Original Article

Ann Lab Med 2012; 32(1): 17-22

Published online January 1, 2012

Copyright © Korean Society for Laboratory Medicine.

Effect of Iron Deficiency Anemia on Hemoglobin A1c Levels

Nitin Sinha, M.D.1, T.K. Mishra, M.D.2, Tejinder Singh, M.D.3, and Naresh Gupta, M.D.1

Department of Medicine1, Lok Nayak Hospital, Delhi; Departments of Biochemistry2 and Pathology3, Maulana Azad Medical College, Delhi, India

Correspondence to: Naresh Gupta
Department of Medicine, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, 110002, India
Tel: +91-11-2322-1922
Fax: +91-11-2321-0861

Received: October 4, 2010; Revised: May 28, 2011; Accepted: June 26, 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: Iron deficiency anemia is the most common form of anemia in India. Hemoglobin
A1c (HbA1c) is used in diabetic patients as an index of glycemic control reflecting glucose levels of the previous 3 months. Like blood sugar levels, HbA1c levels are also affected
by the presence of variant hemoglobins, hemolytic anemias, nutritional anemias, uremia, pregnancy, and acute blood loss. However, reports on the effects of iron deficiency
anemia on HbA1c levels are inconsistent. We conducted a study to analyze the effects of iron deficiency anemia on HbA1c levels and to assess whether treatment of iron deficiency
anemia affects HbA1c levels.
Methods: Fifty patients confirmed to have iron deficiency anemia were enrolled in this study. HbA1c and absolute HbA1c levels were measured both at baseline and at 2 months after treatment, and these values were compared with those in the control population.
Results: The mean baseline HbA1c level in anemic patients (4.6%) was significantly lower than that in the control group (5.5%, P<0.05). A significant increase was observed in the patients’ absolute HbA1c levels at 2 months after treatment (0.29 g/dL vs. 0.73 g/dL, P< 0.01). There was a significant difference between the baseline values of patients and controls
(0.29 g/dL vs. 0.74 g/dL, P<0.01).
Conclusions: In contrast to the observations of previous studies, ours showed that HbA1c levels and absolute HbA1c levels increased with treatment of iron deficiency anemia. This could be attributable to nutritional deficiency and/or certain unknown variables. Further studies are warranted.

Keywords: Iron deficiency anemia, Hemoglobin A1c, HbA1c, Glycated hemoglobin