Iron status and its association with HbA1c levels in Dutch children with diabetes mellitus type 1

Marjolijn D. Akkermans, E. C. A. Mieke Houdijk, Boudewijn Bakker, Agnes Clement-de Boers, Daniëlle C. M. van der Kaay, Martine C. de Vries, M. Claire Woltering, Dick Mul, Johannes B. van Goudoever, Frank Brus

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Children with diabetes mellitus (DM) type 1 may be at risk for iron deficiency (ID) although this has been little studied. ID is either an absolute (depleted iron stores) or a functional (restricted iron stores due to chronic inflammation) deficiency each requiring a different therapeutic approach. Unfortunately, absolute ID is often not distinguished from functional ID. Furthermore, iron-deficient anemia may influence hemoglobin A1c (HbA1c) levels.We aimed to determine the prevalence and type of ID and investigate its association with HbA1c levels in pediatric DM type 1 patients. We performed a two-center prospective observational study in which the iron status of Dutch children with DM type 1 was determined during a regular check-up. Absolute ID and functional ID were found in 13/227 (5.7%) and 100/214 (47%) patients, respectively, while only 15/113 (13%) patients also had anemia. HbA1c levels in patients with and without a deprived iron status (absolute or functional) were not significantly different (65 ± 17 vs. 65 ± 16 mmol/mol, p = 0.815). Conclusion: Functional, but not absolute, ID was common in Dutch pediatric DM type 1 patients. HbA1c levels were not associated with ID, which can be explained by the relatively mild deprived iron status in our patients. Trial registration: NTR4642.
Original languageEnglish
Pages (from-to)603-610
JournalEuropean Journal of Pediatrics
Volume177
Issue number4
DOIs
Publication statusPublished - 2018

Cite this

Akkermans, M. D., Houdijk, E. C. A. M., Bakker, B., Clement-de Boers, A., van der Kaay, D. C. M., de Vries, M. C., ... Brus, F. (2018). Iron status and its association with HbA1c levels in Dutch children with diabetes mellitus type 1. European Journal of Pediatrics, 177(4), 603-610. https://doi.org/10.1007/s00431-018-3104-3
Akkermans, Marjolijn D. ; Houdijk, E. C. A. Mieke ; Bakker, Boudewijn ; Clement-de Boers, Agnes ; van der Kaay, Daniëlle C. M. ; de Vries, Martine C. ; Woltering, M. Claire ; Mul, Dick ; van Goudoever, Johannes B. ; Brus, Frank. / Iron status and its association with HbA1c levels in Dutch children with diabetes mellitus type 1. In: European Journal of Pediatrics. 2018 ; Vol. 177, No. 4. pp. 603-610.
@article{50862703ca75404f9b241f4fd9188608,
title = "Iron status and its association with HbA1c levels in Dutch children with diabetes mellitus type 1",
abstract = "Children with diabetes mellitus (DM) type 1 may be at risk for iron deficiency (ID) although this has been little studied. ID is either an absolute (depleted iron stores) or a functional (restricted iron stores due to chronic inflammation) deficiency each requiring a different therapeutic approach. Unfortunately, absolute ID is often not distinguished from functional ID. Furthermore, iron-deficient anemia may influence hemoglobin A1c (HbA1c) levels.We aimed to determine the prevalence and type of ID and investigate its association with HbA1c levels in pediatric DM type 1 patients. We performed a two-center prospective observational study in which the iron status of Dutch children with DM type 1 was determined during a regular check-up. Absolute ID and functional ID were found in 13/227 (5.7{\%}) and 100/214 (47{\%}) patients, respectively, while only 15/113 (13{\%}) patients also had anemia. HbA1c levels in patients with and without a deprived iron status (absolute or functional) were not significantly different (65 ± 17 vs. 65 ± 16 mmol/mol, p = 0.815). Conclusion: Functional, but not absolute, ID was common in Dutch pediatric DM type 1 patients. HbA1c levels were not associated with ID, which can be explained by the relatively mild deprived iron status in our patients. Trial registration: NTR4642.",
author = "Akkermans, {Marjolijn D.} and Houdijk, {E. C. A. Mieke} and Boudewijn Bakker and {Clement-de Boers}, Agnes and {van der Kaay}, {Dani{\"e}lle C. M.} and {de Vries}, {Martine C.} and Woltering, {M. Claire} and Dick Mul and {van Goudoever}, {Johannes B.} and Frank Brus",
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pages = "603--610",
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Akkermans, MD, Houdijk, ECAM, Bakker, B, Clement-de Boers, A, van der Kaay, DCM, de Vries, MC, Woltering, MC, Mul, D, van Goudoever, JB & Brus, F 2018, 'Iron status and its association with HbA1c levels in Dutch children with diabetes mellitus type 1' European Journal of Pediatrics, vol. 177, no. 4, pp. 603-610. https://doi.org/10.1007/s00431-018-3104-3

Iron status and its association with HbA1c levels in Dutch children with diabetes mellitus type 1. / Akkermans, Marjolijn D.; Houdijk, E. C. A. Mieke; Bakker, Boudewijn; Clement-de Boers, Agnes; van der Kaay, Daniëlle C. M.; de Vries, Martine C.; Woltering, M. Claire; Mul, Dick; van Goudoever, Johannes B.; Brus, Frank.

In: European Journal of Pediatrics, Vol. 177, No. 4, 2018, p. 603-610.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Iron status and its association with HbA1c levels in Dutch children with diabetes mellitus type 1

AU - Akkermans, Marjolijn D.

AU - Houdijk, E. C. A. Mieke

AU - Bakker, Boudewijn

AU - Clement-de Boers, Agnes

AU - van der Kaay, Daniëlle C. M.

AU - de Vries, Martine C.

AU - Woltering, M. Claire

AU - Mul, Dick

AU - van Goudoever, Johannes B.

AU - Brus, Frank

PY - 2018

Y1 - 2018

N2 - Children with diabetes mellitus (DM) type 1 may be at risk for iron deficiency (ID) although this has been little studied. ID is either an absolute (depleted iron stores) or a functional (restricted iron stores due to chronic inflammation) deficiency each requiring a different therapeutic approach. Unfortunately, absolute ID is often not distinguished from functional ID. Furthermore, iron-deficient anemia may influence hemoglobin A1c (HbA1c) levels.We aimed to determine the prevalence and type of ID and investigate its association with HbA1c levels in pediatric DM type 1 patients. We performed a two-center prospective observational study in which the iron status of Dutch children with DM type 1 was determined during a regular check-up. Absolute ID and functional ID were found in 13/227 (5.7%) and 100/214 (47%) patients, respectively, while only 15/113 (13%) patients also had anemia. HbA1c levels in patients with and without a deprived iron status (absolute or functional) were not significantly different (65 ± 17 vs. 65 ± 16 mmol/mol, p = 0.815). Conclusion: Functional, but not absolute, ID was common in Dutch pediatric DM type 1 patients. HbA1c levels were not associated with ID, which can be explained by the relatively mild deprived iron status in our patients. Trial registration: NTR4642.

AB - Children with diabetes mellitus (DM) type 1 may be at risk for iron deficiency (ID) although this has been little studied. ID is either an absolute (depleted iron stores) or a functional (restricted iron stores due to chronic inflammation) deficiency each requiring a different therapeutic approach. Unfortunately, absolute ID is often not distinguished from functional ID. Furthermore, iron-deficient anemia may influence hemoglobin A1c (HbA1c) levels.We aimed to determine the prevalence and type of ID and investigate its association with HbA1c levels in pediatric DM type 1 patients. We performed a two-center prospective observational study in which the iron status of Dutch children with DM type 1 was determined during a regular check-up. Absolute ID and functional ID were found in 13/227 (5.7%) and 100/214 (47%) patients, respectively, while only 15/113 (13%) patients also had anemia. HbA1c levels in patients with and without a deprived iron status (absolute or functional) were not significantly different (65 ± 17 vs. 65 ± 16 mmol/mol, p = 0.815). Conclusion: Functional, but not absolute, ID was common in Dutch pediatric DM type 1 patients. HbA1c levels were not associated with ID, which can be explained by the relatively mild deprived iron status in our patients. Trial registration: NTR4642.

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DO - 10.1007/s00431-018-3104-3

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Akkermans MD, Houdijk ECAM, Bakker B, Clement-de Boers A, van der Kaay DCM, de Vries MC et al. Iron status and its association with HbA1c levels in Dutch children with diabetes mellitus type 1. European Journal of Pediatrics. 2018;177(4):603-610. https://doi.org/10.1007/s00431-018-3104-3