Evaluation of Iron Profile and Essential Trace Elements in Patients with Type 2 Diabetes Mellitus Attending a Tertiary Care Center

Background: Type 2 diabetes mellitus (T2DM) is associated not only with chronic hyperglycemia but also with disturbances in iron metabolism and essential trace elements, which may influence glycemic regulation. Evidence regarding these associations remains limited in Bangladesh. 
Objective: To evaluate the iron profile and essential trace elements among patients with type 2 diabetes mellitus and to assess their relationship with glycemic status. 
Methods: This hospital-based cross-sectional study was conducted from May 2025 to July 2025 at a tertiary-level diabetic hospital in Bangladesh. A total of 100 patients with T2DM were included using hospital logbook data. Demographic information and laboratory parameters, including fasting blood sugar (FBS), HbA1c, serum iron, total iron binding capacity (TIBC), unsaturated iron binding capacity (UIBC), serum ferritin, hemoglobin, copper, magnesium, and zinc, were collected from medical records. Statistical analysis was performed using SPSS version 26.0. Group comparisons were conducted using independent samples t-test, correlations were assessed using Pearson’s correlation coefficient, and multivariate linear regression analysis was performed to identify independent predictors of HbA1c. 
Results: The mean age of the participants was 52.6 ± 9.8 years, and 62% were male. The mean FBS and HbA1c levels were 162.4 ± 42.7 mg/dL and 8.21 ± 1.63%, respectively, with 72% of patients having HbA1c ≥7%. Participants with HbA1c ≥7% had significantly higher serum ferritin (204.9 ± 78.4 vs. 142.5 ± 48.6 ng/mL, p < 0.001) and copper levels (123.2 ± 27.1 vs. 106.4 ± 21.7 µg/dL, p = 0.006), and lower serum iron (75.2 ± 21.9 vs. 86.3 ± 19.1 µg/dL, p = 0.018), magnesium (1.66 ± 0.31 vs. 1.92 ± 0.28 mg/dL, p < 0.001), zinc (68.4 ± 15.1 vs. 80.6 ± 14.2 µg/dL, p = 0.002), and hemoglobin (12.6 ± 1.4 vs. 13.4 ± 1.3 g/dL, p = 0.021). HbA1c showed a positive correlation with ferritin (r = 0.46, p < 0.001) and copper (r = 0.34, p = 0.001), and inverse correlations with magnesium (r = −0.51, p < 0.001), zinc (r = −0.42, p < 0.001), and serum iron (r = −0.29, p = 0.004). In multivariate analysis, ferritin (β = 0.31, p < 0.001), magnesium (β = −0.38, p < 0.001), zinc (β = −0.27, p = 0.001), and copper (β = 0.19, p = 0.005) remained independently associated with HbA1c. 
Conclusion: Alterations in iron metabolism and essential trace elements are significantly associated with poor glycemic control in patients with type 2 diabetes mellitus, suggesting their potential relevance in metabolic assessment.