DOI: 10.36347/sjams.2019.v07i04.015

Pages: 1440-1446

Background and objectives: HbA1c is recommended for diagnosis of diabetes, is the most common means of guiding management of diabetes, and is the primary predictor of complications. It is well established that HbA1c can be affected by haemolytic anaemia, blood loss and iron deficiency. There is need for more evidence, especially in identifying the types and degrees of anaemia likely to have significant impact on HbA1c in diabetics. Objectives of our study were to study the correlation between HbA1c and blood glucose levels in anaemic diabetics, to assess the influence of anaemia on HbA1c and to study the effect of severity and type of anaemia on HbA1c. Methods: This was a case control study of 100 cases and 100 controls. Anemic diabetics and non-anemic diabetic controls were chosen, and patients with CKD and haemolytic anemia were excluded. Hemoglobin, erythrocyte indices, peripheral smear, vitamin B12 level and iron studies were done in cases. Mean of FBS, PPBS and post lunch blood glucose was taken as Mean blood Glucose and compared with HbA1c in cases and controls. Various statistical tests were applied to assess the effect of anemia on HbA1c. Results: Mean HbA1c in anemic individuals was 9.91±3.13 which is lower than that of controls i.e 10.51±2.90, though not significant. When compared with mean HbA1c in controls, mean HbA1c of Iron deficiency anemia was higher, whereas of vitamin B12 deficiency and anemia of chronic disease was lower. MeanHbA1c in iron sufficient individuals was 8.67±2.55, whereas in iron deficient individuals was 10.23±3.20, with a significant P value of 0.042. Severe anemia leads to statistically significant reduction in HbA1c than controls. Conclusion: Anemia especially when severe, leads to significant reduction in HbA1c. Iron deficiency leads to spurious increase in HbA1c. Hence larger studies are needed to identify definite association of anemia with HbA1c and also to comment on the utility of HbA1c as