Comparative Analysis of Glycemic Control and Iron-Related Anemia Parameters in Diabetic and Non-Diabetic Women in Bangladesh

Background: Type 2 diabetes mellitus (T2DM) is increasingly prevalent among women in South Asia and is associated not only with metabolic complications but also with hematological and nutritional abnormalities. Anemia and disturbances in iron metabolism may coexist with poor glycemic control, potentially worsening clinical outcomes, particularly in resource-limited settings such as Bangladesh. 
Objective: To compare glycemic control and iron-related anemia parameters between diabetic and non-diabetic women in Bangladesh and to examine the association between glycemic status and hematological as well as iron indices. 
Methods: This hospital-based comparative cross-sectional study was conducted at a tertiary care diabetic center in Bangladesh from January to April 2025. A total of 120 adult women were included, comprising 60 diabetic and 60 non-diabetic participants. Data were collected from hospital record books and laboratory reports. Fasting blood glucose (FBS), HbA1c, lipid profile, complete blood count, serum iron, ferritin, and total iron-binding capacity (TIBC) were analyzed. Group comparisons, correlation analyses, and multivariable linear and logistic regression analyses were performed using SPSS version 26.0. 
Results: Diabetic women had significantly higher FBS (8.6 ± 2.1 vs 5.1 ± 0.6 mmol/L; p < 0.001) and HbA1c levels (8.1 ± 1.3% vs 5.4 ± 0.4%; p < 0.001) than non-diabetic women. Mean hemoglobin concentration was significantly lower in diabetic women (10.9 ± 1.4 g/dL) compared with non-diabetic women (12.1 ± 1.3 g/dL; p < 0.001), and anemia prevalence was markedly higher (56.7% vs 30.0%; p = 0.003). Diabetic women also showed lower serum ferritin [48 ng/mL (IQR 32–86) vs 62 ng/mL (IQR 41–102); p = 0.02] and serum iron levels (62 ± 18 vs 74 ± 20 µg/dL; p = 0.004), along with higher TIBC (418 ± 52 vs 392 ± 47 µg/dL; p = 0.01). HbA1c was negatively correlated with hemoglobin (r = −0.41), serum ferritin (r = −0.29), and serum iron (r = −0.33), and positively correlated with TIBC (r = 0.27) (all p < 0.01). In multivariable analysis, diabetic status (β = −0.38; p < 0.001) and HbA1c (β = −0.29; p < 0.001) were independently associated with lower hemoglobin levels, while low ferritin was the strongest predictor of anemia (adjusted OR = 3.02; 95% CI: 1.48–6.18). 
Conclusion: Diabetic women in Bangladesh experience a significantly higher burden of anemia and adverse iron-related alterations compared with non-diabetic women. Poor glycemic control is independently associated with reduced hemoglobin levels and depleted iron stores.