Red Cell and Platelet Indices as Biomarkers of Poor Glycemic Control in Patients With Type 2 Diabetes: A Case-Control...

Type 2 diabetes mellitus (T2DM) is associated with systemic inflammation and altered hematological function, including changes in red cell indices and platelet hyperreactivity. While glycosylated hemoglobin (HbA1c) is the gold standard for monitoring glycemic control, its cost and susceptibility to conditions like anemia highlight the need for accessible, reliable alternative biomarkers, particularly for identifying patients with poor glycemic control (HbA1c ≥ 7.0%). This case-control study, therefore, investigated the utility of red cell and platelet indices as potential biomarkers of poor glycemic control in Ghanaian T2DM patients.

This study recruited 134 people living with T2DM and 134 nondiabetic controls. Cases were categorized into groups with poor glycemic control (HbA1c ≥ 7.0%) and good glycemic control (HbA1c < 7.0%). HbA1c was measured using an automated analyzer, and hematological indices were measured using a Sysmex XN 2000 analyzer. Statistical analyses were performed in R Language and SPSS version 26 at a significance level of 0.05% and 95% confidence interval employing a logistic prediction model.

Prevalence of poor glycemic control was 60.9%. Cases with poor glycemic control had significantly lower red cell indices such as hemoglobin, hematocrit, red blood cells count, and MCV, but a higher MPV compared to controls (p < 0.05). Multivariate logistics regression showed increasing hemoglobin levels (aOR: 0.40, 95% CI: [0.11-0.78]; p = 0.0130) and hematocrit (aOR: 0.03, 95% CI: [0.01-0.92]; p = 0.0140) were independently associated with decreased likelihood of poor glycemic control, whiles increasing MPV (aOR: 1.15, 95% CI: [1.02-3.09]; p = 0.0440) demonstrated an independent association with increased likelihood of poor glycemic control.

Hemoglobin level, hematocrit, and mean platelet volume are significantly associated with, and can potentially serve as independent predictors of poor glycemic control. These routine, cost-effective hematological parameters could be incorporated into risk assessment and management protocols for T2DM in resource-limited settings.