Red blood cell abnormalities and anemia among Diabetes Mellitus adult outpatients at University of Gondar Specialized Referral Hospital, Northwest Ethiopia: A Comparative cross-sectional study

Abstract

ABSTRACT Background: Diabetes mellitus (DM) patients show a significant derangement in various hematological parameters including changes affecting the red blood cells (RBCs). All these derangements have an imposing effect on any of the RBC indices. Anemia is one of the common but unrecognized hematological finding in DM patients. Objectives: The main aim of this study was determining the RBCs parameters in DM patients with those of healthy controls. Methods: A comparative cross-sectional study was conducted on a total of 246 participants (82 Type 1 DM, 82 Type 2 DM and 82 controls). Convenient sampling technique was used to select the study participants. The Socio-demographic data were collected using a structured questionnaire. Five ml venous blood (3 ml whole blood with K2 Ethylene diamine tetracetic acid (EDTA) anticoagulant and 2 ml in the serum separation tube) was collected from each participant by vacutainer blood collection technique. RBC parameters and renal function tests were determined by using Sysmex KX21N and BS-200E Mindray analyzers, respectively. The data were tested for normality with the help of Shapiro-wilk and Kolmogorov–Smirnov tests. Independent sample t-test, one way ANOVA, and bivariate correlation (Pearson’s and spearman’s rank) were used to analyze continuous variables. A p-value ? 0.05 was considered as statistically significant. Results: The mean Hemoglobin (Hb) concentration was 13.8 ± 1.8 g/dl and 15±1.3 in the diabetic groups and controls, respectively. Hb (p ?0.001), hematocrit (Hct) (p ?0.001), and mean cell volume (MCV) (p ?0.001) were among the RBC indices that showed a significant decrement in the diabetic patients as compared to controls. On the other hand, MCHC was significantly increased in DM patients (p ?0.001) than the controls. However, there was no significant difference between the diabetic and control groups respecting RBC, RDW, and MCH values. Moreover, anemia was prevalent in 12.2% (95% CI; 5-19.7%), 14.6% (95% CI; 6.8-22.4%), and 11% (95% CI; 4-17.9%) in Type 1 DM, Type 2 DM and controls, respectively. Besides, a significant negative correlation was found between Hb and creatinine in Type 2 DM patients. Conclusion: The mean values of RBC parameters (Hb, Hct, and MCV) for diabetic patients were found significantly lower than the control groups. It is, therefore, suggested that RBC parameters should be evaluated and treated periodically in DM patients for better prognosis and q