Glycated albumin versus HbA1c as indicators of glycemic control in type I diabetic children with iron deficiency anemia

We evaluated the clinical usefulness of glycated albumin (GA) and glycated hemoglobin (HbA1c) as indicators of glycemic control in type I diabetic (T1DM) children with and without iron deficiency anemia (IDA). Our prospective cross-sectional study was conducted on 147 T1DM children who were classified into Group I (with IDA) and Group II (without anemia). The participants were classified as controlled and uncontrolled based on mean blood glucose (MBG) in the past 30 days. The 5–12-yr-olds with MBG above 200 and 12–15-yr-olds with levels above 180 md/dl were considered uncontrolled. HbA1c increased significantly in the participants with IDA compared to those without anemia (p < 0.01). HbA1c in those with IDA showed insignificant difference between the controlled and uncontrolled (p = 0.5), while GA was significantly higher in the uncontrolled than the controlled (p = 0.3). Receiver operating characteristic (ROC) curve analysis showed that GA had 87.2% sensitivity and 75.8% specificity at a cut-off point of 16.9%. HbA1c at a cut-off point of 7.09% showed 80% sensitivity and 57.6% specificity. For prediction of uncontrolled diabetes in children with IDA, we concluded that HbA1c increases significantly in diabetic children with IDA. GA may be a useful alternative biomarker for evaluating the glycemic control in such children.