Evaluation of Haematological Parameters among Pre- Diabetic and Diabetic Subjects in Urban Setting, Nigeria

This study compared the hematological parameters of prediabetic and diabetic subjects in an urban setting. The study was conducted between June 2018 and November 2018 in Abuja, Nigeria. Only confirmed diabetic and pre-diabetic subjects were recruited into the study. The plasma glucose level of each of the participants was measured after 12-14 hours of fasting. An oral glucose tolerance test was performed on those that did not have a history of diabetes in line with the American Diabetes Association (ADA) classification. Venipuncture was done on each subject, 2ml of venous blood was collected in EDTA for complete blood count for determination of hematological parameters and the assays were performed using an automated Chemistry analyzer (Selectra Pro S). Data were analyzed with IBM-SPSS for Windows version 24. The study comprised 96 participants (43 diabetics and 53 pre-diabetics). Among the pre-diabetics, 45.3% were males and 54.7% were females while 41.9% of the diabetics were males and 58.1% were females. Only MCHC and platelets were significantly different between the two groups, though no gender difference was observed. There was a positive correlation between WBC and Neutrophils of diabetic subjects with FBS while other parameters did not show a significant association. Lymphocyte was negatively correlated with FBS for diabetic subjects while PCV negatively correlated with FBS among pre-diabetes subjects. No significant between pre-diabetics and diabetics. Hence, periodical screening for the hematological profile is recommended in both pre-diabetic and diabetic subjects to initiate early prevention and management of diabetes. Sanni Olaniyi Felix Department of Global Health-WABCS, Lagos State University Teaching Hospital, Ikeja, Nigeria. Submission: 25 May 2019 Accepted: 30 May 2019 Published: 30 June 2019 www.ijsrm. humanjournals.com Citation: Sanni Olaniyi Felix. Ijsrm.Human, 2019; Vol. 12 (4): 24-30. 25 INTRODUCTION Both the developed and the developing countries of the world are suffering the impact of the diabetes epidemic and the impact is worse in those countries that are socially and economically disadvantaged [1]. Diabetes threaten the accomplishment of the Millennium Development Goals (MDGs), increases the risk of developing tuberculosis and is closely associated with several other infections [2]. The International Diabetes Federation (IDF) regional estimates for diabetes in the age group 20 to 79 years in 2011 show significant diabetes prevalence in the seven IDF regions; Africa-4.5%; Europe-6.7%; Mediterranean/ North Africa-11.0%; North America/ Carribean-10.7%, South/Central America-9.2%; Southeast Asia-9.2%, Western Pacific-8.3%, and the entire world-8.5% [1-2]. According to the IDF (2011) report, Africa has the highest (80%) number of undiagnosed diabetes followed by Western Pacific (60%) and the Middle East/North Africa (55%). Others include South-east Asia (50%), South/Central America (45%), Europe and North America/Carribean (35%) each [2]. Pre-diabetes is described as Impaired Fasting Glucose (IFG), impaired glucose tolerance [3] or a when the range of glycosylated hemoglobin (A1c) is between 6.0% 6.4%, the situations that put individuals at high risk of developing diabetes and the consequent complications [4]. The World Health Organization (WHO) criteria for diagnosing pre-diabetes are fasting plasma glucose level of between 6.1 mmol/l 6.9 mmol/l while a fasting plasma glucose level 7.0 mmol/l or more meet the criteria for the diagnosis of diabetes. Fasting value for venous and capillary plasma glucose are identical [5]. A previous study demonstrated that people with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), i.e. prediabetes, had a greater chance of developing diabetes after 5-10 years [6]. Many researchers have documented the prevalence of diabetes in Nigeria, studies also exist that compared hematological parameters of diabetic patients with apparently healthy controls [7–17] but information on a comparative study of hematological parameters between diabetics and pre-diabetics are rather scanty. Therefore, this study is aimed at evaluating hematological parameters of both pre-diabetic and diabetic subjects in a tertiary institution in Nigeria. www.ijsrm. humanjournals.com Citation: Sanni Olaniyi Felix. Ijsrm.Human, 2019; Vol. 12 (4): 24-30. 26 METHODOLOGY This study conducted at Abuja Metropolis, Nigeria between June 2018 and November 2018. A total of 96 subjects were recruited for this study, which consists of 54 pre-diabetic and 43 diabetic subjects. Only confirmed diabetic and pre-diabetic subjects were recruited into the study after they were made to understand the reasons for the study and signed informed consent. Approval was gotten from the Ministry of health and all samples were analyzed in the laboratory. The plasma glucose level of each of the participants was measured after 12-14 hours of fasting. An oral glucose tolerance test was performed on those that did not have a history of diabetes, using 75 g of glucose; this was done in line with the American Diabetes Association (ADA) classification [18-19]. Fasting Plasma Glucose between 100 – 200 mg/dL was defined as impaired fasting glucose (IFG) while impaired glucose tolerance is taken to be 2-h value in the oral glucose tolerance (OGTT) test ≥ 200 mg/dL. Diabetes cases were determined as one of the FPG ≥ 125 mg/dL, 2-h post-load glucose ≥ 200 mg/dL during an OGTT, previously diagnosed diabetes, or the regular consumption of oral medication or insulin [19]. The subjects with known hematologic diseases were not included in the study. Venipuncture was done on each subject, 2ml of venous blood was collected in EDTA for complete blood count for determination of hematological parameters. These assays were performed using an automated Chemistry analyzer (Selectra Pro S). The data were imputed and analyzed with IBM-SPSS for Windows version 24. Comparison of mean between two groups was analyzed using paired sample T-test, (p<0.05) was considered statistically significant.