Integrity loss of glycosylated hemoglobin with deepening anemia

Year 2022, Volume: 5 Issue: 3, 839 - 843, 30.05.2022

Bünyamin Aydın , Aysun Gönderen

https://doi.org/10.32322/jhsm.1098573

Abstract

Introduction: Iron deficiency anemia (IDA) has been shown to cause a false increase in glycosylated hemoglobin (HBA1c), but how much increase in hemoglobin (Hgb) causes a certain decrease in HBA1c remains unknown. Knowledge of this ratio will enable more accurate clinical diagnosis and follow-up of diabetes. This study aimed to investigate whether IDA causes a decrease in HBA1c and if it does, how much of a decrease it causes.
Material and Method: One hundred and twenty-two patients with IDA made up the study group and sixty-two health volunteers formed the control group. 270 mg ferrous sulphate (=80 mg elemental iron) were administered to the study group each day, orally for 3 months, and a control of age/sex matched healthy participants were monitored. Hgb, serum iron, serum iron binding capacity (SIBC), ferritin and HbA1c levels of all participants were measured and compared at baseline and at the third month of the study.
Results: There was a significant decrease in HbA1c and SIBC levels at baseline and 3 months in the study group (p<0.001, p<0.001, p<0.001 respectively) and a significant increase in serum iron, ferritin and Hgb (p<0.001, p<0.001, p<0.001 respectively). It was found that a 1 mg/dl increase in Hgb level resulted in a 0.113% decrease in HbA1c.
Conclusion: As anemia deepens, HBA1c loses its reliability for diagnosis and follow-up of DM. IDA should be considered before any diagnosis or treatment decisions are made according to HbA1c levels.

Keywords

anemia, diabetes, glycosylated hemoglobin

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