Diabetes linked to changes in hematological parameters including increase in TLC and absolute differential counts: Study
T2DM is the most common form of diabetes, accounting for approximately 90% of all cases. It is characterized by autoimmune destruction of pancreatic B-cells, leading to insulin deficiency in adults and children. According to current data, around 537 million adults have diabetes mellitus, and the prevalence is expected to reach 783 million by 2045. In 2015, 8.8% of adults were affected, projected to increase to 10.04% by 2024.
A study published in Frontiers in Medicine found an elevation of white blood cells and other specific blood cells in T2D patients. White and red blood cells were decreased with type 1 diabetes.
Diabetes is a chronic metabolic disorder. This condition is associated with health issues. Although haematological parameters significantly affect the progression and pathogenesis, previous studies demonstrated contradictory findings. This evidence-based determined the pooled mean difference of WBC and RBC parameters in diabetic patients to investigate haematological dysfunctions in type 1 and type 2 diabetes mellitus.
Articles were extensively searched in PubMed, Cochrane Library, Scopus, Web of Science, PsycINFO, Embase, online archives and university repository databases with appropriate search terms. Study details were extracted using Microsoft Excel and exported to Stata 11 for meta-analysis. The pooled standardized mean difference was determined using the random effects model, and heterogeneity was quantified using Higgins’ I2 statistics. Egger’s test and funnel plot were performed to measure bias.
Key findings from the study are:
Researchers identified 39 222 articles, and after screening, 22 articles were included in the study, which had 6,146 T2DM, 416 T1DM patients and 7,479 healthy controls.
, in T2DM and T1DM, The pooled SMD in TLC (109/L) was 0.66 and −0.21, respectively.
Differences in absolute differential WBC counts for neutrophils, eosinophils, basophils, lymphocytes and monocytes in T2DM were 0.84, −1.59, 3.20, 0.36 and 0.26, respectively.
The differences in relative differential counts (%) in T2DM for neutrophils, eosinophils, basophils, lymphocytes and monocytes were 1.31, −0.99, 0.34, −0.19 and −0.64, respectively.
The SMD of differential counts of WBC (109/L) parameters, neutrophils, lymphocytes, monocytes, and basophils in T1DM were −0.10, −0.69, 0.19, and −0.32, respectively.
The pooled SMD in RBC parameters in T2DM were as follows: RBC: −0.57 (106/μL), Hb: −0.73 g/dL and HCT: −1.22%, Whereas in T1DM, RBC, Hb, and HCT were −1.23 (106/μL), −0.80 g/dL and −0.29%, respectively.
T2DM patients had higher TLC counts, absolute neutrophil, basophil, lymphocyte, and monocyte counts, and relative neutrophil and basophil counts than controls. Conversely, absolute eosinophil count and relative lymphocyte, eosinophil, and monocyte counts were lower. In T1DM, all WBC parameters, except monocytes, were significantly reduced. RBC parameters were also decreased in T2DM patients. In T1DM, Hb and HCT were significantly lower, and there was no significant difference in RBC compared to the non-diabetic controls. These results suggest considerable metabolic effects of diabetes on hematologic parameters.
Reference:
Bambo et al. Changes in selected hematological parameters in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis. Frontiers in Medicine, 11. https://doi.org/10.3389/fmed.2024.1294290
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