Highlights
- •Our study has shown that IDA is related to increased HbA1c concentrations and HbA1c decreases following treatment with iron.
- •Making any decisions regarding diagnosis or treatment according to HbA1c, IDA should be considered.
- •Early diagnosis and treatment of IDA in diabetic patients may improve glycemic control.
Abstract
Introduction
Both diabetes mellitus (DM) and iron deficiency anemia (IDA) are prevalent in every
area of the world, and so, the possibility of these two diseases co-existing is also
very high. It is our belief that clinical results of any correlation between iron
status of the body and glycosylated haemoglobin (HbA1c) would be beneficial to many
patients, therefore in this study, the effect of IDA on HbA1c was investigated.
Materials – methods
A total of 146 patients with DM and IDA were evaluated prospectively. While the patients
were administered 270 mg/day of ferrous sulphate (80 mg elemental iron) orally for
three months for the treatment of IDA, no interventions were made for the treatment
of DM. Patient levels of hemoglobin (Hb), hematocrit, red blood cells (RBC), mean
corpuscular volume (MCV), platelet, white blood cells (WBC), serum iron, serum iron
binding capacity (SIBC), ferritin, fasting plasma glucose (FPG), HbA1c, body mass
index (BMI), C-reactive protein (CRP) values were measured at baseline and at the
third month of treatment with iron, and were compared.
Results
The median age of our patients was 45 (40–50) and median duration of diabetes was
3 years (1,75–5). While the baseline median Hb was 10.4 (mg/dL) (9.5–11.1), MCV was
74 (fL) (70.8–77), ferritin was 4 (ug/L) (3–6) at three months, Hb was measured at
12.6 (mg/dL) (12.1–13.2), MCV was measured at 82 (fL) (80–86), ferritin was measured
at 15 (ug/L) (9–21.2) and was significantly higher compared to baseline values (p < 0.001).
The baseline median HBA1c of patients was 7.09 ± 0.51 (%) and three month HBA1c was
6.69 ± 0.53 (%), which was significantly lower than when comparing baseline values
with values at third month (p < 0.001). Baseline and three month values for FPG were
118 (mg/dL) (108–132) and 116 (mg/dL) (106–125) respectively, and there was no significant
difference (p:0.07). A 2.2 mg/dL (1.5–3.5) increase in median Hb level accompanied
a 0.4 % (0.2–0.6) decrease in median HbA1c levels (Spearman rho = −0.362; p < 0.001).
Conclusion
Our study has shown conclusivly that IDA is related to increased HbA1c concentrations
and HbA1c decreases significantly following treatment with iron. IDA should be considered
before making any decisions regarding diagnosis or treatment according to HbA1c.
Keywords
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Article info
Publication history
Published online: January 06, 2022
Accepted:
January 1,
2022
Received in revised form:
December 19,
2021
Received:
September 27,
2021
Identification
Copyright
© 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
