A prospective study of effect of iron deficiency anemia on HbA1c levels in non-diabetics

Background: The traditional role of HbA1c analysis has been for assessing glycemic control in patients with diabetes. The results of semi-final studies demonstrated that early, intensive glycemic control could significantly reduce the risk of a range of diabetes related complications, and permitted the establishment of precise HbA1c target values for treatment goals. Aim: This study was to determine the effect of IDA on HbA1c levels in non-diabetic patients, so as to consider IDA as an important factor which influenced the HbA1c levels, while monitoring the glycemic status of diabetics. Materials and methods: Total number of 150 patients attending (both men and women) Medical department of PSIMS & RF, Chinaoutapalli and were enrolled after they provided written consent. This study was conducted over a period of two years (November 2014 to November 2016). Results: The mean HbA1c levels in anemic patients were 5.1%, 4.9% and 4.7%at baseline and after 1 and 2 months, respectively while that in the controls was 5.3%. The base line HbA1c levels were significantly lower in patients than controls, however, there was a significant decrease in HbA1c levels in patients after 2 months of treatment for iron deficiency anemia (P<0.01). The mean HbA1c levels were significantly lower in patients after 2 months of treatment than in the controls (P<0.01). The mean absolute HbA1c level in patients at baseline and after 1 and 2 months were 0.49g/dL, 0.57g/dL and 0.66g/dL, respectively while in that controls was 0.72g/dL. A significant difference was observed between the baseline values of patients and controls (P<0.01). Additionally there was a significant decrease in absolute HbA1c levels over the 2 month treatment period (P<0.01). However after 2 months of treatment, there was no significant difference between the absolute HbA1c levels of patients and controls (P>0.05). A significant correlation between hemoglobin and HbA1c levels in patients at baseline (coefficient of correlation) was observed. It was observed that a significant correlation between hemoglobin and HbA1c levels in patients at baseline (coefficient of correlation= -0.1316; p<0.001; and after 1 month of treatment (coefficient of correlation= -0.391; p<0.001. However, there was no positive correlation between hemoglobin and HbA1c levels at the end of the 2-month treatment period (coefficient of correlation= -0.42; p >0.05. Conclusion: This study concluded that before considering HbA1c as a diagnostic parameter and glycemic control in Diabetes, Iron Deficiency Anemia should be ruled out; as the severity of the anemia has effect on quantity of HbA1c.