Does Iron Deficiency Anaemia and its  Severity Influence HbA1C Level in Non  Diabetics? An Analysis of 150 Cases

Rajagopal, Lavanya; Ganapathy, Shivashekar; Sundaram, Arunachalam; Raja, Veena; Ramraj, Balaji

doi:10.7860/jcdr/2017/25183.9464

Cited by 17 publications

(22 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6 et al showed that HbA1c levels were higher in patients with iron deficiency anaemia and decreased significantly upon treatment with iron. Similar results were also seen in studies carried out by Gram-Hansen et al 11 In Lavanya Rajagopal 16 et al study, non-diabetics with IDA had a mean HbA1c % (6.84 ± 0.07), which was significantly higher (p < 0.05) than the non-anaemic group (5.12 ± 0.04).…”

Section: Sl Nosupporting

confidence: 86%

TO STUDY THE EFFECT OF IRON DEFICIENCY ANAEMIA ON HbA1C IN NON-DIABETIC

Manjhvar¹,

P.²,

Niranjan³

2017

jemds

View full text Add to dashboard Cite

BACKGROUND The most common form of anaemia plaguing our country is Iron deficiency anaemia. The extent of diabetic control is measured by HbA1c, which is the average blood glucose level of the patient over the past 3 months. HbA1c levels depend upon a multitude of factors such as the presence of different types of haemoglobins, any haemolytic anaemia, any nutritional deficiency anaemias, uraemia, pregnancy and acute blood loss. Older studies suggest that Iron deficiency anaemia is another one of the factors affecting HbA1C levels. We conducted a prospective observational study to analyse the effect of iron deficiency anaemia on glycated haemoglobin (HbA1c) in non-diabetic Indians. MATERIALS AND METHODS A prospective observational study on 500 iron deficiency patient cases was carried out in SGM Hospital, Rewa from the period July 2016 to June 2017. Exclusion and inclusion criteria were used to recruit cases from the wards and OPDs of the hospital. Appropriate descriptive statistics was used to analyse the data. RESULTS The mean HbA1c level in the patients with iron deficiency anaemia (IDA) is 6.19 ± 0.58. In our study, we found increased severity of iron deficiency anaemia is associated with increased level of HbA1c. In female patients (379 out of 500) mild anaemia (73)mean HbA1c 5.79 ± 0.35; moderate anaemia (242)-mean HbA1c 6.16 ± 0.39; and severe anaemia (64)-mean HbA1c 7.2 ± 0.46. In our study in male patients (121 out of 500) mild anaemia (34)-mean HbA1c 5.79 ± 0.35; moderate anaemia (73)-mean HbA1c 5.86 ± 0.26; and severe anaemia (14)-mean HbA1c 6.80 ± 0.354. CONCLUSION It was found that IDA was more common among the reproductive age group women. It was associated with shift in the HbA1c levels to higher side with severity of anaemia.

show abstract

Section: Sl Nosupporting

confidence: 86%

TO STUDY THE EFFECT OF IRON DEFICIENCY ANAEMIA ON HbA1C IN NON-DIABETIC

Manjhvar¹,

P.²,

Niranjan³

2017

jemds

View full text Add to dashboard Cite

show abstract

“…Although the HbA1c value is well established as a biomarker for the diagnosis of diabetes and for monitoring the treatment of diabetes, its reliability, especially under conditions of an altered iron homeostasis, has been challenged. HbA1c levels appear to be affected by iron status, as several studies have demonstrated increased values under conditions of iron depletion and iron deficiency anemia (IDA) in both type 1 diabetic and nondiabetic populations [ 4 – 7 ]. On the other hand, iron substitution therapy results in a significant drop in HbA1c values [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Intravenous Ferric Carboxymaltose in Patients with Type 2 Diabetes Mellitus and Iron Deficiency: CLEVER Trial Study Design and Protocol

et al. 2017

View full text Add to dashboard Cite

IntroductionHbA1c is the gold standard for glycemic control in pre-diabetes and diabetes. However, its validity has been questioned, especially in the presence of imbalanced iron homeostasis. The CLEVER trial aims to evaluate the relationship between iron deficiency and HbA1c (a biomarker for the diagnosis and therapeutic monitoring of type 2 diabetes) in a randomized, placebo-controlled, multicenter clinical trial.MethodsThe CLEVER (intravenous ferric CarboxymaLtosE for improVement of mEtabolic parameters in type 2 diabetes patients with iRon deficiency) trial is a randomized, single-blind, proof-of-concept study with two treatment arms. 140 men and women diagnosed with type 2 diabetes and iron deficiency will receive either placebo or ferric carboxymaltose (500 or 1000 mg) as intravenous infusions. The primary outcome measure is the change in HbA1c level between baseline and after 12 weeks of treatment. Secondary endpoints include change of iron status and metabolic markers as well as treatment safety and tolerability. Furthermore, the potential clinical improvement in quality of life and the reliability of HbA1c measurement in patients with type 2 diabetes and iron deficiency will be investigated.ResultsBoth excessive iron and iron deficiency are associated with metabolic disorders; excessive iron is a risk factor for the development of diabetes, whereas iron deficiency is associated with obesity and insulin resistance. It has been suggested that iron increases insulin secretion in pancreatic beta-cells. CLEVER is the first study to investigate the hypothesis that intravenous substitution with ferric carboxymaltose reduces HbA1c levels in patients with type 2 diabetes and iron deficiency, thereby improving metabolic status and quality of life.Clinical Trial RegistrationClinicalTrials.gov (NCT01513369).FundingGWT-TUD GmbH acts as sponsor of the clinical trial. Financial support is provided by Vifor Pharma.

show abstract

“…7 DEA'da gözlenen yüksek HbA1c düzeylerine yol açan mekanizmalar henüz netlik kazanmamış olup, bazı teoriler ileri sürülmüştür. 8,9 Bunlardan ilki globin zincirinin daha hızlı glikolizasyonuna yol açan hemoglobin (Hb)'in kuaterner yapısının değişmesidir. 10,11 Başka bir teoriye göre, HbA1c total HbA'nın bir yüzdesi olarak ölçüldüğünden, sabit bir glukoz düzeyinde Hb konsantrasyonunun azalması glikozile fraksiyonda artışa neden olabilmektedir.…”

unclassified

“…13 DEA hastalarında HbA1c düzeylerinin kontrol grubuna göre istatistiksel olarak anlamlı yüksek olduğunu ve demir tedavisi ile HbA1c düzeylerinde azalma görüldüğünü bildiren çalışmalar olduğu gibi, DEA ve kontrol grupları arasında HbA1c düzeyleri açısından bir fark bulunmadığını veya DEA'da HbA1c düzeylerinin azaldığını ve demir tedavisi ile HbA1c düzeylerinde artış görüldüğünü öne süren çalışmalar da mevcuttur. 3,4,8,12,[14][15][16][17][18][19][20] Yapılmış olan çalışmalara bakıldığında; örneklem sayısı genellikle az olup, DEA'da ve demir tedavisi sonrasında HbA1c düzeylerinde artma veya azalma görüldüğü yönünde birbiriyle oldukça çelişen sonuçlar görülmektedir. Uyumsuz sonuçların birçok nedeni olabileceği gibi bir nedeni de çalışmaların küçük örnek gruplarında yürütülmesi olabilmektedir.…”

unclassified