The relationship between some biochemical and hematological changes in type 2 diabetes mellitus

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Zafer Saad Al Shehri


Introduction: The aim of this study was to investigate various biochemical and hematological parameters in patients with type 2 diabetes mellitus (T2DM) and compare those with non-diabetic subjects (control group).

Subjects: The study was conducted on 405 subjects (ages ranging from 26-65 years old; sex matched) who were classified into two groups: diabetic (n=205 subjects; males-105, females-100) and non-diabetic  subjects (n=200; males-100, females-100). The study was carried out during the period of November 2016 to April 2017 in the Department of Clinical Laboratory Sciences at the College of Applied Medical Science Al-Dawadmi, Shaqra University in Saudi Arabia (with the collaboration of the General Hospital Al-Dawadmi).

Methods: The following various parameters were assessed for all subjects: body mass index (BMI), systolic and diastolic blood pressure (SBP-DBP), fasting blood sugar (FBS), serum glutamic pyruvic transaminase (SGPT), alkaline phosphatise (ALP), total cholesterol (T. Ch), triglyceride (TG), low-density lipoprotein (LDL), high density lipoprotein (HDL), hemoglobin (HB), red blood cell count (RBC), hematocrit (Ht), mean corpuscular volume (MCV), mean corpuscle hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), red cell distribution width (RDW), platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW), total white blood cell count (WBC), lymphocyte count (L), neutrophil count (N),  eosinophil count (E), monocyte count (M), basophil count (B), neutrophil/lymphocyte ratio (N/L), and platelet/lymphocyte ratio (P/L).

Results: The results showed an increase in the mean values of SGPT, alkaline phosphatase, urea, serum creatinine, total cholesterol, triglyceride, and LDL in the T2DM group relative to the control group. Meanwhile, the mean value of HDL was significantly decreased in the T2DM group compared to the control group (p<0.05). The mean values of hemoglobin, RBC, MCV, MCHC and MCH were significantly decreased in the T2DM group compared to the control group. In contrast, the red cell distribution width significantly increased in the T2DM group versus control group (p<0.05). The mean platelet count was not significantly changed in the T2DM group compared to the control group (p> 0.05), but the mean values of PDW and MPV were significantly higher in the T2DM group compared to the control group (p<0.05). The mean white blood cell count and differential white blood cell was significantly higher in the T2DM group compared to control group (p<0.05). Lastly, the mean neutrophil/lymphocyte ratio and platelet/lymphocyte ratio was not significantly different in the T2DM group compared to control group (p>0.05).

Conclusion: In diabetes mellitus type 2 patients, certain biochemical and hematological changes are distinct from healthy subjects. It is important to follow up and monitor these parameters carefully in diabetic patients.

Peer Review Details

  • Peer review method: Single-Blind (Peer-reviewers: 02) Peer-review policy
  • Plagiarism software screening?: Yes
  • Date of Original Submission: 30 September 2017
  • Date accepted: 05 November 2017
  • Peer reviewers approved by: Dr. Lili Hami
  • Editor who approved publication: Dr. Phuc Van Pham



  1. ADVANCE Collaborative Group. (2008). Intensive control of blood glucose and vascular outcomes in patients with type 2 diabetes. The New England Journal of Medicine, 358(24), 2560–2572.

  2. Arun, G. S., & Ramesh, K. G. (2002). Improvement of insulin sensitivity by perindopril in spontaneously hypertensive and streptozotocindiabetic rats. Indian Journal of Pharmacology, 34, 156–164.

  3. Aslant, M., Orhan, D. D., Orhan, N., Sezik, E., & Yesilada, E. (2006). In vivo Antidiabetic and Antioxidant Potential of Helichrysum Plicatum ssp. In Streptozotocin induced diabetic rats. Journal of Ethnopharmacology, 109, 54–59.

  4. Balogun WO, Adeleye JO, Akinlade KS, Adedapo KS, Kuti M.Frequent. (2008). Occurrence of high gamma-glutamyl transferase and alanine amino transferase among Nigerian patients with type 2 diabetes. The African Journal of Medical Sciences, 37, 177–183.

  5. Barzilay JI, Abraham L, Heckbert SR, Cushman M, Kuller LH, Resnick HE, Tracy RP (2001). The relation of markers of inflammation to the development of glucose disorders in the elderly: the Cardiovascular Health Study. Diabetes. Oct; 50(10):2384-9.

  6. Beyan, C., Kaptan, K., & Ifran, A. (2006). Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggregation responses in healthy volunteers. Journal of Thrombosis and Thrombolysis, 22(3), 161–164.

  7. Chung, F.-M., Tsai, J. C.-R., Chang, D.-M., Shin, S.-J., & Lee, Y.-J., & the Fu-mei Chung. (2005). Peripheral Total and Differential Leukocyte Count in Diabetic Nephropathy. Diabetes Care, 28(7), 1710–1717.

  8. Guariguata, D. R., Whiting, D. R., Hambleton, I., Beagley, J., Linnenkamp, U., & Shaw, J. E. (2014). Whiting, I. Hambleton, J. Beagley, U. Linnenkamp, and J. E. Shaw, “Global estimates of diabetes prevalence for 2013 and projections for 2035 [View at Publisher · View at Google Scholar · View at Scopus]. Diabetes Research and Clinical Practice, 103(2), 137–149.

  9. Guyton, A. C., & Hall, J. E. (2002). Medical Physiology (10th ed., pp. 797–801). London: W.B. Saunders.

  10. Jones, R. L., & Peterson, C. M. (1981). Hematologic alterations in diabetes mellitus. The American Journal of Medicine, 70(2), 339–352.

  11. Kunst A, Drager B, Ziegenhorn J, (1983). UV methods with hexokinase and glucose-6-phosphate dehydrogenasen, Methods of enzymatic Analysis, Vol. VI, Bergmeyer, HY, Ed, Verlag chemie Deerfield, FL., 163-172.

  12. Levinthal, G. N., & Tavill, A. J. (1999). Liver disease anddiabetes mellitus. Clinical Diabetes, 17, 73.
    Marchesiri, G., Brizi, M., & Bianchi, G. (2001). Nonalcoholic fatty liver disaes. A feature of metabolic syndrome. Diabetes, 50(8), 1844–1850.

  13. Anjaneyulu, Muragundla, and Kanwaljit Chopra (2004). Quercetin, an anti‐oxidant bioflavonoid, attenuates diabetic nephropathy in rats. Clinical and Experimental Pharmacology and Physiology 31.4, 244-248.

  14. Papanas, N., Symeonidis, G., Maltezos, E., Mavridis, G., Karavageli, F., Vosnakidis, T., & Lakasas, G. (2004). Lakasas, Mean platelet volume in patients with type 2 diabetes mellitus. Platelets, 15(8), 475–478.

  15. Nakanishi, N. T. S., & Wada, M. (2005). Association between fasting glucose and Creactive protein in a Japanese population: The Minoh study. Diabete Res. Clinics and Practice, 69, 88–98.

  16. Neam Ţu MC1, CrăiŢoiu Ş, Avramescu ET, Margină DM, Băcănoiu MV, Turneanu D, Dănciulescu Miulescu R. (2015). The prevalence of the red cell morphology changes in patients with type 2 diabetes mellitus. Romanian Journal of Morphology and Embryology, 56(1), 183–189.

  17. Ohlson, L. O., Larsson, B., Borntorp, P., Eriksson, H., Svardsudd, K., Welin, L., . . .. (1988). Risk factors for type 2 (non-insulin-dependent) diabetes mellitus. Thirteen and one-half years of folow up of the participants in a study of sweedish men born in 1913. Diabetologia, 31, 798–805.

  18. Ohshita, K., Yamane, K., Hanafusa, M., Mori, H., Mito, K., Okubo, M., . . . Kohno, N. (2004). Elevated white blood cell count in subjects with impaired glucose tolerance. Diabetes Care, 27(2), 491–496.

  19. Oyedemi, S. O., Yakubu, M. T., & Afolayan, A. J. (2011). Antidiabetic activities of aqueous leaves extract of Leonotis leonurus in streptozotocin induced diabetic rats. Journal of Medicinal Plants Research, 5, 119–125.

  20. Pagano, G., Pacini, G., Musso, G., Gambino, R., Mecca, F., Depetris, N., . . .. (2002). Nonalcoholic steatohepatitis, insulin resistance, and metabolic syndrome: Further evidence for an etiologic association. Hepatology (Baltimore, Md.), 35(2), 367–372.

  21. Sattar, N. O., Scherbakova, I., Ford, O. R., Eilly, D. S., Stanley, E. A., Forrest, P. W., . . . Cobbeand, J. (2004). Shepherd. Elevated alanine aminotransferase predicts new-onset type 2 diabetes independently of classical risk factors metabolic syndrome, and Creactive protein in the west of Scotland coronary prevention study. Diabetes, 53(11), 2855–2860.

  22. Sing, M., & Shin, S. (2009). Changes in erythrocyte aggregation and deformability in diabetes mellitus: A brief review. Indian Journal of Experimental Biology, 47(1), 7–15.

  23. Thomas, M., Maclsaac, R., Tsalamandris, C., . . .. (2003). Unrecognized anemia in patients with diabetes: A cross sectional survey. Diabetes Care, 26(4), 1164–1169.

  24. Thomas, M. C. (2003). Anemia in diabetes: Marker of mediator microvascular disease. Nature Clinical Practice. Nephrology, 3(1), 20–30.

  25. Vozarova, B., Weyer, C., Lindsay, R. S., Pratley, R. E., Bogardus, C., & Tataranni, P. A. (2002). Tataranni PA High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes. Diabetes, 51(2), 455–461.

  26. Wannamethee, S. G., Shaper, A. G., Lennon, L., & Whincup, P. H. (2005). Hepatic enzymes the metabolic syndrome and the risk of type 2 diabetes in old men. Diabetes Care, 28(12), 2913–291.

  27. Weiss, G., & Goodnough, L. T. (2005). Anemia of chronic disease. The New England Journal of Medicine, 352(10), 1011–1023.

  28. Weyer, C., Hanson, K., Bogardus, C., & Pratley, R. E. (2000). Long-term changes in insulin action and insulin secretion associated with weight gain, loss, regain and maintenance of body weight. Diabetologia, 43(1), 36–46.

  29. Zahid, N. (2015). Burden of Diabetes Mellitus in Saudi Arabia. Int J Health Sci (Qassim). Jul; 9(3). V–VI.


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SHEHRI, Zafer Saad Al. The relationship between some biochemical and hematological changes in type 2 diabetes mellitus. Biomedical Research and Therapy, [S.l.], v. 4, n. 11, p. 1760-1774, nov. 2017. ISSN 2198-4093. Available at: <>. Date accessed: 14 dec. 2017. doi:
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