cell parameters as a biomarker for long-term glycemic control monitoring among type 2 diabetic patients in Southwest Ethiopia: a cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 4993–5000. https://doi:10.2147/DMSO.S348907
  • Awofisoye, O.I., Adeleye, J.O., Olaniyi, J.A., & Esan, A. (2019). Prevalence and correlates of anemia in type 2 diabetes mellitus: a study of a Nigerian outpatient diabetic population. Sahel Medical Journal, 22(2), 55–63. https://doi.10.4103/smj.smj_65_18
  • Barbieri, J., Fontela, P.C., Winkelmann, E.R., Zimmermann, C.E.P., Sandri, Y.P., Mallet, E.K. V., & Frizzo, M.N. (2015). Anemia in patients with type 2 diabetes mellitus. Anemia, 1–7. https://doi.org/10.1155/2015/354737
  • Bekele, A., Teji Roba, K., Egata, G., & Gebremichael, B. (2019). Anemia and associated factors among type-2 diabetes mellitus patients attending public hospitals in Harari Region, Eastern Ethiopia. PloS one, 14(12), 1-17.https://doi.org/10.1371/journal.pone.0225725
  • Bhatt, N., Dawande, P., Noman, O., Bahadure, S., & Bhake, A. (2020). Significance of hematological parameters in uncomplicated diabetes mellitus. Indian Journal of Forensic Medicine & Toxicology, 14(4), 6279-6285. https://doi.org/10.37506/ijfmt.v14i4.12583
  • Biadgo, B., Melku, M., Abebe, S.M., & Abebe, M. (2016). Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 9, 91–99. https://doi.org/10.2147/DMSO.S97563
  • Çakırca, G., & Çelik, M.M. (2019). Relationships between glycemic control and platelet Indices, atherogenic index of plasma and vitamin D in patients with type 2 diabetes. E Journal of Cardiovascular Medicine, 7(3), 147 52. https://doi.org/10.32596/ejcm.galenos.2019.08.047
  • Cappellini, M.D., & Motta, I. (2015). Anemia in Clinical Practice-Definition and Classification: Does Hemoglobin Change With Aging?. Seminars in hematology, 52(4), 261–269. https://doi.org/10.1053/j.seminhematol.2015.07.006
  • Ebrahim, H., Fiseha, T., Ebrahim, Y., & Bisetegn, H. (2022). Comparison of hematological parameters between type 2 diabetes mellitus patients and healthy controls at Dessie comprehensive specialized hospital, Northeast Ethiopia: Comparative cross-sectional study. Plos one, 17(7), 0272145. https://doi.org/10.1371/journal.pone.0272145
  • Farooqui, R., Afsar, N., & Afroze, I.A. (2019). Role and Significance of Hematological parameters in Diabetes Mellitus. Annals of Pathology and Laboratory Medicine, 6(3), 158–162. https://doi.org/10.21276/apalm.2355
  • Harish Kumar, S., Srinivasa, S.V., & Prabhakar, K. (2017). Haematological profile of diabetes and non-diabetes patients in rural tertiary center. International Journal of Advances in Medicine, 4(5), 1271–5. https://doi.org/10.18203/2349-3933.ijam20174111
  • International Diabetes Federation (IDF). (2021). IDF Diabetes Atlas. 10th Ed, 32-114.
  • Jabeen, F., Rizvi, H.A., Aziz, F., & Wasti, A.Z. (2013). Hyperglycemic induced variations in hematological indices in type 2 diabetics. International Journal of Advanced Research, 1(8), 322–34.
  • Jaman, M.S., Rahman, M.S., Swarna, R.R., Mahato, J., Miah, M.M., & Ayshasiddeka, M. (2018). Diabetes and red blood cell parameters. Annals of Clinical Endocrinology and Metabolism, 2, 1-009. https://doi.org/10.29328/journal.acem.1001004
  • Joshi, A.A., & Jaison, J. (2019). The Study of Platelet Parameters- Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) in Type 2 Diabetes Mellitus. Annals of Pathology and Laboratory Medicine, 6(8), 407–413. https://doi.org/10.21276/APALM
  • Kaur, R., Kaur, M., & Singh, J. (2018). Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies. Cardiovascular Dialectology, 17(121), 1–17. https://doi.org/10.1186/s12933-018-0763-3
  • Kizilgul, M., Sencar, E., Bekir, U.C.A.N., Beysel, S., Ozcelik, O., Ozbek, M., & Cakal, E. (2018). Components of the complete blood count in type 2 diabetes mellitus with inadequate glycemic control. Dicle Medical Journal, 45(2), 113 20. https://doi.org/10.5798/dicletip.410811
  • Knychala, M.A., Garrote‐Filho, M.D.S., Batista da Silva, B., Neves de Oliveira, S., Yasminy Luz, S., Marques Rodrigues, M.O., & Penha‐Silva, N. (2021). Red cell distribution width and erythrocyte osmotic stability in type 2 diabetes mellitus. Journal of Cellular and Molecular Medicine, 25(5), 2505–16. https://doi.org/10.1111/jcmm.16184
  • Osman N.A., & Mansour M.M. (2013). Measurement of some haematological parameters in diabetic patient attending military hospsital in Omdurman. Sudan University of science and technology Institutional Digit Repos., 0–1.
  • Shehri, Z.S. (2017). The relationship between some biochemical and hematological changes in type 2 diabetes mellitus. Biomedical Research and Therapy, 4(11), 1760 74. https://doi.org/10.15419/bmrat.v4i11.382
  • Al Salhen, K., & Mahmoud, A. (2017). Hematological profile of patients with type 2 diabetic mellitus in El-Beida, Libya. Ibnosina Journal of Medicine and Biomedical Sciences, 9(03), 76-80. https://doi.org/10.4103/1947-489X.210115
  • Salvagno, G.L., Sanchis-Gomar, F., Picanza, A., & Lippi, G. (2014). Red blood cell distribution width: A simple parameter with multiple clinical applications. Critical Reviews in Clinical Laboratory Sciences, 52(2), 86-105. https://doi.org/10.3109/10408363.2014.992064
  • Sherif, H., Ramadan, N., Radwan, M., Hamdy, E., & Reda, R. (2013). Red cell distribution width as a marker of inflammation in Type 2 diabetes mellitus. Life Science Journal, 10(3), 1501-1507.
  • Shin, G., Jang, K., Kim, M., Lee, J.H., & Yoo, H.J. (2020). Inflammatory Markers and Plasma Fatty Acids in Predicting WBC Level Alterations in Association with Glucose Related Markers: A Cross sectional study. Frontiers in Immunology, 11, 629. https://doi.org/10.3389/fimmu.2020.00629
  • World Health Organization (2016). Global Report on Diabetes. Geneva: World Health Organization; 6.

Assessment of the differences of hematological variables and their correlation with glycemic control among type 2 diabetes mellitus patients in Iraq: Comparative cross-sectional study

Year 2024, Volume: 11 Issue: 3, 435 - 444, 29.08.2024
https://doi.org/10.21448/ijsm.1332875

Abstract

This research aimed to assess the hematological traits of male adults diagnosed with diabetes and investigate the relationship between blood sugar levels with hematological factors among patients. A cross-sectional comparison study was conducted at Fallujah Teaching Hospital from April 1 to July 30, 2023. The research comprised 185 volunteers, including 125 individuals with type 2 diabetes mellitus (65 with well blood sugar levels and 60 with poorly-regulated blood sugar levels) and 60 healthy individuals serving as controls. The evaluation of hematological parameters was conducted using Swelab-Alfa. An independent T-test was used for assessment. The patients exhibited substantially decreased mean absolute lymphocyte count, Hct, MCHC, and PLT values compared to the control group. The diabetic group had significantly higher mean values for total neutrophil count, absolute basophil counts, RDWSD, RDWCV, PDW, PLCR, and MPV than the control group. Patients with poor glycemic control had substantially elevated levels of Mon, Eos, Bas, MCHC, PLT, MPV, PLCR, and PCT. In contrast, individuals with poor glycemic control had substantially lower levels of Neu, RBC count, and PDW. The findings demonstrated a statistically significant positive connection between neutrophil count, MCV, MCH, MCHC, PDW, MPV, PLCR, and PCT with FBG. Lym, RBC count, and Hct exhibited a statistically significant inverse connection with FBG in individuals with type 2 diabetes mellitus (T2DM). This research demonstrated a notable impact of diabetes mellitus, poor glycemic control, and fasting blood glucose levels on some hematological markers.

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References

  • Adane, T., Asrie, F., Getaneh, Z., & Getawa, S. (2021). White blood cells and platelet profiles of diabetic patients at University of Gondar specialized referral hospital: A comparative cross‐sectional study. Journal of clinical laboratory Analysis, 35(6), e23808. https://doi.org/10.1002/jcla.23808
  • Agu, K.C. (2018). Diabetes mellitus: A review of some of the prognostic markers of response to treatment and management. Journal of Insulin Resistance, 3(1), 1 10. https://doi.org/10.4102/jir.v3i1.36
  • Alam, J., Mallik, S.K., Hasan, M.J., Choudhury, S., & Sikder, H. (2015). A Comparative Analysis of Biochemical and Hematological Parameters in Diabetic and Non-Diabetic Adults. Advanced Medical Sciences: An International Journal, 2(1), 1–9.
  • Alhadas, K.R., Santos, S.N., Freitas, M.M.S., Viana, S.M.S., Ribeiro, L.C., & Costa, M.B. (2016). Are platelet indices useful in the evaluation of type 2 diabetic patients?. Jornal Brasileiro de Patologia e Medicina Laboratorial, 52, 96-102. https://doi.org/10.5935/1676-2444.20160017
  • American Diabetes Association (2019). 6. Glycemic targets: standards of medical care in diabetes-2019. Diabetes Care, 42(suppl.1), 61–70.
  • American Diabetes Association (2014). Diagnosis and classification of diabetes mellitus. Diabetes care, 37(Supplement_1), S81-S90. https://doi.org/10.2337/dc19-S006
  • Antwi-Baffour, S., Kyeremeh, R., Boateng, S.O., Annison, L., & Seidu, M.A. (2018). Haematological parameters and lipid profile abnormalities among patients with Type-2 diabetes mellitus in Ghana. Lipids in Health and Disease, 17(1), 1 9. https://doi.org/10.1186/s12944-018-0926-y
  • Arkew, M., Asmerom, H., Tesfa, T., Tsegaye, S., Gemechu, K., Bete, T., & Haile, K. (2022). Red blood cell parameters and their correlation with glycemic control among type 2 diabetic adult patients in Eastern Ethiopia: a comparative cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 15, 3499 3507. https://doi.org/10.2147/DMSO.S386093
  • Arkew, M., Yemane, T., Mengistu, Y., Gemechu, K., & Tesfaye, G. (2021). Hematological parameters of type 2 diabetic adult patients at Debre Berhan Referral Hospital, Northeast Ethiopia: A comparative cross sectional study. PloS one, 16(6), 0253286. https://doi.org/10.1371/journal.pone.0253286
  • Asmah, R.H., Yeboah, G., Asare-Anane, H., Antwi-Baffour, S., Archampong, T.N., Brown, C.A., & Ayeh-Kumi, P.F. (2015). Relationship between oxidative stress and haematological indices in patients with diabetes in the Ghanaian population. Clinical diabetes and endocrinology, 1(1), 1-5. https://doi.org/10.1186/s40842-015-0008-2
  • Asmamaw, M., Sime, T., Kene, K., Fekadie Baye, M., Teshome, M., & Zawdie, B. (2021). Evaluation of red blood cell parameters as a biomarker for long-term glycemic control monitoring among type 2 diabetic patients in Southwest Ethiopia: a cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 4993–5000. https://doi:10.2147/DMSO.S348907
  • Awofisoye, O.I., Adeleye, J.O., Olaniyi, J.A., & Esan, A. (2019). Prevalence and correlates of anemia in type 2 diabetes mellitus: a study of a Nigerian outpatient diabetic population. Sahel Medical Journal, 22(2), 55–63. https://doi.10.4103/smj.smj_65_18
  • Barbieri, J., Fontela, P.C., Winkelmann, E.R., Zimmermann, C.E.P., Sandri, Y.P., Mallet, E.K. V., & Frizzo, M.N. (2015). Anemia in patients with type 2 diabetes mellitus. Anemia, 1–7. https://doi.org/10.1155/2015/354737
  • Bekele, A., Teji Roba, K., Egata, G., & Gebremichael, B. (2019). Anemia and associated factors among type-2 diabetes mellitus patients attending public hospitals in Harari Region, Eastern Ethiopia. PloS one, 14(12), 1-17.https://doi.org/10.1371/journal.pone.0225725
  • Bhatt, N., Dawande, P., Noman, O., Bahadure, S., & Bhake, A. (2020). Significance of hematological parameters in uncomplicated diabetes mellitus. Indian Journal of Forensic Medicine & Toxicology, 14(4), 6279-6285. https://doi.org/10.37506/ijfmt.v14i4.12583
  • Biadgo, B., Melku, M., Abebe, S.M., & Abebe, M. (2016). Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 9, 91–99. https://doi.org/10.2147/DMSO.S97563
  • Çakırca, G., & Çelik, M.M. (2019). Relationships between glycemic control and platelet Indices, atherogenic index of plasma and vitamin D in patients with type 2 diabetes. E Journal of Cardiovascular Medicine, 7(3), 147 52. https://doi.org/10.32596/ejcm.galenos.2019.08.047
  • Cappellini, M.D., & Motta, I. (2015). Anemia in Clinical Practice-Definition and Classification: Does Hemoglobin Change With Aging?. Seminars in hematology, 52(4), 261–269. https://doi.org/10.1053/j.seminhematol.2015.07.006
  • Ebrahim, H., Fiseha, T., Ebrahim, Y., & Bisetegn, H. (2022). Comparison of hematological parameters between type 2 diabetes mellitus patients and healthy controls at Dessie comprehensive specialized hospital, Northeast Ethiopia: Comparative cross-sectional study. Plos one, 17(7), 0272145. https://doi.org/10.1371/journal.pone.0272145
  • Farooqui, R., Afsar, N., & Afroze, I.A. (2019). Role and Significance of Hematological parameters in Diabetes Mellitus. Annals of Pathology and Laboratory Medicine, 6(3), 158–162. https://doi.org/10.21276/apalm.2355
  • Harish Kumar, S., Srinivasa, S.V., & Prabhakar, K. (2017). Haematological profile of diabetes and non-diabetes patients in rural tertiary center. International Journal of Advances in Medicine, 4(5), 1271–5. https://doi.org/10.18203/2349-3933.ijam20174111
  • International Diabetes Federation (IDF). (2021). IDF Diabetes Atlas. 10th Ed, 32-114.
  • Jabeen, F., Rizvi, H.A., Aziz, F., & Wasti, A.Z. (2013). Hyperglycemic induced variations in hematological indices in type 2 diabetics. International Journal of Advanced Research, 1(8), 322–34.
  • Jaman, M.S., Rahman, M.S., Swarna, R.R., Mahato, J., Miah, M.M., & Ayshasiddeka, M. (2018). Diabetes and red blood cell parameters. Annals of Clinical Endocrinology and Metabolism, 2, 1-009. https://doi.org/10.29328/journal.acem.1001004
  • Joshi, A.A., & Jaison, J. (2019). The Study of Platelet Parameters- Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) in Type 2 Diabetes Mellitus. Annals of Pathology and Laboratory Medicine, 6(8), 407–413. https://doi.org/10.21276/APALM
  • Kaur, R., Kaur, M., & Singh, J. (2018). Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies. Cardiovascular Dialectology, 17(121), 1–17. https://doi.org/10.1186/s12933-018-0763-3
  • Kizilgul, M., Sencar, E., Bekir, U.C.A.N., Beysel, S., Ozcelik, O., Ozbek, M., & Cakal, E. (2018). Components of the complete blood count in type 2 diabetes mellitus with inadequate glycemic control. Dicle Medical Journal, 45(2), 113 20. https://doi.org/10.5798/dicletip.410811
  • Knychala, M.A., Garrote‐Filho, M.D.S., Batista da Silva, B., Neves de Oliveira, S., Yasminy Luz, S., Marques Rodrigues, M.O., & Penha‐Silva, N. (2021). Red cell distribution width and erythrocyte osmotic stability in type 2 diabetes mellitus. Journal of Cellular and Molecular Medicine, 25(5), 2505–16. https://doi.org/10.1111/jcmm.16184
  • Osman N.A., & Mansour M.M. (2013). Measurement of some haematological parameters in diabetic patient attending military hospsital in Omdurman. Sudan University of science and technology Institutional Digit Repos., 0–1.
  • Shehri, Z.S. (2017). The relationship between some biochemical and hematological changes in type 2 diabetes mellitus. Biomedical Research and Therapy, 4(11), 1760 74. https://doi.org/10.15419/bmrat.v4i11.382
  • Al Salhen, K., & Mahmoud, A. (2017). Hematological profile of patients with type 2 diabetic mellitus in El-Beida, Libya. Ibnosina Journal of Medicine and Biomedical Sciences, 9(03), 76-80. https://doi.org/10.4103/1947-489X.210115
  • Salvagno, G.L., Sanchis-Gomar, F., Picanza, A., & Lippi, G. (2014). Red blood cell distribution width: A simple parameter with multiple clinical applications. Critical Reviews in Clinical Laboratory Sciences, 52(2), 86-105. https://doi.org/10.3109/10408363.2014.992064
  • Sherif, H., Ramadan, N., Radwan, M., Hamdy, E., & Reda, R. (2013). Red cell distribution width as a marker of inflammation in Type 2 diabetes mellitus. Life Science Journal, 10(3), 1501-1507.
  • Shin, G., Jang, K., Kim, M., Lee, J.H., & Yoo, H.J. (2020). Inflammatory Markers and Plasma Fatty Acids in Predicting WBC Level Alterations in Association with Glucose Related Markers: A Cross sectional study. Frontiers in Immunology, 11, 629. https://doi.org/10.3389/fimmu.2020.00629
  • World Health Organization (2016). Global Report on Diabetes. Geneva: World Health Organization; 6.
There are 35 citations in total.

Details

Primary Language English
Subjects Biochemistry and Cell Biology (Other)
Journal Section Articles
Authors

Osamah Ahmed 0000-0003-3546-2136

Early Pub Date August 6, 2024
Publication Date August 29, 2024
Submission Date July 26, 2023
Published in Issue Year 2024 Volume: 11 Issue: 3

Cite

APA Ahmed, O. (2024). Assessment of the differences of hematological variables and their correlation with glycemic control among type 2 diabetes mellitus patients in Iraq: Comparative cross-sectional study. International Journal of Secondary Metabolite, 11(3), 435-444. https://doi.org/10.21448/ijsm.1332875
International Journal of Secondary Metabolite

e-ISSN: 2148-6905