The Association of Red Blood Cell Indices with Glycosylated Hemoglobin and Microalbuminuria in Patients with Type 2 Diabetes Mellitus in a Tertiary Care Hospital – A Prospective Cross-sectional Study

Background: Type 2 Diabetes Mellitus (T2DM) is a major global health concern, often presenting asymptomatically and diagnosed only after complications arise. Poor glycemic control is linked to increased morbidity, including diabetic nephropathy. This study investigates the association between red blood cell (RBC) indices, glycosylated hemoglobin (HbA1c), and urinary albumin-to-creatinine ratio (UACR) to explore their potential in predicting early diabetic complications. Methods: A prospective cross-sectional study was conducted in a tertiary care hospital after institutional ethical clearance. Relevant clinical and laboratory data—including hemoglobin, MCV, MCH, MCHC, RDW, HbA1c, and UACR—were collected from patients with T2DM. Statistical analysis was performed using SPSS and EZR software. Normality was assessed using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Associations were analyzed using Spearman’s correlation and the Mann–Whitney U test, with p < 0.05 considered statistically significant. Results: A weak, though statistically non-significant, positive correlation was observed between RDW and HbA1c (p = 0.50). No significant association was found between HbA1c and other RBC indices. A statistically significant positive correlation was observed between HbA1c and UACR, suggesting that poor glycemic control is associated with early renal impairment. Conclusion: RDW may serve as a useful indicator for early hematologic alterations in T2DM, while elevated UACR reflects early nephropathy associated with poor glycemic control. These markers could aid in the timely detection and prevention of diabetic complications.