Clin Chim Acta. Download Download PDF. Florkowski C (2013) HbA(1c) as a Diagnostic Test for Diabetes Mellitus - Reviewing the Evidence. Eating well, in conjunction with exercise, can prevent . Sinha Nitin, HbA1c and factors other than diabetes mellitus . However, HbAlc is not affected by blood sugar levels alone. than 45 years with major risk factors. 19 Non-glycaemic genetic determinants of glycation and differences in erythrocyte survival are . Furthermore, the . Eating unhealthily is a major cause of type 2 diabetes, as over 90 per cent of type 2 diabetics are overweight. Nitin S: HbA1c and factors other than diabetes mellitus affecting it. We estimated associations of diabetes mellitus status and hemoglobin A1c (HbA1c) with all‐cause and CVD mortality using covariate‐adjusted incidence rates and multivariable Cox proportional hazards regression. HbA1c is a biomarker with a central role in the diagnosis and follow-up of patients with diabetes, although not a perfect one. They constitute the HbAI fraction of the adult haemoglobin HbA. Diabetes mellitus (DM) describes a group of metabolic diseases that are characterized by chronic hyperglycemia. These levels are lowered by different forms of anemia, but reverse is the case in iron deficiency anemia (IDA). A: Normal human hemoglobin is made up of about 98% hemoglobin A (HbA). Keywords: Diabetes Mellitus, Glycated hemoglobin (HbA1c), Lp (a) INTRODUCTION adult blindness. DM develops from either a deficiency in insulin production or an impaired utilization of insulin. The relationship between type 2 diabetes mellitus and male hypogonadism is well known, 1, 2 whereas the impact of type 1 diabetes mellitus (DM1) on male fertility and testis functions has been less studied. Introduction Diabetes is a complex metabolic disease characterized by a state of chronic hyperglycemia. Several previous studies have analyzed the relationship between blood glucose (BG) and HbA 1c.Svendson et al. The expert group concluded that there is currently insufficient evidence to make any formal recommendation on the interpretation of HbA1c levels below 6.5%. Rafat D, Rabbani TK, Ahmad J, Ansari MA. However, HbA1c is not affected by blood sugar levels alone. A fasting plasma glucose of ≥7.0 mmol/L, a 2-hour plasma glucose value in a 75 g oral glucose tolerance test of ≥11.1 mmol/L or a glycated hemoglobin (A1C) of ≥6.5% can predict the development of retinopathy. Harefa E. Standarisasi dan harmonisasi pemeriksaan HbA1c. Diabetes mellitus has become a worldwide epidemic, physically affecting more . The data analysis did not affect the subsequent clinical management of the patients, no conflict of interest, and of no commercial value. FBS and HbA1c in type 2 diabetes mellitus and to evaluate the role of serum ferritin on glycemic status. obtained repeated preprandial and postprandial BG samples from 21 subjects with type 1 . some races than other races.26 Blacks and populations of Middle-East ancestry, compared to nHws have been shown on average to have higher HbA1c values, even after adjust-ment for factors likely to affect glycemia, although there are much wider differences within races than . Primary endpoints were SBP development and mortality. Estimation of Glycosylated hemoglobin (HbA1c) remains one of the most important and indispensable tools of investigation besides fasting and postprandial blood sugar levels and is a proven tool in the management and follow up of Diabetes Mellitus. This article reviews in detail the structure, formation, methods of measurement, factors . Keywords: Diabetes mellitus, ferritin, oxidative stress, HbA1c I. obtained repeated preprandial and postprandial BG samples from 21 subjects with type 1 . Singapore Med J. Prevalence of DM is a normal hemoglobin concentration and normal in our country is about 6.1% (5.6 millions) and it red blood cell survival.1,10 will hold the 8th position in the world according to the total cases of diabetes in adult population Total glycated hemoglobin (Total GHb) refers to (20 to 79 years) by the year 2030.2,3 all the . PERKENI, 2011. and other lipoprotein factors with HbA1c to change was observed with serum levels of LDL assess the risk for development of CHD in DM. However, HbA1c is not affected by blood sugar levels alone. Early symptoms are related to hyperglycemia and include polydipsia, polyphagia, polyuria, and blurred vision. <i . INTRODUCTION. Diabetes mellitus is clearly a major health problem that needs addressing at all levels. Randie R. Little, Curt L. Rohlfing, Alethea L. Tennill, et al. Hemoglobin A1 (HbA1) adalah derivat adult hemoglobin (HbA), dengan penambahan monosakarida (fruktosa atau glukosa). assessed 15 subjects with type 1 diabetes who collected seven-point BG profiles over a 5-week period (three profiles per week) and used a curvilinear equation to correlate BG and HbA 1c.Nathan et al. Common comorbidities encountered in patients with diabetes mellitus, such as renal insufficiency, high output states (iron deficiency anaemia, haemolytic anaemia, haemoglobinopathies and pregnancy) and intake of specific drugs could compromise the sensitivity and . It has been observed that an HbAlc value of less than seven percent reduces the microvascular complications in diabetic patients. Little RR, Wiedmeyer HM, England JD, Madsen R, Harris MI, et al. A value less than 6.5% does not exclude diabetes diagnosed using glucose tests. Nitin S. HbA1c and factors other than diabetes melitus affecting it. Singapore Medical Journal, 51(8):616-622. Singapore Med J. An A1C test is a blood test that reflects your average blood glucose levels over the past 3 months. • Specify the factors for when not to use HbA1c for diagnostic purposes SECTION 1 INTRODUCTION TO DIABETES. The amount of HbA1c formed is directly related to the average blood glucose concentration over the previous 8 to 12 weeks . Asian J. Methods: Adult patients with type 1 diabetes mellitus (T1D) were enrolled from five hospitals in China. HOW DOES CHRONIC KIDNEY DISEASE AFFECT HBA1C? HbA1c is the predominant fraction of HbA1 and gives an estimate of the blood sugar levels of an individual over the last three months. HbA1C and CGM data were . Background Serum fructosamine is a routine test used for clinical monitoring of diabetes mellitus (DM) but the usefulness of HbA1c for this purpose has not been extensively studied. 2011;34:61-99. An HbA 1c level of <48 mmol/mol (<6.5%) does not negate a diagnosis of diabetes based on elevated glucose parameters. The A1C test can also be used for diagnosis, based on the following guidelines: If your A1C level is between 5.7 and less than 6.5%, your levels have been in the prediabetes range. Animals 28 client-owned dogs with . HbA1c reflects average glycaemia over the preceding 6-8 weeks. Glycated haemoglobins are haemoglobins with an attached sugar moiety. . All subjects wore the iPro ™ 2 system for 14 days before HbA1c was measured at baseline, 3 months and 6 months. Your doctor will interpret this test, taking into account your medical history and other test results. Sinha N. HbAIc and factors other than diabetes mellitus affecting it. Abstract Glycated haemoglobins are haemoglobins with an attached sugar moiety. . Use of GHb (HbA1c) in . some races than other races.26 Blacks and populations of Middle-East ancestry, compared to nHws have been shown on average to have higher HbA1c values, even after adjust-ment for factors likely to affect glycemia, although there are much wider differences within races than . Mean glucose and mean amplitude of glucose excursion (MAGE) were calculated from CGM data and correlated with HbA1C and HbA1C-derived eAG using the ADAG study formula. Diabetes mellitus (DM) encompasses a heterogeneous group of disorders with the common characteristic of altered glucose tolerance or impaired lipid and carbohydrate metabolism. Data derived from iPro ™ 2 sensor was used to calculate GMI and GV parameters [standard deviation (SD), glucose coefficient of variation (CV), and mean amplitude of glycemic . Nitin S. HbA1c and factors other than diabetes mellitus affecting it. J . Exclusion Criteria: Pregnancy; Breast feeding; Use of any other diabetes treatment other than metformin within the past 3 months; Type 1 diabetes; HbA1c > 9% or less than . Many clinical conditions affect erythrocyte turnover which influence HbA1c levels. 3. : A number of factors determine HbA1c other than the level of glucose exposure alone. Paputungan SR, Sanusi H. Peranan Pemeriksaan Hemoglobin A1c pada Pengelolaan Diabetes Melitus. Introduction. World Health Organization. HbS trait, HbC trait), elevated fetal hemoglobin (HbF) and chemically modified derivatives of hemoglobin (e.g. It commonly manifests during childhood, often with an acute onset (e.g., diabetic ketoacidosis). Isocaloric exchange of sucrose with other carbohydrates did not affect glycemic control [14,15,16,17], including HbA1c-level (a marker of glycated hemoglobin, reflecting long-term average blood . Nitin S, 2010. Nitin, S. 2010. Association of soft tissue infection in the extremity with glucose and lipid metabolism and inflammatory factors. Keep a supply of foods that are easy on your stomach, such as gelatin, crackers, soups and applesauce. HbA1c is the predominant fraction of HbA1 and gives an estimate of the blood sugar levels of an individual over the last . Based upon these 2 conditions, diabetes mellitus can be divided into 2 main types: Type 1 (formerly . 1 The A1C test is also the primary test used for diabetes management. Factors altering HbA1c concentrations are Hb variants . mortality in patients with liver cirrhosis and ascites. The data analysis did not affect the subsequent clinical management of the patients, no conflict of interest, and of no commercial value. the nonglycemic factors that could affect the HbA1c levels of a patient [29,30]. 26. . 36 Full PDFs related to this paper. Sacks DB, Arnold M, Bakris GL, Bruns DE, et al. 2010, 51:616-22. Factors altering HbA1c concentrations are Hb variants . 35. For decades, hemoglobin A1c (A1c) has remained the standard biomarker for glycemic control. An HbA 1c level of ≥48 mmol/mol (≥6.5%) is recommended as the cut-off point for diagnosing diabetes. Glycated haemoglobin (Syn. Recovery from definite- or severe CAN to normal status was only observed in younger . . Hba1c And Factors Other Than Diabetes Mellitus Affecting It. They constitute the HbA1 fraction of the adult haemoglobin HbA. 2010, 51:616-22. 2012).Diabetic retinopathy (DR) is characterized by retinal microvascular damage, based on ischaemic changes and increased capillary permeability. It has been observed that an HbA1c value of less than seven percent reduces the microvascular complications in diabetic patients. The A1C test can be used to diagnose type 2 diabetes and prediabetes. The structure, formation, methods of measurement, factors affecting HbA1c levels and their clinical significance are reviewed in detail. Randie R. Little, Curt L. Rohlfing, Alethea L. Tennill, et al. Patients were followed up for a mean of 266 days. Singapore Med J. HbAl c and factors other than diabetes mellitus affecting it Nitin S ABSTRACT Glycated haemoglobins are haemoglobins with an attached sugar moiety. Diagnostic efficacy of HbA1c in diagnosis of diabetes mellitus in a Bangladesh population. Clin Chim Acta. It is of value for clinicians to understand how the various diagnostic criteria were developed and the potential factors, other than glycemia, which may affect the different tests. HbA1c is formed when haemoglobin joins with glucose in the blood becoming 'glycated'. . 27. and Research. HbA1c and factors other than diabetes mellitus affecting it. Objectives . The most common long-term diabetes-related health problems are: damage to the large blood vessels of the heart, brain and legs (macrovascular complications) damage to the small blood vessels, causing problems in the eyes, kidneys, feet and nerves (microvascular complications). J Bangladesh Med, 41 (2012), pp. HbA1c has been shown to be . [2] Jiang R, Manson JE, Meigs JB, Ma J, Rifai N, et al. Currently, HbA1c levels > 6.5 . Tables (2) Videos (1) Diabetes mellitus is impaired insulin secretion and variable degrees of peripheral insulin resistance leading to hyperglycemia. The disease is characterized by . 1 INTRODUCTION. Other factors, including neuropathy, retinopathy, nephropathy and vasculopathy did not increase the risk for hearing . Type 1 diabetes mellitus is the result of an autoimmune response that triggers the destruction of insulin-producing β cells in the pancreas and results in an absolute insulin deficiency. 2010;51:616-622. Diabetes Res Clin Pract 2011;93:299-9. . Jeeva S., Molly Babu. Journal of Ethnopharmacology, 2015. Knowledge of Diabetic Clients Regarding Self-care Practices in Management of type II Diabetes Mellitus at selected Rural Community of Bangalore, Karnataka. A short summary of this paper. Some hemoglobin variants can affect some HbA1c methods, but not all of them. RESULTS: According to Diamodul, the HbA1c levels are significantly worse than they were reported to NDR: the proportion of patients achieved HbA1c <7% for T1DM is 13.3% and 11.7%; T2DM - 25.1% . blood glucose control of the patients with diabetes mellitus. Introduction. Clin . obesity and other diabetic factors. It has many subclassifications, including type 1, type 2, maturity-onset diabetes of the young (MODY), gestational diabetes, neonatal diabetes, and steroid-induced diabetes. HbA1c and factors other than diabetes mellitus affecting it. Methods: A number of 475 consecutive patients with liver cirrhosis and ascites were analyzed. Guideline and recommendations for laboratory analysis in the diagnosis and management of diabetes melitus. A large number of patients with diabetes remain undiagnosed. and total cholesterol. 2013, 418:73-76. Animal and in vitro studies showed that insulin has a favorable effect on the gonadal function and spermatogenesis. Singapore Med J. Different types of anemia can have a negative . Diagnostic efficacy of HbA1c in diagnosis of diabetes mellitus in a Bangladesh population. Docsubty: REVDiabetes Mellitus and its management with medicinal plants: A perspective based on Iranian Research. Later complications include vascular disease, peripheral neuropathy, nephropathy, and . The chronic hyperglycemia of diabetes is associated with significant long-term microvascular and cardiovascular complications. 1 In 1993, the landmark Diabetes Control and Complications Trial (DCCT) demonstrated its importance as a predictor of diabetes-related outcomes, and the ADA . Prospects for reseach in diabetes mellitus. Hypothesis The study aimed to compare the ability of blood HbA1c and serum fructosamine tests to correctly classify DM control determined using a clinically-based assessment. The authors give a brief overview of the HbA1c and the factors affecting its value. ask whether HbA1c is reliable as . A so called Western diet, with a reliance on processed foods, poor quality fats and little fibre content, is thought to be a major contributor to diabetes and metabolic syndrome. 3-6 Insulin deficiency, the hallmark of patients . assessed 15 subjects with type 1 diabetes who collected seven-point BG profiles over a 5-week period (three profiles per week) and used a curvilinear equation to correlate BG and HbA 1c.Nathan et al. 11. Though OGTT was traditionally used as the gold-standard diagnostic test for diabetes, more clinicians are now switching to HbA1c or FPG, largely for convenience. HbA1c has revolutionised the diagnosis and monitoring of diabetes mellitus. Introduction. Hemoglobin A1c (HbA1c) is widely used as a diagnostic tool for diabetes. Lippi G, Targher G. Glycated hemoglobin (HbA1c): Old dogmas, a new perspective? glycemic control in patients with diabetes. Full PDF Package Download Full PDF Package. . HbA1c, also known a Glycated Haemoglobin, is used in the monitoring and diagnosis of diabetes mellitus. Cold weather may increase HbA1c levels in people with type 2 diabetes. For every 1°C decrease in temperature, there was an increase in the risk of having a HbA1c level >7% (R). . This study used primary data from Kumasi, Ghana, to examine whether social networks, social support, diabetes-related stigma, religion, and traditional medicine affected blood glucose (HbA1c) control among adults with type 2 diabetes mellitus (T2DM). 34. Singapore Med J 51(8): 616-622. Konsensus pengelolaan dan pencegahan diabetes melitus Tipe 2 di Indonesia. Additionally, diabetic patients were at higher risk of having HbA1c over 7% in the winter and spring than in the summer (R). It also predisposes to Diabetes mellitus (DM) is an iceberg disease. Arezou Rezaei. Stick to your diabetes meal plan. in pregnancy when up to six tests in a 12 month period can be subsidised). Results: Overall, 118 (25%) patients were diagnosed with . 10. Factors that Interfere with HbA1c Measurement: Genetic variants (e.g. Drink lots of water or other fluids that don't add calories, such as tea, to make sure you stay hydrated. 2011;51(8):616-22. This article reviews in detail the structure, formation, methods of measurement, factors affecting HbA1c levels and their clinical significance. 1 In some patients, HbA1c may be measured more frequently than 3 monthly to closely monitor glycaemic control (eg. Methods: A number of 475 consecutive patients with liver cirrhosis and ascites were analyzed. The existing criteria based on fasting and random glucose levels, and on the oral glucose tolerance test, remain valid, and . International Journal of A rare haemoglobin variant (Hb Iraq-Halabja) Diabetes in Developing Countries, 30(2): 86. causing spuriously low haemoglobin A1c values. Other parts of the body can also be affected by diabetes, including . Introduction. Nursing Edu. Updated 02/03/2022. Nat Rev Endocrinol 2020;16(12):717-30. doi: 10.1038/s41574-020-00425-6 Sinha N. HbA1c and factors other than diabetes mellitus affecting it. Included participants also had relatively well-controlled diabetes with baseline HbA1c of 7.3 ± 1.4%, change in HbA1c of 0.04 ± 1.21% during follow-up, and mean HbA1c of 7.1 ± 0.1%, compared to those who were included in other studies for CAN progression . HbA1c and factors other than diabetes mellitus affecting it. This Paper. The importance of controlling blood glucose levels to prevent cardiovascular events in patients with type 2 diabetes is not a new concept [1, 2].On the other hand, mortality rates were not decreased in recent clinical trials that set strict HbA1c control targets or, contrary to expectation, the mortality rate was reported to be higher in an intensive-therapy group than in a . Nitin S (2010) HbA1c and factors other than diabetes mellitus affecting it. Globally, type 2 diabetes mellitus (T2DM) is a swiftly escalating public health issue with noteworthy effects on human health, living standards, the economy and health care systems. This study screened for factors affecting coronavirus disease 2019 (COVID-19) incidence in type 1 diabetes mellitus (T1DM) patients, appraised vitamin D's efficacy in preventing COVID-19, and assessed the effects of clinical characteristics, glycemic status, vitamin D, and hydroxychloroquine administration on COVID-19's progression and severity in T1DM patients. This is suggested by various studies which propose an increase in HbA1c levels in patients with IDA. The prevalence of diabetes mellitus, and in particular type 2 diabetes, is increasing not only in Europe, but also in most other parts of the world at an alarming rate ().It is known to be a major risk factor for several diseases, including coronary artery diseases and acute myocardial infarctions (AMI) ().Diabetes mellitus not only increases the risk of experiencing such an . 1. HbA1c and factors other than diabetes Internal Medicine, 52(21): 2443-2446. mellitus affecting it. Singapore Med J 2010;51:616-22. . A1c in Diabetes Mellitus David C. Klonoff, MD, FACP, FRCP (Edin . A1c in Diabetes Mellitus David C. Klonoff, MD, FACP, FRCP (Edin . DOI: 10.5958/2349-2996.2017.00018. 1 Statistics from the International Diabetes Federation (IDF) indicate that 425 million adults worldwide have diabetes mellitus (DM) and that by 2045, the number of DM patients will be 629 million and . Results: Overall, 118 (25%) patients were diagnosed with . HbA1c is the predominant fraction of HbA1 and gives an estimate of the blood sugar levels of an individual over the last three months. Though a widely used tool the value of HbA1c is influenced by various factors which, if not kept in mind of the treating clinician may lead to a false diagnosis or false sense of diabetic control. Clinical Chemistry and Laboratory Medicine [IFCC]). Pemeriksaan HbA1c memiliki kelebihan dibandingkan dengan pemeriksaan glukosa puasa dan tes toleransi glukosa 2 jam, namun terdapat beberapa keadaan yang dapat memengaruhi nilai HbA1c. Identification of the correlation between HbA1c and diabetic complications has yielded one of the most clinically useful biomarkers. This study aimed to characterize and identify the factors affecting fatigue in patients with type II diabetes mellitus in Korea. The trials and tribulations of determining HbA1c targets for diabetes mellitus. HbAlc is the predominant fraction of HbAI and gives an estimate of the blood sugar levels of an individual over the last three months. Nitin S: HbA1c and factors other than diabetes mellitus affecting it. In the multivariate regression analysis, in addition to age and diabetes duration, a duration of diabetes longer than 10 years, HbA1c levels ≥8 and the presence of hypertension were significant risk factors for hearing loss. Singapore Med J. The test is subsidised by Medicare up to four times in a 12 month period. Nitin S. . . The higher the percentage, the higher your blood sugar levels over the past two to three months. People may have diabetes by other criteria and at lower HbA1c levels. 2014;24(3):90-4. First, the study evaluated whether three social network characteristics (kin composition, household composition, and network density) were . Diabetes mellitus (DM) is a disease of inadequate control of blood levels of glucose. They constitute the HbA1 fraction of the adult haemoglobin HbA. Presence of DM as well as HbA1c was assessed at the time of the first paracentesis. Olefsky JM, 2001. HbA1c values ranged from 5.50% to 13.2% (M . The diagnosis can be made with a fasting plasma glucose level of 126 mg . Kata kunci: Diabetes melitus, HbA1c, pengelolaan. Diabetes mellitus was known to mankind since antiquity although the name diabetes mellitus is introduced much later. Diabetic retinopathy (DR) is a potentially sight threatening microvascular complication of diabetes mellitus (DM), affecting a third of all DM patients worldwide (Ding & Wong 2012; Yau et al. The A1C test is sometimes called the hemoglobin A1C, HbA1c, glycated hemoglobin, or glycohemoglobin test. to separate HbA1c from other . Glycohemoglobin), reported as HbA1c, is a marker of long-term average blood glucose levels i.e. In an subset analysis of the Atherosclerosis Risk in Communities study of 941 diabetic people with varying degrees of chronic kidney disease (CKD), as well as 724 who did not have CKD, and mean age in the eighth decade, Jung et al. : Measurement of HbA1c in patients with chronic renal failure. 36. Nitin S. HbA1c and factors other than diabetes mellitus affecting it. Introduction. However, with widespread adoption of HbA1c has come increasing recognition that non-glycaemic variables can also affect HbA1c, with varying clinical significance. carbamylated Hb in patients with renal failure) can affect the . Several previous studies have analyzed the relationship between blood glucose (BG) and HbA 1c.Svendson et al. Presence of DM as well as HbA1c was assessed at the time of the first paracentesis. : Measurement of HbA1c in patients with chronic renal failure. Apart from blood sugar, there are other factors that affect HbA1c. J . 53-54. . Numerous assay-related artefacts can affect the HbA1c. 53-54. . 2010;51(8):616-22. . also suffered from concomitant diseases other than diabetes. GRADE quality of evidence: moderate mortality in patients with liver cirrhosis and ascites. If you have an A1C level of 6.5% or higher, your levels were in the . 2013, 418:73-76. A1c assays became commercially available in 1978, and the American Diabetes Association (ADA) first recommended using A1c in 1988. JAMA, 285(5):628-632. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus. cdkjournal. Information for physicians and patients regarding HbS, HbC, HbE and HbD traits. Diagnosed Type 2 diabetes with a HbA1c of 6.5-9%, treated with either lifestyle alone or with metformin; Weight stable for 3 months as defined by no greater than a 5% change. Type 1 and 2 DM are the main subtypes, each with different pathophysiology . 2017; 7(1): p. 86-94. Studies have shown . Primary endpoints were SBP development and mortality. HbA1c measurements. Patients were followed up for a mean of 266 days. Some people have both HbA and another kind of Hb, such as hemoglobin S, C, D or E. These less common forms of hemoglobin are called hemoglobin variants, or hemoglobinopathies. Singapore Med Journal 2010; 51: 616-622. Jakarta: PB PERKENI Powers AC, 2015. If you can, eating as usual will help you control your blood sugar levels. Sun H . a Good control indicates patients who achieved and maintained a mean HbA1c of less than 7% for 3 years (2007-2009) after the baseline year (2006); poor control indicates patients who had a mean HbA1c higher than 9% for 3 years after the baseline year; wide glycemic variability indicates patients who had a reduction in annual mean HbA1c from higher than 9% to less than 7%, followed by an . HbA1c and factors other than diabetes mellitus affecting it. We retrospectively studied 963 648 adults receiving care in the US Veterans Affairs Healthcare System from 2002 to 2014; mean follow‐up was 8 years. Apart from blood sugar, there are other factors that affect HbAlc. Methods and Results. An HbA1c of 6.5% is recommended as the cut point for diagnosing diabetes. Diabetes Care. (2004) Body iron stores in relation to risk of type 2 diabetes in . The normal range for HbA1c is 4 - 5.6% (20 - 38 mmol/mol) in healthy people; values between 5.7% and 6.4% (39 - 46 mmol/mol) point to prediabetes, while HbA1c over 6.5% (47 mmol/mol) may indicate diabetes. J Bangladesh Med, 41 (2012), pp. Diabetes mellitus is one of the most common diagnoses made by family physicians. studies on patients with type II diabetes mellitus are limited, and comparisons were made against . Influence of iron metabolism indices on HbA1c in non-diabetic pregnant women with and without iron-deficiency anemia: Effect of Iron supplementation.
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