Critical Relationship Between Iron Deficiency Anaemia (IDA) and Glycated Haemoglobin (HbA1c): An Updated Review.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing 57 published studies without quantitative meta-analysis
PubMed 41588960 · doi:10.2174/0113895575401602251127012254
What was done
A narrative mini-review searched PubMed, MEDLINE, and Google Scholar for English-language studies published between 1982 and 2024 examining the relationship between iron deficiency anaemia (IDA) and glycated haemoglobin (HbA1c). Following PRISMA search guidelines, 57 articles met the selection criteria and were synthesized to assess how IDA affects diabetes diagnosis and monitoring.
What was found
The abstract reports no numerical values, effect sizes, or pooled statistical results. It notes conflicting outcomes across the 57 studies: several reported elevated HbA1c levels in patients with IDA independent of actual glycaemic status, while others identified no significant link. Iron replacement therapy was observed to normalize HbA1c levels in many cases. Proposed mechanisms included altered red blood cell turnover, structural modifications to haemoglobin, and oxidative stress-induced glycation.
Why it matters
Iron deficiency anaemia may distort HbA1c readings and lead to the overdiagnosis or mismanagement of diabetes, highlighting the need to verify iron status or use alternative markers like fructosamine or glycated albumin in at-risk populations.
Limits
The review is qualitative and does not conduct a meta-analysis or report quantitative summary metrics. Confounding across studies was high due to differing HbA1c assay methodologies and diverse patient populations. Total human sample size, study-level quality assessments, and precise magnitudes of HbA1c changes are not reported in the abstract.
Cited by
- supports Red blood cell disorders and variations in erythrocyte lifespan can alter hemoglobin A1c (HbA1c) readings.