Background and Objectives: HbA1C is measured in diabetics as well as in those with impaired glucose tolerance to assess the glycaemic status over the last two to three months. But there are numerous conditions causing falsely low or high HbA1c measurements. One condition that effect erythrocyte turnover is anemia. Here we aimed to estimate the levels of HbA1c in iron deficiency or mixed deficiency anemia patients without diabetes and to assess the changes in HbA1c levels 3 months after treatment of nutritional anemia.

Methods: It is a hospital based prospective interventional study done in Department of General medicine, Kozhikode medical college from June 2021 to December 2022. The study comprises 120 patients with nutritional anemia, including iron deficiency anemia and mixed deficiency anemia. We treated the patients with nutritional supplementation for three months and noted anemia parameters and HbA1c levels before and after the therapy. Data was collected using a semi structured questionnaire, entered in excel and analysed using SPSS software.

Results: The prevalence of nutritional anemia was found to be more common in females. After 3 months of treatment of anemia there was statistically significant increase in Hemoglobin, MCV and RBC count and a significant fall in RDW and Platelet count. The mean HbA1c of the study population decreased from 6.07(±0.53) % to 5.40(±0.52) % after 3 months of treatment which was statistically significant. (P<0.001). There was a noticeable, though statistically insignificant, inverse relationship between rising Hb levels and falling HbA1c levels in patients with anemia.

Interpretation and Conclusions: HbA1c in anemic subjects showed a significant decrease with appropriate therapy. As nutritional anemia and Diabetes mellitus both being frequent in India, anemia is to be taken in consideration while interpreting HbA1c in diagnosis and monitoring of Diabetes mellitus.