Résumé:
Glycemic control is very important for the management of the risk of
long-term complications in diabetic patients. The HbA1c is the most
commonly used marker but its rate is a ected by numerous physiological and
pathological variations as seen during renal failure, hemolyse, hemoglobinopathies
and also iron deficiency anemia during which levels are falsely
higher.In this case, particular interest is given to fructosamine which is
independent of the fluctuations incurred by hemoglobin.Our present study
aims to determine the impact of iron deficiency anemia on glycated hemoglobin
determination
and the place
of fructosamine
in this situation.
We
conducted a case-control study at the central laboratory of medical
analysis. We realize di erent biochemical parameters in cases and controls
such as: glycaemia, HbA1C, Fructosamine, iron, ferritin, hemoglobin and
others, the statistical study was done with excel and SPSS So ware
Our study focused on a series of 100 type 2 diabetic patients, 50 of whom were
anemic (cases) with a sex ratio of 0.21 and 50 non anemic (controls)with a sex
ratio of 0.72.
The mean HbA1c in cases (no iron treated)is 8.83% (SD=2.6) and 7.77 %( SD=1)
in controls. The average fructosamine in cases (no iron treated) is 395.50
umol/dl (SD=118.03) and 449.11 umol/dl (SD=146,43)in controls. The student
test demonstrated significant di erence of HbA1c levels between cases and
controls independently of glycaemia nevertheless no di erence in fructosamine
rates.
In
anemic diabetics we found no significant correlation between glycated
hemoglobin and Glycaemia while fructosamine was well correlated, also no
correlation between HbA1c and fructosamine while this two parameters were
correlated in patients without anemia.
Our results confirm that fructosamine values evolve in parallel with those of
glycated hemoglobin, but are not subject to variations in hemoglobin hence
the usefulness of this parameter in these situations
