Abstract
Aim: To study the presence of anaemia in patients with Type 2 DM without nephropathy and to use serum Iron studies as a marker for anaemia. In addition, the incidence and risk of anaemia were assessed according to age, gender, duration of diabetes and glycemic control status.
Methods: The study group consisted of 100 individuals with type 2 diabetes. Patients were divided on the basis of age, gender and duration of diabetes. Fasting and post prandial blood sugars and HbA1C for diabetic profiling, peripheral blood smear and serum Iron studies for anaemic profiling, serum urea and creatinine to rule out nephropathy, were evaluated.
Results: The study showed the prevalence of anaemia was present in 33% of study population. Normochromic normocytic (18%) was the most common type of anaemia amongst them with more female predominance(12%).The duration of diabetes was also associated with increase in incidence of anaemia. Blood sugar levels (fasting and post prandial), glycosylated haemoglobin and serum ferritin values were also significantly higher in anaemic group as compared to non-anaemic group whereas TIBC level and serum Iron was significantly lower in anaemic group as compared to non-anaemic group.
Conclusion: Our study suggested that poor glycemic control, longer duration of disease and old age are associated with increased incidence of anaemia in diabetic patients with normal renal function with normocytic normochromic anemia being the most common type. Another conclusion was that Serum ferritin can be considered as a sensitive marker of iron status and glycemic control in diabetics. So we would like to recommend that routine hematological tests along with blood glucose level and serum iron studies should be done mandatory in diabetic patients in order to give optimal treatment of anaemia in Type-2 diabetes mellitus which may have a potential to make a great impact in managing the various vascular complications of diabetes and thus improving the quality of life.
References
- Francisco, Priscila Maria Stolses Bergamo, Ana Paula Belon, Marilisa Berti de Azevedo Barros, Luana Carandina, Maria Cecília Goi Porto Alves, Moises Goldbaum, and Chester Luiz Galvão Cesar. “[Self-reported diabetes in the elderly: Prevalence, associated factors, and control practices].” Cadernos de Saude Publica26, no. 1 (Jan 2010): 175–84.
- International Diabetes Federation. IDF Diabetes Atlas. seventh edition 2015, 2015. [online].
- Arokiasamy, P., S. Parasuraman, T. V. Sekher, and H. Lhungdim. India: Study on global Ageing and adult health (SAGE), Wave 1. International Institute for Population Sciences. Geneva: World Health Organization, 2013.
- Prevalence of diabetes and prediabetes Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, Bhansali A, Joshi SR, Joshi PP, Yajnik CS, Dhandhania VK, Nath LM, Das AK, Rao PV, Madhu SV, Shukla DK, Kaur T, Priya M, Nirmal E, Parvathi SJ, Subhashini S, Subashini R, Ali MK, Mohan V for the ICMR– INDIAB Collaborative Study Group.
- Mohan, V., and G. H. R. Rao. Type 2 Diabetes in South Asains. 1st ed. New Delhi: South Asian Society on Atherosclerosis and Thrombosis, 2007.
- Winkler, A. S., J. Marsden, K. R. Chaudhuri, H. Hambley, and P. J. Watkins. “Erythropoietin depletion and anaemia in diabetes mellitus.” Diabetic Medicine16, no. 10 (Oct 1999): 813–9.
- Spannhake, E. W., and J. W. Fisher. “Partial inhibition of hypoxia-induced erythropoietin production by cholinergic blockade in the dog (39866).” Proceedings of the Society for Experimental Biology and Medicine156, no. 1 (Oct 1977): 19–23.
- Takaku, F., K. Hirashima, and S. Okinaka. “Effect of the bilateral section of the splanchnic nerve on erythropoiesis.” Nature191, no. 4787 (Jul 29, 1961): 500–1.
- Biaggioni, I., D. Robertson, S. Krantz, M. Jones, and V. Haile. “The anemia of primary autonomic failure and its reversal with recombinant erythropoietin.” Annals of Internal Medicine121, no. 3 (Aug 1, 1994): 181–6.
- Corona, G., M. Monami, G. Rastrelli, A. Aversa, A. Sforza, A. Lenzi, G. Forti, E. Mannucci, and M. Maggi. “Type 2 diabetes mellitus and testosterone: A meta-analysis study.” International Journal of Andrology(October 24, 2010). https://doi.org/10.1111/j.1365-2605.2010.01117.x.
- Silva, T. R., J. Zanuzzi, C. D. M. Silva, X. S. Passos, and B. M. F. Costa. “Prevalence of cardiovascular diseases in diabetic and nutritional status of patientes.” Journal of the Health Sciences Institute30, no. 3 (2012): 266–70.
- Subashini Chellappah Thambiah, M. M. “Intan Nureslyna Samsudin, Elizabeth George ....” Malaysian Journal of Medicine and Health Sciences11, no. 1 (2015): 49–62.
- Rathod, G. B., P. Parmar, S. Rathod, and A. Parikh. “Study of Dyslipidemic Pattern and Glycosylated Hemoglobin Status in Diabetic Patients.” Endocrinol Diabetes Res1, no. 01 (2015): 1.
- Anemia in Patients with Type 2 Diabetes Mellitus Jéssica Barbieri et.al. Hindawi Anemia Volume 2015 (2015), Article ID 354737, 7 pages http://dx.doi.org/https://doi.org/10.1155/2015/354737.
- Salman, M. A. “Anemia in Patients with Diabetes Mellitus: Prevalence and Progression.” General Medicine (Los Angeles, Calif.)3 (2015): 162.
- Sharif, A., S. Younus, K. Baig, and N. Ali. “Prevalence and Risk of Anemia in Type-2 Diabetic Patients.” Health6, no. 12 (2014): 1415–9.
- International Journal of Research in Medical Sciences Borah M et al. Int J Res Med Sci. 2016 Nov;4(11):4916-4921 msjonline.orgpISSN 2320-6071 | eISSN 2320-6012
- Smotra, S., and R. P. Kudyar. “Relationship between Serum Ferritin and Type-2 Diabetes Mellitus.” JK Science.10, no. 4 (2008): 170.
- Kim, N. H., J. H. Oh, K. M. Choi, Y. H. Kim, S. H. Baik, D. S. Choi, and S. J. Kim. “Serum ferritin in healthy subjects and type 2 diabetic patients.” Yonsei Medical Journal41, no 3 (Jun 2000): 387–92.
- Canturk, Zeynep, Berrin Cetinarslan, Ilhan Tarkun, and Nuh Zafer Canturk. “Serum ferritin levels in poorly- and well-controlled diabetes mellitus.” Endocrine Research29, no. 3 (Aug 2003): 299–306.
- Oberley, L. W. “Free radicals and diabetes.” Free Radical Biology & Medicine5, no. 2 (1988): 113–24.
- Wolff, S. P. “Diabetes mellitus and free radicals. Free radicals, transition metals and oxidative stress in the aetiology of diabetes mellitus and complications.” Cite this article as: Borah M, Gosw. British Medical Bulletin49, no. 3 (Jul 1993): 642–52.
- Fernández-Real, José Manuel, Abel López-Bermejo, and Wifredo Ricart. “Iron stores, blood donation, and insulin sensitivity and secretion.” Clinical Chemistry51, no. 7 (Jul 2005): 1201–5.
- Genuth, S., and F. Ismail-Beigi. “Clinical implications of the ACCORD trial.” Journal of Clinical Endocrinology and Metabolism97, no. 1 (Jan 2012): 41–8.
- Locatelli, Francesco, Pedro Aljama, Bernard Canaud, Adrian Covic, Angel De Francisco, Iain C Macdougall, Andrzej Wiecek, and Raymond Vanholder, and the Anaemia Working Group of European Renal Best Practice (ERBP). “Target haemoglobin to aim for with erythropoiesis-stimulating agents: A position statement by ERBP following publication of the Trial to reduce cardiovascular events with Aranesp therapy (TREAT) study.” Nephrology, Dialysis, Transplantation25, no. 9 (Sep 2010): 2846–50.
National Institute for Health and Care Excellence - NICE
Corresponding Author
Dr Karandeep Singh
Third year Resident, Department of General Medicine,
MGM Medical College and Hospital,
Kamothe, Navi Mumbai, Maharashtra
DOI: https://dx.doi.org/10.18535/jmscr/v5i9.51
