Research Article

Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study

Volume: 8 April 28, 2026

Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study

Abstract

Objective: To evaluate six-month changes in hemogram-derived inflammatory indices (neutrophil-tolymphocyte ratio [NLR], systemic immune-inflammation index [SII], systemic inflammation response index [SIRI], and aggregate index of systemic inflammation [AISI]) and their association with glycemic parameters in patients with type 2 diabetes mellitus (T2DM) under routine clinical care. 

Methods: This retrospective cohort study analyzed electronic medical records of 183 adults with T2DM from a single center (2022–2023). All patients had paired laboratory measurements approximately six months apart. Primary analysis examined overall changes in glycemic parameters (fasting glucose, HbA1c) and inflammatory indices using Wilcoxon signed-rank tests; correlations were assessed with Spearman’s rho. 

Results: Over six months, all four inflammatory indices decreased significantly: NLR (2.14→1.66, p<0.001, r=0.87), SII (593.6→476.0, p<0.001, r=0.74), SIRI (0.88→0.70, p<0.001, r=0.70), and AISI (231.5→188.0, p<0.001, r=0.63). Fasting glucose decreased (125→109 mg/dL, p<0.001, r=0.80), while HbA1c showed a small reduction (7.00%→6.80%, p<0.001, r=0.23). Changes in glycemic parameters correlated poorly with changes in inflammatory indices (all |ρ|<0.20). 

Conclusion: Hemogram-derived inflammatory indices improve markedly and consistently in T2DM patients over six months of real-world treatment. These improvements are largely independent of glycemic response, suggesting that NLR, SII, SIRI, and AISI may capture anti-inflammatory effects not reflected by HbA1c. These low-cost, universally available indices may serve as complementary markers in routine T2DM care.

Keywords

Ethical Statement

Clinical Research Ethics Committee of Usak University, No: 293-293-25/2024

References

  1. Burgos-Morón E, Abad-Jiménez Z, Marañón AM, Iannantuoni F, Escribano-López I, López-Domènech S, et al. Relationship between oxidative stress, ER stress, and inflammation in type 2 diabetes: the battle continues. J Clin Med. 2019;8(9):1385. doi:10.3390/jcm8091385.
  2. Nedosugova LV, Markina YV, Bochkareva LA, Kuzina IA, Petunina NA, Yudina IY, et al. Inflammatory mechanisms of diabetes and its vascular complications. Biomedicines. 2022;10(5):1168. doi:10.3390/biomedicines10051168.
  3. Hotamisligil GS. Inflammation, metaflammation and immunometabolic disorders. Nature. 2017;542:177-85. doi:10.1038/nature21363.
  4. Donath MY, Dinarello CA, Mandrup-Poulsen T. Targeting innate immune mediators in type 1 and type 2 diabetes. Nat Rev Immunol. 2019;19:734-46. doi:10.1038/s41577-019-0213-9.
  5. Aghaei M, Bahreiny SS, Zayeri ZD, Davari N, Abolhasani MM, Saki N. Evaluation of complete blood count parameters in patients with diabetes mellitus: a systematic review. Health Sci Rep. 2025;8(2):e70488. doi:10.1002/hsr2.70488.
  6. Islam MM, Satıcı M, Eroğlu S. Unraveling the clinical significance and prognostic value of the neutrophil-tolymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index: an extensive literature review. Turk J Emerg Med. 2024;24(1):8-19. doi:10.4103/tjem.tjem_198_23.
  7. Zhang J, Fan X, Xu Y, Wang K, Xu T, Han T, et al. Association between inflammatory biomarkers and mortality in individuals with type 2 diabetes: NHANES 2005-2018. Diabetes Res Clin Pract. 2024;209:111575. doi:10.1016/j.diabres.2024.111575.
  8. Gong Y, Wang L, Li Q, Wang M, Luan R, Gao F, et al. Evaluating neutrophil-lymphocyte ratio, systemic immuneinflammation index, and systemic inflammation response index for diagnosing and predicting progression in diabetic retinopathy: a cross-sectional and longitudinal study. BMC Ophthalmol. 2025;25(1):398. doi:10.1186/s12886-025-04222-5.

Details

Primary Language

English

Subjects

​Internal Diseases , Clinical Sciences (Other)

Journal Section

Research Article

Publication Date

April 28, 2026

Submission Date

February 24, 2026

Acceptance Date

April 14, 2026

Published in Issue

Year 2026 Volume: 8

APA
Özcan, B., & Ümit Kurban, M. (2026). Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study. Turkish Journal of Internal Medicine, 8, 74-80. https://doi.org/10.46310/tjim.1893961
AMA
1.Özcan B, Ümit Kurban M. Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study. Turk J Int Med. 2026;8:74-80. doi:10.46310/tjim.1893961
Chicago
Özcan, Bilge, and Meryem Ümit Kurban. 2026. “Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients With Type 2 Diabetes: A Real-World Retrospective Study”. Turkish Journal of Internal Medicine 8 (April): 74-80. https://doi.org/10.46310/tjim.1893961.
EndNote
Özcan B, Ümit Kurban M (April 1, 2026) Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study. Turkish Journal of Internal Medicine 8 74–80.
IEEE
[1]B. Özcan and M. Ümit Kurban, “Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study”, Turk J Int Med, vol. 8, pp. 74–80, Apr. 2026, doi: 10.46310/tjim.1893961.
ISNAD
Özcan, Bilge - Ümit Kurban, Meryem. “Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients With Type 2 Diabetes: A Real-World Retrospective Study”. Turkish Journal of Internal Medicine 8 (April 1, 2026): 74-80. https://doi.org/10.46310/tjim.1893961.
JAMA
1.Özcan B, Ümit Kurban M. Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study. Turk J Int Med. 2026;8:74–80.
MLA
Özcan, Bilge, and Meryem Ümit Kurban. “Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients With Type 2 Diabetes: A Real-World Retrospective Study”. Turkish Journal of Internal Medicine, vol. 8, Apr. 2026, pp. 74-80, doi:10.46310/tjim.1893961.
Vancouver
1.Bilge Özcan, Meryem Ümit Kurban. Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study. Turk J Int Med. 2026 Apr. 1;8:74-80. doi:10.46310/tjim.1893961

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