The Immunohematology of Hyperglycemia: Laboratory Evidence and Hematological Changes
Keywords:
Immunohematology, Hyperglycemia Laboratory, Hematological ChangesAbstract
Hyperglycemia, whether acute or chronic, has extensive harmful consequences on both the haematologic and immunological systems. In addition to its well-known effects on metabolism, high blood sugar levels for a long time can seriously mess up cellular homeostasis and the integrity of blood vessels. High levels of glucose change the shape, flexibility, and longevity of red blood cells (RBCs), making it harder for them to carry oxygen and causing problems with the microcirculation. At the same time, hyperglycemia changes the way white blood cells move, stick to things, move around, and eat things, which weakens both innate and adaptive immune responses. Additionally, hyperglycemia promotes platelet activation and aggregation, fostering a pro-thrombotic and pro-inflammatory environment that increases the risk of vascular problems. Long-term exposure to high glucose causes non-enzymatic glycation of membrane proteins and haemoglobin. This creates advanced glycation end products (AGEs) that cause oxidative stress, problems with the endothelium, and problems with the immune system. These molecular occurrences jointly foster low-grade systemic inflammation, compromised haemostasis, and modified cellular signalling pathways.
References
1. Sharma, S., Patel, R., & Dutta, A. (2022). Hyperglycemia-induced hematological changes: laboratory evidence of immune and erythrocyte dysfunction. Journal of Diabetes Research, 2022, Article ID 9823471. https://doi.org/10.1155/2022/9823471
2. Shi, F., & Colleagues. (2025). Association of hemoglobin glycation index with all-cause and cardiovascular mortality: hematological implications. Scientific Reports, 15, Article 7743. https://doi.org/10.1038/s41598-025-07743-7
3. Toma, A., & Al-Khafaji, N. (2022). Correlation between glycemic status and hematological parameters in patients with diabetes mellitus: evidence from an Iraqi laboratory cohort. Clinical Laboratory Science, 35(4), 231–238.
4. Ulutas, P., & Colleagues. (2021). Mean platelet volume and glycemic control: routine hemogram marker for metabolic status in type 2 diabetes. Hematology Reports, 13(1), 88–96.
5. Yang, J., Li, Y., & Xu, Y. (2021). Hyperglycemia and immune-hematological dysregulation: Mechanistic insights from laboratory and clinical studies. Frontiers in Immunology, 12, 715; 726.
6. Al-Qaysi, Z. T., & Al-Azawi, A. M. (2024). Association between hematological indices and blood glucose level among patients with type 2 diabetes in Mosul: A case-control study. Medical Journal of Babylon, 21(2), 134–141.
7. Kalaska, B., & Pawlak, D. (2024). Hematological and hemorheological parameters of blood platelets as biomarkers in diabetes mellitus type 2: A comprehensive review. Applied Sciences, 14(11), 4684.
8. Gerganova, A., & Colleagues. (2022). Stress hyperglycemia, diabetes mellitus and COVID-19: interactions and hematological implications. International Journal of Infectious Diseases, 120, 300-310.
9. Greaves, J., & Colleagues. (2025). Hyperactivity and pro-inflammatory functions of platelets in diabetes: mechanisms and laboratory evidence. Frontiers in Biosciences – Landmark, 30(1), 1-16.
10. Abbas, A. B., Al Hussaini, R., & Al Khadra, A. (2023). A casecontrol study to evaluate hematological indices in patients with type 2 diabetes mellitus. Scientific Reports, 13,
11. AlShareef, A. A., & AlSaleh, N. (2024). Association of hematological parameters and diabetic status: cross-sectional evidence. BMC Hematology, 24, Article 84.
12. Bambo, G. M., & Oladele, O. (2024). Changes in selected hematological parameters in patients with diabetes: a systematic review and meta-analysis. Journal of Clinical Hematology, 9(4), 125-138. (systematic review; meta-analytic data)
13. Chaudhary, P. K., Kim, S., & Kim, S. (2022). An insight into recent advances on platelet function in health and disease. International Journal of Molecular Sciences, 23(11), 6022.
14. Essawi, K., & Al-Najjar, R. (2023). Comparative analysis of red blood cells, white blood cells and platelet indices in type 2 diabetes patients vs. healthy controls. Frontiers in Hematology, 14, Article 10563775.
15. Sharma, S., Patel, R., & Dutta, A. (2022). Hyperglycemia-induced hematological changes: Laboratory evidence of immune and erythrocyte dysfunction. Journal of Diabetes Research, 2022, 1-10.
16. Al-Shoaibi, A. M., Al-Otaibi, M. M., & Al-Humaidi, A. H. (2019). Hyperglycemia effect on red blood cell indices among Saudi type 2 diabetic patients: A cross-sectional study. Saudi Medical Journal, 40(3), 277–283
17. El-Aarag, B. Y., Hassan, M. H., & Mohamed, M. A. (2024). Impact of blood glucose level on hematological indices in patients with type 2 diabetes mellitus. Journal of the Association of Physicians of India, 73(5), 42–49.
18. Toma, A., & Al-Khafaji, N. (2022). Correlation between glycemic status and hematological parameters in patients with diabetes mellitus: Laboratory evidence from Iraq. Clinical Laboratory Science, 35(4), 231-238.
19. Adekunle, O. F., & Ojo, A. R. (2023). Hematological parameters and oxidative stress markers in hyperglycemic states: Evidence from Nigerian cohort studies. African Journal of Laboratory Medicine, 12(1), 111–119.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Chinedu-madu Jane Ugochi, Kanu Stella Ngozika (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
