Correlation of glycated hemoglobin with coagulation profile and hematological parameters in type II diabetes mellitus

BACKGROUND: Patients with diabetes mellitus (DM) have a high risk of atherothrombotic events, with 80% of patients with DM dying a thrombotic death and 75% of these deaths being due to cardiovascular complications. This study aims to evaluate glycated hemoglobin [hemoglobin A1c (HbA1c)] with other parameters [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, and complete blood count (CBC) indices] and compare various hematological parameters between people with DM and people without complications. METHODS: This cross-sectional study was conducted at Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India, over period of 2016 to 2018 on those diagnosed as a case of type II DM (T2DM) with or without complication. Blood samples from all 108 cases were collected. Statistical analysis was performed by Student's unpaired t-test, Bonferroni multiple comparison test, one-way analysis of variance (ANOVA) test, and chi-square test. RESULTS: In T2DM cases, mean PT was 12.25 ± 1.22 seconds and APTT in total T2DM cases was 30.12 ± 3.05 seconds (P ≤ 0.005). Hemoglobin (Hb) and hematological parameters like mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were decreased significantly in DM cases compared to the control group, while red cell distribution width (RDW) and total white blood cell (WBC) counts were found to be significantly increased in DM group (P = 0.021, t = 3.37; P = 0.001, t = 3.51, respectively). The correlation of HbA1c with PT, APTT, international normalized ratio (INR), and fibrinogen was statistically significant (P = 0.005, P = 0.0001, P = 0.005, and P = 0.0001, respectively). The mean fibrinogen level was 422.22 ± 119.77 mg/dl and was statistically significant (P = 0.0001). CONCLUSION: There was a shortening of PT and APTT, indicating a hypercoagulable state in T2DM. Glycemic control affects the PT, APTT, INR, and fibrinogen levels.