A Ghanaian study suggests that haemoglobin, haematocrit and mean platelet volume may help identify people with poorly controlled type 2 diabetes where repeated HbA1c testing is difficult to access.
A study published in Health Science Reports suggests that three routine blood tests-hemoglobin, haematocrit and mean platelet volume-could help flag poor glucose control in people with type 2 diabetes, particularly in settings where access to repeated HbA1c testing is limited. The case-control study from Kumasi, Ghana, found that lower haemoglobin and haematocrit levels, together with higher mean platelet volume, were independently linked to a greater likelihood of poor glycaemic control.
The researchers at Kwadaso SDA Hospital compared 134 adults with type 2 diabetes with 134 people without diabetes. Among the diabetes group, 60.9% had HbA1c levels at or above 7%, the threshold used in the study to define poor control. The authors say this points to a substantial burden of suboptimal management in the cohort, even though most participants were already receiving treatment, mainly with oral glucose-lowering medicine.
The diabetic group was older on average than the control group and more likely to report a family history of diabetes, higher body mass index and less frequent exercise. Blood test results also showed a consistent pattern: people with diabetes had lower haemoglobin, haematocrit and red blood cell counts than controls, alongside higher white blood cell and platelet counts. The paper also recorded a lower platelet distribution width in the diabetic group, although mean platelet volume was only modestly higher overall.
When the diabetes group was split by glycaemic status, those with poor control had clearly worse red cell measures than those with better control. They had lower haemoglobin, haematocrit, red blood cell count and mean cell volume, and a higher mean platelet volume. In the multivariable model, haemoglobin and haematocrit were associated with a reduced likelihood of poor control, while mean platelet volume was associated with an increased likelihood of it.
The authors argue that these findings fit with the broader understanding of diabetes as a condition that affects more than glucose alone. Chronic hyperglycaemia can damage red cells through oxidative stress and non-enzymatic glycation, while also promoting platelet activation and a pro-thrombotic state. Related studies have reported similar links between raised mean platelet volume and poorer glycaemic control, reinforcing the idea that platelet size may reflect platelet reactivity in type 2 diabetes.
The practical appeal of the Ghanaian study is that haemoglobin, haematocrit and mean platelet volume are all generated during a standard full blood count. That makes them cheap, widely available and potentially useful as early warning markers in low-resource health systems. The authors stop short of claiming that these indices can replace HbA1c, but they say they may complement it by helping clinicians identify patients whose control is worsening and who may face greater vascular risk.
Still, the study has clear limits. It was observational, so it cannot prove cause and effect, and the case and control groups differed substantially in age, which may have influenced the results. The authors also note that they did not measure inflammatory markers such as C-reactive protein, or factors including insulin resistance and oxidative stress, which could help explain the blood changes they observed. Even so, their conclusion is straightforward: routine blood counts may carry more clinical value in diabetes care than is often assumed.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
