Association of Hematological Inflammatory Indices with Glycemic Control in Type 2 Diabetes Mellitus- A Cross-sectional study.

INTRODUCTION

Type 2 Diabetes Mellitus (T2DM) is a significant global health concern characterized by chronic low-grade inflammation, contributing to various complications. While Glycated Hemoglobin (HbA1c) is a primary tool for assessing glycemic control, hematological inflammatory indices derived from routine Complete Blood Count (CBC) are emerging as promising, low-cost indicators of systemic inflammation. This study aimed to investigate the association between these indices and glycemic control in T2DM patients.

METHODOLOGY: This comparative cross-sectional study included 750 individuals, equally categorized into non-diabetic, well-controlled T2DM (HbA1c < 7%), and poorly controlled T2DM (HbA1c ≥ 7%) groups. HbA1c, and eleven hematological inflammatory indices like NLR, MLR, SII, SIRI, etc, were calculated and compared between the groups using JASP software followed by correlation, Receiver Operating Characteristic (ROC) curves, and binary logistic regression.

RESULTS

NLR, SII, SIRI, and AISI consistently showed a rising trend with poorer glycemic control, correlated moderately with HbA1c, and demonstrated moderate predictive performance for uncontrolled diabetes (AUC > 0.6). Subgroup analysis also revealed higher NLR in poorly controlled diabetics and regression analysis proved NLR as an independent predictor of poor glycemic control (adjusted odds ratio = 4.73, p < 0.001).

CONCLUSION

This study demonstrates that hematological inflammatory indices, particularly NLR, SII, SIRI, and AISI, are significantly elevated in patients with poorly controlled T2DM, reflecting a state of chronic systemic inflammation. Among these, NLR shows the strongest and independent association with poor glycemic status, highlighting its potential as a low-cost, accessible adjunct marker for monitoring glycemic control and systemic inflammation in T2DM.