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Effects of iron deficiency anemia on hemoglobin A1c in type 1 diabetes mellitus
O Tarim1, A Küçükerdoğan, U Günay
1Department of Pediatrics, Uludağ University, Bursa, Turkey. tarim@superonline.com
Insights
Iron deficiency is linked to higher hemoglobin A1c (HbA1c) in type 1 diabetes. Iron therapy improved HbA1c in both diabetic and non-diabetic patients, highlighting the importance of iron status in diabetes management.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Hematology
Background:
- The interplay between iron status and glycemic control, specifically hemoglobin A1c (HbA1c), in type 1 diabetes mellitus (DM) remains underexplored.
- Iron deficiency and insufficient iron stores are common comorbidities that may influence HbA1c levels.
Purpose of the Study:
- To investigate the impact of iron deficiency on HbA1c levels in patients with type 1 DM.
- To assess the effect of iron supplementation on HbA1c in iron-deficient individuals with and without diabetes.
Main Methods:
- A prospective study involving 37 patients with type 1 DM, categorized into iron-deficient (ID) and iron-sufficient (IS) groups.
- Iron-deficient patients received iron therapy (6 mg/kg/day for 3 months).
- Glycemic control was monitored at home, and HbA1c was measured pre- and post-intervention.
Main Results:
- Patients with ID DM exhibited significantly higher HbA1c levels compared to controls (P < 0.001).
- Iron supplementation led to a significant decrease in HbA1c in ID DM patients (10.1% to 8.2%, P < 0.05) and ID non-diabetic patients (7.6% to 6.2%, P < 0.05).
- No significant changes in weekly average glucose concentrations were observed after iron therapy in ID DM patients.
Conclusions:
- Iron deficiency anemia is associated with elevated HbA1c concentrations in type 1 DM patients with comparable glycemic levels.
- Iron replacement therapy effectively reduces HbA1c in both diabetic and non-diabetic individuals with iron deficiency.
- Clinicians should consider iron status when interpreting HbA1c values in type 1 DM patients.
Background:
The relationship between hemoglobin A1c (HbA1c) and iron status in type 1 diabetes mellitus (DM) has not been adequately studied. In this prospective investigation, we aimed to determine the effect of iron deficiency on HbA1c in diabetic patients who also had insufficient iron stores.
Methods:
Thirty-seven patients with type 1 DM were included in the study. Eleven of them were also iron deficient (ID) and the remaining 26 were iron-sufficient (IS). Two non-diabetic control groups were selected for the ID and IS groups. All patients with ID were treated with iron at 6 mg/kg per day for 3 months. Glycemia in diabetic patients was monitored at home before breakfast and supper by a glycometer. Hemoglobin A1c was measured in all subjects at the beginning and the end of the study.
Results:
Patients with ID DM had higher levels of HbA1c than those in the control group (P < 0.001). There were no significant differences in the weekly average glucose concentration of the patients with ID DM before and after iron supplementation. In contrast, HbA1c decreased from a mean of 10.1 +/- 2.7% to a mean of 8.2 +/- 3.1% (P < 0.05). Additionally, HbA1c in ID non-diabetic patients decreased from a mean of 7.6 +/- 2.6% to 6.2 +/- 1.4% after iron therapy (P < 0.05).
Conclusions:
We conclude that among type 1 DM patients with similar level of glycemia, iron deficiency anemia is associated with higher concentrations of HbA1c. In addition, iron replacement therapy leads to a drop in HbA1c in both diabetic and non-diabetic patients. The iron status of the patient must be considered during the interpretation of HbA1c concentrations in type 1 DM.