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Journals / Turkish Journal of Internal Medicine / 2026 / Volume: 8

Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study

Bilge Özcan(USAK UNIVERSITY)0000-0001-9255-7057
Meryem Ümit Kurban(USAK UNIVERSITY, SCHOOL OF MEDICINE)0009-0008-3881-361X
Pages
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Publication Date
2026-04-28
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⚡ TL;DR(Too Long; Didn't Read)

Primary analysis examined overall changes in glycemic parameters (fasting glucose, HbA1c) and inflammatory indices using Wilcoxon signed-rank tests; correlations were assessed with Spearman’s rho.

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Objective & Hypothesis:Objective: To evaluate six-month changes in hemogram-derived inflammatory indices (neutrophil-tolymphocyte ratio [NLR], systemic immune-inflammation index [SII], systemic inflammation response index [SIRI], and aggregate index of systemic inflammation [AISI]) and their association with glycemic parameters in patients with type 2 diabetes mellitus (T2DM) under routine clinical care.
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Key Findings & Data:Methods: This retrospective cohort study analyzed electronic medical records of 183 adults with T2DM from a single center (2022–2023).
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Conclusion & Impact:Primary analysis examined overall changes in glycemic parameters (fasting glucose, HbA1c) and inflammatory indices using Wilcoxon signed-rank tests; correlations were assessed with Spearman’s rho.
🔬Design:Research Article
📍Scope:2022–2023 Verileri
⚙️Variables:Type 2 diabetes · NLR · SII

Abstract

Objective: To evaluate six-month changes in hemogram-derived inflammatory indices (neutrophil-tolymphocyte ratio [NLR], systemic immune-inflammation index [SII], systemic inflammation response index [SIRI], and aggregate index of systemic inflammation [AISI]) and their association with glycemic parameters in patients with type 2 diabetes mellitus (T2DM) under routine clinical care. Methods: This retrospective cohort study analyzed electronic medical records of 183 adults with T2DM from a single center (2022–2023). All patients had paired laboratory measurements approximately six months apart. Primary analysis examined overall changes in glycemic parameters (fasting glucose, HbA1c) and inflammatory indices using Wilcoxon signed-rank tests; correlations were assessed with Spearman’s rho. Results: Over six months, all four inflammatory indices decreased significantly: NLR (2.14→1.66, p<0.001, r=0.87), SII (593.6→476.0, p<0.001, r=0.74), SIRI (0.88→0.70, p<0.001, r=0.70), and AISI (231.5→188.0, p<0.001, r=0.63). Fasting glucose decreased (125→109 mg/dL, p<0.001, r=0.80), while HbA1c showed a small reduction (7.00%→6.80%, p<0.001, r=0.23). Changes in glycemic parameters correlated poorly with changes in inflammatory indices (all |ρ|<0.20). Conclusion: Hemogram-derived inflammatory indices improve markedly and consistently in T2DM patients over six months of real-world treatment. These improvements are largely independent of glycemic response, suggesting that NLR, SII, SIRI, and AISI may capture anti-inflammatory effects not reflected by HbA1c. These low-cost, universally available indices may serve as complementary markers in routine T2DM care.

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Cite This Article

Özcan, B., Kurban, M. Ü. (2026). Six-Month Changes in Hemogram-Derived Inflammatory Indexes and Glycemic Parameters in Patients with Type 2 Diabetes: A Real-World Retrospective Study. Turkish Journal of Internal Medicine, Volume: 8. https://doi.org/10.46310/tjim.1893961

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References (21)

  1. Burgos-Morón E, Abad-Jiménez Z, Marañón AM, Iannantuoni F, Escribano-López I, López-Domènech S, et al. Relationship between oxidative stress, ER stress, and inflammation in type 2 diabetes: the battle continues. J Clin Med. 2019;8(9):1385. doi:10.3390/jcm8091385.
  2. Nedosugova LV, Markina YV, Bochkareva LA, Kuzina IA, Petunina NA, Yudina IY, et al. Inflammatory mechanisms of diabetes and its vascular complications. Biomedicines. 2022;10(5):1168. doi:10.3390/biomedicines10051168.
  3. Hotamisligil GS. Inflammation, metaflammation and immunometabolic disorders. Nature. 2017;542:177-85. doi:10.1038/nature21363.
  4. Donath MY, Dinarello CA, Mandrup-Poulsen T. Targeting innate immune mediators in type 1 and type 2 diabetes. Nat Rev Immunol. 2019;19:734-46. doi:10.1038/s41577-019-0213-9.
  5. Aghaei M, Bahreiny SS, Zayeri ZD, Davari N, Abolhasani MM, Saki N. Evaluation of complete blood count parameters in patients with diabetes mellitus: a systematic review. Health Sci Rep. 2025;8(2):e70488. doi:10.1002/hsr2.70488.
  6. Islam MM, Satıcı M, Eroğlu S. Unraveling the clinical significance and prognostic value of the neutrophil-tolymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index: an extensive literature review. Turk J Emerg Med. 2024;24(1):8-19. doi:10.4103/tjem.tjem_198_23.
  7. Zhang J, Fan X, Xu Y, Wang K, Xu T, Han T, et al. Association between inflammatory biomarkers and mortality in individuals with type 2 diabetes: NHANES 2005-2018. Diabetes Res Clin Pract. 2024;209:111575. doi:10.1016/j.diabres.2024.111575.
  8. Gong Y, Wang L, Li Q, Wang M, Luan R, Gao F, et al. Evaluating neutrophil-lymphocyte ratio, systemic immuneinflammation index, and systemic inflammation response index for diagnosing and predicting progression in diabetic retinopathy: a cross-sectional and longitudinal study. BMC Ophthalmol. 2025;25(1):398. doi:10.1186/s12886-025-04222-5.
  9. Song Y, Zhao Y, Shu Y, Zhang L, Cheng W, Wang L, et al. Combination model of neutrophil to high-density lipoprotein ratio and system inflammation response index is more valuable for predicting peripheral arterial disease in type 2 diabetic patients: a cross-sectional study. Front Endocrinol (Lausanne). 2023;14:1100453. doi:10.3389/fendo.2023.1100453.
  10. Nie Y, Zhou H, Wang J, Kan H. Association between systemic immune-inflammation index and diabetes: a population-based study from the NHANES. Front Endocrinol (Lausanne). 2023;14:1245199. doi:10.3389/ fendo.2023.1245199.
  11. Guo H, Wan C, Zhu J, Jiang X, Li S. Association of systemic immune-inflammation index with insulin resistance and prediabetes: a cross-sectional study. Front Endocrinol (Lausanne). 2024;15:1377792. doi:10.3389/fendo.2024.1377792.
  12. Yeşilyurt S, Özsenel EB, Senat A, Erinc O. The relationship between hemoglobin A1c and hemogram-derived novel inflammatory indices. South Clin Ist Euras. 2024;35(1):47-53. doi:10.14744/scie.2024.07992.
  13. Yaribeygi H, Atkin SL, Pirro M, Sahebkar A. A review of the anti-inflammatory properties of antidiabetic agents providing protective effects against vascular complications in diabetes. J Cell Physiol. 2019;234(6):8286-94. doi:10.1002/jcp.27699.
  14. Scheen AJ, Esser N, Paquot N. Antidiabetic agents: potential anti-inflammatory activity beyond glucose control. Diabetes Metab. 2015;41(3):183-94. doi:10.1016/j.diabet.2015.02.003.
  15. Bonnet F, Scheen AJ. Effects of SGLT2 inhibitors on systemic and tissue low-grade inflammation: the potential contribution to diabetes complications and cardiovascular disease. Diabetes Metab. 2018;44(6):457-64. doi:10.1016/j.diabet.2018.09.005.
  16. Kothari V, Galdo JA, Mathews ST. Hypoglycemic agents and potential anti-inflammatory activity. J Inflamm Res. 2016;9:27-36. doi:10.2147/JIR.S86917.
  17. Wang Y, Li Q, Zhang L, Chen H, Liu J, Zhao Y, et al. Association of immune-inflammation indexes with incidence and prognosis of diabetic nephropathy: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2025;16:1532682. doi:10.3389/fendo.2025.1532682.
  18. Wu H, Esteve E, Tremaroli V, Khan MT, Caesar R, Mannerås-HolmL, et al. Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug. Nat Med. 2017;23(7):850-8. doi:10.1038/nm.4345.
  19. Yang L, Zhang X, Wang Q. Effects and mechanisms of SGLT2 inhibitors on the NLRP3 inflammasome, with a focus on atherosclerosis. Front Endocrinol (Lausanne). 2022;13:992937. doi:10.3389/fendo.2022.992937.
  20. American Diabetes Association Professional Practice Committee. Pharmacologic approaches to glycemic treatment: standards of care in diabetes-2026. Diabetes Care. 2026;49(Suppl 1):S183-215. doi:10.2337/dc26-S009.
  21. Yazar BT, Eren F, Fırat Oğuz E. The relationship of inflammatory markers NLR and PLR with HbA1c in Turkish diabetic patients. Diabetes Res Clin Pract. 2025;224:112213. doi:10.1016/j.diabres.2025.112213.