Relation between Iron Status and Hemoglobin A1c in Children with Type-1 Diabetes Mellitus

Background: Hemoglobin A1c [HbA1c] is the best standard for measurements of glycemic control level in type 1 diabetes mellitus, especially in children. As iron deficiency anemia is a prevalent finding in children with diabetes, it may affect HbA1c levels in those children.  Aim of the work:  To determine the effects of iron deficiency anemia on hemoglobin A1c in type 1 diabetes mellitus Patients and methods:This was cross-sectional analytic study was done on 80 children with diabetes with type 1DM receiving insulin therapy; the patients divided into two groups, 21 diabetic children with iron deficiency anemia and 59 diabetic children with iron sufficient state, attending to the pediatric department of Al-Azher University Hospital in Damietta from February 2019 to September 2019. All children included were subjected to complete medical history, general examination, systemic examination, and laboratory investigations; [Complete blood count [CBC], HbA1c, Serum Iron, Serum Ferritin, Total Iron Binding Capacity, Fasting blood glucose, Post Prandial blood glucose, and ESR]. Results:In our study, we divided all patients [80 diabetic children] regarding glycemic control according to HbA1c value into three levels, the first level was optimal glycemic control level [HbA1c< 7.6%], the second level was suboptimal glycemic control [HbA1c 7.6 – 9.0%] and the third level was poor glycemic control level [HbA1c> 9.0%], there was a statically highly significant increase in HbA1c value of the iron-deficient diabetic group in compared to iron sufficient diabetic group at all levels of glycemic control. Conclusion: Iron deficiency anemia seems to increase HbA1c value in diabetic children Type 1, at the same degree of glycemia.