COMPARATIVE ANALYSIS OF COMPLETE BLOOD COUNT PARAMETERS IN INSULIN-DEPENDENT AND NON-INSULIN-DEPENDENT DIABETIC PATIENTS
DOI:
https://doi.org/10.71000/1dkevq41Keywords:
Blood Cell Count, Diabetes Mellitus, Type 2, Hematology, Inflammation, Insulin, Leukocytes, PakistanAbstract
Background: Diabetes mellitus is a chronic metabolic disorder that affects multiple organ systems, including the hematopoietic system. Hematological alterations are increasingly recognized as indicators of disease progression and potential complications in diabetes. Complete blood count (CBC) parameters, particularly differences between insulin-dependent and non-insulin-dependent patients, may provide clinically valuable insights for monitoring disease activity and guiding individualized management strategies.
Objective: The objective of this study was to compare CBC parameters among insulin-dependent, non-insulin-dependent, and non-diabetic control groups to determine significant differences with potential clinical implications.
Methods: This descriptive cross-sectional study was conducted at District Headquarters Hospital, Buner, Khyber Pakhtunkhwa, from April to August 2024. A total of 159 participants were enrolled, comprising 53 insulin-dependent diabetics, 53 non-insulin-dependent diabetics, and 53 age-matched healthy controls. Inclusion criteria required patients aged over 40 years with a confirmed diagnosis of type 2 diabetes mellitus of at least three years. Blood samples were collected following overnight fasting and analyzed using an automated hematology analyzer. Statistical analysis was performed in SPSS version 26, employing one-way ANOVA and regression tests, with p-values <0.05 considered significant.
Results: The study population had a mean age of 61.27 ± 12.86 years, with 56% males and 44% females. Insulin-dependent patients demonstrated the longest mean diabetes duration (85.43 ± 62.69 months) compared to non-insulin-dependent patients (49.55 ± 48.24 months; p < 0.001). Systolic blood pressure was higher in diabetic groups (133.26 ± 21.65 mmHg insulin-dependent; 133.02 ± 19.66 mmHg non-insulin-dependent) than in controls (124.19 ± 22.73 mmHg; p = 0.048), while diastolic pressure showed no significant difference (p = 0.681). Total WBC counts were significantly greater in insulin-dependent patients (11.75 ± 5.91 × 10⁹/L) than in non-insulin-dependent (10.07 ± 4.22 × 10⁹/L) and controls (9.42 ± 3.41 × 10⁹/L; p = 0.030). Neutrophil counts were also higher in the insulin-dependent group (8.87 ± 5.44 × 10⁹/L; p = 0.054), whereas hemoglobin, RBC, and platelet counts did not differ significantly (p > 0.05).
Conclusion: The findings highlight that insulin-dependent diabetics exhibit elevated WBC and neutrophil counts compared to non-insulin-dependent and control groups, indicating a heightened inflammatory response. Although other hematological indices remained comparable, the results suggest that disease duration and treatment modality may influence hematological profiles, underscoring the need for tailored monitoring and personalized diabetes care.
References
Wan Z, Song L, Hu L, Lei X, Huang Y, Lv Y, et al. The role of systemic inflammation in the association between serum 25-hydroxyvitamin D and type 2 diabetes mellitus. Clin Nutr. 2021;40(6):3661-7.
Yazar BT, Eren F, Fırat Oğuz E. The relationship of inflammatory markers NLR and PLR with HbA1c in Turkish diabetic patients. Diabetes Res Clin Pract. 2025;224:112213.
Aydın MS, Eren MA, Uyar N, Kankılıç N, Karaaslan H, Sabuncu T, et al. Relationship between systemic immune inflammation index and amputation in patients with diabetic foot ulcer. J Orthop Sci. 2024;29(4):1060-3.
Liu W, Zhu J, Cheng J, Tang Q, Long S. Relationship between Platelet Index and Lipid Metabolism, Coagulation Function, and Inflammation in Diabetic Patients. Clin Lab. 2024;70(1).
He X, Dai F, Zhang X, Pan J. The neutrophil percentage-to-albumin ratio is related to the occurrence of diabetic retinopathy. J Clin Lab Anal. 2022;36(4):e24334.
Ratter-Rieck JM, Maalmi H, Trenkamp S, Zaharia OP, Rathmann W, Schloot NC, et al. Leukocyte Counts and T-Cell Frequencies Differ Between Novel Subgroups of Diabetes and Are Associated With Metabolic Parameters and Biomarkers of Inflammation. Diabetes. 2021;70(11):2652-62.
Khudhair Z, Alhallaf R, Eichenberger RM, Whan J, Kupz A, Field M, et al. Gastrointestinal Helminth Infection Improves Insulin Sensitivity, Decreases Systemic Inflammation, and Alters the Composition of Gut Microbiota in Distinct Mouse Models of Type 2 Diabetes. Front Endocrinol (Lausanne). 2020;11:606530.
Paven E, Dillinger JG, Bal Dit Sollier C, Vidal-Trecan T, Berge N, Dautry R, et al. Determinants of aspirin resistance in patients with type 2 diabetes. Diabetes Metab. 2020;46(5):370-6.
Fajkić A, Jahić R, Begić E, Dervišević A, Kurtović A, Lepara O. Complete blood count inflammation derived indexes as predictors of metabolic syndrome in type 2 diabetes mellitus. Technol Health Care. 2024;32(4):2321-30.
Li J, Wang X, Jia W, Wang K, Wang W, Diao W, et al. Association of the systemic immuno-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio with diabetic microvascular complications. Front Endocrinol (Lausanne). 2024;15:1367376.
Yang C, Yang Q, Xie Z, Peng X, Liu H, Xie C. Association of systemic immune-inflammation-index with all-cause and cause-specific mortality among type 2 diabetes: a cohort study base on population. Endocrine. 2024;84(2):399-411.
Chen G, Tan C, Liu X, Chen Y. Association Between the Neutrophil-To-Lymphocyte Ratio and Diabetes Secondary to Exocrine Pancreatic Disorders. Front Endocrinol (Lausanne). 2022;13:957129.
Wang J, Zhou D, Dai Z, Li X. Association Between Systemic Immune-Inflammation Index and Diabetic Depression. Clin Interv Aging. 2021;16:97-105.
Hu W, Yuan Q, Hu J, Li M, Xi Y, Luo L. The association between C-reactive protein-albumin-lymphocyte index and depression in adults with type 2 diabetes mellitus: A cross-sectional study from NHANES. Psychoneuroendocrinology. 2025;176:107442.
Zhang S, Gang X, Yang S, Cui M, Sun L, Li Z, et al. The Alterations in and the Role of the Th17/Treg Balance in Metabolic Diseases. Front Immunol. 2021;12:678355.
Alshareef AA, Alrawaili MS, Almutairi SA, Ayyad MM, Alshora W. Association of Hematological Parameters and Diabetic Neuropathy: A Retrospective Study. Diabetes, Metabolic Syndrome and Obesity [Internet]. 2024 Feb 13 [cited 2024 Nov 23];17:779–93.
The relationship between some biochemical and hematological changes in type 2 diabetes mellitus | Biomedical Research and Therapy [Internet]. [cited 2024 Nov 23].
Shehri Z, Shehri ZS Al. The relationship between some biochemical and hematological changes in type 2 diabetes mellitus. Biomedical Research and Therapy [Internet]. 2017 Nov 29 [cited 2024 Nov 23];4(11):1760–74.
Hematological parameters of type 2 diabetic adult patients at Debre Berhan Referral Hospital, Northeast Ethiopia: A comparative cross-sectional study - PMC [Internet]. [cited 2024 Nov 23].
Boels AM, Rutten G, Cleveringa F, van Avendonk M, Vos R. Insulin Therapy in Type 2 Diabetes Is Associated With Barriers to Activity and Worse Health Status: A Cross-Sectional Study in Primary Care. Front Endocrinol (Lausanne). 2021 Mar 10;12.
Arkew M, Yemane T, Mengistu Y, Gemechu K, Tesfaye G. Hematological parameters of type 2 diabetic adult patients at Debre Berhan Referral Hospital, Northeast Ethiopia: A comparative cross-sectional study. PLoS One [Internet]. 2021 Jun 1 [cited 2024 Nov 23];16(6):e0253286.
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