Diabetes Anemia Research Articles

Anemia among adult patients with diabetes attending King Abdulaziz University Hospital: A retrospective study.

The prevalence of anemia in adults with diabetes is of growing importance due to its impact on overall health and the management of diabetes-related complications. This study aimed to determine the prevalence of anemia among adult patients with diabetes at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. A retrospective study was done on 1208 patients with diabetes >18 years who attended the study setting from 2010 to 2022. Data about patients' demographics, body mass index, glycated hemoglobin (HbA1c; %), hemoglobin (Hb), serum ferritin, iron, mean corpuscular Hb, mean corpuscular volume, free thyroxine and triiodothyronine (T3), and serum thyroid-stimulating hormone (TSH) were collected. Of patients, 86.6% had anemia with a prevalence of 30.2%, 47.6%, and 22.2% for mild, moderate, and severe anemias, respectively. The prevalence of anemia was significantly higher among females, those with high serum ferritin, normal serum iron or normal serum T3, lower mean HbA1c level (%), lower serum iron or T3, and higher serum ferritin or TSH. A significant positive correlation was found between Hb level and HbA1c level (%), serum iron, free T3, and body mass index. A significant negative correlation was found between Hb level and mean corpuscular volume, serum ferritin, and serum TSH. Being female, having high serum ferritin, lower mean free T3, and a high TSH were risk factors for anemia. The prevalence of severe anemia was significantly higher among patients with uncontrolled diabetes mellitus. A high prevalence of anemia was found among studied diabetics. Anemia screening should be included in the routine assessment of patients with diabetes. A multidisciplinary approach involving endocrinologists, hematologists, and dietitians is recommended to ensure holistic care and address all aspects of the patient's health. In addition, further research should be supported to better understand the mechanisms linking diabetes and anemia and to establish evidence-based guidelines for managing anemia in diabetics.

Modification Effects of Albuminuria on the Association Between Kidney Function and Development of Anemia in Diabetes.

Previous studies failed to adjust for estimated glomerular filtration rate (eGFR) in evaluating the association between albuminuria and anemia development, and we aimed to investigate whether albuminuria independently affects anemia development. We conducted a retrospective cohort study and retrospectively identified adults with diabetes from a Japanese nationwide clinical database (JMDC, Tokyo, Japan). To assess the modification effects of albuminuria on the association between eGFR and anemia development, we estimated prevalence of anemia, defined as hemoglobin < 13 g/dL in men and < 12 g/dL in women, using a modified Poisson regression and marginal standardization form of predictive margins, stratified by albuminuria severity after adjusting for eGFR. Hence, we revealed at which eGFR level this modification effect appeared and the extent to which this modification effect increased the prevalence of anemia. We identified 327 999 data points from 48 056 individuals [normoalbuminuria: 186 472 (56.9%), microalbuminuria: 107 170 (32.7%), and macroalbuminuria: 34 357 (10.5%)]. As eGFR declined, anemia prevalence increased. Albuminuria severity modified this association induced by decreased eGFR among individuals with eGFR <30 mL/min/1.73 m2 after adjusting for multivariable factors, including age, sex, comorbidities, and medication use. Compared with the normoalbuminuric group, the macroalbuminuric group had a 5% to 20% higher anemia prevalence among individuals with eGFR of <30 mL/min/1.73 m2. We revealed that the severity of albuminuria modified the association between eGFR and anemia development among individuals with eGFR <30 mL/min/1.73 m2, highlighting the modification effect of albuminuria on the association between kidney function and anemia development in diabetes.

Effects of Iron Deficiency Anaemia on HbA1c Levels in Non-Diabetics and Diabetics

Background: Iron deficiency anaemia is one of the most common anaemia striking in our country. The level up to which blood sugar level is regulated is measured by HbA1c. HbA1c represents sugar level in the blood for 120 days. HbA1c could be dependent upon an assemblage of factors like variants of haemoglobinopathies, haemolytic anaemia, other deficiency anaemia, acute loss of blood, uraemia, and pregnancy. Thus, it is crucial to determine the role of HbA1c in iron deficiency anemia in diabetics and non-diabetics before treating the patients.&#x0D; Methods: Total of 58 articles were collected and based on our study objective total of 19 articles were included in this study. Iron deficiency anaemia, HbA1c, diabetics and non-diabetics has been added in pub med advanced searches and Google scholar. Original articles which compare the correlation between these two were taken. All the information was gathered from original and review articles. Articles which were qualified for review, their inclusion criteria, exclusion criteria, quality of assessment and data collections were taken into consideration. Structure of heme particle, basic mechanism of HbA1c formation in RBCs is elaborated. Review articles which were taken include RCT, retrospective analysis and observational studies. The results were all compared and concluded of each articles. Basic mechanism of formation of HbA1c in RBCs is shown. Also necessary conclusions were derived from each study.&#x0D; Results: In a wide range of studies, HbA1c was found to be raised in IDA. After iron supplements, studies showed a decrease in HbA1c. Our study showed there is a need to correct anemia in diabetic patients before starting treatment.&#x0D; Conclusions: Strict HbA1c control is not a prerequisite and prior anaemia correction should be done. Nevertheless, a study which will be conducted in representative population matching to the prevalence and incident of disease in our country also which should be interventional is required for the highest correction value of HbA1c in DM and NDM population.

Anemia in Diabetes – An Added Dilemma

Aim: To study the frequency of anemia in diabetes of an adult population.&#x0D; Methodology: This cross-sectional observational study included 277 adult patients, above the age of 18 years, who were diagnosed as having diabetes by clinical and laboratory basis and were considerably controlled on their prescribed management. The study was conducted in Creek General Hospital Karachi from October to December 2020 by random based sampling technique. After a written consent answers were noted according to the questionnaire and the relevant data was tabulated and analyzed. Patients with complications or with other chronic illness, except hypertension, were excluded. The data was evaluated for the frequency of anemia in diabetics, categorizing the severity of anemia into mild, moderate, and severe. Universal variables like gender and age were assessed.&#x0D; Results: Among the 277 patients in the study, there were 121(43.7%) males and 156 (56.3%) females. There were 17 (6%) in the young age group, 162 (58.5%) in the middle age group and 98 (35.4%) elders. The mean hemoglobin was 11.1 gm/dl. Out of 277 there were 222 (80%) who fell in the category of anemia. There were 90 out of 121 (74%) males who were anemic and 132 out of 156 (84%) females who were anemic. The most frequent category of anemia was moderate anemia (48%) followed by mild category (46%). Mild anemia was more frequent in males while moderate anemia was more prevalent in females. Anemia was higher in percentage in the younger group (88%). Mild to moderate anemia was more prevalent than severe in all age groups. 81% of hypertensive, diabetic patients was anemic. 78% smokers had anemia. There was visible increase in frequency of anemia as the duration of diabetes increased. Conclusion: Anemia is highly prevalent in diabetics.

Anemia in diabetes and pre-diabetes with normal kidney function: Prevalence and long- term association with morbidity and mortality

Anemia in diabetes and pre-diabetes with normal kidney function: Prevalence and long- term association with morbidity and mortality

1052 Do adverse neonatal outcomes differ by anemia type among women with pre-existing diabetes?

The etiology of anemia in diabetes is likely mediated through a combination of dietary iron deficiency, functional iron deficiency due to IL-6, erythropoietin deficiency, and drug exposure. We sought to determine whether adverse pregnancy outcomes differ by anemia sub-type among pregnant women with pre-existing diabetes. We conducted a cohort study of pregnant patients with type 1 or 2 diabetes who received care at a tertiary referral center from 2007-2017. Patients with a known hemoglobinopathy and macrocytic anemia were excluded. Women diagnosed with a microcytic or normocytic anemia at any point in pregnancy were compared to those with no documented anemia as the referent group. The primary outcome was a neonatal composite morbidity index including polyhydramnios, preterm birth, neonatal hypoglycemia, Neonatal Intensive Care Unit admission, and respiratory distress syndrome. Secondary outcomes included individual components of the composite. Logistic regression was used to control for potential confounding variables including race, nulliparity, and diabetes type. Of 450 patients, 3 were excluded for having macrocytic anemia. Of the remaining 447, 162 (36%) did not have anemia during pregnancy, 85 (19%) had microcytic anemia, and 200 (45%) had normocytic anemia. Demographic characteristics were similar between groups except those without anemia were more likely to be nulliparous and those with microcytic anemia were more likely to be obese or Black. There were no significant differences in the neonatal composite index by anemia sub-type after controlling for confounding variables. Normocytic anemia was associated with early preterm delivery (aRR 4.8; 95% CI 1.45-15.2). There were no differences in other secondary outcomes by anemia sub-type. Normocytic anemia is the predominant sub-type among women with diabetes in pregnancy, and it is associated with an increased risk of early preterm birth.

Study on Microbiome of Chronic Non Healing Diabetic Ulcers with Special Reference to Biofilm and Multidrug Resistant Strains

Introduction: Diabetic Foot Ulcers (DFU) represent a silent epidemic and are the leading cause of 80% of non traumatic lower-limb amputations. Anaemia in diabetes may have adverse effects on systemic diseases and predict the progression of diabetes complications. Biofilms act as a mechanical barrier to antimicrobials and immune system cells and contribute to Multidrug Resistance (MDR). Aim: To determine the bacteriome and mycobiome of diabetic ulcers and the associated biofilm formation and anti-microbial resistance profile of the pathogens. Also, to determine the molecular characterisation of biofilm-forming resistant isolates by Polymerase Chain Reaction (PCR). Materials and Methods: This cross-sectional study was done on 150 diabetic patients with non healing ulcers and was chosen and studied from January-December 2019. Pus and tissue bit samples were processed as per standard microbiological procedures. Antimicrobial susceptibility test was performed as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Biofilm formation was detected by the tissue culture plate method. Molecular characterisation of resistant pathogens was done by PCR. Variables were expressed as proportions or percentages. Results: Out of 150 diabetic patients, 17.3% of patients underwent amputation. A 90% of patients were associated with anaemia. Most ulcers were polymicrobial in nature. Predominantly isolated pathogens were Pseudomonas aeruginosa 37 (17.1%) and Staphylococcus aureus 33 (15.2%) among aerobic bacteria, Peptostreptococcus 10 (4.6%) among the anaerobes and Candida albicans 20 (9.2%) in fungus. Gram negative bacteria showed high sensitivity to piperacillin-tazobactam, meropenem, and gram positive cocci to vancomycin and linezolid. A 82% of bacterial isolates and 50% of fungal isolates were biofilm producers. Staphylococcus aureus was a strong biofilm producer. On molecular characterisation, blaCTX-M, blaTEM, blaNDM-1, blaOXA-23, mecA genes were present in resistant biofilm-forming isolates. Conclusion: Polymicrobial wound infection and biofilm formation in DFU confers antibiotic resistance and contributes to Multidrug Resistant Organisms (MDRO’s). However, proper antibiotic surveillance and antibiotic policy, and preventive strategies can curtail the spread of resistant strains.

Frequency of Anemia Among the Patients of Type 2 Diabetes Attending Outpatient Clinic of Mirpurkhas, Sindh

Background: Anemia is the most common blood disorder in patients with Type 2 diabetes. The hematological profile of diabetic patients is often missed clinically until to start the manifestation of clinical features of anemia. Anemia increases the hindrances and financial burden on the patient by frequent hospitalization. It increases the risk of microvascular complications, heart diseases, morbidity and death in diabetes mellitus. Therefore, it is imperative to recognize and treat anemia for the sake of patient care.&#x0D; Objectives: To evaluate the frequency of anemia in Type 2 Diabetic patients attending diabetic outpatients clinics of Mirpurkhas, Sindh.&#x0D; Methodology: A case-control study has been done to compare the hemoglobin level of Type 2 diabetics and non-diabetics. The data was collected over a period of three months from the patients who were visiting the diabetes clinic for their regular checkup. Data for controls were collected from the patient’s attendants. Diabetics and non-diabetics were under observations throughout the period. There were 206 subjects’ including 106 diabetics (52 females and 54 males) and 100 non-diabetics (50 females and 50 males). Research concerns included the duration of the disease, family history &amp; presence of hypertension. Methods such as cyan methemoglobin were used to estimate hemoglobin &amp; random blood glucose by glucose oxidase as recommended by the World Health Organization (WHO) and then read through Micro-lab 300 chemistry analyzer.&#x0D; Results: The frequency of occurrence of anemia in diabetics was 33.3% in males and 48.1% in females. Whereas in controls, 16.0% males and 32.0% females were anemic. The family history of diabetes and hypertension was also found higher among diabetic individuals as compare to healthy counterparts.&#x0D; Conclusion: The study has shown that anemia is twice as common in diabetics as compared with non-diabetics. Early diagnosis of anemia in a diabetic patient, and to treat so, will improve the quality of life and delay the complications to be developed in these patients.

Study of anemia in diabetic and non-diabetic subjects: A hospital-based study in Lucknow, Uttar Pradesh

Background: India is expected to be the Diabetic Capital of World in the coming years. Alarmingly by 2045, it is expected that 130 million Indians will be having diabetes. It alters the physiology of the human body and the associated renal insufficiency, inflammation, and oxidative stress further complicate the disease. Anemia is expected to be present in 11–65% of diabetics. Anemia in diabetics thus requires investigation and cannot be neglected. Aims and Objectives: The present study was undertaken to study the anemia in diabetic and non-diabetic subjects. Materials and Methods: The present study included 92 subjects divided into diabetic (n = 48) and non-diabetic (n = 44) groups. Hemoglobin (Hb) and blood indices (mean corpuscular volume [MCV], mean corpuscular Hb [MCH], and MCHC concentration [MCHC]) were compared and further evaluation was done on the basis of the severity of anemia (as per the WHO classification). Statistical unpaired t-test was employed for data analysis. P < 0.05 was taken as statistically significant. Results: Among the diabetic group out of 48 subjects, mild, moderate, and severe anemia was present in 8 (Hb in g/dl was 11.25 ± 0.26), 11 (9.73 ± 0.83 g/dl Hb), and 4 (6.13 ± 1.15 g/dl Hb) subjects, respectively. In non-diabetic subjects, mild and moderate anemia was present in 5 (11.42 ± 0.33 g/dl Hb) and 7 (9.98 ± 0.83 g/dl Hb) subjects, respectively. Thus, in diabetics, the percentage of those having moderate anemia was more as compared to non-diabetics. In diabetics out of 48 subjects, 27 were female (56.25%) and 21 (43.75%) were male. Similarly, in non-diabetics, 28 (63.64%) were female and 16 (36.36%) were male. In the present study, the mean ± SD age (years) of diabetics and non-diabetics was found to be 44.17 ± 8.82 and 41.6 ± 8.80, respectively. The difference in mean ± SD values of Hb was found to be insignificant with P = 0.167. Similarly, insignificant differences were found between the mean ± SD values of blood indices, namely, MCV (P = 1.795), MCH (P = 0.897), and MCHC (P = 1.484), respectively, between diabetics and non-diabetics. Conclusions: On the basis of the study, it may be concluded that female gender and the elderly are prone to anemia and thus are expected to be more prone to complications due to anemia in diabetes. The duration of diabetes is expected to influence the results and thus requires inclusion in the study design.

Ethnobotanical Uses, Phytochemistry and Pharmacological Activities of Pterocarpus marsupium: A Review

Pterocarpus marsupium is an important therapeutic and medicinal plant belonging to family Fabaceae and commonly named as Indian Kino tree, Bijasal, Venga or Vijayasara. It is a huge deciduous plant and widely distributed in the Central, Western and Southern regions of India. Role of P. marsupium is found in Ayurveda, Homeopathic and Unani systems of medicine. It is a decent source of tannins and flavonoids hence, used as influential astringent, anodyne, cooling, regenerating agent and also used for the treatments of leprosy, leucoderma, toothache, fractures, diarrhea, passive hemorrhage, and dysentery, bruises and diabetes. It is also used to treat rheumatoid arthritis, gout, diabetic anemia, indigestion, asthma, cough, discoloration of hair, bronchitis, ophthalmic complications, elephantiasis and erysipelas. Researchers have been stated the presence of several phytoconstituents in P. marsupium and also their pharmacological activities. The current review aimed to define the phytochemical and pharmacological aspects of P. marsupium which will have been help in the researchers for further qualitative research.

Revisiting the Role of Chronic Kidney Disease and Its Association With Anemia in Diabetics and Non-Diabetics: A Cross Sectional Audit Of 450 Cases

BACKGROUND: Anemia is twice common in diabetics compared with non-diabetics. The etiopathogenesis of anemia in diabetes is multifactorial [Chronic Kidney Disease (CKD), Iron Deficiency Anemia (IDA), B12 and folate deficiency, etc]. Anemia in diabetic patients prior to the evidence of renal impairment is rarely reported. OBJECTIVE: To determine the role of CKD and other etiological factors of anemia in diabetics and non-diabetics. To correlate the degree of anemia with severity of CKD and glycemic status. METHODS: A cross-sectional study carried out in SRM Hospital and Research Centre, Chennai. Total 450 subjects (150 controlled & 150 poorly controlled diabetics, 150 non-diabetics) with equal number of anemic and not-anemic patients in each group were included. Further categorized into those with CKD and without CKD. RESULTS: In our study, only 33% anemic patients with diabetes had low eGFR and CKD (p<0.05). Among the rest 67% majority of anemia in diabetics was due to IDA which became evident from low iron profile and microcytic blood picture. As CKD progressed, anemia worsened. Moreover poorly controlled diabetics with CKD showed statistical significant difference between anemic and not-anemic patients. Anemia was highly prevalent in females and CKD in males in both diabetics and non-diabetics. CONCLUSION: In this study we insist on the utter importance of evaluating other etiological factors apart from CKD such as IDA for accurate diagnosis, treatment of anemia in diabetics and thereby preventing the prognosis of complications. DOI: 10.21276/APALM.1590

Study of anemia in diabetes and its association with diabetic retinopathy

Background: Anemia is an increasingly recognized entity in patients with diabetes mellitus. Reduced hemoglobin levels identify diabetic patients with an increased risk of microvascular complications.Methods: A hospital based observational prospective study was conducted in Department of medicine, J.A. Group of Hospitals, Gwalior from June 2014 to October 2015. Adults with diabetes mellitus both type 1 and type 2 were selected as subjects are included and anemia due to blood loss and anemia due to chronic kidney diseases were excluded from the study. Estimation of hemoglobin was done by using capillary method by calorimetric hemoglobinometer. Anemia was defined as hemoglobin &lt;13 g/dl in men and &lt;12 g/ dl in women. All the patients were examined for diabetic retinopathy and graded as none, mild, moderate, severe and proliferative retinopathy as per International clinical diabetic retinopathy disease severity scale.Results: 100 patients were enrolled as subjects. Most of the patients 26 (26%) were in the age group 46-55 years. There were 53 males and 47 females. 42%, 45% and 13% had diabetes of &lt;5 years, 5-10 years and &gt; 10 years duration respectively. HbA1c levels were &lt;7.5 in 74 (74%), 7.5-10 in 23 (23%) patients and &gt; 10 in 3 (3%) patients. Overall 67 (67%) diabetics had anemia. Out of 53 males 30 (56.6%) had anemia and amongst females, out of 47 cases 37 (78.72%) had anemia P value 0.009. Anemia was more common in patients less than 50 years 36 (70.59%) compared to31 (63.2%) with anemia in patients more than 50 years. 65 (65%) patients had diabetic retinopathy (DR). 30 (46.1%) males and 35 (53.8%) females had diabetic retinopathy. All patients with diabetic retinopathy had anemia. Among 35 (35%) patients without DR only 2 (5.71%) had anemia. P value &lt;0.001.Conclusions: Anemia is a common accompaniment to diabetes. Anemia was more common in females and in those less than 50 years. Anemia was frequently associated with diabetic retinopathy. The high prevalence of anaemia supports regular screening for anemia, alongside that for other diabetes-related complications. This might help to delay the progression of vascular complications in these patients.

Anemia in diabetes: Experience of a single treatment center in Kuwait

AimsDiabetes mellitus is the most common metabolic disorder in Kuwait. Anemia is a known outcome of diabetes and its related complications. This study examined the prevalence of anemia in diabetic subjects in Kuwait as well as any association between the presence of anemia with Hemoglobin A1c and diabetes complications. MethodsThe study subjects were diabetic patients with complete records and two or more visits at Dasman Diabetes Institute. Patient’s data included demographics, complications, medications and laboratory results. Descriptive statistics were applied using SPSS. ResultsOf 1580 included diabetic patients; the prevalence of anemia was 28.5% (95% CI: 26.3, 30.8). Diabetic females had a higher rate of anemia compared to males (35.8% vs. 21.3% respectively, p<0.001). There was no association between diabetes control (HbA1c) and anemia in both genders (p=0.887). Patients with elevated serum creatinine and microalbuminuria were more likely to be anemic (p<0.001). Diabetic patients with anemia had higher presence of peripheral neuropathy and diabetic foot (p<0.001). ConclusionThis study shows high prevalence of anemia in diabetic patients, particularly in those with diabetic complications. These results should prompt treatment centers to include anemia investigation and management within their diabetes treatment protocols to reduce morbidity in diabetes.

新型PHD抑制剂类口服抗贫血药物分子的计算机辅助设计

目的：以目标靶蛋白为研究对象设计一系列可口服的抗贫血类化学药物分子结构。方法：本文针对肾性和肿瘤相关性贫血设计口服小分子治疗药物。贫血，特别是糖尿病性贫血治疗领域是一个非常有前景的市场。HIF-PHD抑制剂作为新型治疗贫血药物，可从注射用促红细胞生成药物, 尤其是透析前慢性肾病患者中获取较大的市场份额。更重要的是，由于这类药物可作为对现有促红细胞生成药物治疗无效或因故不能使用、或因价格太贵而未使用人群的一种新的、有效的替代治疗选择，故也具显著拓展贫血治疗市场规模的潜力。通过对已知有活性的化合物的结构特性以及与靶蛋白的作用机制为基础进行研究，设计合成出治疗效果更好的、副作用更小的潜在治疗贫血的口服药物，在贫血治疗领域必将占有一席之地。采用计算机辅助药物设计将理论计算和实际试验相结合，通过计算机的模拟、计算和预算药物与受体生物大分子之间的关系，设计和优化脯氨酸羟化酶抑制剂类先导化合物。采用体外模拟试验进行理论验证，以期对发现新的具有更大的潜在活性药物提供较大的应用价值。结果：设计出一系列以吲哚为母核结构的化合物分子，通过分子对接从理论上证实其中一些分子化合物为潜在的活性化合物。结论：为新型口服抗贫血化学药物的开发奠定了一定的理论基础。 A series of small molecule compound structures oral administration anti-anemia drugs were de-signed based on target protein. Small molecule drug designed in this project is targeted at renal and cancer related anemia. Anemia treatment field, especially diabetic anemia, is a very promising market. As a new kind of anemia inhibitor, HIF-PHD inhibitors could obtain a larger market share from erythropoietic drugs for injection, especially pre-dialysis patients with chronic kidney diseases. More importantly, this kind of drugs could be used as a new, effective replacement therapy for those patients that could not be treated by the existing erythropoietic drugs for that the drugs are invalid for them, or cannot be used for them for some other reasons, or too expensive for them to afford to. So, the potential drugs with better therapeutic effects, less adverse effects, and oral administration developed on the basis of structural characteristic of known active compound and its mechanism of action with target proteins, are doomed to hold a place in the field of anemia treatment. By com-bining theoretical calculation and practical test together via computer aided drug design, with the computer’s simulation, calculation and estimation on the relationship between drugs and biological receptor molecules, this project starts from designing and optimizing the leading compounds of proline hydroxylase inhibitors, then carrying out In Vitro experiments to verify the theoretical ac-tivity, which is of great application value for discovering greater potential active agents. Result: A series of compounds with indole as the parent nucleus structure were designed and some molecular compounds were theoretically confirmed by molecular docking as potential reactive compounds. Conclusion: It has laid a theoretical foundation for the development of new oral anti-anemia drugs.

Study of Anemia in Diabetics

Study of Anemia in Diabetics

Newly diagnosed anemia in admitted diabetics, frequency, etiology and associated factors.

To determine the frequency of newly-diagnosed anemia in diabetics admitted to the Internal Medicine Department and its etiology and contributing factors. A cross-sectional, analytical study. Department of Internal Medicine, Sir Syed Trust Hospital and College of Medical Sciences, Karachi, from July 2011 to December 2012. Adult diabetic patients first diagnosed as having anemia upon hospital admission during the specified duration were included. Patients with active bleed, acute renal impairment, critical illness, pregnancy and previously diagnosed anemia were excluded. Etiology and risk factors of anemia were determined in each case on the basis of history, clinical findings and relevant laboratory investigations i.e. complete blood picture, red cell indices, iron profile, renal function tests, urine and stool examination. Association of anemia was determined using chi-square and t-tests with p-value < 0.05 taken as significant. One hundred and thirty patients (34 males and 96 females) were included. Mean age was 51 ± 12.4 years, with mean BMI of 25.4 ± 5.2 kg/m2, mean duration of diabetes of 7.6 ± 5.5 years and mean glycated haemoglobin (HbA1c) 8.47 ± 1.58%, with 75% diabetics having unsatisfactory glycemic control. Mean haemoglobin was 11.6 ± 1.96 g/dl. Anemia was present in 63% diabetics (18 males and 64 females). It was normocytic in 59.8%, microcytic in 37.8% and macrocytic in 2.4%. Chronic Kidney Disease (CKD) was present in 44%, iron deficiency in 23%, mixed etiology in 6%, vitamin B-12 deficiency in 2% and thalassemia minor in 1% cases. Statistically significant association of anemia was found with poor glycemic control (p=0.002), dietary restriction for red meat (p < 0.001), history of blood loss (p < 0.001), gastrointestinal disorders (p < 0.001), CKD (p < 0.001) and retinopathy (p=0.011). Anemia in two out of every three diabetics in this study points to need for haematological screening in all diabetics presenting to healthcare facility. In addition to chronic kidney disease, dietary iron and vitamin deficiency, glycemic control, presence of CKD, retinopathy and gastrointestinal disorders need to be evaluated and rectified.

The Occurrence of Iron-Deficiency Anemia in Children With Type 1 Diabetes

ObjectiveA higher risk for iron deficiency, which can lead to anemia, has been noticed in children with early stages of type 1 diabetes. Anemia in diabetes is not uncommon and...

ANAEMIA, DIABETES AND CHRONIC KIDNEY DISEASE: WHERE ARE WE NOW?

SUMMARYAnaemia is a common finding in people with diabetes and chronic kidney disease and failure of the kidney to produce erythro‐poietin in response to a falling haemoglobin concentration is a key component, correlating with the degree of albuminuria, renal dysfunction and iron deficiency. Anaemia in diabetes is associated with a number of adverse outcomes, including increased risk of all cause and cardiovascular mortality. Whether or not anaemia is a marker or mediator of adverse outcome still remains to be completely resolved. Treatment of anaemia in diabetes has quality of life benefits and reduces transfusion requirements. Correction of anaemia to normal haemoglobin concentrations is associated with significant adverse cardiovascular outcomes and is not recommended, escalating doses of erythropoiesis‐stimulating agents should be avoided. The treatment of anaemia in people with diabetes and chronic kidney disease should begin with optimisation of iron stores. An aspirational haemoglobin concentration range of 10–12 g/dl with anaemia management, balances proven benefits of anaemia treatment with potential cardiovascular risk.

The prevalence of anaemia in diabetes with stage 3 chronic kidney disease: a retrospective analysis

The aim of this retrospective study was to assess the prevalence and causes of anaemia in patients with diabetes and stage 3 chronic kidney disease (CKD). Details of patients (n=3,499) with stage 3 CKD were extracted from the renal database of a hospital in Birmingham, UK, which serves a multiethnic population. Of the 2,438 patients with diabetes and stage 3 CKD, haemoglobin (Hb) measurements were available for 1,086 patients, of whom 289 were anaemic. Anaemia was defined as Hb &lt;11.0 g/dl and subnormal Hb was defined as Hb &lt;11.5 g/dl in women and &lt;13.0 g/dl in men. The prevalence of anaemia was 31% among females and 21% among male patients. A ferritin level assessment had been undertaken in 34 of the 289 patients with anaemia (Hb &lt;11.0 g/dl) and 23 of them showed iron deficiency (ferritin &lt;100 µg/L). The prevalence of anaemia was higher in stage 3 CKD patients with diabetes (27%) than without diabetes (14%) and was 33% in patients of South Asian descent (p&lt;0.0001 vs. no diabetes). There is a high prevalence of anaemia in people with diabetes and stage 3 CKD, and thus screening for anaemia should be part of their routine management.

The effect of oxidative stress on human red cells glutathione peroxidase, glutathione reductase level, and prevalence of anemia among diabetics.

Background:The oxidative stress is considered as major consequence of diabetes mellitus affecting red cell antioxidant enzymesAim:The present study was conducted to assess the impact of oxidative stress (reduced glutathione) on glutathione peroxidase, and glutathione reductse and prevalence of anemia among diabetic patients.Materials and Methods:The study involved 100 adult patients attending Buraidah Central Hospital and 30 healthy controls. Blood samples were collected and analyzed for glutathione (GSH) concentration, glutathione peroxidase (GPO), glutathione reductase (GR), fasting blood sugar (RBS), hemoglobin (HGB), red cell count (RBCs) hematocrit (HCT) mean cell volume (MCV) mean cell hemoglobin (MCH) and mean cell hemoglobin concentration (MCHC) and hemoglobin A1c. Blood urea, serum creatinine, and microalbuminuria were measured to exclude diabetes mellitus nephropathy.Results:were obtained showed significant correlation between deficiency of glutathione peroxidase, glutathione reductase and deficient of glutathione among diabetics, which has significant correlation between low hemoglobin concentration (females <120 g/L, males <130 g/L), also there is low concentration of red cell count and red cell indices (MCV, MCH and MCHC). The prevalence of anemia was 22% in diabetes patients.Conclusion:It can be concluded that there is strong significant effect of oxidative stress (reduced glutathione) on glutathione peroxidase, glutathione reductase level these may reduce hemoglobin concentration in diabetic patients. This means oxidative stress of diabetes mellitus is the possible cause of anemia in diabetics without nephropathy.