AUTHOR=Bambo Getachew Mesfin , Asmelash Daniel , Alemayehu Ermiyas , Gedefie Alemu , Duguma Tadesse , Kebede Samuel Sahile 

TITLE=Changes in selected hematological parameters in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1294290

DOI=10.3389/fmed.2024.1294290

ISSN=2296-858X

ABSTRACT=Background: Diabetes mellitus is a chronic metabolic disorder that causes hyperglycemia and various life threating health problems. Hematological parameters play a significant role in the progression and pathogenesis of diabetes. Therefore, this evidence based study was aimed to determine the pooled mean difference in WBC and RBC parameters in diabetic patients. 
Methods: Articles were extensively searched in reputable bibliographic databases. For studies meeting the eligibility criteria, all required data  were extracted using Microsoft Excel and exported to Stata 11 for meta-analysis. Pooled standardized mean difference was determined using a random effects model. heterogeneity was quantified using Higgin's I 2 statistics. Egger's test and funnel plot were performed to measure bias. Furthermore, sensitivity analysis was employed to determine the small study effect. 
Result: Finally, 22 articles with a total of 14,041 study participants (6,146 T2DM, 416 T1DM patients and 7,479 healthy controls) participated in this study. SMD in TLC was 0.66 and -0.21, in T2DM and T1DM, respectively. Differences in absolute neutrophil, eosinophil, basophil, lymphocytes and monocytes in T2DM were 0.84, -1.59, 3.20, 0.36 and 0.26, respectively. Relative differential counts in T2DM were as following; neutrophil: 1.31, eosinophil:-0.99, basophil: 0.34, lymphocyte: -0.19 and basophil: -0.64. SMD in absolute neutrophil, lymphocyte, monocyte and basophil in T1DM were -0.10, -0.69, 0.19 and -0.32, respectively. SMD in RBC parameters  in T2DM were as following; RBC: -0.57 (10 6 / µl), Hb: -0.73 g/dl and HCT: -1.22%. Where as in T1DM; RBC: -1.23 (10 6 / µl), Hb: -0.80 g/dl and HCT: -0.29% at p < 0.001.
Conclusion: Patents of T2DM had significantly increased TLC count and absolute neutrophil, basophil, lymphocyte, monocyte counts and relative count of neutrophil and basophil in comparison to control. Contrary, absolute eosinophil count, relative lymphocyte and monocyte count were decreased. In T1DM, WBC parameters were significantly decreased except monocyte. RBC parameters have been found decreased significantly in T2DM diabetic patients. In T1DM, Hb and HCT were significantly decreased. However, there is no significant difference in RBC as compared with non-diabetic controls. The findings indicated significant alteration of WBC and RBC parameters in both diabetes.