Letter to the Editor Open Access
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2022; 13(5): 420-421
Published online May 15, 2022. doi: 10.4239/wjd.v13.i5.420
Admission hemoglobin level and prognosis of type 2 diabetes mellitus and possible confounding factors: Correspondence
Pathum Sookaromdee, Private Consultant, Private Academic Consultant, Bangkok 23020202, Thailand
Viroj Wiwanitkit, Department of Community Medicine, DY Patil University, Pune 2223043003, India
ORCID number: Pathum Sookaromdee (0000-0002-8859-5322); Viroj Wiwanitkit (0000-0003-1039-3728).
Author contributions: Sookaromdee P gave ideas, analyzed the data, wrote the manuscript, revising and approving final submission; Wiwanitkit V gave ideas, analyzed the data, revising, supervising and approving final submission; All authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pathum Sookaromdee, PhD, Adjunct Professor, Private Consultant, Private Academic Consultant, 11 Bangkok 112, Bangkok 23020202, Thailand. pathumsook@gmail.com
Received: January 19, 2022
Peer-review started: January 19, 2022
First decision: March 11, 2022
Revised: March 12, 2022
Accepted: April 20, 2022
Article in press: April 20, 2022
Published online: May 15, 2022
Processing time: 113 Days and 22.2 Hours

Abstract

This letter to editor discusses on the publication on admission hemoglobin level and prognosis of type 2 diabetes mellitus. A comment on published article is raised. The specific confounding conditions on the hemoglobin level are mentioned. Concerns on clinal application are raised and discussed.

Key Words: Diabetes; Hemoglobin; Confounding; Type 2 diabetes mellitus

Core Tip: This letter to editor discussing on the publication on admission hemoglobin level and prognosis of type 2 diabetes mellitus. Concerns on clinal application are raised and discussed.
TO THE EDITOR

We read with interest a case report on “Association between admission hemoglobin level and prognosis in patients with type 2 diabetes mellitus” by Song et al[1]. A retrospective examination of patients diagnosed with type 2 diabetes mellitus (T2DM) bet was undertaken[1]. End-stage renal disease or a 50% drop in estimated glomerular filtration rate was the composite outcome[1]. Song et al[1] concluded that Hemoglobin levels and renal damage were found to have a U-shaped connection in T2DM patients. Hemoglobin levels below 13.3 g/dL at admission are an independent indicator of renal injury[1]. This report by Song et al[1] might add some data on application of hemoglobin level in monitoring of diabetic patient. In type 2 diabetes patients, Matsuoka et al[2] found that the duration of hypoglycemia was inversely associated with hemoglobin and hemoglobin A1C levels, and was longer at night than during the day. The kidney issue could be the result of a protracted period of hyperglycemia.

There are many possible confounding conditions on the hemoglobin level. In our setting in Indochina, many local people have a common inherited disorder, thalassemia, that has low hemoglobin level. In these thalassemic patients, renal impairment is also common regardless having diabetes or not[3]. Therefore, the conclusion on association by Song et al[1] might be applicable in some settings, but not all settings, such as our setting in Indochina. This correspondence can provide a novel insight that the application of hemoglobin level as an indicator might be limited in the area with high prevalence confounding hemoglobin disorder problem.

Footnotes

Provenance and peer review: Invited article; Externally peer reviewed.

Peer-review model: Single blind

Specialty type: Endocrinology and metabolism

Country/Territory of origin: Thailand

Peer-review report’s scientific quality classification

Grade A (Excellent): 0

Grade B (Very good): B, B

Grade C (Good): 0

Grade D (Fair): 0

Grade E (Poor): 0

P-Reviewer: Ekine-Afolabi B, United Kingdom; Wan XH, China S-Editor: Zhang H L-Editor: A P-Editor: Zhang H

References
1.  Song HY, Wei CM, Zhou WX, Hu HF, Wan QJ. Association between admission hemoglobin level and prognosis in patients with type 2 diabetes mellitus. World J Diabetes. 2021;12:1917-1927.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in CrossRef: 4]  [Cited by in F6Publishing: 3]  [Article Influence: 0.8]  [Reference Citation Analysis (0)]
2.  Matsuoka A, Hirota Y, Takeda A, Kishi M, Hashimoto N, Ohara T, Higo S, Yamada H, Nakamura T, Hamaguchi T, Takeuchi T, Nakagawa Y, Okada Y, Sakaguchi K, Ogawa W. Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross-sectional study. J Diabetes Investig. 2020;11:417-425.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 11]  [Cited by in F6Publishing: 10]  [Article Influence: 2.0]  [Reference Citation Analysis (0)]
3.  Demosthenous C, Vlachaki E, Apostolou C, Eleftheriou P, Kotsiafti A, Vetsiou E, Mandala E, Perifanis V, Sarafidis P. Beta-thalassemia: renal complications and mechanisms: a narrative review. Hematology. 2019;24:426-438.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 19]  [Cited by in F6Publishing: 23]  [Article Influence: 3.8]  [Reference Citation Analysis (0)]