Effect of Severity of Anemia on HBA1C in Non Diabetic Patients – One year Hospital Based Study in KLES Dr. Prabhakar Kore Hospital and Medical Research Centre

Abstract

ackground and Objectives Anemia continues to be a medical and financial burden for both developed and developing countries, and affects all age groups. The normal value of hemoglobin varies with age, gender, ethnicity and physiologic status of the population. Diabetes mellitus is another condition with increased global prevalence along with anemia and depends on postprandial blood sugar, fasting blood sugar and hemoglobin A1c (HbA1c) for its diagnosis. The use of HbA1c for the diagnosis of diabetes mellitus is widely advocated despite caveats to its use with anemia being cited as a major confounding factor. The value of HbA1c may be erroneous in those with anemia, thus mandating its evaluation prior to using HbA1c as a guide for diagnostic or therapeutic decisions of glycemic status. The objective of this study was to identify a correlation between severity of different types of anemia and the derangement of HbA1c levels in an adult non-diabetic population. Materials and Methods The present study was conducted on non-diabetic anemic patients admitted in the Department of General Medicine of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre from January 2018 to December 2018. Relevant data was collected by a detailed interview with the patient, clinical examination and blood investigations. The fasting blood sugars and post prandial blood sugars were measured in order to rule out a diagnosis of diabetes mellitus. Following this, the patients were categorised into the 3 categories of severity of anemia, based on the WHO Grading, as per the patient’s hemoglobin values. Peripheral smear and HbA1c was measured and recorded and a correlation of severity of different types of anemia with HbA1c values was studied. Statistical tests such as Chi Square test and ANOVA were used for analysis. Results In the 100 non diabetic anemic patients, age ranged from 18-86 years. The number of female patients was slightly more than males. The commonest symptom of patient presentation was generalized weakness, and the most common sign was pallor. Majority of our patients were found to have iron deficiency anemia. It was observed that that the HbA1c was significantly higher in females as compared to males (p value 0.0106). No correlation was found on comparison of age, types of anemia or severity of anemia with HbA1c. Conclusion HbA1c may be affected by variables such as age, sex, anemia, chronic illnesses or drugs. We feel it is worthwhile to study these confounding factors with large sample sizes for ascertaining a correlation of HbA1c with these variables before diagnosing and treating diabetes mellitus based on it alone.