Study of glycated haemoglobin (hba1c) level in non diabetic iron deficiency anemia

Background: Glycated haemoglobin is produced by a ketoamine reaction between glucose and the N-terminal valine of both ß-chains of the haemoglobin molecule. The major form of glycated haemoglobin is haemoglobin A1c (HbA1c) .The HbA1c fraction is abnormally elevated in chronic hyperglycaemic diabetic patients and it correlates positively with the glycaemic control. However, increased glycated haemoglobin levels have been documented in iron deficiency anaemic patients without any history of diabetes. Aims and Objectives: The aim of this study was to determine the effect of IDA on the HbA1c levels in nondiabetic patients. Methods: 60 non-diabetic, anaemic patients and 60 age-matched healthy subjects were involve in this study. Haematologic investigations were done and the fasting and postprandial glucose and HbA1c levels were measured in all the subjects. Results: The mean HbA1c (8.9 ± 1.8%) level in the patients with IDA was higher than that in the control group (5.4% ± 0.8) (p < 0.05). There were no differences in the levels of fasting and postprandial glucose between the IDA and the control groups (p > 0.05). Conclusion: HbA1c is not affected by the blood sugar levels alone, and there are various confounding factors when HbA1c is measured, especially that of iron deficiency, which is the commonest of the deficiency diseases worldwide. It is hence important to rule out IDA before making a therapeutic decision, based on the HbA1c levels.

Dr. Chhabra, R. J., Dr. Rakesh dhadhal and Dr. Kiran Sodvadiya
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