Abstract

Diabetes mellitus (DM) and also anemia are common in the elderly and have a negative impact on the clinical outcomes of patients. The coexistence of anemia and DM seems to be insufficiently recognized; therefore, the aim of our study is to analyze the incidence and clinical consequences of this coexistence, including mortality, in the population of people aged ≥60. A retrospective study was conducted on 981 primary care clinic patients aged ≥60 during 2013-2014. The prevalence of coexistence of DM and anemia (defined in accordance with WHO) and data on the incidence of comorbidities, hospitalization, medical procedures, and all-cause mortality were analyzed. In the study population, 25% had DM, while 5.4% had both DM and anemia. Peripheral artery disease (PAD) was found in 48 patients (4.89%) of the entire study population, more often in men (p < 0.001). Diabetic patients with anemia compared to nonanemic diabetics had more comorbidities (median 4 (4, 5) vs. 3 (2–4); p < 0.001)—PAD more often (p = 0.004), more hospitalization (median 2 (0–11) vs. 0 (0–11); p < 0.001), and more frequent medical procedures (e.g., percutaneous coronary intervention (p < 0.001), coronary artery bypass surgery (p = 0.027), arteriography (p < 0.001), and bypass surgery or endovascular treatments of lower limb ischemia (p < 0.001)). The cumulative survival of patients with both DM and anemia vs. nonanemic diabetics at 36 months was 86.4% vs. 99.3% (p < 0.001). A multivariate logistic regression model showed anemia to be a significant risk factor for death in diabetic patients (p = 0.013). Patients with both DM and anemia have more comorbidities than nonanemic diabetic patients; they are more often hospitalized, require medical procedures more frequently, and are at a higher risk of death. Effective treatment of anemia in patients with DM is advisable and may well improve the prognosis of patients.

Highlights

  • Both diabetes mellitus (DM) and anemia are common in the elderly population, and both are associated with the severity of the course of many comorbidities and an increase in the risk of death [1,2,3,4,5]

  • DM with complications was found in 143 patients (74 women: 51.75%; 69 men: 48.25%)—58.37% of the diabetic group. 53 patients had both anemia and DM, including 40 (75.47%) patients with DM with complications, whereas the diabetics without anemia amounted to 192 patients (of whom 103 (53.65%) have DM with complications)

  • Our results demonstrated that patients with DM and anemia had more comorbidities, were more often hospitalized, and had a higher risk of death

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Summary

Introduction

Both diabetes mellitus (DM) and anemia are common in the elderly population, and both are associated with the severity of the course of many comorbidities (especially cardiovascular diseases) and an increase in the risk of death [1,2,3,4,5]. The long-term course of diabetes leads to micro- and macrovascular damage, which negatively affects the circulatory system, nervous system, kidneys, and eyes [8]. Especially in elderly patients, has a negative impact on the circulatory system and leads to left ventricular hypertrophy [9], exacerbation of symptoms of ischemic heart disease, heart failure [10, 11], or the formation of atherosclerotic changes in the vessels [12]. A significant group of elderly anemic patients remains untreated due to the lack of a known cause of the decrease in hemoglobin (Hb) [14]; anemia can negatively affect health for many years

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