Relation between iron status and hemoglobin A1c in children with type 1 Diabetes Mellitus

Abstract

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.

Serum iron is negatively correlated with the HbA1c level in children and adolescents with type 1 diabetes mellitus

“…So far, only small studies with similar objectives have been reported in child and adolescent populations. Research by El-Nezely et al (12). in 80 children on insulin therapy in Egypt found a significant increase in the HbA1c levels in a group of patients with iron deficiency, even after HbA1c had been stratified for glycemic control.…”

“…The effect of iron deficiency on the HbA1c levels was first investigated by Brooks et al (9) and several studies have reported similar results (10)(11)(12)(13)(14). Therefore, the potential effect of iron deficiency on the HbA1c levels should be observed by clinicians; additionally, the status of iron levels in children with T1DM should be adequately assessed before interpreting the HbA1c results (15).…”