Effects of iron deficiency anemia on the level of glycosylated hemoglobin (HbA1c) in non-diabetic patients

Abstract

The major form of glycohemoglobin is hemoglobin A1c (HbA1c). The Hb A1c  fraction is elevated in chronic hyperglycemic diabetic patients and correlates positively with glycemic control. Previous studies suggest that iron deficiency anemia ( IDA) affects the level of HbA1c. Aim of study: To determine the effect of IDA on HbA1c level in non- diabetic patients before and after treatment with iron. Material and methods: The study included 100 females from Al jmail General Hospital at the west of Tripoli, 50 were with IDA and 50 were not anemic (control group). Age ranged from ( 20-40) years. Fasting blood  glucose, HbA1c , complete blood count , serum iron, total iron binding capacity and serum Ferritin were measured in all females before treatment and after treatment. Patients who had glucose tolerance abnormality ( impaired glucose tolerance or diabetes mellitus), hemoglobinopathy ,hemolytic anemia , chronic alcohol ingestion , chronic renal disease , chronic liver disease and rheumatoid arthritis were excluded from study.  All patients with IDA were treated with ferrous sulfate as 325mg orally three times a day for 3 months. Results: The mean percentage of the HbA1c in non anemic patients control group was 5.2% . The mean percentage of HbA1c in patients with mild anemia was (6%) , moderate anemia (5.9 %) . In patients with severe anemia HbA1c was (3.2%) which is significantly low in comparison to normal females. After treatment with iron , significant increase in HbA1c was observed  in patients with severe anemia (5.2%) p < 0.001 and significant decrease in HbA1c in female with mild and moderate anemia  5.2%,5.3% respectively P<0.001  . Conclusion: In patient with iron deficiency anemia , hemoglobin A1c in not reliable parameter for follow up of patients with diabetes mellitus.