Background: Type 2 diabetes mellitus (T2DM) is a global health concern, with a majority of cases in low-income countries. Around 56% of subjects in Bangladesh go undiagnosed, increasing the risk of stroke and cardiovascular issues. Iron store's impact on diabetes is gaining attention, with ferritin as a key biomarker. Hyperferritinemia probably contributes to insulin resistance and subsequently to decreased insulin secretion, causing the development of insulin resistance. The link between ferritin and insulin resistance (IR) varies based on ethnicity, gender, and glycemic state. This study investigates serum ferritin's association with insulin resistance markers in Bangladeshi adults on different glycemic states.

Objectives: This study investigates serum ferritin levels in different glycemic stages and explores potential correlations between ferritin and insulin resistance markers (blood glucose, serum insulin and HOMA-IR)

Materials & Methods: The study, conducted at the Department of Biochemistry, Sir Salimullah Medical College, from March 2018 to February 2019, investigated the relationship between ferritin levels and diabetes mellitus in adults. Participants were categorized into three groups: those with normal fasting glucose (NFG group), impaired fasting glucose (IFG group), and newly diagnosed type 2 diabetes mellitus (Diabetic group) according to WHO (2006) criteria. A purposive convenient sampling method was used, focusing on adults aged 25 to 55 years of both genders. Exclusion criteria were applied to eliminate individuals with inflammatory diseases, chronic conditions, major cardiovascular events, anemia, or specific medications that could affect ferritin levels. 

Results: The study found that serum ferritin levels significantly differed among three glycemic groups (NFG, IFG, and T2DM) with higher levels in T2DM. IFG and T2DM groups also had elevated serum insulin and HOMA-IR. Serum ferritin correlated strongly with fasting blood glucose, serum insulin, HOMA-IR, and BMI . The highest tertile of ferritin levels were associated with impaired glycemic status, especially in T2DM.

Conclusion. Elevated serum ferritin levels in IFG and type 2 diabetes may significantly impact glucose regulation. Compared to NFG, there are high insulin resistance markers (fasting insulin, glucose, HOMA-IR) in T2DM and IFG. They have crucial implications for both therapy and prognosis in these conditions.