Correlation between Fasting Blood Glucose, Serum Ferritin and Glycated Haemoglobin (Hba1c) Level in Patients of Type 2 Diabetes Mellitus

Abstract

The study was undertaken to evaluate the correlation of serum ferritin with fasting blood sugar and HbA1c in diabetes mellitus and to assess the possible relation between them to have better understanding of the disease process. Fasting blood sugar, serum ferritin and HbA1c were assayed in type 2 diabetic patients. Hyperglycemia was observed in all the diabetic patients. Serum ferritin levels in diabetic cases were significantly higher and also statistically significant.
 Persistent hyperglycemia in uncontrolled diabetics can cause damage via increased production of free radicals especially ROS, from glucose auto-oxidation and inflammation. Elevated levels of serum ferritin are triggered by inflammation, independent of iron stores. Low- grade inflammation plays a predominant role in the pathogenesis of diabetes mellitus. Reactive oxygen species interfere with insulin signaling and may be the main mechanism for insulin resistance resulting in hyperglycemia.
Increased glucotoxicity contributes to oxidative stress and increased predisposition to inflammation consequently resulting in elevated serum ferritin levels.
Due to hyperglycemia, there is enhanced oxidative stress sequentially leading to increased inflammation and endothelial dysfunction. Elevated levels of inflammation predisposes to decline in sensitivity to insulin further triggering the cyclical process and resulting in detrimental effects in diabetes mellitus. The pathological sequence for type 2 diabetes is complex and entails many different elements that act in concert in the progression of the disease. Thus, a focus on reducing glycemia alone is inadequate to diminish the damaging effects in diabetes, highlighting the need for aggressive treatment of other risk factors.