Effect of Iron Deficiency Anemia on HbA1c in Diabetic Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A case control study, 2016
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Date
2016-10
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Addis Ababa University
Abstract
Background: Hemoglobin A1C (HbA1c) is the predominant hemoglobin found in HbA1
fractions. The International Expert Committee recommends A1C assay is accurate, precise
measures of chronic glycemic levels thus recommend the use of HbA1c for diagnosing diabetes.
On the other hand, the committee stated any condition that changes red cell turnover, such as
sickle cell anemia, hemolytic anemia, chronic malaria, major blood loss, or blood transfusions,
iron deficiency anemia (IDA), renal failure will lead to spurious A1C results.
Objective: To determine the effect of IDA on HbA1c in diabetic patients in Tikur Anbessa
Specialized Hospital, Addis Ababa, Ethiopia.
Method: A case-control study was conducted to assess the effect of IDA on HbA1c in diabetic
patients from April to July 2016. A convenient sampling method was used and 174 diabetic
patients (87 IDA and 87 without IDA) were included in the study. CBC (Complete blood count),
Serum ferritin were performed by Cell dyn 1800 hematology analyzer, COBAS INTEGRA 400
plus 800 Chemistry analyzer and HbA1c by COBAS C 111 analyzer respectively for the IDA
and control group. The data was entered into Excel Spread sheet and exported to Statistical
Package for Social Sciences (SPSS) version 21 software systems for analysis. Pearson‟s
correlation, chi-square, independent t-test was calculated. The data was presented as mean ± SD.
P-value of <0.05 was taken as statistically significant.
Result: Our finding showed that the mean RBC, Hgb, HCT, MCV, MCH, MCHC were lower in
IDA group compared to the control group. HbA1c (%) level were significantly lower in IDA
group (6.18 ± 1.57) compared with the control group (7.74 ± 1.81) (p<0.05). The association
between HbA1c and hematological parameters of the IDA patients showed no stastical
significance.
Conclusion: HbA1c were significantly lower in IDA group compared to the control group.
Therefore monitoring these patients could be misleading hence physician and health care
providers should take this into account before making any therapeutic decision.
Keyword: HbA1c, Iron deficiency anemia, diabetic mellitus
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Keywords
HbA1c; Iron deficiency anemia; Diabetic mellitus