Treat anemia first, before using HbA1c for accurate estimati
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Diabetes is prevalent in the Indian population, to the extent that the diabetes burden matches that of nutritional anemia. Researchers aimed to determine the effects of iron and vitamin B12 deficiency anemia on glycated haemoglobin (HbA1c) concentrations in individuals without diabetes.

The study comprised 100 patients with iron deficiency anemia, 100 with vitamin B12 deficiency anemia, and 100 healthy volunteers as a control group. Each of the first two groups was subdivided into two groups depending on the severity of anemia based on Hb levels. Iron replenishment in the iron deficiency group and B12 replenishment in the B12 deficiency group was treated for three months. HbA1c levels before and after the therapy were noted. Data were entered into the SPSS package.

Results:
-- The mean HbA1c before treatment were 6.1% ± 0.23% and 5.5% ± 0.24%, and the values after treatment were 5.1% ± 0.14% and 4.6% ± 0.2% in severe iron deficiency anemia subgroup and mild to moderate subgroup, respectively.

-- The mean HbA1c in the iron-deficiency anemia control group was 5.2% ± 0.2%. The mean HbA1c levels before treatment were 5.9% ± 0.3% and 5.6% ± 0.19%, and after treatment were 5.0% ± 0.15% and 4.9% ± 0.16% in severe and mild to moderate B12 deficiency anemia, respectively.

-- The mean HbA1c in the vitamin B12 deficiency anemia control group was 5.1% ± 0.2%.

Conclusively, HbA1c in both types of anemia subjects showed a significant decrease with appropriate therapy. Physicians should consider rechecking patient haemoglobin values and correcting a patient's anemia before determining the patient's glycemic status using HbA1c to avoid misinterpretation of their diabetes status.

Source: https://www.cureus.com/articles/40199-glycated-haemoglobin-hba1c-variations-in-nondiabetics-with-nutritional-anemia
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