Prevalence of Nutritional Anaemia in Type 2 Diabetes Mellitus in the Absence of Renal Impairment

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Dec 5

PMID 39634981

Authors

Suresh Kanna Subramaniam

Umashankar R

Vinatha M C

Aravind Raj

Keerthana I

V Ramachandra Rao

Affiliations

Soon will be listed here.

Abstract

Background: Anemia is more common in people with type 2 diabetes mellitus (T2DM) and is more likely when glycemic control is poor. Anemia in T2DM can reduce quality of life and increase cardiovascular risk, and therefore, its prevalence and contributory factors in diabetic patients with normal kidney function are important to understand.

Aim And Objectives: The aim of this study is to assess the prevalence of anemia in individuals with type 2 diabetes and normal kidney function, focusing on blood glucose, serum creatinine, HbA1c, hemoglobin, and hematocrit levels. The research also examined the influence of gender, age, and glycemic control on anemia occurrence.

Materials And Methods: This study was conducted at Balaji Medical College and General Hospital from March 2021 to January 2023 to evaluate blood glucose, HbA1c, serum creatinine, hemoglobin, and hematocrit levels in type 2 diabetes patients. Data were collected using a standardized proforma, including age, sex, occupation, physical activity, and clinical history. Biochemical and hematology analyses were performed on venous blood samples collected via venipuncture. Statistical analysis used an unpaired two-tailed t-test with a significance level of p < 0.05. The study included 100 patients categorized by glycemic control, gender, age, and socioeconomic status.

Results: Results showed a high prevalence of anemia in uncontrolled diabetic patients (mean hemoglobin level 11.75 ± 1.72 g/dL vs. 14.46 ± 1.445 g/dL in the controlled cases, p = 0.0001). The mean hematocrit level was 35.46 ± 5.136% in uncontrolled patients compared to 43.62 ± 4.59% in controlled patients (p = 0.0001), showing a direct relationship between poor glycemic control and low hematological indices.

Conclusion: The study shows that anemia is common in people with type 2 diabetes, especially if their blood sugar is not well controlled or as they get older. It highlights the need for regular blood tests to check for anemia in diabetes patients, especially older ones. The study recommends adding iron supplements, balanced diets, and vitamins to treatment plans. These steps can help manage both diabetes and anemia better, leading to improved patient care and outcomes.

References

Bayes B, Serra A, Junca J, Lauzurica R . Successful treatment of anaemia of nephrotic syndrome with recombinant human erythropoietin. Nephrol Dial Transplant. 1998; 13(7):1894-5. View

James A . Iron Deficiency Anemia in Pregnancy. Obstet Gynecol. 2021; 138(4):663-674. DOI: 10.1097/AOG.0000000000004559. View

Astor B, Muntner P, Levin A, Eustace J, Coresh J . Association of kidney function with anemia: the Third National Health and Nutrition Examination Survey (1988-1994). Arch Intern Med. 2002; 162(12):1401-8. DOI: 10.1001/archinte.162.12.1401. View

. IV. NKF-K/DOQI Clinical Practice Guidelines for Anemia of Chronic Kidney Disease: update 2000. Am J Kidney Dis. 2001; 37(1 Suppl 1):S182-238. DOI: 10.1016/s0272-6386(01)70008-x. View

Alamri B, Bahabri A, Aldereihim A, Alabduljabbar M, Alsubaie M, Alnaqeb D . Hyperglycemia effect on red blood cells indices. Eur Rev Med Pharmacol Sci. 2019; 23(5):2139-2150. DOI: 10.26355/eurrev_201903_17259. View

Cody J, Daly C, Campbell M, Donaldson C, Grant A, Khan I . Recombinant human erythropoietin for chronic renal failure anaemia in pre-dialysis patients. Cochrane Database Syst Rev. 2001; (4):CD003266. DOI: 10.1002/14651858.CD003266. View

Asmah R, Yeboah G, Asare-Anane H, Antwi-Baffour S, Archampong T, Brown C . Relationship between oxidative stress and haematological indices in patients with diabetes in the Ghanaian population. Clin Diabetes Endocrinol. 2017; 1:7. PMC: 5471723. DOI: 10.1186/s40842-015-0008-2. View

Molitch M, DeFronzo R, Franz M, Keane W, Mogensen C, Parving H . Nephropathy in diabetes. Diabetes Care. 2003; 27 Suppl 1:S79-83. DOI: 10.2337/diacare.27.2007.s79. View

Mohan V, Sandeep S, Deepa R, Shah B, Varghese C . Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007; 125(3):217-30. View

10.

Keane W, Brenner B, de Zeeuw D, Grunfeld J, McGill J, Mitch W . The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy: the RENAAL study. Kidney Int. 2003; 63(4):1499-507. DOI: 10.1046/j.1523-1755.2003.00885.x. View

11.

Pretorius E, Bester J, Vermeulen N, Alummoottil S, Soma P, Buys A . Poorly controlled type 2 diabetes is accompanied by significant morphological and ultrastructural changes in both erythrocytes and in thrombin-generated fibrin: implications for diagnostics. Cardiovasc Diabetol. 2015; 14:30. PMC: 4364097. DOI: 10.1186/s12933-015-0192-5. View

12.

Horwich T, Fonarow G, Hamilton M, MacLellan W, Borenstein J . Anemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with advanced heart failure. J Am Coll Cardiol. 2002; 39(11):1780-6. DOI: 10.1016/s0735-1097(02)01854-5. View

13.

Dikow R, Schwenger V, Schomig M, Ritz E . How should we manage anaemia in patients with diabetes?. Nephrol Dial Transplant. 2002; 17 Suppl 1:67-72. DOI: 10.1093/ndt/17.suppl_1.67. View

14.

Hosseini M, Rostami Z, Saadat A, Saadatmand S, Naeimi E . Anemia and microvascular complications in patients with type 2 diabetes mellitus. Nephrourol Mon. 2015; 6(4):e19976. PMC: 4317715. DOI: 10.5812/numonthly.19976. View

15.

. Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser. 1968; 405:5-37. View

16.

Sahay M, Kalra S, Badani R, Bantwal G, Bhoraskar A, Das A . Diabetes and Anemia: International Diabetes Federation (IDF) - Southeast Asian Region (SEAR) position statement. Diabetes Metab Syndr. 2017; 11 Suppl 2:S685-S695. DOI: 10.1016/j.dsx.2017.04.026. View