Determinants of Hematological Abnormalities in Patients with Type 2 Diabetes Mellitus: a Cross Sectional Study

Abstract

Hematological abnormalities are commonly observed in patients with type 2 diabetes mellitus (T2DM) and may serve as markers of complication risk, thereby playing an important role in T2DM management; however, the determinants and regional variations remain incompletely understood, particularly in Lampung. This cross-sectional observational study was conducted among patients with T2DM attending the Internal Medicine Outpatient Clinic of RSUD Dadi Tjokrodipo, Bandar Lampung, from April to September 2024, enrolling 80 participants who met the inclusion and exclusion criteria. Data were obtained from complete blood count testing, medical records, and structured interviews with direct observation, and were analyzed using bivariable and multivariable logistic regression. The most frequently identified hematological abnormalities were anemia (45%), leukocytosis (32%), and an elevated neutrophil-to-lymphocyte ratio (NLR) (46%). In multivariable analysis, anemia was independently associated with uncontrolled glycemic status (adjusted OR = 15.914; p = 0.001), not following a recommended dietary pattern (adjusted OR = 7.402; p = 0.003), smoking (adjusted OR = 7.920; p = 0.015), and age ≥61 years (adjusted OR = 29.643; p = 0.004), whereas leukocytosis was independently associated only with uncontrolled glycemic status (adjusted OR = 4.310; p = 0.020). High NLR was independently associated with uncontrolled glycemic status (adjusted OR = 18.811; p = 0.001), employment status (adjusted OR = 8.630; p = 0.003), and not following a recommended dietary pattern (adjusted OR = 5.287; p = 0.015). Overall, uncontrolled glycemic status was the most dominant and consistent factor associated with hematological abnormalities among patients with T2DM.