COMPARATIVE ANALYSIS OF COMPLETE BLOOD COUNT PARAMETERS IN INSULIN-DEPENDENT AND NON-INSULIN-DEPENDENT DIABETIC PATIENTS

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.