Hematological parameters of type 2 diabetic adult patients at Debre Berhan Referral Hospital, Northeast Ethiopia: A comparative cross-sectional study

Mesay Arkew, Tilahun Yemane, Yordanos Mengistu, Kabtamu Gemechu, Girum Tesfaye, Mesay Arkew, Tilahun Yemane, Yordanos Mengistu, Kabtamu Gemechu, Girum Tesfaye

Abstract

Background: Diabetes is a global public health problem and associated with metabolic, cellular, and blood disturbances. Hematological changes have been reported in diabetes and play a major role in diabetes-associated complications. However, reports are contradicting and data on hematological parameters of type 2 diabetic patients in the study area are scarce. Therefore, the aim of this study was to assess the hematological parameters of type 2 diabetic adult patients at Debre Berhan Referral Hospital, Northeast Ethiopia from May 01 to June 30, 2020.

Methods: A comparative cross-sectional study was conducted on 268 (134 type 2 diabetic patients and 134 controls) study participants selected by systematic random sampling technique. Socio-demographic, behavioral, and clinical data were collected using a structured questionnaire and checklist. Ethical approval was obtained from Jimma University. All phase of quality assurance was maintained. Hematological parameters and blood glucose levels were determined using UniCel DxH 800 (Beckman Coulter, USA) and Biosystems A25 (Costa Brava, Spain) analyzers, respectively. Independent t-test, Mann-Whitney U-test, correlation, and logistic regression were used during data analysis. P-value <0.05 was considered as statistically significant.

Results: The current study found that total white blood cell count, absolute counts of neutrophil, lymphocyte, eosinophil, and basophil, red blood cell distribution width, platelet count, and mean platelet volume were significantly higher in type 2 diabetic patients as compared to the control group (P<0.05). On the other hand, the mean hemoglobin was significantly lower in type 2 diabetic patients than the control group (P = 0.007). Anemia was found in 17.9% of type 2 diabetic patients. Longer duration of diabetes (AOR = 3.05, 95% CI = 1.12-8.34) and milk consumption (AOR = 4.60, 95% CI = 1.50-14.00) were significantly associated with anemia.

Conclusion: This study showed a statistically significant variation in some hematological parameters of type 2 diabetic patients compared to control group. Anemia among type 2 diabetic patients was found to be a mild public health problem. Therefore, routine screening of hematological parameters should be considered for proper management of type 2 diabetic patients. Close attention should also be given to the duration of diabetes and dietary practice.

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2014;37(supplement 1):81–90. doi: 10.2337/dc14-S081
    1. International Diabetes Federation (IDF). IDF Diabetes Atlas. 9th ed. 2019. 34–60 p.
    1. Agu K. Diabetes mellitus: A review of some of the prognostic markers of response to treatment and management. J Insul Resist. 2018;3(1):1–10.
    1. Karaman A, Ozturk A, Ph D, Altunbas H, Gökce C, Kalkan A, et al.. Prevalence of metabolic syndrome in the Mediterranean Region of Turkey: evaluation of hypertension, diabetes mellitus, obesity, and dyslipidemia. Metab Syndr Relat Disord. 2009;7(5):427–34. doi: 10.1089/met.2008.0068
    1. Antwi-Baffour S, Kyeremeh R, Boateng S, Annison L, Seidu M. Haematological parameters and lipid profile abnormalities among patients with Type-2 diabetes mellitus in Ghana. Lipids Health Dis. 2018;17(283):1–9. doi: 10.1186/s12944-018-0926-y
    1. Waggiallah H, Alzohairy M. The effect of oxidative stress on human red cells glutathione peroxidase, glutathione reductase level, and prevalence of anemia among diabetics. N Am J Med Sci. 2011;3(7):344–7. doi: 10.4297/najms.2011.3344
    1. Gauci R, Hunter M, Bruce DG, Davis WA, Davis TME. Anemia complicating type 2 diabetes: Prevalence, risk factors and prognosis. J Diabetes Complications. 2017;31(7):1169–74. doi: 10.1016/j.jdiacomp.2017.04.002
    1. Barbieri J, Fontela PC, Winkelmann ER, Eloise C, Zimmermann P, Sandri YP, et al.. Anemia in Patients with type 2 diabetes mellitus. Hindawi Publ Corp. 2015;2015:1–7. doi: 10.1155/2015/354737
    1. Feteh VF, Choukem S, Kengne A, Nebongo DN. Anemia in type 2 diabetic patients and correlation with kidney function in a tertiary care sub-Saharan African hospital: a cross-sectional study. BMC Nephrol. 2016;17(29):1–7.
    1. Asmah RH, Yeboah G, Archampong TN, Brown CA, Amegatcher G, Adjei DN. Relationship between oxidative stress and haematological indices in patients with diabetes in the Ghanaian population. Clin Diabetes Endocrinol. 2015;1(7):4–8. doi: 10.1186/s40842-015-0008-2
    1. Kaur R, Kaur M, Singh J. Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies. Cardiovasc Diabetol. 2018;17(121):1–17. doi: 10.1186/s12933-018-0763-3
    1. Hillson R. Diabetes and the blood–white cells and platelets. Pract Diabetes. 2015;32(5):159–60.
    1. Demirtas L, Degirmenci H, Akbas EM, Ozcicek A, Timuroglu A, Gurel A. Association of hematological indicies with diabetes, impaired glucose regulation and microvascular complications of diabetes. Int J Clin Exp Med. 2015;8(7):11420–7.
    1. Cakir L, Gulali A, ENGINYURT O, CAKIR S. Mean platelet volume increases in type 2 diabetes mellitus independent of HbA1c level. Acta Medica Mediterr. 2014;30:425–8.
    1. Vozarova B, Weyer C, Lindsay RS, Pratley RE, Bogardus C, Tataranni PA. High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes. Diabetes. 2002;51:455–61. doi: 10.2337/diabetes.51.2.455
    1. Korniluk A, Koper-lenkiewicz OM, Kami J, Kemona H, Dymicka-piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Hindawi Publ Corp. 2019;1–26. doi: 10.1155/2019/9213074
    1. Pujani M, Gahlawat H, Agarwal C, Chauhan V, Singh K. Platelet parameters: Can they serve as biomarkers of glycemic control or development of complications in evaluation of type 2 diabetes mellitus? Iraqi J Hematol. 2018;7(72–78).
    1. Yazici S, Turfan M, Hizal F. Coronary heart disease is associated with mean platelet volume in type 2 diabetic patients. Platelets. 2010;21(5):368–72. doi: 10.3109/09537101003628421
    1. Alhadas KR, Santos SN, Freitas MMS, Viana SMSA. Are platelet indices useful in the evaluation of type 2 diabetic patients? J Bras Patol Med Lab. 2016;52(2):96–102.
    1. Kizilgul M, Sencar E, Ucan B, Beysel S, Ozcelik O, Ozbek M, et al.. Components of the complete blood count in type 2 diabetes mellitus with inadequate glycemic control. Dicle Med J. 2018;45(2):113–20.
    1. Osman NA, Mansour MM. Measurement of some haematological parameters in diabetic patient attending military hospsital in Omdurman. Sudan Univ Sci Technol Institutional Digit Repos. 2013;0–1.
    1. Jabeen F, Rizvi HA, Aziz F, Wasti AZ. Hyperglycemic induced variations in hematological indices in type 2 diabetics. Int J Adv Res. 2013;1(8):322–34.
    1. Biadgo B, Melku M, Mekonnen S, Abebe M. Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia. Diabetes, Metab Syndr Obes Targets Ther. 2016;9:91–9. doi: 10.2147/DMSO.S97563
    1. Saad Z, Shehri A. The relationship between some biochemical and hematological changes in type 2 diabetes mellitus. Biomed Res Ther. 2017;4(11):1760–74.
    1. Milosevic D, Panin VL. Relationship between hematological parameters and glycemic control in type 2 diabetes mellitus patients. J Med Biochem. 2019;38(2):164–71. doi: 10.2478/jomb-2018-0021
    1. Ethiopian Roads Authority. Consultancy service for detailed engineering design, tender document Debre Berhan–Ankober road project environmental impact assessment report. 2011. 69 p.
    1. American International Health Alliance. How twinning helped transform Debre Berhan Referral Hospital into a national model for quality care and effective management. 2014. 1 p.
    1. World Health Organization (WHO). Guidelines on standard operating procedures for clinical chemistry. World Health Organization, Regional Office for South-East Asia. 2000. p. 15.
    1. NHANES. Complete blood count with 5-Part Differential laboratory procedure manual. 2014. 1–174 p.
    1. World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva, World Health Organization. Vitam Miner Nutr Inf Syst. 2011;11(1):1–6.
    1. Christian M, Adebayo A, Chinyere N, Wisdom N. Some haematological parameters in diabetic patients in Port Harcourt Nigeria. Asian J Multidiscip Stud. 2015;3(2):21–5.
    1. S HK, Srinivasa S V, Prabhakar K. Haematological profile of diabetes and non-diabetes patients in rural tertiary center. Int J Adv Med. 2017;4(5):1271–5.
    1. Salhen KS Al Mahmoud AY, City E. Hematological profile of patients with type 2 diabetic mellitus in El-Beida, Libya. Ibnosina J Med Biomed Sci. 2017;9(3):76–80.
    1. Olana C, Seifu D, Menon MKC, Natesan G. Abnormal hematological indices and anthropometric parameters associated with type 2 Diabetes. Int J Biomed Adv Res. 2019;10(11):1–8.
    1. Cho YI, Mooney MP, Cho DJ. Hemorheological disorders in diabetes mellitus. J Diabetes Sci Technol. 2008;2(6):1130–8. doi: 10.1177/193229680800200622
    1. Abdel N, Hamed M. Alterations in hematological Parameters: could it be a marker in diabetes mellitus? BAOJ Diabet. 2016;2(1):1–9.
    1. Ellinger V, Carlini L, Moreira R, Meirelles R. Relation between insulin resistance and hematological parameters in a brazilian sample. Arq Bras Endocrinol Metab. 2006;50(1):114–7.
    1. Salvagno GL, Sanchis-gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2014;1–20. doi: 10.3109/10408363.2014.992064
    1. Sherif H, Ramadan N, Radwan M, Hamdy E, Rabab R. Red cell distribution width as a marker of inflammation in Type 2 diabetes mellitus. Life Sci J. 2013;10(4):32–9.
    1. Alam J, Mallik SC, Mokarrama N-E, Hoque M, Hasan M, Islam S. A comparative analysis of biochemical and hematological parameters in diabetic and non -diabetic adults. Adv Med Sci. 2015;2(1):1–9.
    1. Awofisoye OI, Adeleye JO, Olaniyi JA, Esan A. Prevalence and correlates of anemia in type 2 diabetes mellitus: A study of a Nigerian outpatient diabetic population. Sahel Med J. 2019;22:55–63.
    1. Fiseha T, Adamu A, Tesfaye M, Gebreweld A. Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia. PLoS One. 2019;14(9):1–12. doi: 10.1371/journal.pone.0222111
    1. Sahay M, Kalra S, Badani R, Bantwal G, Bhoraskar A, Das AK, et al.. Diabetes and Anemia: International Diabetes Federation (IDF) -Southeast Asian Region (SEAR) position statement. Diabetes Metab Syndr Clin Res Rev. 2017;11:685–95. doi: 10.1016/j.dsx.2017.04.026
    1. Gkrania-Klotsas E, Ye Z, Cooper AJ, Sharp SJ, Luben R, Biggs M, et al.. Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies. PLoS One. 2010;5(10):1–12. doi: 10.1371/journal.pone.0013405
    1. Jiang H, Yan W, Li C, Wang A, Dou J. Elevated white blood cell count is associated with higher risk of glucose metabolism disorders in middle-aged and elderly Chinese people. Int J Environ Res Public Heal. 2014;11:5497–509. doi: 10.3390/ijerph110505497
    1. Alba-Loureiro TC, Munhoz CD, Martins JO, Cerchiaro GA, Scavone C, Curi R, et al.. Neutrophil function and metabolism in individuals with diabetes mellitus. Braz J Med Biol Res. 2007;40:1037–44. doi: 10.1590/s0100-879x2006005000143
    1. Akinsegun A, Olusola D, Sarah J, Olajumoke O, Adewumi A, Majeed O, et al.. Mean platelet volume and platelet counts in type 2 diabetes mellitus on treatment and non-diabetic mellitus controls in Lagos, Nigeria. Pan Afr Med J. 2014;18(42):1–5. doi: 10.11604/pamj.2014.18.42.3651
    1. Lee RH, Bergmeier W. Sugar makes neutrophils RAGE: linking diabetes- associated hyperglycemia to thrombocytosis and platelet reactivity. J Clin Invest. 2017;127(6):2040–1. doi: 10.1172/JCI94494
    1. Kakouros N, Rade JJ, Kourliouros A, Resar JR. Platelet function in patients with diabetes mellitus: from a theoretical to a practical perspective. Int J Endocrinol. 2011;2011:1–14. doi: 10.1155/2011/742719
    1. Kshirsagar R, Deoke S, Akhtar S. Platelet indices in type 2 diabetes mellitus and their association with microvascular complications. Panacea J Med Sci. 2019;9(1):23–8.
    1. Jabeen F, Fawwad A, Rizvi H, Alvi F. Role of platelet indices, glycemic control and hs-CRP in pathogenesis of vascular complications in type-2 diabetic patients. Pak J Med Sci. 2013;29(1):152–6. doi: 10.12669/pjms.291.2592
    1. Randriamboavonjy V. Mechanisms involved in diabetes-associated platelet hyperactivation. 2015. 177–190 p.
    1. Wang Z-S, Song Z-C, Bai J-H, Li F, Wu T, Ji Qi, et al.. Red blood cell count as an indicator of microvascular complications in Chinese patients with type 2 diabetes mellitus. Vasc Health Risk Manag. 2013;9:237–43. doi: 10.2147/VHRM.S43211
    1. Bayoumi M, Mourtadaa S, Elbager S. Altered platelets morphological parameters in obese adults with Type 2 Diabetes Mellitus in Sudan. Am J Diabetes, Obes Metab. 2018;4(1):17–24.

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