Abstract
Background: Diabetes is a global public health problem and associated with metabolic, cellular, and blood disturbances. The red cell distribution width (RDW) is an index of heterogeneity & has been recently recognised as an inflammatory marker for various diseases. In this study, we assessed the relation between RDW with HbA1C and vascular complications and to find the correlation between RDW and glycemic control (HbA1c) as well as vascular complications in patients with Type 2 DM
Material and Methods: Present study was single-center, prospective, observational study, conducted in patients of either gender, age >20yrs with diagnosed case of Type 2DM, levels of Glycated Hemoglobin (HbA1c) and RDW (Red Cell Distribution Width) were measured.
Results: Among 100 patients, majority were from > 60 years age group (35 %), followed by 51-60 years (28 %) & mean age of study group was 55.3 ± 7.51 years. Male patients (54 %) were marginally more than female patients (46 %). Majority of patients had duration of DM of 0-5 years (47 %) & 22 % had duration of DM of >10 years. In majority of patients HbA1C was ≥ 8.5 % (82 %).Mean RDW values in patients with HbA1C ≥ 8.5 % was 14.31 ± 2.45 as compared to .patients with HbA1C ≥ 8.5 % as 13.56 ± 2.11, difference was significant statistically (p value- 0.039).We compared RDW values in patients with & without vascular complications (retinopathy, neuropathy, nephropathy, ischemic heart disease, cerebro-vascular accident & peripheral arterial disease) &, difference was not significant statistically (p value- >0.05).
Conclusion: RDW was significantly higher in patients with uncontrolled sugars, As RDW is an inexpensive, noninvasive, and convenient indicator, RDW can be used as a surrogate marker for HbA1C in assessing glycemic control.
Keywords: red cell distribution width (RDW), HbA1C, glycemic control, diabetes mellitus.
References
- Mahsud MAJ, Khan A, Hussain J. Hematological changes in tobacco using type 2 diabetic patients. Gomal J Med Sci. 2010;8:8–11.
- Grossin N, Wautier MP, Wautier JL. Red blood cell adhesion in diabetes mellitus is mediated by advanced glycation end product receptor and is modulated by nitric oxide. Biorheology. 2009;46:63-72.
- American Diabetes Association. Standards of Medical Care in Diabetes—2014. Diabetes Care. 2014;37(Supplement 1):S14-80.
- Lippi G, Targher G. Glycated hemoglobin (HbA1c): old dogmas, a new perspective? Clin Chem Lab Med. 2010;48(5):609-14.
- Zalawadiya SK, Zmily H, Farah J, Daifallah S, Ali O, Ghali JK. Red cell distribution width and mortality in predominantly African-American population with decompensated heart failure. J Card Fail. 2011;17:292–298.
- Morris M, Davey F. Basic examination of blood. In: Henry JB, editor. Henry’s clinical diagnosis and management by laboratory methods. 20th ed. Philadelphia: Saunders; 2001.
- K. Ogurtsova, J. D. da Rocha Fernandes, Y. Huang et al., “IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040,” Diabetes Research and Clinical Practice, vol. 128, pp. 40–50, 2017.
- Weijers RN. Membrane flexibility, free fatty acids, and the onset of vascular and neurological lesions in type 2 diabetes. J Diabetes Metab Disord. 2015;15:13.
- Agrawal R, Smart T, Nobre-Cardoso J, et al. Assessment of red blood cell deformability in type 2 diabetes mellitus and diabetic retinopathy by dual optical tweezers stretching technique. Sci Rep. 2016;6:e15873.
- Felker GM, Allen LA, Pocock SJ et al (2007) Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol 50:40–47
- Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M, for the Cholesterol and Recurrent Events (CARE) Trial Investigators (2008) Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 117:163–168
- Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM (2009) Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 169:515–523
- Perlstein TS, Weuve J, Pfeffer MA, Beckman JA (2009) Red blood cell distribution width and mortality risk in a community based prospective cohort. Arch Intern Med 169:588–594
- Chitra Srinivasan and Adithya Biswas, Correlation of Red Blood Cell Distribution Width (RDW) and Hemoglobin A1C (HbA1c) Levels, In Patients with Type 2 Diabetes Mellitus, Int. J. Res. Pharm. Sci., 2020, 11(1), 1160-1164
- Barla K and Kavya SV: Evaluation of correlation between glycated hemoglobin and hematological indices in type 2 diabetes mellitus patients. Int J Pharm Sci & Res 2021; 12(10): 5364-70.
- Nada AM. Red cell distribution width in type 2 diabetic patients. Diabetes Metab Syndr Obes Targ Ther. 2015;8:525–33.
- Peersab M Pinjar, Jithin George, Georgin Mani, Correlation between Red Cell Distribution Width and Glycemic Control in Diabetic Patients, International Journal of Science and Research (IJSR) February 2018, 7 (2)
- Engstrom G, Smith JG, Persson M, Nilsson PM, Melander O, Hedblad B. Red cell distribution width, haemoglobin A1c and incidence of diabetes mellitus. J Intern Med. 2014;276(2):174–83.
- Nguyen T, Quang Vo T, Nguyen G, Nguyen T. Assessment of Health-Related Quality of Life in Patients with Type II Diabetes Mellitus: A Population-Based Study at a Tertiary Hospital. Journal of Clinical and Diagnostic Research. 2018;12
Corresponding Author
Dr S. Senthilnathan
Professor, Department of General Medicine, Annapoorana Medical College and Hospitals, Salem