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Reviews on Recent Clinical Trials

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ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

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Clinical Trial

Effect of Iron Deficiency Anemia on Blood Glucose and Insulin Resistance in Women with Type II Diabetes: A Single-group, Clinical Interventional Study

Author(s): Mahmoud Parham, Gholam Reza Tavasoli, Shahram Arsang-Jang, Mohammad Amin Habibi, Davood Olad Dameshgi, Mohammad Reza Pashaei, Sajjad Ahmadpour* and Jamshid Vafaeimanesh*

Volume 19, Issue 3, 2024

Published on: 29 March, 2024

Page: [215 - 220] Pages: 6

DOI: 10.2174/0115748871297808240308102327

Price: $65

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Abstract

Aims: Iron deficiency anemia (IDA) is one of the disorders recently associated with an increase in insulin resistance (IR) and, consequently, diabetes mellitus (DM) affection by causing oxidative stress. In this study, we look at how IDA may contribute to developing type II diabetes mellitus (T2DM), controlling diabetes, and reducing IR in women with T2DM.

Methods: In this single group, clinical interventional study, we enrolled 40 women with T2DM and IDA. Before and after intervention with ferrous sulfate tablets, their blood glucose (BG) levels and IR levels were evaluated. This study was approved by the Ethics Committee of Qom University of Medical Sciences (ethics code: IR.MUQ.REC.1397.031) and registered at the Iranian Center for Clinical Trials (No. IRCT20170215032587N3). A significant level was considered p <0.05.

Result: The mean age of patients was 48.18 ± 4.6 years, with 5.3-5.8 years duration of T2DM. After the intervention, the mean fasting blood glucose (FBG) level reached 198.53 ± 48.11 to 170.93 ± 37.41, which was significant (p <0.0001). Also, hemoglobin A1C level reached from 8.49 ± 0.9 to 7.96 ± 0.58, which was significant (p <0.0001). Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) demonstrating a significant reduction of IR levels after intervention with ferrous sulfate tablets (p <0.018).

Conclusions: IDA treatment in patients with T2DM can significantly reduce the BG and IR levels. To better control BG, checking iron status and its correction may provide better clinical outcomes in these patients.

Keywords: Iron deficiency anemia, type 2 diabetes mellitus, insulin resistance, hemoglobin A1C, fasting blood glucose.

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[1]
Rashedi V, Asadi-Lari M, Delbari A, Fadayevatan R, Borhaninejad V, Foroughan M. Prevalence of diabetes type 2 in older adults: Findings from a large population-based survey in Tehran, Iran (Urban HEART-2). Diabetes Metab Syndr 2017; 11: S347-50.
[http://dx.doi.org/10.1016/j.dsx.2017.03.014] [PMID: 28314537]
[2]
Parham M, Bagherzadeh M, Ghasembeglou MH, Vafaeimanesh J. Gestational diabetes: Worrisome Prevalence. J Biostat Epid 2018; 4: 216-21.
[3]
Gromova LV, Fetissov SO, Gruzdkov AA. Mechanisms of glucose absorption in the small intestine in health and metabolic diseases and their role in appetite regulation. Nutrients 2021; 13(7): 2474.
[http://dx.doi.org/10.3390/nu13072474] [PMID: 34371983]
[4]
Diagnosis and classification of diabetes mellitus. Diabetes Care 2009; 32(1): S62-7.
[PMID: 19118289]
[5]
Dilworth L, Facey A, Omoruyi F. Diabetes mellitus and its metabolic complications: The role of adipose tissues. Int J Mol Sci 2021; 22(14): 7644.
[http://dx.doi.org/10.3390/ijms22147644] [PMID: 34299261]
[6]
Fahed M, Abou Jaoudeh MG, Merhi S, et al. Evaluation of risk factors for insulin resistance: A cross sectional study among employees at a private university in Lebanon. BMC Endocr Disord 2020; 20(1): 85.
[http://dx.doi.org/10.1186/s12902-020-00558-9] [PMID: 32522257]
[7]
Semple RK, Savage DB, Cochran EK, Gorden P, O’Rahilly S. Genetic syndromes of severe insulin resistance. Endocr Rev 2011; 32(4): 498-514.
[http://dx.doi.org/10.1210/er.2010-0020] [PMID: 21536711]
[8]
Newsholme P, Cruzat VF, Keane KN, Carlessi R, de Bittencourt PIH Jr. Molecular mechanisms of ROS production and oxidative stress in diabetes. Biochem J 2016; 473(24): 4527-50.
[http://dx.doi.org/10.1042/BCJ20160503C] [PMID: 27941030]
[9]
Maamoun H, Benameur T, Pintus G, Munusamy S, Agouni A. Crosstalk between oxidative stress and endoplasmic reticulum (ER) stress in endothelial dysfunction and aberrant angiogenesis associated with diabetes: A focus on the protective roles of heme oxygenase (HO)-1. Front Physiol 2019; 10: 70.
[http://dx.doi.org/10.3389/fphys.2019.00070] [PMID: 30804804]
[10]
Barone E, Di Domenico F, Perluigi M, Butterfield DA. The interplay among oxidative stress, brain insulin resistance and AMPK dysfunction contribute to neurodegeneration in type 2 diabetes and Alzheimer disease. Free Radic Biol Med 2021; 176: 16-33.
[http://dx.doi.org/10.1016/j.freeradbiomed.2021.09.006] [PMID: 34530075]
[11]
Rehman K, Akash MSH. Mechanism of generation of oxidative stress and pathophysiology of type 2 diabetes mellitus: How are they interlinked? J Cell Biochem 2017; 118(11): 3577-85.
[http://dx.doi.org/10.1002/jcb.26097] [PMID: 28460155]
[12]
Ma X, Cui Z, Du Z, Lin H. Transforming growth factor‐β signaling, a potential mechanism associated with diabetes mellitus and pancreatic cancer? J Cell Physiol 2020; 235(9): 5882-92.
[http://dx.doi.org/10.1002/jcp.29605] [PMID: 32017070]
[13]
Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American diabetes association (ADA) and the European association for the study of diabetes (EASD). Diabetologia 2022; 65(12): 1925-66.
[http://dx.doi.org/10.1007/s00125-022-05787-2] [PMID: 36151309]
[14]
Tasali E, Wroblewski K, Kahn E, Kilkus J, Schoeller DA. Effect of sleep extension on objectively assessed energy intake among adults with overweight in real-life settings: A randomized clinical trial. JAMA Intern Med 2022; 182(4): 365-74.
[http://dx.doi.org/10.1001/jamainternmed.2021.8098] [PMID: 35129580]
[15]
Sondrup N, Termannsen AD, Eriksen JN, et al. Effects of sleep manipulation on markers of insulin sensitivity: A systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev 2022; 62: 101594.
[http://dx.doi.org/10.1016/j.smrv.2022.101594] [PMID: 35189549]
[16]
Cheung CL, Cheung TT, Lam KSL, Cheung BMY. High ferritin and low transferrin saturation are associated with pre-diabetes among a national representative sample of U.S. adults. Clin Nutr 2013; 32(6): 1055-60.
[http://dx.doi.org/10.1016/j.clnu.2012.11.024] [PMID: 23312547]
[17]
Liu Q, Sun L, Tan Y, Wang G, Lin X, Cai L. Role of iron deficiency and overload in the pathogenesis of diabetes and diabetic complications. Curr Med Chem 2009; 16(1): 113-29.
[http://dx.doi.org/10.2174/092986709787002862] [PMID: 19149565]
[18]
Fernández-Real JM, McClain D, Manco M. Mechanisms linking glucose homeostasis and iron metabolism toward the onset and progression of type 2 diabetes. Diabetes Care 2015; 38(11): 2169-76.
[http://dx.doi.org/10.2337/dc14-3082] [PMID: 26494808]
[19]
Fernández-Real JM, López-Bermejo A, Ricart W. Cross-talk between iron metabolism and diabetes. Diabetes 2002; 51(8): 2348-54.
[http://dx.doi.org/10.2337/diabetes.51.8.2348] [PMID: 12145144]
[20]
Coban E, Ozdogan M, Timuragaoglu A. Effect of iron deficiency anemia on the levels of hemoglobin A1c in nondiabetic patients. Acta Haematol 2004; 112(3): 126-8.
[http://dx.doi.org/10.1159/000079722] [PMID: 15345893]
[21]
Davis RE, McCann VJ, Nicol DJ. Influence of iron‐deficiency anaemia on the glycosylated haemoglobin level in a patient with diabetes mellitus. Med J Aust 1983; 1(1): 40-1.
[http://dx.doi.org/10.5694/j.1326-5377.1983.tb136024.x] [PMID: 6571525]
[22]
Silva JF, Pimentel AL, Camargo JL. Effect of iron deficiency anaemia on HbA1c levels is dependent on the degree of anaemia. Clin Biochem 2016; 49(1-2): 117-20.
[http://dx.doi.org/10.1016/j.clinbiochem.2015.09.004] [PMID: 26365695]
[23]
Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: Insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. diabetologia 1985; 28: 412-9.
[24]
Zhou Y, Wu W, Xu Z, et al. Iron regulatory protein 2 deficiency may correlate with insulin resistance. Biochem Biophys Res Commun 2019; 510(2): 191-7.
[http://dx.doi.org/10.1016/j.bbrc.2019.01.022] [PMID: 30685084]
[25]
Feng Y, Qi R, Xu M, Shen Z, Li M. Dietary iron supplements may affect stress adaptation and aggravate stress hyperglycemia in a rat model of psychological stress. Nutrition 2012; 28(6): 691-7.
[http://dx.doi.org/10.1016/j.nut.2011.09.014] [PMID: 22365910]
[26]
Farrell PA, Beard JL, Druckenmiller M. Increased insulin sensitivity in iron-deficient rats. J Nutr 1988; 118(9): 1104-9.
[http://dx.doi.org/10.1093/jn/118.9.1104] [PMID: 3047344]
[27]
El-Agouza I, Abu Shahla A, Sirdah M. The effect of iron deficiency anaemia on the levels of haemoglobin subtypes: Possible consequences for clinical diagnosis. Clin Lab Haematol 2002; 24(5): 285-9.
[http://dx.doi.org/10.1046/j.1365-2257.2002.00464.x] [PMID: 12358889]
[28]
Sadeghian M, Fatourechi A, Lesanpezeshki M, Ahmadnezhad E. Prevalence of anemia and correlated factors in the reproductive age women in rural areas of tabas. J Family Reprod Health 2013; 7(3): 139-44.
[PMID: 24971116]
[29]
Tarim OMER, Küçükerdoğan AYGUN, Günay UNSAL, Eralp OZGEN, Ercan I. Effects of iron deficiency anemia on hemoglobin A1c in type 1 diabetes mellitus. Pediatr Int 1999; 41(4): 357-62.
[http://dx.doi.org/10.1046/j.1442-200X.1999.t01-1-01083.x] [PMID: 10453183]
[30]
Hashimoto K, Noguchi S, Morimoto Y, et al. A1C but not serum glycated albumin is elevated in late pregnancy owing to iron deficiency. Diabetes Care 2008; 31(10): 1945-8.
[http://dx.doi.org/10.2337/dc08-0352] [PMID: 18599529]
[31]
Sathiyapriya V, Bobby Z, Vinod Kumar S, Selvaraj N, Parthibane V, Gupta S. Evidence for the role of lipid peroxides on glycation of hemoglobin and plasma proteins in non-diabetic asthma patients. Clin Chim Acta 2006; 366(1-2): 299-303.
[http://dx.doi.org/10.1016/j.cca.2005.11.001] [PMID: 16380104]
[32]
Sundaram RC, Selvaraj N, Vijayan G, Bobby Z, Hamide A, Rattina Dasse N. Increased plasma malondialdehyde and fructosamine in iron deficiency anemia: Effect of treatment. Biomed Pharmacother 2007; 61(10): 682-5.
[http://dx.doi.org/10.1016/j.biopha.2007.06.013] [PMID: 17698317]
[33]
Madhu SV, Raj A, Gupta S, Giri S, Rusia U. Effect of iron deficiency anemia and iron supplementation on HbA1c levels: Implications for diagnosis of prediabetes and diabetes mellitus in Asian Indians. Clin Chim Acta 2017; 468: 225-9.
[http://dx.doi.org/10.1016/j.cca.2016.10.003] [PMID: 27717800]

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