Impact of iron deficiency anemia on HbA1c level in non-diabetic children

Abstract

Background and objective: HbA1c has been endorsed by the American Diabetes Association and World Health Organization to diagnose and monitor diabetes mellitus. Its value is directly proportional to the blood glucose level. However, besides the blood glucose level, other factors like iron deficiency anemia can affect HbA1c level. We conducted this study to reveal the impact of iron deficiency anemia on HbA1c level and to assess whether HbA1c result changes after the correction of iron deficiency anemia. Methods: Twenty five non-diabetic children who were confirmed to have iron deficiency anemia were enrolled. HbA1c, hemoglobin, serum iron, and ferritin were measured and compared at baseline and post-correction of iron deficiency anemia with a three-month age-appropriate dose of iron therapy. The baseline results were compared with 25 age- and sex-matched normal controls. Results: Children with iron deficiency anemia had significantly higher HbA1c level (6.144±0.6312, P <0.001) than the control group (5.032±0.5558, P <0.001). After three months of treatment of iron deficiency anemia, HbA1c significantly dropped (from 6.144±0.6312, P <0.001 to 5.604±0.51, P <0.001). Conclusion: This study concluded that HbA1c is inversely proportional to iron deficiency anemia in non-diabetic children, and treatment of iron deficiency anemia led to a drop in HbA1c level. Due to this false elevation of HbA1c by iron deficiency anemia, iron deficiency anemia should be considered and excluded before making the diagnosis or deciding on any therapeutic change in diabetic children. Keywords: Iron deficiency anemia; HbA1c; Non-diabetic children.